Breast Cancer (Hansard, 25 May 1995)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, our proposals are contained in A Policy Framework for Commissioning Cancer Services, the report of the Chief Medical Officers for England and Wales Expert Advisory Group on Cancer which was published on 24th April.

§ Lord Dubs
My Lords, while we accept that progress has been made, is it not unthinkable that the Royal Marsden Hospital in Fulham—widely acknowledged to be Europe's centre of excellence in the treatment of cancer, particularly breast cancer—should be under threat 1044 of closure or at least has an uncertain future? The consequence is that the hospital has a lesser ability to attract high quality staff and there is a disastrous effect on the attitude of patients who have gone to the hospital for its high quality of treatment. That hospital, unlike others, treats patients as human beings.

§ Baroness Cumberlege
My Lords, I absolutely agree with the noble Lord that the Royal Marsden Hospital is a place of excellence, with a world-wide reputation. As your Lordships will be aware, it has become a trust and I am sure that health authorities will recognise that and will continue to use it.

§ Lord Ironside
My Lords, as the Question points to the considerable public unease about the quality of breast cancer services, I welcome the steps that my noble friend has taken to improve them. Will she say what steps she is taking to provide for the clinical treatment services and needs of a large number of women who have been permanently and adversely affected and injured by radiotherapy treatment? The Minister has already given me assurances that the clinical outcomes group in her department is considering this month, during May, the recommendations of the Royal College of Radiology to manage the treatment services which are needed. Can she say whether the clinical outcomes group has given its approval, and if not why not? There is a crying need for the services.

§ Baroness Cumberlege
My Lords, I should like to pay tribute to my noble friend for the work that he has done in the field, especially concerned with the organisation RAGE. The NHS Executive is at the moment considering ways of disseminating the guidance that has been prepared by the Royal College of Radiologists. That will shortly go out to the service.

§ Lord Ashley of Stoke
My Lords, is the Minister aware that many noble Lords will welcome the assurance that she has given in response to my noble friend, so far as it goes? If closure of the Royal Marsden came to be envisaged, will the Government actively step in and prevent the closure? May we have a guarantee of that?

§ Baroness Cumberlege
My Lords, if there is a change in service and if it is opposed by the local community health council, then the matter has to go for determination to the Secretary of State. It would be wrong for me to give any assurances at this time with regard to a single institution because we know the enormously rapid change in medical science, in the way that services are provided, and in the needs of the population. So although I know it would be a great comfort to many of your Lordships in this House to give some kind of cast iron assurance, I am afraid that I am unable to do so.

§ Lord Skelmersdale
My Lords, has my noble friend had time this morning to read the Daily Express newspaper? In it there is a report of American research suggesting that wearing a brassiere for more than 12 hours a day will increase the incidence of breast cancer by 11 per cent. Has any comparable research been done in this country or is it likely that the suggestion will become the medical flavour of the month, with imported, unchecked 1045 American research? Will we forget about it in a few years' time as we have done with butter and many other substances?

§ Lord Lyell
Do you wear them?

§ Baroness Cumberlege
My Lords, I heard a Member of your Lordships' House asking whether I wear them. This is a very grown up question. The answer is that I am still trying to think of ways of abandoning my liberty bodice!
I have no knowledge of any research in this country in that field. I suspect that it is an example of a newspaper anxious to fill its pages.

The Viscount of Falkland
My Lords, can the noble Baroness tell the House how the treatment of breast cancer, particularly for women between the ages of 50 and 65, compares in quality with that of other developed countries?

§ Baroness Cumberlege
My Lords, there has been a recent report comparing the survival rates in Europe with those in this country. In fact, we are suspicious of some of that research. In our country we have a comprehensive cancer registry system but only our country, Denmark and the Netherlands have a similar system. We also do not fully believe the basis of that research. When it was published there were qualifications made by the researchers that those who were taking part in the study were volunteers and therefore it was not a comprehensive study. It is an area which needs further research, but, as I have said, cancer registration is patchy in most of Europe.

§ Lord Campbell of Alloway
My Lords, does my noble friend's answer to the noble Lord, Lord Dubs, mean that the Royal Marsden is no longer under threat of closure?

§ Baroness Cumberlege
My Lords, at the moment there is no intention of closing the Royal Marsden Hospital.

§ Baroness Jay of Paddington
My Lords, is the Minister aware—there is no reason why she should be— that this morning I opened a conference of the Royal College of Midwives and the Health Visitors' Association, designed to promote breast feeding in this country? In that area there is substantial research which is neither in the Daily Express nor in any sense questionable that breast feeding can prevent breast cancer. In future, will the Government promote the link between those two as part of their health education campaign?

§ Baroness Cumberlege
Yes, my Lords. Indeed, we have put a huge investment into the current National Breast Feeding Awareness Week. We recognise that "breast is best". It is the designer food for babies, and we want to encourage women to breast-feed.

§ Lord Dubs
My Lords, will the Minister agree that when she says she is unable to give an assurance about the future of the Royal Marsden in Fulham, the truth is that the way in which her department is reorganising cancer care in London is likely to mean that the Royal Marsden's future is doomed? It is not part of one of the other teaching hospitals and therefore has no obvious catchment area. Is it not a rather sad day when a masterplan for the health 1046 service in London —dare I add, Soviet style?—is likely to lead to the closure of Britain's best hospital for treating cancer?

§ Baroness Cumberlege
My Lords, it is a very sorry day today, when the noble Lord puts such a question. It will raise a whole lot of fears that are totally unfounded. It is scaremongering. I have already told noble Lords that there is no question at this time of the Royal Marsden Hospital closing. The noble Lord will know as well as anyone that I cannot say that in 100 years, 150 years or whenever, this hospital will never, ever close. That would be a ridiculous statement for any Minister to make.