HC Deb 22 January 2003 vol 398 cc385-6W
Dr. Julian Lewis

To ask the Secretary of State for Health (1) if it is his policy to support the introduction of brachytherapy treatment facilities by hospital trusts; [91274]

(2) what his policy is to eliminate the differential availability of brachytherapy for prostate cancer patients in different parts of the country; [91275]

(3)if he will make a statement on the efficiency of brachytherapy as a treatment for certain prostate cancers; and if he will list those primary care trusts which are known to his Department (a) to fund and (b) to refuse to fund brachytherapy for the treatment of prostate cancer; [91277]

(4) what guidance he has issued to PCTs on the desirability of (a) their determining which prostate cancer sufferers should be funded for brachytherapy treatment and (b) their allocating cancer treatment funds en bloc to hospital trusts for them to determine which patients should receive funding for brachytherapy. [91278]

Ms Blears

[holding answers 21 January 2003]The National Institute for Clinical Excellence (NICE) recently published guidance on the organisation and delivery of services for people with urological cancers, including prostate cancer. The guidance states that the option of brachytherapy should be discussed with men with early prostate cancer.

However, the NICE guidance also acknowledges that the place of brachytherapy in the treatment of prostate cancer is uncertain and notes the importance of research to evaluate the effectiveness of brachytherapy for prostate cancer. The guidance refers to a randomised intergroup trial comparing brachytherapy with radical surgery that is being organised by the National Cancer Institute of Canada and the American College of Surgeons Oncology Group and strongly encourages United Kingdom participation in this study. As a result, the Department is making £900,000 available through the National Cancer Research Network (NCRN) to enable national health service patients to enter this trial. The National Cancer Research Institute Prostate Cancer Clinical Studies Group and the NCRN are working closely together to take this trial forward in the NHS.

No guidance has been issued to primary care trusts (PCTs) on the allocation of funding for brachytherapy treatment. We are devolving power from the centre to enable PCTs to use the extra resources for the NHS to deliver on both national and local priorities for their communities, accounting publicly for how they have used them.

It is not possible to list which PCTs fund brachytherapy, as this information is not collected centrally. Decisions on this treatment are a matter for the clinician and funding authority concerned and should be made in the light of all the available evidence.

As more evidence on the effectiveness and cost effectiveness of brachytherapy becomes available, the Department will consider whether this treatment is a suitable topic for referral to NICE as a technology appraisal.

Dr. Julian Lewis

To ask the Secretary of State for Health if he will make a statement on the refusal of the New Forest Primary Care Trust to offer brachytherapy treatment for prostate cancer. [91276]

Ms Blears

[holding answer 21 January 2003]The decision on whether or not to commission brachytherapy for local patients is currently a matter for individual primary care trusts (PCTs). Brachytheraphy is a comparatively new therapy, for which there is currently a limited evidence base which many clinicians regard as inconclusive.

Local PCTs recognise the need to consider very carefully whether to provide a treatment for which the National Institute for Clinical Excellence has asserted that more research on effectiveness is needed.

In view of this, and the understandable desire of patients for brachytherapy, concerted work is currently underway through the central south coast cancer network to review this treatment and agree a way forward for local health services. This process of review is currently underway and is expected to conclude before the end of the financial year.

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