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Baroness Jay of Paddington: My Lords, I am grateful for the noble Lord's congratulations to the Government on their efforts to extend people's understanding of this very important service. I agree that it is extremely important that older women should come forward if they have any concerns. The number of women getting breast cancer each year peaks in the 60 to 64 age group; but that does not mean that the suffering of those in an older age group who get breast cancer is any the less. That is why we intend to make sure that the older age group are aware and, if necessary, extend the recall programme to them.
Lord Dean of Beswick: My Lords, is the Minister aware that we are grateful to the Government for making increased finance available, as announced in the Budget, to deal with this problem? It is still a very serious problem and, as I understand it, has slightly increased. The Government ought to be commended for making increased finance so quickly available.
Baroness Jay of Paddington: My Lords, I am grateful to my noble friend. I believe he refers to the £10 million that we made available last year for breast cancer services almost immediately after being elected. The Chancellor of the Exchequer and the Secretary of State for Health announced the week before last that further money would be available to reduce waiting lists, and cancer will be given high priority in that area.
Lord Ironside: My Lords, is the noble Baroness aware that most of the mammographic X-ray equipment installed in the 1989-90 period to meet the Forrest plans is now reaching the end of its design life? Is she further aware that radiologists are now finding that X-ray film is reaching the limits of resolution, and that digital imaging is now needed to reduce the diagnostic uncertainties which lead to false negatives and false positives? Does she accept that there is a need to raise throughput? Will the Minister therefore agree that the time has now come for investment in an advanced equipment replacement programme to improve the National Health Service breast screening programme and help to reduce waiting times? Could some of the £10 million of extra money recently put into the services be made available?
Baroness Jay of Paddington: My Lords, the Government are extremely aware of the concern felt about the need for high quality breast screening services. We announced last November an overhaul of breast screening precisely to enhance the existing quality control. That obviously includes a review of the machinery used, but we felt it was equally important to review the standards of screening of individuals within the service, and that is now being undertaken.
Earl Howe: My Lords, is the Minister aware that Professor Fentiman of Guy's Hospital has estimated that the lives of up to 2,000 older women could be saved each year if that age group were routinely invited for screening? In the light of that, can the Minister say what kind of results from the pilot study would be conclusive enough to ensure that women of up to age 69 are included in routine screening or will the decision be determined by resources alone?
Baroness Jay of Paddington: My Lords, I can assure the noble Earl that the decision will not be determined by resources alone. We are concerned to balance the needs of care and screening for women in all age groups. At the moment, the research project to which I referred, which is considering the necessity for screening those in the 65 to 69 age group, is also looking, for example, at whether there is a case to be made for lowering the age at which women are screened to 40 or for closing up the gap between screenings for individuals to fewer than three years. All these matters will be considered. They will obviously need to be looked at in terms of cost-effectiveness, but resources will not be the single determinant.
Lord Carter: My Lords, the declaration of compound feed ingredients, either by specific ingredient or category of ingredient, has been an EC requirement since 1991. The Commission is currently considering whether to remove the category option altogether, a proposal which the Government would support. This change would require amendments to a directive at Council level. Pending this development, we welcome the moves already being made by feed compounders towards listing ingredients and away from listing categories. In 90 per cent. of compound feeds the ingredients are declared in full.
Viscount Gage: My Lords, I am grateful to the Minister for his reply. It is satisfactory that so much progress has been made since the late 1980s, when the listing of ingredients in animal feedstuffs was extremely vague and mainly done by groups. The Minister said that in 90 per cent. of cases listing is now done ingredient by ingredient. That still leaves 10 per cent. Can the Minister tell us when he expects the new directive from Brussels which will make the individual listing of ingredients mandatory? Will that listing include a declaration of whether the feedstuffs have been genetically modified? If there is not an early decision by Brussels, do the Government have any plans for making that mandatory?
Lord Carter: My Lords, regarding how soon we can expect the directive, the proposal is unlikely to emerge before the end of July. As a draft Council directive, it will not be agreed until next year. In the meantime, on the majority of feeds the ingredients are declared in full.
Regarding the disclosure of GM ingredients, any such labelling will be subject to separate rules--to use the jargon--on novel feed materials. This is a controversial area and will take some time to resolve. The Government will therefore consider whether to press for earlier labelling of animal feed once it is clear what rules will apply to GMOs and indeed all novel foods.
Lord Monkswell: My Lords, is my noble friend aware of the report by the expert group led by Professor Lamming which recommended the setting up of an advisory committee on animal feedstuffs? Can he say what happened following that recommendation of the committee?
Lord Carter: My Lords, my noble friend is correct that a committee chaired by Professor Lamming reported to the previous government in July 1992. Its main recommendation was that an independent animal feedstuffs advisory committee should be established to take an overview of all feedstuffs issues in relation to human and animal health. The government response accepted the recommendation, but they then decided that it should not be implemented, I imagine because of their attitude at the time to deregulation. I understand that Professor Lamming pressed the previous government again in June 1996, but there was still no response. I am pleased to say that we have accepted the recommendation and the committee is now in the process of appointment.
Sadly, the decision of the previous government not to implement the Lamming recommendation undoubtedly contributed to the feeding of infected meal after it was banned, with the result we all know of the incidence and severity of the BSE outbreak.
Baroness Nicholson of Winterbourne: My Lords, does the Minister agree that the previous government should have responded to my Parliamentary Questions and pressure in 1987 and 1988, which came from farmers themselves, requiring declaration of ingredients in animal feedstuffs to be mandatory on labelling, and that the fact that they did not do so was a tragic error which may have had bad consequences for human health?
Lord Carter: My Lords, the noble Baroness is absolutely right. For a long time the agricultural industry pressed for the full declaration of ingredients. This was resisted by manufacturers at the time, and the Government, with their view about deregulation, agreed with them. Sadly, it was the BSE crisis which led to the change within the past two years--which we had been told by the industry and manufacturers was not possible--so that on 90 per cent. of feedstuffs the ingredients are now declared in full.
Baroness Pitkeathley: My Lords, I thank the Minister for that reply. Many of us look forward with great anticipation to the SSI report. However, is the Minister aware of the great concern among disabled people and their carers about the restrictions in local authority budgets which are leading to cuts in the respite care and short-term breaks that are available? Is she further aware of the effect that that has on carers who wish to remain in paid employment, many of whom, sadly, have the experience of Joyce? Because respite care for her mother is now available for only two days a week instead of four, she has had to give up her paid employment and become dependent on state benefits, perhaps building up poverty for herself in the future. Can the Minister give us an assurance that her department is concerned about this aspect of the issue?
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