HL Deb 01 February 1994 vol 551 cc1188-90

2.55 p.m.

Lord Ironside asked Her Majesty's Government:

Whether they will request the British Standards Institution to develop an interpretation and application of BS5750 quality standard for use by the radiotherapy treatment profession in the United Kingdom, which local health authorities can link to a professional code of practice to prevent permanent injury being caused to those receiving radiotherapy treatment following breast cancer surgery.

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

My Lords, in 1991 the Government commissioned two radiotherapy centres to pilot implementation of a quality standard entitled quality assurance in radiotherapy. The results of that work have now been received and will be disseminated to the National Health Service later this year.

Lord Ironside

My Lords, I thank my noble friend for that encouraging Answer. I thank her in particular for a willingness to look seriously at the whole question of radiotherapy treatment following breast cancer surgery. I thank her too for holding discussions with RAGE, the Radiotherapy Action Group Exposure. She knows my anxieties about that. Will my noble friend ensure that BS5750 assessments are carried out by accredited bodies which are approved and authorised by the President of the Board of Trade?

Baroness Cumberlege

My Lords, I thank my noble friend for the gracious comments he made in the initial part of his supplementary question. I regret that I cannot give him the assurance that he wants. BS5750 is only one system. It offers no guarantee of a quality service or improvement to clinical practice unless the quality systems and clinical protocols are right. All quality systems are based on professional standards.

Lord Dormand of Easington

My Lords, will the Minister confirm that she referred to a trial period? If that is the case, when is the period likely to end? Furthermore, is the Minister aware that BS5750 is internationally accepted and that the British Standards Institution would not have approved it unless it was completely and utterly satisfied?

Baroness Cumberlege

My Lords, I understand that the BS5750 procedures were initially drawn up for the defence manufacturing industry and that they have been interpreted for different forms of quality assurance. We believe that in some instances they are good for the National Health Service. If the initial protocols are flawed BS5750 does not help. However, two centres have been accredited and we are examining those results to see whether they are satisfactory. We shall disseminate those results to other centres so that they can see whether they too wish to adopt the same approach.

Baroness Gardner of Parkes

My Lords, do such incidents have an element of human error? If so, could that be eliminated by computer control? Cases of overdosage and underdosage have been reported in the press. Is that due to human error, incorrect technology or the lack of a code of practice?

Baroness Cumberlege

My Lords, the issue of breast cancer is extremely difficult because there is no definitive or right way to treat it. It depends on factors such as the size of the cancer, the stage it has reached, the site, and the overall health of the individual woman. There is no question of coming up merely with a definitive answer, and that is why we must rely on training, medical audit and the skills of individual radiotherapists.

Lord Rea

My Lords, with regard to these sad cases of post-radiation injury, is the Minister aware that whatever code of practice is adopted the Royal College of Radiologists is willing and wishes to adopt a code of good practice? Does the Minister believe that in this instance the proper role of government is to act as a mediator between the sufferers, who are represented by RAGE, and the Royal College of Radiologists? Does she agree that dialogue is better than confrontation? Will she use her good offices to persuade RAGE to give the Royal College of Radiologists full details of the cases of radiotherapy damage which it has collected throughout the country in order to identify accurately and scientifically the particular radiotherapy regimes and dosage schedules responsible for the injuries sustained and why?

Baroness Cumberlege

My Lords, it is absolutely essential that the National Health Service works with those who receive the treatment. I am grateful to my noble friend Lord Ironside for meeting me on 24th January to discuss those issues. I understand that the organisation with which he is closely involved—RAGE—is extremely anxious to co-operate with the department, the Chief Medical Officer and Dr. Karol Sikora, an expert in the field, who together will be meeting the Royal College of Radiologists to pursue the matter. I am grateful to RAGE and I hope that we can work closely with it.