Royal Marsden Hospital: Cancer Patients (Hansard, 27 July 1993)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, generally speaking, cancer patients do not wait for treatment. The South West Thames regional health authority returns show that for 31st March 1993 only five patients were waiting, and that was for clinical reasons. The Royal Marsden has no plans to close its site in Surrey.

§ Lord Auckland
My Lords, I thank the Minister for that largely reassuring Answer. Will she confirm or deny that there are plans for the Royal Marsden to be linked with St. George's Hospital in Tooting when the official announcement is made? If so, and while realising that this is speculative, is she aware that car parking facilities at St.George's, Tooting, are totally inadequate, and that this will have an adverse effect on those patients and staff?

§ Baroness Cumberlege
My Lords, there are a number of options open, not only for the Royal Marsden Hospital but for a number of hospitals within the London area. I am not sure whether that specific proposal is at the moment receiving attention by the Royal Marsden Hospital. Certainly we know that in our review of London many options are being explored.

§ Lord Williams of Mostyn
My Lords, bearing in mind that this is the last occasion before the autumn that the Minister will answer Questions, and reflecting on her invariable courtesy, to me at least, over the past months. I should like to ask this question. Does she agree that the key word in the Question of the noble Lord, Lord Auckland, is "uncertainties"? Will she undertake to indicate to the Secretary of State what I believe to be the feeling in every corner of this House that these uncertainties are eroding staff confidence; are a significant burden on those who are ill; and are now becoming intolerable?

§ Baroness Cumberlege
My Lords, I thank the noble Lord for his opening remarks. I appreciate exactly what he says with regard to uncertainty. That is why the Government are anxious to come to some conclusions quickly. Speed is of the essence. This has been a long-standing problem. It is important that all the information is gathered first before decisions are reached.

§ Lord Boyd-Carpenter
My Lords, is my noble friend aware that the uncertainty to which the noble Lord opposite referred has been created by the 1168 Government's failure to give a complete and emphatic rejection of the proposals of the Tomlinson Report in respect of the Royal Marsden? Will she now say that it is the Government's intention to preserve the Royal Marsden in its full vigour and in its present places?

§ Baroness Cumberlege
My Lords, I cannot give my noble friend the assurances that he seeks. I appreciate the uncertainties that are being caused at the moment. But it is important that before they reach decisions, the Government should take into account the research reviews recently carried out and also the specialty reviews. The situation in London is very complex. I believe that it would be unwise for any government at this time to rule out any options.

§ Lord Cledwyn of Penrhos
My Lords, will the Minister accept that there is a group of hospitals in the London area of international repute and significance? There is no doubt about that at all. Does she agree that the delay in coming to a conclusion is causing great anxiety and unrest and that if those hospitals, including the Royal Marsden, were closed, it would be a tragedy of considerable proportions? Can she tell her right honourable friend that it is therefore essential that some conclusion should be announced as soon as possible?

§ Baroness Cumberlege
Yes, my Lords. It is recognised that there are some specialties, units and departments in London that are of international importance. It is the Government's intention to ensure that the excellence in London is preserved. But it does not necessarily mean that facilities will be in the same buildings as now. We are seeking to ensure that those units that have very good reputations and superb services are preserved. We want a situation in London where we do not have 13 cancer units, 13 neuro-science units, 14 cardiac centres and nine plastic surgical centres. When services are so fractured, it is very hard to get the amount of expertise in one place to ensure that London competes internationally in those particular fields. I have to say that in some areas it is not doing so.

Viscount Tonypandy
My Lords, is the Minister aware that those of us who live far from London do not regard the Marsden as a London hospital? It belongs to the rest of the country. Will she accept that the whole world envies the accumulated wisdom and experience that is there? Will she further accept that the Government will be under very special scrutiny if they propose to weaken in any way the experience gathered as one body at the Marsden? The House will understand that it is not often that a Southwalian gives way to a Northwalian.

§ Baroness Cumberlege
My Lords, in no way do we wish to detract from the London hospitals. The situation in which we now find ourselves is due to the success of London. London has trained many specialists in different fields who have left London. They have gone to other parts of the country and set up superb services all over the land: in Newcastle, Southampton, Leeds, Leicester and Manchester—I could go on. Increasingly, specialties in other parts of 1169 the country are attracting patients to their units. As a consequence fewer patients now go to the London hospitals.

§ Baroness Gardner of Parkes
My Lords, can my noble friend say how long people have to wait for the first appointment? Does she accept that with regard to the treatment of cancer, although she said that there is a very short waiting time for treatment, early diagnosis is of the utmost importance?

§ Baroness Cumberlege
My Lords, my noble friend is absolutely right. Looking through all the waiting lists for the cancer units, I can find nobody waiting longer than two weeks.

§ Lord Richard
My Lords, it is clearly right that the uncertainties should be cleared up as soon as possible. But will the noble Baroness agree that it is also right that the decision should be announced to Parliament? Can she give us an undertaking, an assurance or some indication that the decisions in which this House and the other place are extremely interested will not be allowed to trickle out in the Recess when we shall have no opportunity to question the Government?

§ Baroness Cumberlege
My Lords, I can give the noble Lord an assurance that there will be no trickling during the Recess.

§ Lord Peyton of Yeovil
My Lords, will my noble friend keep in mind the tendency of those who conduct such reviews to listen to the wrong people and jump to the wrong conclusions? Will she accept that in the case of the Marsden they seem to have been marvellously blind to what everyone else knows very well?

§ Baroness Cumberlege
My Lords, the Government have absolute confidence in the reviews. They were conducted by people with national reputations. Indeed, some of them have international reputations. Those results will be considered when decisions are reached. Perhaps I could also say that the decisions will not be reached without further consultation. Then the Secretary of State will then decide a way forward.

§ Lord Orr-Ewing
My Lords, is my noble friend aware that the Royal Marsden and the Sutton associate was the first cancer hospital in the world, and is the largest in western Europe? Does she agree that it would be a shame if all that knowledge and expertise and all the money spent on modern equipment (£13 million from government funds and no less than £25 million from voluntary contributions last year—that is a substantial amount and it has only been used for a single year) as well as the expertise of the staff were abandoned in view of the reputation of the hospital worldwide?

§ Baroness Cumberlege
My Lords, all the points made by my noble friend will be taken into account before any decisions are reached.

§ The Countess of Mar
My Lords, will the noble Baroness agree that continuity of care is very important for all patients and particularly for cancer patients, whose treatments can be very long drawn out? Can she say what reassurances are being given to 1170 the staff of the Royal Marsden that their teams will be kept together so that the patients can receive satisfactory treatment?

§ Baroness Cumberlege
My Lords, it would be our intention to keep all the expertise that we can. A clearing house has been set up for staff in London to ensure that their futures are explored and that opportunities are given to them.