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Health: Breast Cancer

Volume 734: debated on Thursday 12 January 2012


Asked by

To ask Her Majesty’s Government what assessment they have made of the implications for women with breast cancer of the recent concerns regarding Poly Implant Prothese implants.

My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I declare an interest as chief executive of the research charity Breast Cancer Campaign.

My Lords, the expert group chaired by Sir Bruce Keogh concluded that, on the available data, PIP implants are not associated with a higher risk of breast cancer than other silicone gel implants. Women who have had PIP implants on the NHS following surgical treatment for breast cancer will be able to consult an NHS doctor and if they wish, in the light of that clinical advice, have the implants removed and, if appropriate, replaced.

I thank the Minister for that Answer. I welcome the Statement made by the Secretary of State for Health in the other place and the reviews being set up to look at both of the issues here. This is an issue that is causing a huge amount of concern for women with breast cancer. I welcome the assurances of the Secretary of State that, where women have been treated on the NHS, the PIP implant will be removed, and where patients have been treated privately, and those companies refuse to remove the implant, they can then seek help from their GP from the NHS.

I apologise, but I need to get the detail right. I am concerned about women who are diagnosed with breast cancer, treated privately and are then refused help from that private practitioner. At the moment, when they come to the NHS they are only promised the removal of that PIP implant, not subsequent replacement and reconstruction. I do not think that is right, and I hope the Minister will be able to reconsider that.

My Lords, I understand the point that the noble Baroness is making, but I think that most people would agree that it would be wrong to let private providers off the hook. In the first instance, we are saying that the woman, if she has been treated privately in the circumstances the noble Baroness has described, should seek advice from her private clinician. Only then, if the clinician or the clinic let her down, will she be able to have recourse to the National Health Service. I think that that is fair.

As regards the replacement of the implant, we do not think that other NHS patients should be disadvantaged in this way. Every time the NHS picks up the tab for the private sector, we are displacing patients of the NHS who are in need. Therefore, there is a balance to be struck here and we have made our decision on a very good basis.

My Lords, how is it that these PIP implants, which are now declared unsafe and substandard, were given the European CE mark—the safety kitemark? Does the Minister share my concern and dismay at the Harley Medical Group’s announcement yesterday? This is a group which for years and years has ruthlessly advertised, sold and fitted these substandard PIP implants to nearly 14,000 women and is now saying that it will not replace them. Is it not time to take action against these unscrupulous—it seems—private practitioners to make them take some responsibility?

We believe that in many instances private practitioners have a legal duty—certainly a moral duty —to address these matters on behalf of their patients. Eight private companies are offering to replace implants for their patients. We welcome that and are urging the Harley Medical Group to follow suit. I was encouraged to hear that the professional bodies representing cosmetic surgeons have sent out a letter, urging surgeons not to charge for their time when they remove these implants privately.

As regards the first part of my noble friend’s question, it remains to be seen whether there has been a failure of regulation. We are looking here at a deliberate criminal act by the manufacturer of these implants. It is very difficult to see how regulation, however tight and effective, could pick up something such as this, where there has been a deliberate effort to conceal facts from the inspectors.

Would the noble Earl not agree with me that the kind of behaviour by private companies that we are talking about, whereby they seek to wash their hands of problems that they have created, is the kind of thing that we will see a lot more of once the provisions regarding increased competition in the National Health Service contained in the Health and Social Care Bill come into force?

I could not disagree more with the noble Lord. He refers to the policy of “any qualified provider”. That policy gives absolute assurance to every NHS patient about the quality of the treatment that they get if they are treated by the NHS, whatever the provider setting. Therefore, the idea that this incident has any bearing on the provisions of the Health and Social Care Bill is absolutely misplaced. I cannot emphasise that more.

The noble Lord, Lord Low, asked a legitimate question. Any qualified provider goes through a process of approval in which the CQC is responsible for regulating clinics and services. That is exactly what the CQC has done for these private clinics. They have all been given a stamp of approval to carry out these operations by the CQC. That, surely, was the point of the noble Lord’s question. Therefore, what are the implications for “any qualified provider” under the fragmentation and increased marketisation of the NHS by the Bill?

The “any qualified provider” policy was instigated by the Government of the noble Baroness. There is no suggestion that these clinics have been carrying out procedures badly; the issue is around the quality of the implant, which they could not be expected to know about. Nevertheless, the CQC is conducting inspections, some of them unannounced, on cosmetic clinics to assure itself that everything is being done properly. I will not stand here and say that any of these clinics have carried out the procedures badly. We have no evidence to show that they have.