Breast Cancer: Specialist Care (Hansard, 7 March 1995)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
Yes, my Lords. We have a national strategy which we are developing further.

§ Baroness Jay of Paddington
My Lords, I thank the Minister for that reply; but I find it slightly disappointing. I had hoped that in this week of International Women's Day she might have taken the opportunity to express broader support for a wide initiative to reduce our appalling rate of mortality from breast cancer which, as I am sure noble Lords know, is the worst in the world. Does the noble Baroness intend that the Government will support the all-party Bill recently introduced in another place to develop a formal national strategy?

§ Baroness Cumberlege
My Lords, I am not sure how the noble Baroness can say that our rates are the worst in the world. International comparisons are misleading. Only the UK, Denmark and the Netherlands have comprehensive cancer registry systems. With regard to the Bill—wait and see.

§ Baroness Young
My Lords, does my noble friend agree that this is an extremely serious issue for women, and that the Government have taken a great many steps to improve the situation? Can she confirm whether it is the case that breast cancer is far more prevalent in countries in northern Europe than in southern Europe, and in northern parts of the United States than in southern states? If that is the case, are we undertaking research into that aspect? That should reveal factors which we clearly do not understand at present.

§ Baroness Cumberlege
Yes, my Lords, my noble friend is right. We are doing more research into cancer, and particularly breast cancer. We spend £100 million a year on research and development work.
We do not have comprehensive cancer registry systems across the world; and in the USA only 8 per cent. of the population is covered. Therefore it is a difficult area in which to research. My noble friend is right in that we are taking a number of initiatives, and recently we undertook consultation with the publication of the document entitled, A Policy Framework for Commissioning Cancer Services. The results of that 112 consultation are now in and officials are considering the 300 replies that we received. The results will be submitted to Ministers very shortly.

§ Baroness Robson of Kiddington
My Lords, does the noble Baroness agree that one of the problems is that in this country we suffer from a great shortage of clinical oncologists? I am informed that we have 272 clinical oncologists, all of whom see about 560 new patients a year (whereas the recommended maximum is 350 new patients a year) and in the United States the figure is only 200. Does the noble Baroness agree that if we doubled the number of clinical oncologists, we could save thousands of lives a year?

§ Baroness Cumberlege
My Lords, that is one of the issues that has been addressed in the consultation document to which I referred, The noble Baroness is right; we need more oncologists. Indeed, the Government have encouraged health authorities to expand the manpower rate of 2 per cent. a year.

§ Baroness Jeger
My Lords, can the noble Baroness assure the House and the public that they will make sure that the Royal Marsden Hospital is safe from any depredations of this Government? The Royal Marsden is a world-renowned hospital for teaching and training; and if there is any reduction in the work of that hospital, among others (I do not say it is the only one), it will be very difficult to staff the new breast cancer units which we, the Government and everybody want.

§ Baroness Cumberlege
My Lords, the noble Baroness is right. The Royal Marsden has a very fine reputation, as do other hospitals in the country, including the Christie Hospital in Manchester. The noble Baroness will remember that when we looked at the reorganisation of clinical services in London, we agreed that the Royal Marsden should stay as a trust and should offer its services in the same way as other hospitals.

§ Lord Renton
My Lords, can my noble friend say to what extent breast cancer has so far been found to be hereditary?

§ Baroness Cumberlege
My Lords, we believe that it is one of the factors, but we cannot pinpoint exactly how strong it is in relation to others such as diet and lifestyle. That is part of the research which is being carried out.

§ Lord Molloy
My Lords, does the noble Baroness agree that the great value of the noble Baroness's Question is that it has the support of the Minister and members of all parties in this House? Intensified research is now called for so that we in this House can ensure that women who suffer from breast cancer know that their case is understood and that tremendous research will now be undertaken.

§ Baroness Cumberlege
My Lords, the noble Lord is right. Indeed, as I have said, we spend £100 million a year on research; and £400 million is spent by the cancer 113 charities. Pharmaceutical companies spend a further £300 million. Therefore investment in research into this cancer is incredibly large.

§ Lord Ironside
My Lords, is my noble friend aware that the European Union third action plan on cancer now proposes that women who have a "suspect image"—those are not my words but the words of the Commission in Brussels—should be screened in addition to those who are in the 50 to 69 year age group? The plan also emphasises that proper quality assurance controls should be put in place in all the processes involved with breast cancer. Does the Minister therefore believe that our own programme on screening should be expanded so that it includes those people with a symptomatic background? I shall not use the Commission's words but those that the Minister has used before. Will she therefore ask the British Standards Institution whether it will draw up an interpretation of ISO 9000 which will provide sufficient quality assurance control, for the profession to use?

§ Baroness Cumberlege
My Lords, I should like to take this opportunity to pay a tribute to my noble friend who has worked tirelessly for the organisation, RAGE, which concentrates on breast cancer. I know that he feels strongly about quality assurance standards. However, we believe that to have a single quality assurance standard would be difficult because different cancers require a whole range of different treatment machines. It depends on the site, the stage, the size and the kind of cancer as well as the age and general health of the patient. However, my noble friend will know of the work that we have been doing in Manchester and Bristol and of the two reports that were issued in July 1991.

§ Baroness Macleod of Borve
My Lords, can the Minister assure the House that enough money is being poured into this problem? Does she know that 520 different charities are raising money for this project, and indeed for the whole of the cancer problem?

§ Baroness Cumberlege
My Lords, I am convinced that, as in other fields, the National Health Service could always spend more money, albeit that every year we increase its budget. However, in this specific field, the cancer charities are remarkable. They raise an enormous amount of money. They do some very interesting and worthwhile work. But I also should like to remind your Lordships that ours was the first country to introduce a full screening programme for breast cancer. Indeed, we put a huge amount of investment into that.