AIDS and Cancer Treatment: NHS Expenditure (Hansard, 2 May 1991)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, substantial sums have been expended in both general and specific programmes; but since treatment for these conditions is provided in a variety of specialties and settings, it is not possible to identify accurately the total cost.

Lore Constantine of Stanmore
My Lords, I thank my noble friend the Minister for that reply. Is she aware 1 hat the organisations publishing cancer relief funds state many times in their advertising that one in five people get cancer and one in three die of it? Therefore, can the Government say whether there are any official figures for the number of deaths per annum from both AIDS and cancer for the three years stated in the Question?

§ Baroness Hooper
My Lords, I am aware of the Cancer Research Campaign that states that one in three people get cancer and that one in four die from it. We are very much aware of those figures. That is why it is our aim to improve knowledge about its causes, prevention and treatment. Where a complete cure is not possible a great deal can be done, and is being done, to maximise the length and quality of life for sufferers. We very much appreciate and recognise the major contribution that the cancer charities are making to this effort. I regret that I do not have the total figures on either disease to give to the noble Lord at this point.

Viscount Tonypandy
My Lords, is the Minister aware that enormous strides have been made because of cancer research and that there are many people alive now who would not be were it not for the research undertaken by the National Health Service? Therefore, does she agree that the Macmillan Fund appeal and other such organisations are well worth supporting?

§ Baroness Hooper
My Lords, the noble Viscount is living testimony of that. We are very happy to have him contributing to this Question Session. We recognise the importance of research. The total amount spent on research by the Government and the major cancer charities in 1989–90 was about £95 852 million. The Government's comprehensive research and development strategy for health which has just been launched indicates that we are seeking priorities which still have to be worked out in discussions with the National Health Service, medical experts, research councils and other research funders. We attribute considerable importance to the research aspect.

§ Baroness Masham of Ilton
My Lords, does the Minister believe that enough is done in all schools, including private schools, in teaching prevention as regards both AIDS and cancer?

§ Baroness Hooper
My Lords, again, health education is an extremely important area both in terms of helping the teachers to get the message across as well as specific programmes. Most of the Government's campaign is directed through the Health Education Authority. That goes towards various programmes directed at smoking education, nutrition, alcohol education, and so on.

§ Lord Auckland
My Lords, can my noble friend the Minister give any figures as to how many people are currently being treated at the Royal Marsden hospitals in Fulham and Sutton? Is she satisfied that there is enough money going into research for those very fine hospitals?

§ Baroness Hooper
My Lords, we are certainly all aware of the splendid work that is being done at the Royal Marsden hospitals, particularly in the area of childhood cancer treatment. I cannot give the specific figures for which my noble friend asks. I repeat that we attribute considerable importance to the research aspect.

§ Lord Constantine of Stanmore
My Lords, is my noble friend aware that in the BBC "Panorama" programme shown on 22nd April, Professor Karol Sikora of Hammersmith hospital claimed that of patients treated for cancer and AIDS in teaching hospitals, 60 per cent. survived as against 28 per cent. in district and general hospitals? That implies that if the skills of the teaching hospitals were transmitted to the district and general hospitals that would make much more money available for research in both respects?

§ Baroness Hooper
My Lords, I regret to say that I was unable to see the "Panorama" programme to which my noble friend referred. I believe that Professor Sikora referred to the difficulty of constructing league tables for cancer care in the absence of comprehensive information on the outcome of treatment at different centres.

§ Lord Molloy
My Lords, can the noble Baroness give an assurance that general practitioners who on examination of a patient suspect that cancer may be present will be able to seek confirmation almost immediately? I understand from one or two general practitioners that any delay can be most serious.

§ Baroness Hooper
My Lords, general practitioners are well aware of the importance of their initial screening role. Indeed, the Government's efforts 853 through encouraging cervical and breast screening programmes and through funding in those specific areas are showing helpful results.

§ Lord Ennals
My Lords, does the Minister share my view that, quite apart from the medical forms of treatment, natural therapies can have a profound influence both in terms of cancer and AIDS victims? That is beginning to be shown by work in places such as the Bristol Cancer Health Centre.

§ Baroness Hooper
Yes, my Lords, I believe that what I understand to be the holistic approach is one that is increasingly finding favour with practitioners.

§ The Countess of Mar
My Lords, is the noble Baroness aware that the television programme referred to by the noble Lord, Lord Constantine, carried some extremely disturbing implications, particularly for people who are at present suffering from cancer and who are being treated perhaps in district general hospitals rather than in main teaching hospitals? Will the Government do anything to allay the fears of these people and to assure them that the treatment they are receiving is the very best, wherever they are treated?

§ Baroness Hooper
My Lords, the aim of the Government's recent reforms has been to improve the treatment on all fronts for patients who require the services of the National Health Service. I understand that there is little evidence that treatment in specialist centres, in particular for the common adult solid tumours, results in better survival rates than can be obtained in district general hospitals.

§ Lord McColl of Dulwich
My Lords, does my noble friend agree that there are dangers in comparing the results of treatment in teaching hospitals with those in district general hospitals? The only fair and just way so to do is to have a controlled clinical trial. Therefore, I think we can reassure those being treated in district general hospitals that the television programme did not present an accurate picture.

§ Baroness Hooper
My Lords, my noble friend speaks as an expert in this matter. I am grateful to him for giving that reassurance.

§ Lord Constantine of Stanmore
My Lords, my noble friend Lord McColl is obviously an expert in this field. However, is my noble friend aware that Mr. William Heald, who is a cancer expert at Basingstoke hospital, claims that by using a very simple method called the staple gun method the hospital experiences a recurrence rate of only 4 per cent.?

§ Baroness Hooper
My Lords, I am advised that the results reported by Mr. Heald are considered to be exceptionally low by international standards. This is a matter for clinicians themselves. I understand that the profession is currently addressing the question of guidelines on the role of surgery in the management of colorectal cancer.