HL Deb 11 October 1993 vol 549 cc5-7

2.50 p.m.

Lord Ironside asked Her Majesty's Government:

Whether some 1,100 members of RAGE (Radiotherapy Action Group Exposure) have been injured by the effects of radiotherapy treatment in the United Kingdom following breast cancer surgery, and whether they are satisfied that patients in such cases are now receiving treatment best suited to their needs.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)

My Lords, the Government cannot give an opinion as to whether members of RAGE have been injured by the effects of radiotherapy treatment since they have not had an opportunity to examine the evidence. If evidence is presented which does cause concern Ministers would wish to discuss those concerns with the medical profession to see whether the patients are receiving the treatment best suited to their needs.

Lord Ironside

My Lords, in thanking my noble friend for her Answer I should like to say how grateful I am to her for considering all the background information which I provided her with in recent weeks, together with some of the personal interest which I declared to her. In view of the nearly 2:1 variation in dosage for treating the same hypothetical lump in 54 different radiotherapy treatment centres in the United Kingdom—I do not believe that they can all be right—does my noble friend believe that there is a case for introducing national quality assurance standards, say, to the British Standards Institution BS5750, to ensure that the best techniques and practices are adopted throughout the United Kingdom, especially in view of the fact that at recent public meetings experts have said that a great many of the practices are sloppy?

Baroness Cumberlege

My Lords, this is a very difficult area. As yet we do not have any definitive or right way to treat breast cancers despite the substantial resources and efforts which have been put into research and development. The treatment regimes have to vary depending on a range of factors including the size of the cancer, the stage which it has reached, the site and the overall health of individual women. I understand the point which my noble friend has made. This is an area which I would wish to discuss with the Chief Medical Officer to see whether we should take the matter forward.

Lord Ennals

My Lords, as several hundred patients are involved and have suffered greatly, is it not important and of some urgency that the department should give advice so that patients will know whether to choose radiotherapy or some other form of therapy, in consultation with their doctor? Can I have an assurance from the Minister that the women who have so suffered are receiving back-up support?

Baroness Cumberlege

My Lords, women are receiving the back-up support which is necessary. But if there is a shortfall then clearly individual cases would have to be considered. As I have said, this is a very difficult area. Guidance on quality assurance in radiotherapy was issued in July 1991. It set out 18 requirements to ensure that quality is maintained. That guidance has been evaluated at two sites, and both centres have completed their final assessments. So the department is now considering how best to disseminate those assessments to other units.

Lord Rea

My Lords, does not the noble Baroness agree that much of this problem centres around the fact that the patients concerned do not feel that they were fully informed of the risks involved in radiotherapy treatment before they received that treatment? Is the Minister aware that there is an increasing burden on radiotherapists and that many of them feel that they do not have the time that they would like to have for full and frank discussion with their patients? Is she also aware that they are themselves pressing for an increase in their numbers which would allow for such provision?

Baroness Cumberlege

My Lords, I am not aware that the radiotherapists are under particular strain. But again, if there are specific instances then clearly the department would wish to know about them. As regards consent and informing women about their condition, that is a matter for the clinicians involved. But the Government have made it quite clear that they want people to be much more involved in their treatment and that clinicians should be as fair and as frank as possible so that women are fully informed. We believe that that actually aids recovery.

Baroness Oppenheim-Barnes

My Lords, does my noble friend agree that as radiotherapy and acceptance of it often means the difference between life and death for many patients, it is absolutely essential that they should have confidence that if that form of treatment has been prescribed they can undergo it without some of the very frightening and horrible side effects which have been recently publicised?

Baroness Cumberlege

My Lords, my noble friend is absolutely right. We are increasingly seeing treatments being more and more successful so that now three out of four women treated make a complete recovery.