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House of Commons

Tuesday 6 February 2001

The House met at half-past Two o'clock


[Mr. Speaker in the Chair]

Oral Answers to Questions


The Secretary of State was asked--


1. Miss Anne McIntosh (Vale of York): What representations he has received on the prescribing of herceptin for the treatment of breast cancer; and if he will make a statement. [147327]

The Minister for Public Health (Yvette Cooper): We have received representations, including that from the hon. Lady on behalf of her constituent, on this matter. Herceptin was licensed in August 2000, and we are keen to ensure that it is used appropriately across the national health service. We are also keen to prevent a postcode lottery for care. That is why we have referred the drug to the National Institute for Clinical Excellence, which expects to issue its report in June.

Miss McIntosh: Does the Minister agree that it has been proven that herceptin can extend life? Does she also accept that it is apparently much more widely available in the south-east of England than in the north, and in particular north Yorkshire? My constituent, Eileen Quigley, was told that she could have the drug if she was prepared to pay for it. Does the Minister accept that the Government have failed my constituent, and that they must now bring forward the date by which the drug will be registered and accepted by NICE for use?

Yvette Cooper: The drug was licensed in August. We are concerned about the postcode lottery for care in relation to a number of cancer drugs, which is why we have rapidly referred them to the National Institute for Clinical Excellence. We also did that with taxanes, and 5,000 women are now receiving treatment that they would not have received had we continued with the policies of the previous Government, who promoted a postcode lottery for care by promoting an internal market.

The case of the hon. Lady's constituent was originally raised by the patient's partner, and the trust has not yet received the patient's consent to release the details, although it has pursued that matter several times. Once consent is received, I shall be happy to pursue that patient's case.

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It was the Conservative Government who promoted the postcode lottery for care by promoting the internal market. That is why we established the National Institute for Clinical Excellence to deal with such drugs as rapidly as they come on to the market, and to provide national guidance so that we have a truly national health service.

Joan Ruddock (Lewisham, Deptford): I thank my hon. Friend for her reply. We have real confidence that NICE will make an appropriate decision on the issue. Does she accept that the major breast cancer charities, including Breakthrough Breast Cancer, have made representations about herceptin because it is the one drug known not to have side effects and to be beneficial in cases involving metastases, and for patients for whom all else has failed?

Yvette Cooper: I am aware of the representations that my hon. Friend mentions, and we have referred the drug to NICE for those reasons. I cannot pre-empt the guidance that the institute will give, but we have referred cancer drugs to it as a priority because of our concern about the matter. In the past it has often taken a long time for effective licensed drugs to be used routinely in the NHS; that is why this drug was referred to NICE even before it was licensed. We look forward to receiving a report speedily, so that all patients can be reassured that they are getting the best treatment, and the treatment that they need.

Cancer Services

2. Mr. David Chaytor (Bury, North): If he will make a statement on the Government's progress on improvements in services to patients suffering from cancer. [147328]

3. Mr. Eric Martlew (Carlisle): If he will make a statement on the Government's progress on improvements in services to patients suffering from cancer. [147329]

7. Helen Jackson (Sheffield, Hillsborough): If he will make a statement about the development of cancer services in the NHS. [147335]

The Secretary of State for Health (Mr. Alan Milburn): After decades of neglect, cancer services are receiving record levels of extra investment. Tens of thousands of cancer patients who are urgently referred to hospitals by their GPs are now being seen within two weeks. By the end of this year, patients with acute leukaemia or testicular cancer, and children with cancer, will have a maximum wait of one month from urgent referral to treatment.

Mr. Chaytor: That news will be welcome to my constituents in Bury, North. The importance of the hospice movement for palliative care for cancer sufferers must not be overlooked in the new approach to cancer treatment. I pay tribute to the staff and volunteers of the Bury hospice. Will my right hon. Friend assure the House that the hospice movement will get its fair share of the new investment going into the national health service?

Mr. Milburn: I know that my hon. Friend has a close working relationship with his local hospices. It is important to note that across the piece--in prevention,

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treatment and palliative care--we are investing appropriate sums of money to provide cancer patients with the treatment and care that they need.

