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Baroness Blackstone: My Lords, I utterly refute that. This is all about providing an opportunity for parents to exercise choice about the form of secondary education that they prefer. That seems to me to be democratic and utterly appropriate in the circumstances. Moreover, as I said only last week, it is democratic since the electorate

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was consulted on this matter following an election manifesto commitment to consult parents on their views about admission policies.

Baroness Platt of Writtle: My Lords, the noble Baroness said last week that a school would have 20 months in which to prepare for going comprehensive. Does she agree that the minimum size of a good comprehensive school is at least five, and preferably six or eight, forms of entry? How does the noble Baroness envisage that within 20 months a building programme can be planned, the allocation of resources made and the architectural plans arranged to give those non-selective children the education that they deserve in buildings that are ready to admit them?

Baroness Blackstone: My Lords, I do not accept the assumptions that lie behind the question of the noble Baroness. The average grammar school in this country has about 800 pupils. Some 40 per cent. of comprehensive schools have fewer than 800 pupils, so many comprehensive schools operate perfectly effectively with school rolls that are lower than the average for grammar schools. There need be no reorganisation of the kind to which the noble Baroness refers.

Lord Tope: My Lords, will the Minister explain why parents of key stage 1 pupils in a primary school will be eligible to take part in a ballot while parents of key stage 1 children in an infant school will not? Is that fair?

Baroness Blackstone: My Lords, we have gone through the issue of what is an appropriate group of parents to vote on ballots on countless different occasions, including when the Bill was going through this House. The Government believe that they have devised the most sensible and fair system of balloting which could possibly be achieved. We have been criticised by my noble friend Lord Hattersley on the one hand and by the noble Lord, Lord Tope, and the noble Baroness, Lady Blatch, on the other. I suspect that that means that we must have got it about right.

Baroness Blatch: My Lords, the average size of grammar schools is not 800 pupils. I hope that the noble Baroness will look again at those figures. In fact, a large majority of grammar schools have only four forms of entry which, as my noble friend said, means that they are not sufficiently large to be viable as comprehensive schools. Will the noble Baroness tell the House how standards will be raised if those fine schools are removed?

Baroness Blackstone: My Lords, I must contradict the noble Baroness. First, I have in front of me the figures which are provided by statisticians in my department which show that the average grammar school has 800 pupils on its roll. Secondly, I do not believe for a moment that standards will fall. Those schools are not to be abolished; they will continue.

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Christie Hospital, Manchester: Funding

3 p.m.

Lord Dean of Beswick asked Her Majesty's Government:

    Whether they consider that present funding for the Christie cancer hospital in Manchester is sufficient to meet the present demand of people requiring cancer treatment at that hospital.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Hayman): My Lords, in May 1998 an additional £500,000 was allocated to meet the increasing demand for radiotherapy services at the Christie Hospital. Discussions are now taking place with the local health authorities on the level and funding of chemotherapy services at the hospital. A review of specialist cancer services across the north-west region is nearing completion and will make recommendations about the level of service provision at all three of the regional cancer centres.

Lord Dean of Beswick: My Lords, I am grateful to the Minister for that detailed reply. She stated that this is the second time this year that the Christie Hospital has had to reduce vitally needed services because of the financial situation. The Government have already declared that cancer is the primary illness to be tackled. Is there not, therefore, something wrong in view of the fact that those services are being cut? Should not the financing arrangements of specialist hospitals such as the Christie Hospital and others be made directly through the department itself and not left to the whims and quirks of the local area health authority, which may act quite differently?

Baroness Hayman: My Lords, I recognise that my noble friend is an extremely effective advocate of the services of the Christie Hospital. The whole House will recognise the quality of those services. It is not a matter of services being cut. Rather it is an issue of more and more patients being referred to cancer units in the north- west, despite the fact that a new unit has been opened recently at Preston.

However, I agree with my noble friend that it is unsatisfactory to have hand-to-mouth funding and to be dealing with those issues as and when they arise. That is why I hope that the regional survey of cancer services will allow for more coherent planning in the future. The Christie Hospital has a national and international profile for research and development, which is funded separately. But given that the vast majority of patients come from the north-west region, as is the situation with other specialist centres in the country, current funding arrangements can be made appropriately. We must just make sure that they are.

Lord Clement-Jones: My Lords, the Christie Hospital is clearly a major cancer centre which is currently lacking resources. Is the Minister aware of the estimate given by Professor Karol Sikora of the World

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Health Organisation and the Hammersmith Hospital that more than £100 million is needed to implement in full the 1994 Calman-Hine proposals which were designed to ensure that there were high quality cancer services across the country? Does the Minister agree with that estimate?

Baroness Hayman: My Lords, I certainly agree that we need to build on the implementation of the Calman-Hine framework for improving cancer services. The Government are committed to that work. As part of that implementation we have been publishing evidence-based guidance on common cancer sites. Guidance has already been published on breast, colorectal and lung cancer. We shall see guidance relating to gynaecological cancer in the spring. We are already building on the substantial funding that is provided to health authorities for cancer services by making available extra funding: some £20 million since 1997 to improve breast cancer services and an additional £10 million to improve colorectal cancer services. We have the prospect of even greater investment when the announcements are made regarding the New Opportunities Fund.

Lord Wade of Chorlton: My Lords, first, I declare an interest as I lead a campaign to raise some £25 million for the Christie Hospital, of which we have already raised about £16.5 million. What role does the Minister believe that private funding of that nature--appealing to the local business community and individuals--should play in providing the high quality and excellent standards that the Christie Hospital intends to provide?

Baroness Hayman: My Lords, I applaud the noble Lord's efforts in that area. There is a fine tradition within the health service of local support and fund-raising, enhancing and providing even higher quality standards of care, particularly in the areas of environment and additional equipment, which has taken place throughout the history of the health service. We wish to see that encouraged. It is exactly that sort of partnership with charitable and local interests that we intend to build on in the New Opportunities Fund programme.

Lord Dean of Beswick: My Lords, I am grateful to the Minister for the extremely detailed Answer which she gave to my first Question. Does she agree with me that one of the worst aspects of this stop-go programme which Christie's has had to undertake is its effect on forward planning for future treatment? It is almost wrecking any prospect of real improvement. As the Minister said, the Christie Hospital is one of the best centres of excellence in the world in relation to the disease.

Baroness Hayman: My Lords, I certainly agree that stop-go funding is not satisfactory. I believe that the trust understands that if the situation persists it may be necessary to open additional beds to make sure that chemotherapy patients receive the treatment they need.

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I understand that an application has been made for emergency pressure funding to do that. We are also looking at ways in which the ambulance service can provide transport for radiotherapy patients who cannot otherwise travel to and from the hospital.

I accept absolutely that we need to provide a sensible regional framework in which the hospital can plan ahead although I should say to my noble friend that, particularly on issues such as communications with patients and providing the most efficient services possible, the hospital must also look internally at what it can do to improve services.

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