§ 2.51 p.m.
§ Baroness Sharples asked Her Majesty's Government:
§ What action is being taken to promote cervical screening.
§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)My Lords, the computerised call and recall systems which invite women for a cervical smear test in themselves draw attention to the need for regular screening. Furthermore, the system of target payments introduced in the GPs' new contract is already stimulating doctors to encourage women to be screened. The programme is also promoted through health education leaflets and through our meetings with representatives from womens' organisations and other representative bodies in the voluntary sector.
§ Baroness SharplesMy Lords, I thank my noble friend for that reply. Can she please tell the House whether the number of deaths from cervical cancer has fallen in the past few years and what age groups are covered by the call for cervical tests?
§ Baroness HooperMy Lords, all women aged between 20 and 64 will be brought into the scope of the programme over the five years to 1993. That is in England. As I understand it, the effect of the screening system has been very beneficial in terms of the mortality rate, but I do not have precise numbers; to quote.
§ Lord EnnalsMy Lords, the Minister referred to the GP's contract. Is she aware that there is considerable concern that, under the operation of the new contract, GPs who see no hope of reaching the target will simply stop carrying out regular smear tests? Cm the Minister comment on that? Is she aware of the recent report made by the Association of Community Health Councils which criticises the current screening campaign for its slowness in informing patients of the results of their tests following abnormal smears?
§ Baroness HooperMy Lords, we believe that the new GPs' contract is extremely beneficial. The contract as a whole places a much greater emphasis on health promotion and ill health prevention. The target payments already are proving to be an increased stimulus on improving the rate of take-up of cervical screening. The department monitors Iaborato;7 backlogs on a quarterly basis. As at December 1989 around 80 per cent. of laboratories were meeting the target time for reporting results to the smear taker within one month. Action taken to reduce backlogs includes overtime working, the employment of additional staff, and the use of other laboratory facilities within the NHS and the private sector. We believe that these facilities are working satisfactorily.
§ Lord EnnalsMy Lords, I am grateful to the Minister for that informative reply. However, does she accept that if 20 per cent. of those who may be facing some danger do not receive information within a month, there is some real danger for them? Is there not something that can be done to improve that performance level in terms of reportage?
§ Baroness HooperMy Lords, I have already quoted the varicus methods which are being used in order to improve that level.
§ Baroness Masham of IltonMy Lords, if someone is called back for a second smear if the first is not conclusive, how long does that person have to wait before she is called back again? It can be a worrying period.
§ Baroness HooperMy Lords, obviously that varies in different parts of the country. I do not have figures which give any kind of average, but clearly the aim of the health authorities and the GPs is to make that waiting period as short as possible.
§ Lord Nugent of GuildfordMy Lords, the result of the new GPs' contract has been a significant increase in the number of tests taken, running into hundreds of thousands. Therefore, does my noble friend not agree that we should give credit for the contract despite the fears which the noble Lord opposite has about what might happen in the future?
§ Baroness HooperMy Lords, I am grateful to my noble friend.
§ Lord GlenamaraMy Lords, can the Minister say when the Government propose to raise the age above 64, which these days is comparatively youthful?
§ Baroness HooperMy Lords, though women aged 65 years and over are not invited to be screened by the call and recall systems they are not excluded from the screening programme. We have told health authorities that women of this age who have not had two consecutive negative smear tests in the past 10 years should be screened. We know that such women consult their doctor more than six times a year on average. The new GPs' contract should provide additional opportunities for GPs to offer a cervical smear test to women in this age group when appropriate.