My hon. Friend is right; for years hospices have relied on charitable and voluntary fund-raising endeavours. I pay tribute to all those involved. The national health service has never matched the contributions from voluntary and charitable donations, but that is about to change. As a result of the extra investment now going into cancer services--particularly into palliative care--the national health service will be matching the amounts raised voluntarily to invest in hospices and the palliative care movement within three to four years.

Mr. Martlew: May I draw my right hon. Friend's attention to the Eden Valley hospice in my constituency, which has a tremendous reputation and full support from the community? It has recently decided to employ a consultant specialist in medical care to improve care in the hospice and take it out into the community. What my right hon. Friend has said is good news for the hospice because there will be extra resources, but may I bring him back to another aspect of our cancer care policies--regional centres of excellence? People in constituencies such as mine in Cumbria realise that we are a long way from the centre and we need a place such as Newcastle--I am sure that it will be Newcastle--where our constituents can go to receive the finest cancer treatment anywhere in the country. I hope that he will confirm that.

Mr. Milburn: I hesitate to confirm the idea of Newcastle, or Sunderland--or even Carlisle--but my hon. Friend's general point is right. We must make sure that the best treatment is available to the maximum number of cancer patients. As he is aware, we recently announced extra funding for stomach cancer services, because stomach cancer kills so many people every year and, regrettably, the interventions generally come too late.

We also need to concentrate the expertise in the national health service better, and make it available in specialist regional centres. The Government are investing a record amount of extra money in cancer services, but although the Conservative party, too, now says that cancer services are a priority, it is a pity that the Government in which the hon. Member for Woodspring (Dr. Fox) served did not earmark a single penny piece of extra investment for cancer treatment. That explains precisely why, in today's NHS, including our cancer services, there are the following problems: too few doctors, too few nurses, and not enough modern equipment.

We are putting that right by investing extra money, which we can do because of the choices that we have made--for economic stability and more investment in public services. All that is put at risk by the policies of the Conservative party, which would return us to stop-go economics and cuts in public services.

Helen Jackson: Sheffield health authority is absolutely clear about the fact that the combination of the Government's setting access targets and providing extra resources and investment has enabled it to develop its breast cancer centre at the Royal Hallamshire hospital, which means that nobody in the Sheffield area has to wait more than two weeks for rapid access to a specialist. The Government's insistence on access targets is important and welcome, but do we not have to keep providing

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resources to enable health authorities to put treatment for other types of cancer at the top of their list and to receive the investment necessary to develop it?

Mr. Milburn: My hon. Friend is right.

Mr. John Bercow (Buckingham): What a surprise.

Mr. Milburn: She is right and, invariably, the hon. Gentleman is wrong. There are no surprises there.

My hon. Friend is right because, as she and other hon. Members throughout the House know, the NHS needs not what it had in the past--peaks of investment followed by cuts--but sustained investment over time. That is precisely what is happening under this Government. This year, for example, we shall invest an extra £280 million in cancer services. That will rise to an extra £570 million by 2003-04, precisely because of the choices we have made and the priorities we have set. The NHS is a priority, and within that, cancer services are a priority.

Mrs. Marion Roe (Broxbourne): As chairman of the all-party hospice group, I welcome any additional funding for palliative care, especially the £50 million by 2004 allocated in the NHS cancer plan. Will the Secretary of State tell the House when those funds will become available and how they will be distributed? Will he also confirm that they will be allocated not just to NHS units, but to independent hospices?

Mr. Milburn: That is a very important point and the hon. Lady is absolutely right. Palliative care services inside and outside the NHS are excellent and, as she knows, many hospices have been established because of massive fund-raising endeavours by a few individuals, and I pay tribute to them. She is also right to say that some hospices are under financial pressure, and she will be aware that some health authorities have made extra cash available. She should also be aware that part of the £50 million extra for hospices and palliative care that I announced in September will come on stream not in 2004, but from this April.

