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2.35 pm

Dr. Ian Gibson (Norwich, North): For me, the inquiry was precipitated by two matters. First, cancer survival rates in the United Kingdom are atrocious when compared with those in other countries, especially in Europe, and they fall far short of those in the United States. That is true for breast, lung and colon cancers; indeed, it is true for 10 major cancers suffered by men and women.

Secondly, basic biomedical research into cancer in the United Kingdom is world class, yet the major discoveries are not being translated into clinical practice. There is little political recognition of that, and a serious lack of noise from many cancer interest groups. It took 26 years from the initial laboratory work to develop the drugs that we use to treat breast cancer today. That is far too long. We need a different infrastructure to make sure that that does not happen again.

The question is not whether the Government have tried to tackle cancer--they certainly have--but whether they will solve the problems that I described. Will the many recent announcements, including the national cancer plan and increased investment, correct the position whereby cancer survival rates in the United States are three times greater than those in the United Kingdom? Analysis of the statistics clearly shows that five-year survival rates for the major cancers are better in most European countries than in the United Kingdom. Let us put that in perspective: approximately 10,000 deaths per annum could be avoided if we attained the average European survival rates. Two thousand of those deaths are from breast cancer.

There are major geographical variations in the incidence of colon cancer in this country. High incidence rates are associated with economic deprivation and poverty. I acclaim the Government's attitude towards tackling poverty because health will benefit from that. We could save 2,500 lives a year through equality of diagnosis, treatment and patient care throughout the country. For major cancers, the 10-year survival rate for the richest sector of our society is better than the five-year survival rate for the poorest. We cannot justify that, and we cannot sleep until we correct that aberration.

I appreciate that basic scientific and medical research has received a large injection of money from the Government for equipment, repairing, for example,

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university laboratories and bringing the boys--and, hopefully, the girls--back home from their rich, luxury laboratories in the United States. However, is it enough? I agree with some other speakers who doubt whether it is enough at this stage.

It takes time to train clinical oncologists, thoracic cancer surgeons, histopathologists, radiographers, biochemists and physics technicians. I welcome the Government's injection of massive sums into the pay packets of such people in the past 48 hours. They are essential for providing cancer screening in this country. The Government's action constitutes a major political advance. Many of us acclaim it, and we will be proud to talk to the unions who represent those professions and the Institute of Biomedical Science, which campaigned for that tremendous leap forward. Many graduates will welcome the chance to enter those professions because we have addressed the pay problem and begun to consider the career structure.

I say to the Government, "Yes, great, more money has been put in, but we need even more." We can improve our basic research and cancer services even more. We can carry out clinical trials, which are shown to benefit patients, if we provide more money. I shall say more about the way in which we could do that. A local consultant told me last week that Culyer money was available to fund trials co-ordinators. The local trust refused the money and charity money had to be found to enable the trials to happen. I could repeat many such anecdotal stories of available money that does not get to the place where it counts.

We may need to think in the same way as we did for education. Perhaps we should give a pot of money directly to the relevant cancer network, unit or centre so that the practitioners can use it to effect improvements.

In order to establish a challenging service, we need to develop not a virtual cancer institute but a real one: a small centre, not a huge, rambling building as in Washington. It should co-ordinate and develop a national strategy for all aspects of the cancer journey and cancer care. That must be supported by a national cancer Act, as in the United States. The Government side-stepped that issue in their reply, so I look forward to the Minister saying something about that now.

A national cancer Act would make the matter independent of which party was in Government. The question whether we are putting enough money and resources into cancer research would have to be reviewed every year. That is a challenge for this century, and one that we could take up.

It is a tremendous advance that the Government have acknowledged the need for a national cancer research institute. The silence on that issue has been deafening. It is a major political contribution to the cancer arena and the national health service, and I look forward to hearing more about it. A national cancer institute could co-ordinate work on a tobacco policy, on diet and cancer, on the new human genome project and the outcomes of that, and the knowledge that we will have. It would be a real step forward to have an institute where people could talk about cancer and develop a national strategy and priorities.

