Cervical Screening (Hansard, 18 April 1985)

§ Baroness Fisher of Rednal
My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Baroness Trumpington)
Yes, my Lords. It is our aim that the standards of screening services in all localities should be brought up to the level of the best. Therefore, as my noble friend Lord Glenarthur said on 18th March, we shall shortly be asking all health authorities to review the effectiveness of the cervical screening programmes for which they are responsible.

§ Baroness Fisher of Rednal
My Lords, while I thank the noble Baroness for that Answer, can she say whether the recommendations will be based upon the seven tests that will be applicable to women over 35 years of age? Does she think that those recommendations will get rid of the anxiety and the despondency about the statements and the counter-statements that have arisen regarding the cytology programme?

Barones Trumpington
My Lords, the Government are extremely anxious that the ones who are most at risk should be the ones to be brought into the net, so to speak. The Government are of course anxious to stop all worries in this area.

§ Lord Avebury
My Lords, if the Government are satisfied that screening ought to be extended to women of lower ages, as it is in cities in other countries, what additional resources will the Government make available to hospital authorities to expand the level of their services?

§ Baroness Trumpington
My Lords, it is a matter for the local health authorities to apportion the money they have where they feel it is most needed.

§ Lord Avebury
My Lords, in other words the answer is none, is it?

§ Baroness Trumpington
No, my Lords.

§ Baroness Ewart-Biggs
My Lords, is the Minister aware that the Women's National Cancer Control 800 Campaign, of which I am chairman, arranges thousands of screening programmes throughout the country each year to try to get at the women who are most at risk, and that they employ the system of giving a record card to each woman which not only gives the result of the test but also gives the date when the next test is necessary? Would the Minister agree that this is the best way of avoiding unnecessary deaths and of relieving anxiety and stress? Would the Minister say why the National Health Service does not emulate this highly successful system?

§ Baroness Trumpington
My Lords, I cannot answer for the particular system which the noble Baroness has brought up. What we are most anxious to do is to extend the test and get as many as possible of the age group who are most at risk from cervical cancer, who are the people over 35, who account for 94 per cent. of the deaths. The under-35s account for 6 per cent. of the deaths but receive over 50 per cent. of the smears taken.

§ Baroness Ewart-Biggs
My Lords, would the Minister comment on my suggestion about a record card system?

§ Baroness Trumpington
My Lords, I take note of what the noble Baroness said.

§ Lord Ennals
My Lords, does the Minister accept the widespread view of the medical and nursing profession that the decision of the Government to abolish the national system of call and recall, placing the responsibility on local health authorities and on family planning committees, was a serious error of judgment? Secondly, does she accept that having taken that decision there really was very little guidance or surveillance by the department of the way in which the local health authorities and family planning committees fulfilled their responsibilities, so that only seven out of 201 local authorities now have an effective scheme?

§ Baroness Trumpington
My Lords, in answer to the noble Lord, Lord Ennals, a call system is dependent on an age/sex register and there is nothing to prevent health authorities from developing a call system if this is felt to be a local priority. The department is at present funding a research project to evaluate the benefits of a call system.

§ Baroness Fisher of Rednal
My Lords, when the noble Baroness answered the question regarding women of the age of 35, may I ask her whether she was aware of the changing patterns of the disease? Is she aware that medical opinion is showing clearly that the disease is taking place at a much younger age than it was? Is she further aware that the British Society for Cervical Cancer is of the opinion that sexually active young people from the age of 18 years should become part of the programme and should be tested every three years? Are they to suffer until they are 35 from a lack of preventive methods for health?

§ Baroness Trumpington
My Lords, of course not, in answer to the last part of the noble Baroness's question. General practitioners are paid to provide full 801 care for patients, including cytology screening for all women. On the question of deaths, the 1983 figures, which are the latest I have, show that there were three between the ages of 20 and 24; 43 between the ages of 25 and 29; 78 between 30 and 34; 1,415 between 35 and 74; and 420 aged 75-plus. That bears out what I said about those who are most at risk; but the number of deaths a year from cancer of the cervix is falling. It has been 13 per cent. overall over the past 10 years.

§ Baroness Fisher of Rednal
My Lords, is the noble Baroness really saying that the women of this country should not be allowed to have preventive health measures where applicable? What she has just said is not what the department has sent out to health authorities. They said that they must concentrate on those aged 35 and over, and give seven smear tests during their lifetime from 35 years onwards.

§ Baroness Trumpington
No, my Lords, of course I am not saying what the noble Baroness has just implied I said. What I say, and wish to repeat, is that 94 per cent. of the deaths occur in women over 35, or who have had three or more pregnancies. The take-up of the smear campaign among younger women is much more prevalent than it is among the older women.

§ Lord Leatherland
My Lords, would the noble Baroness agree that the more we talk publicly about this problem the more likely we are to cause unnecessary worry to millions of women?

§ Baroness Trumpington
No, my Lords, I do not think so. The more we talk about it the better it is, because the more women, I hope, will come forward to take up the test.