HL Deb 28 October 1986 vol 481 cc602-5

2.40 p.m.

Lord Kilmarnock

My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

The Question was as follows:

To ask Her Majesty's Government what steps they propose to take to extend screening facilities in view of the alarming increase of cervical cancer, particularly among younger women.

The Parliamentary Under-Secretary of State, Department of Health and Social Security Baroness Trumpington)

My Lords, our guidance to health authorities is that all women who are or have been sexually active, irrespective of age, should be regularly screened for cervical cancer. In January this year all health authorities were told to give priority to improving their cervical cancer screening programmes, including implementing computerised call and recall systems within two years, and ensuring that laboratories avoid backlogs. We are determined to improve the effectiveness of the screening programme for all women.

Lord Kilmarnock

My Lords, I am grateful to the noble Baroness for that Answer, which is spiced with good intentions; but one would like to ask her what resources she is putting behind that. Is she aware that of the 2,000 women in this country who annually die of this disease, 60 per cent. have never been screened, and that practically all those deaths could have been prevented? Is she also aware that there is a pre-cancerous epidemic of a new and more virulent strain, largely among young women in the 25 to 35 age group, which is likely to lead to a doubling of mortality within 10 years unless urgent steps are taken? Can she perhaps tell us a little more about the progress of the new computerised call and recall system that was ordered by Mr. Kenneth Clarke in 1984? Can she tell us whether we are on course with that programme?

Baroness Trumpington

My Lords, to deal first with the question of finance, health authorities are best placed within the framework of national priority to judge local needs and circumstances. Authorities have been told to attach a high priority to improving their cervical screening programmes. They have the resources: for example, £700 million extra cash for 1986–87, plus over £150 million from cost improvement programmes. Improvements to cervical cancer screening are not expensive. The remaining district health authorities can computerise for only £4 million in 1986–87 and 1987–88.

With regard to the question about younger women and an increase in cervical cancer, the number of cases of cervical cancer and deaths have both declined, but there is an upward trend among women under 45. That makes it all the more important that the screening programme should be made as effective as it can be.

Baroness Robson of Kiddington

My Lords, will the noble Baroness the Minister please agree that we have two ways to attack this problem? I welcome what the Minister has said about the advice to the health authorities on cervical screening, but perhaps she will tell us what the Government are doing about the cases where women who have been lucky enough to be screened have to wait for three or four months with the awful thought hanging over them that something may go wrong in the waiting period.

Baroness Trumpington

Yes, my Lords. The question of call and recall is one that is actively occupying the minds of health authorities and the Government. The Government have issued instructions to health authorities that call and recall systems should be implemented as quickly and efficiently as possible.

Baroness Robson of Kiddington

My Lords, may I ask the Minister to answer my question? I asked what happens when women who have been called in, have been screened and have to go into hospital, have to wait for three or four months with that hanging over their heads?

Baroness Trumpington

My Lords, that is still a matter for local authorities and we are doing the best we can with waiting lists—which is a different subject from the Question on the Order Paper today.

Baroness Ewart-Biggs

My Lords, the Minister has just said that she is determined to improve screening facilities for all women. Can she say whether a decision has been made following the suggestion earlier this year by the TGWU and APEX that women of the Palace of Westminster should have a screening service provided by the Women's National Cancer Control Campaign? Does she recollect that the House of Commons Services Committee rejected this but that the House of Lords Administration Committee is considering it? Does she not agree that this would not only benefit the women working in the Palace of Westminster but would also provide a lead for women all over the country to present themselves for screening?

Baroness Trumpington

My Lords, I understand that the Administration Committee of your Lordships' House has this matter under active consideration. The committee is considering the possibility of ad hoc, on-site screening. No final decision has yet been taken. I understand that the appropriate Commons committee will also be consulted. I agree with the final sentiment expressed by the noble Baroness, but basically this is not a matter for Her Majesty's Government but for the Lord Chairman.

Lord Prys-Davies

My Lords, a report in the Independent newspaper dated 25th October claims that a newer spatula, which is called the Lerner, doubles the detection rate of abnormalities. If that is correct, will the department recommend its adoption by the clinicians?

Baroness Trumpington

My Lords, I am not aware of this new spatula. I suggest that this is a matter for general practitioners to follow up as they see fit.

Lord Ennals

My Lords, I was going to ask the noble Baroness whether she reads the Independent, but my supplementary question relates to the Daily Telegraph. Does she recall that the Daily Telegraph recently published a report which said that only 75 of the district health authorities out of 192 were on target for a full call-and-recall system as recommended by the former Minister of Health and referred to by the noble Baroness? Can she give us an update on where we stand now and what the prospects are for either the end of this year or the end of next year?

Baroness Trumpington

My Lords, I believe that I gave those statistics in an Answer to a similar Question last week. I accept that the performance of individual health authorities varies. Well organised local programmes are successful. Our job is to see that all authorities match the standard of the best. More authorities are directly making improvements to their programmes and we have now told all of them to give cervical cancer screening a higher priority in the future.

Lord Ennals

Forgive me, my Lords, but if cervical cancer screening is a high priority can the noble Baroness give the figures in order to show just what progress has been made? That is what I asked for.

Baroness Trumpington

My Lords, I gave the figures last week.

Lord Kilmarnock

My Lords, can the noble Baroness tell the House whether the Government have carefully studied the BMA's recent report on cervical cancer screening and whether they agree with any of the conclusions? Does she recall that the BMA recommends three-yearly screening for women between the ages of 20 and 65 and that we have not yet even met her own department's 1984 guidelines for five-yearly intervals? Will the Government very seriously study this report and draw the appropriate conclusions?

Baroness Trumpington

Yes, my Lords.

The Countess of Mar

My Lords, is the noble Baroness aware that there is still an acute shortage of laboratory technicians to deal with screening the smear samples and that many of them are so hard pressed that there is a great number of false positives and negatives? Is she also aware that there is new computerised technology which can screen the slides; that any slides which show abnormalities can then be looked at by humans; and that this would considerably speed up the results of the smears?

Baroness Trumpington

My Lords, with regard to laboratory staff, authorities are recruiting more staff. We have told all authorities to give priority to ensuring that the laboratory can meet demand and avoid backlogs.