Cancer Treatment (Hansard, 27 May 1999)

§ Lord Hunt of Kings Heath
My Lords, we recognise that there are variations in the use of cancer drugs in this country. It is important that all clinical decisions are evidence-based and take account of the individual patient's wishes. We will consider carefully the information contained in the report mentioned by the noble Lord as we take forward the work to reduce variations in cancer care across the country.

§ Lord Clement-Jones
My Lords, I thank the Minister for that reply. I also congratulate him on his choice of buttonhole. I welcome the Prime Minister's direct personal interest in cancer services through his hosting of a summit last Thursday on the subject, relating in particular to the on-line connection between cancer BACUP and its telephone information service—I declare an interest as a trustee—and NHS Direct. As a result of the prime ministerial summit, will there be further resources for more oncologists and drugs for cancer treatment in order to bring the United Kingdom up to the standard of other western European countries in terms of survival rates?

§ Lord Hunt of Kings Heath
My Lords, I thank the noble Lord for his commendation of my buttonhole; it is to mark a cancer charity's initiative this week. My right honourable friend the Prime Minister has taken a particularly close interest in these important issues. As the noble Lord said, he held a summit on 20th May where a number of issues were considered, including the research needed by the service in this country and the question of resources. In that regard we have already made a start by investing £60 million into services for the three most common cancers—breast, bowel and lung. A further £150 million will be available over the next three years from the National Lottery New Opportunities Fund. That will be particularly focused 1041 towards new equipment. I should mention here the extra £21 billion that the Government are also putting into the NHS during that period.

Earl Baldwin of Bewdley
My Lords, will the Minister do all that he can to widen the actual research agenda beyond the usual surgery, radiation and drugs, which have had a sadly limited impact—despite what we are sometimes told in newspaper reports—on mortality figures for many years? Does the noble Lord recognise that there are other, shall we say, less orthodox approaches, such as herbal medicines, healing, nutritional medicine and mind/body approaches, which are well worth investigation?

§ Lord Hunt of Kings Heath
My Lords, the NHS research and development programme is always open to suggestions of proposals for research. Perhaps I may take the general point about the availability of homeopathic and herbal medicines. We want the development of cancer services to be patient centred, but the clinical judgment of the clinician in respect of individual patients and decisions made at local level on priorities are matters which must be taken into account.

§ Baroness Pitkeathley
My Lords, does my noble friend the Minister agree that the holistic approach to cancer is what we seek? I declare an interest as the chair of the New Opportunities Fund. Although much of that money will be spent on equipment, it will be part of projects which develop that holistic approach to cancer treatment, keeping, as my noble friend said, the patient at the centre.

§ Lord Hunt of Kings Heath
Yes, my Lords; I very much agree with what my noble friend has said. The holistic approach is very important. However, it is also important that we look at the general availability of services throughout the country to ensure that there is less inconsistency than there has been in the past. In particular, we need to ensure that the various parts of the health service—be it primary care, local district general hospitals and the specialty centres at regional and national level—all work together to provide a comprehensive service.

Earl Ferrers
My Lords, when the lottery fund was first introduced, I thought it was decided that such funds would not be used to replace funds which are normally the responsibility of the Government. Is that not now the case?

§ Lord Hunt of Kings Heath
My Lords, I believe that the Government have shown their commitment to the NHS by investing £21 billion in it over the next three years. The money coming from the lottery fund will be in addition to that sum. If we were to ask members of the public whether they thought that improving cancer services in this country was a good use of such money I think that they would say that they support it.

Earl Howe
My Lords, does the Minister accept that new cancer drugs will need to pass the test of 1042 cost-effectiveness set by the national institute for clinical excellence before they can be put on to the market, but that for palliative cancer treatments, which are designed principally to enhance the quality of life, cost-effectiveness is something which simply cannot be measured? Therefore, does that mean that NICE will become a de facto mechanism for rationing the availability of treatments within the NHS, even in cases where clinical effectiveness is not in doubt?

§ Lord Hunt of Kings Heath
No, my Lords. The noble Earl is absolutely right to point to the valuable role that NICE will play in the future in enabling the NHS to make the most cost-effective decisions about drugs and treatments. However, the real benefit of what NICE is doing is not to take away decisions which will still fall to be dealt with at local level, but to enable those at local level who have to make those decisions make them on the best available clinical evidence.

§ Lord Clement-Jones
My Lords, will the Minister have a further crack at answering my original Question? Professor Karol Sikora said that, without more cash. the prime ministerial summit of last Thursday would simply be window-dressing. Therefore, can the Minister tell us what further cash will be available for cancer services, as a result of that summit?

§ Lord Hunt of Kings Heath
My Lords, I thought that my first Answer was rather good. Nevertheless, I shall have another go. I believe I said that the Government have already started to ensure improvements by investing an extra £60 million directly into the most common cancer services. We have said that a further £150 million will be available from the National Lottery New Opportunities Fund. Moreover, as a result of the additional money that the health service will receive over the next three years, health authorities, together with NHS trusts and primary care groups, will have to decide where to spend that money. I am sure that many of them will decide that cancer services do warrant some further investment. However, those decisions are quite rightly left to local level.