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Many consultants and practitioners would welcome a national institute. They have campaigned for such a body for some time.

Mr. Alan W. Williams (East Carmarthen and Dinefwr): I, too, welcome the Government's acceptance of our Committee's recommendation on the establishment of a national cancer research institute. How would my hon. Friend tie the funders, especially the charities, into the strategy of such an institute?

Dr. Gibson: I would envisage a co-ordinated policy. A council could sit down with the national cancer research institute and combine their knowledge with that of all the other groups--consultants, charities and patients' groups. We should co-ordinate and combine, rather than continue the fragmentation that has beset the cancer challenge year after year.

To get decisions on cancer services and research requires the involvement of 46 groups and individuals. They all have acronyms and they have an input in decisions about funding. There are about 600 cancer charities in this country, and that cannot be right. I welcome the fact that the Imperial Cancer Research Fund and the Cancer Research Campaign have got their trustees together to talk about merger, which cannot come soon enough. The old rivalries must be dispelled, and we must have a unitary policy. We could take a leaf out of the Jubilee 2000 group's book. In a short time, it has affected the politics of world debt and how to handle it. That is a message for cancer charities.

The two-week waiting list proposal is superb, but we must ensure that at the end of that people do not have to wait weeks or months for a CT scanner and a linear accelerator. The whole process can be speeded up. I know that the Minister has many examples of that happening, and we need to make it happen across the country.

The issue is not just about cutting bureaucracy, but about getting trained staff and equipment together to ensure that the journey is much quicker for our people. We must carry out research into many areas of radiotherapy, IMRT and Conformal, because much research has led up a blind ally. That is the challenge of cancer research. There will be new technologies and new techniques, and we need a national strategy that can be developed locally in the various centres.

Although research and infrastructure are crucial to the task of defeating cancer, much can be done more immediately to improve the quality of life of people living with cancer. The increasing use of concepts such as "living with cancer" has shown how, in many cases, cancer can become a chronic long-term condition that responds well to treatment, with a good prospect of survival. Even when the survival prospects are less good, the quality of life of people undergoing treatment can be far greater than could have been envisaged a few years ago. Much research needs to be carried out in that area on quality care, drugs and so on.

Improving the quality of life for patients and coping with the side effects of treatment are just as important as the treatment of the disease itself, and in some cases more important. As the hon. Member for Rayleigh (Dr. Clark) said, many people who visited the Committee called for research into improving the quality of life, yet research into service provision for all aspects of supportive care is

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accorded far less priority for funding and attracts far less academic interest. We have a duty to all who are living with cancer to ensure that the maximum effort is made to give them the best possible support, and to enable them to enjoy as much independence and as good a life as can be provided.

I was proud to be associated with the inquiry, with the members of the Select Committee and with the disciplined way in which some of us were made to respond in certain circumstances. I give credit to our Chairman for ensuring that, when excitement got the better of us, we managed to contain our enthusiasm.

There was a very unco-ordinated campaign, involving many different groups, to put pressure on the Government to show the political will that they are showing now. We have turned a corner, in that the Government now recognise the need to act, but there is never a time for us to rest on our laurels: we must deliver better co-ordination and teamwork between all the groups involved in cancer care.

What we have learned about cancer treatment could, I think, be applied to the treatment of mental health and heart disease. We are developing important structures. In the next few years, our message should be "teamwork, co-ordination, and partnership among industry, patient groups, cancer charities and Government". That will enable us to rise in the league tables and, I am sure, to be at the top in no time. Our people will receive the best treatment that is available to those elsewhere in the world.

The challenge is there, and the Government are taking up the cudgels. We must now give them all possible support in order to ensure that there is no rest, and that we continue to forge ahead in developing even better standards.

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