Over three or four years, we shall build up the investment from the NHS that goes to adult hospices--and, it is important to add, to children's hospices. By 2004 there will be matched funding from the NHS and from voluntary and charitable fund-raising endeavours; we have never been in that position before.

Mr. John Wilkinson (Ruislip-Northwood): Following on from the questions asked by the hon. Members for Bury, North (Mr. Chaytor) and for Carlisle (Mr. Martlew), rather than the speech by the hon. Member for Sheffield, Hillsborough (Helen Jackson), may I emphasise the importance to regional cancer centres of having not just good treatment facilities, such as exist at Mount Vernon hospital, but both exceptional research capabilities and hospices, both of which also exist at Mount Vernon? That combination is surely second to none, and should recommend itself to the Secretary of State. Does he agree?

Mr. Milburn: I certainly agree that we need to increase our efforts in cancer research. That holds the key to some

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of the advances that we all want to be made for cancer patients. This country has a good track record, but much more needs to be done.

As the hon. Gentleman knows, I recently announced that for the first time we shall have a single cancer research institute, which will, I hope, harness the best of British science to provide the best of British expertise and the best for British patients. That is what we want to do, and we will do it on the basis of the extra investment that we are making.

With respect, the question for the hon. Gentleman is this: if he thinks cancer treatment is such a priority, why does he back policies that involve cuts in public spending? Why does he back policies involving, for instance, cutting lottery funding for cancer services? That is the Opposition's policy. [Interruption.] Opposition Members deny it, but that is what their spokesman on culture, media and sport said in 1998. He said that the money that we were putting into the national health service should come not from the lottery, but from general taxation. That spokesman, or one of the Conservative Front-Bench team here now, must answer one of two questions. First, if the money is to come from general taxation rather than lottery funding, where specifically will it come from? Secondly, if the Opposition are not prepared to adopt that option, which programmes will be cut?

Several hon. Members rose--

Mr. Speaker: Order. Before I call another Member, may I say this to Ministers? First, attacks on the Opposition are not really what I am looking for. [Interruption.] Order. Ministers are there to account for their Departments. Secondly, we must have brief questions and also brief answers.

Dr. Liam Fox (Woodspring): Mr. Harvey-Hills, a consultant urologist, recently wrote to his chief executive about the cancellation of cancer services at St Peter's hospital. He wrote:

I am sure Members agree that that was unacceptable, and it is bad enough in itself, but Mr. Harvey-Hills went on to say:

Is there not something fundamentally flawed about a system that refuses to treat the sickest patients first? Is there not a questionable moral basis for a system that puts the targets of politicians before the needs of patients, as happened in this case, in this hospital, under this Government?

Mr. Milburn: That was a good speech, but it does not reflect the reality of the national health service.

I shall certainly do everything in my power to resist the temptation to attack the hon. Gentleman, Mr. Speaker. As for his attack on the Government, we have made two things absolutely clear: clinical priorities, and the sickest patients, come first. What is more, unlike the previous Government, we have put our money where our mouth is.

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If the hon. Gentleman is so concerned about cancer and heart services, why, under the Government in which he served, was not a penny piece earmarked for modernisation and investment in those services?

Mr. Derek Twigg (Halton): The extra money provided in the recent allocation of funds is welcome in areas such as Halton, which for various reasons has the highest cancer rates in the country. Hospices have an important role in the care of cancer patients, particularly those who are terminally ill, and staff do tremendous work in that respect. When extra funds are allocated for hospices and palliative care, should it not be recognised that areas such as Halton--unlike other parts of the country that are not similarly deprived and poor--cannot raise large amounts of money? I hope that my right hon. Friend will take account of that fact.

Mr. Milburn: I am aware of that. As my hon. Friend knows, there is concern in the hospice and palliative care movement because there is a lottery for care in those services too. Hospices have sprung up in various parts of the country, but have not necessarily best matched need. One important action that we have to take--we have asked health authorities to take it now--is to engage with local hospices and with those who are thinking of establishing local hospices to ensure that those services fit the local community's needs. Ultimately, the extra resources that we are putting in will not only help to provide better hospice services, but gear those services better to the areas with the highest need.

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