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Health: Cancer

Volume 725: debated on Wednesday 2 March 2011


Asked by

To ask Her Majesty’s Government what proposals they have for improving outcomes for cancer patients.

My Lords, we published Improving Outcomes: A Strategy for Cancer on 12 January, which sets out a range of actions to improve outcomes for cancer patients. Earlier diagnosis is crucial to improving outcomes, and we have set out plans to deliver this through improving GP access to diagnostic tests, supporting symptom awareness initiatives, and extending cancer screening programmes. We are also improving access to treatment and the quality of support for survivors.

I thank the Minister for his Answer, which is very helpful because it prompts two questions. First, when does he think the procedures which he has put in place will succeed and cancer outcomes will improve, and in the mean time what is likely to happen to cancer outcomes? Secondly, could he also say what the state of radiotherapy treatment in England is?

My Lords, the strategy we have laid out is an ambitious one. It aims to save an additional 5,000 lives every year by 2014-15. That programme is supported by over £750 million of additional money over the next four years. It sets out actions to prevent cancer incidence and to improve the quality and efficiency of cancer services and of patients’ experiences of care. We are giving ourselves a little time, but we are under no illusions, and this is an agenda to be pursued very energetically. We are putting considerable additional money—from memory, it is £150 million—into radiotherapy services, but we also feel that there is an important issue around the use of existing radiotherapy equipment, which is often not utilised as effectively as it could be.

My Lords, would the noble Earl agree that the regional networks of specialist cancer services, established through the co-operation of clinicians themselves, have been instrumental in improving outcomes for patients? If so, how does he think that essentially collaborative model fits with the rigid and mandatory price competition that the Government now want to introduce into the NHS?

My Lords, the Government are not introducing price competition, it has never been our intention to do so, and the Bill that will come before the House will make it absolutely and abundantly clear that price competition is out of range. As regards the cancer networks, the noble Baroness is absolutely right. Over the past 10 years, these have played a crucial role in improving the quality of cancer treatment and the patient experience of care. The outcomes strategy that we have published explicitly states that next year there will be funding for cancer networks to support commissioning.

My noble friend introduced the question of diagnosis, which is increasingly a multi-professional matter, involving pathologists, surgeons, radiologists and so on. This seems self-evidently a good thing. However, is the department accumulating evidence to show that it is actually improving the outcomes? It is of course an expensive procedure to involve so many senior professionals together.

My noble friend is quite right. It does involve often a number of senior clinicians. The key to diagnosis, however, is to get in early, as I am sure he would recognise. The outcomes strategy commits us to saving the additional 5,000 lives very largely through additional identification of early cancer. In fact, 3,000 of the 5,000 lives that we are hoping to save will be saved, we hope, by earlier diagnosis. A good example of that is that over 90 per cent of bowel cancer patients diagnosed with the earliest stage of the disease survive five years from diagnosis, compared to only 6.6 per cent of those diagnosed with the advanced disease.

Would the noble Earl accept that this country has had a very proud record in carrying out clinical trials, not least in the field of cancer; and that since the passage of the European directive on clinical trials, the problem of getting ethical approval for multi-centred trials—in a variety of different centres—has become immense? Is he aware of the recent report of the Academy of Medical Sciences, from a committee chaired by Sir Michael Rawlins, which has made a number of crucial recommendations? If accepted by the Government, those would make the performance of these trials very much easier.

My Lords, I am indeed aware of that excellent report. It is being studied with care in my department. We hope to make an announcement reasonably soon in response to it. It contains some extremely important recommendations which, if implemented, should do a great deal to restore the country's position as a destination of choice for clinical trials.

My Lords, there has been no question from the Conservative Benches so perhaps on this occasion we can hear from my noble friend.

My noble friend, in his original Answer, talked about the importance of early diagnosis. Is he not concerned at the cascade of cases reported in the media of GPs sending patients home with flu symptoms and indigestion and not detecting the cancer until it is too late? What does my noble friend intend to do to improve GP training to assist the earlier diagnosis on which he rightly lays so much emphasis?

My Lords, of course those reports are a matter for concern, which is why we are clear that GP consortia should be supported as much as possible in terms of commissioning guidelines and information. One of the tasks of the NHS commissioning board will be to provide that support and information based on quality standards produced by the National Institute for Health and Clinical Excellence.