Breast Cancer: Screening (Hansard, 15 December 1987)

§ Baroness Sharples
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 (Lord Skelmersdale)
My Lords, the Government are very pleased that each regional health authority in England now has arrangements well under way to have at least one breast cancer screening centre serving a population of about half a million in 596 operation by next spring. The total service in England, involving about 100 centres, is planned to be in operation by the spring of 1990. Arrangements in Scotland, Northern Ireland and Wales are also well advanced.

§ Baroness Sharples
My Lords, I thank my noble friend for that reply, which is extremely encouraging and shows that the Government do care about the National Health Service. Can he say that, should tests prove positive and an operation be necessary, women will always be offered an alternative to total mastectomy?

§ Lord Skelmersdale
My Lords, I am grateful to my noble friend for her introductory comments. Breast cancers that are detected early are likely to have the best chance of a successful cure and to require less radical forms of treatment. It is best clinical practice for any woman needing treatment to be informed of the possible options, but I note that even when less radical treatment is offered research has shown that about half the women choose a mastectomy.

§ Baroness Ewart-Biggs
My Lords, I welcome the news the Minister has given about the setting up of the cancer screening programme. Will he say whether guidelines were set down to help local health authorities to carry out the programme and to carry out quality control? Will he also say whether he feels that there are sufficient back-up services to sort out the abnormalities and bring women back on a recall system in this large and ambitious programme?

§ Lord Skelmersdale
My Lords, I shall have to think about the question of the noble Baroness on guidelines. As regards back-up, each regional health authority has been allocated one-third of a million pounds to set up its first screening centre for a population of about half a million. This was intended to meet the costs not only of screening but also of assessment, diagnosis and treatment. Four of these centres have also been funded to provide training for staff for the whole programme.

§ Lord Kilmarnock
My Lords, many of us have supported the noble Baroness in her idea of checkups at the workplace and possibly in mobile units. The noble Lord said that one-third of a million pounds had been allocated to each regional health authority. Can he say whether that is in addition to the general health budget?

§ Lord Skelmersdale
My Lords, it is an identifiable part of the general health budget for this year. Workplace screening can be very effective, but it will need to be set up in conjunction with the National Health Service system to ensure that if abnormalities are found the necessary follow-up is available and to avoid confusion with the call and recall system.

§ Baroness Masham of Ilton
My Lords, is the Minister aware that many people throughout the country will be encouraged by the fact that the Government are promoting important preventive health measures? Will he ensure that there are enough radiologists and radiographers who can read the 597 X-rays of any abnormalities that may show up, because it is expert work?

§ Lord Skelmersdale
Yes, my Lords, most certainly. This is why I said that we had also funded four centres to provide training for staff for the whole programme. I certainly agree with the noble Baroness.

§ Lord Ennals
My Lords, is it the case that the health authorities have to spend their first year's funding by the end of March 1988, which is really very near? May I ask the noble Lord how many staff would be involved and whether he is satisfied that they will all have had adequate training at the centres to which he referred through the Royal College of Radiologists?

§ Lord Skelmersdale
My Lords, the Government's plans, as I think I made clear earlier, include provision to meet the full, continuing estimated costs of the remaining centres to be set up in 1988–89 and 1989–1990. Judging by the reported state of the health service at the moment, I do not think that regional health authorities will have any difficulty in spending this year's money.