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Breast Cancer
3. Ms Church: To ask the Secretary of State for Health if he will make a statement on breast cancer mortality rates in (a) Britain and (b) other European Union countries. [14729]
The Parliamentary Under-Secretary of State for Health (Mr. Simon Burns): Breast cancer mortality rates in the United Kingdom fell by 6.5 per cent. between 1986 and 1992. They have been falling at a faster rate than the European Union average. That demonstrates the continuing success of the action that we are taking, which includes the "Health of the Nation" targets, the national breast cancer screening service and the issuing of specific guidance on improving outcomes in breast cancer.
Ms Church: I thank the Minister for his answer. While we welcome some of the modest improvements that have been made, 35 women a day--13,000 a year--die from breast cancer. Those are not cold statistics; people's lives are being adversely affected, families are being destroyed, and young children are being left without mothers. Does the Minister accept that there are huge regional variations in how people are treated, which means that there is a lottery for treatment? What steps will the Government take to ensure that early detection occurs in all parts of the country and that treatment is successful?
Mr. Burns: I assure the hon. Lady categorically that the Government take the problem very seriously. That is why we introduced the national breast screening programme. I do not accept that treatment is a lottery. The role of the national health service is to provide the same high-quality care for every patient who suffers from that tragic illness. We shall continue to ensure that that occurs through the screening programme, the guidelines on outcomes and through medical decisions and care.
Mr. Rowe: The Government deserve considerable congratulations on their successes so far and on their continuing efforts to improve the situation, but will my hon. Friend examine the extraordinary imbalance between the funds made available for the important breast cancer campaign and those made available for prostate cancer, which kills an increasing number of men every year?
Mr. Burns: As my hon. Friend will know, this year the Government are making £25 million available for cancer research, the pharmaceutical companies are making £114 million available, and the charities are making £100 million available. That is a considerable amount of money devoted to research into all types of cancer. It is crucial that research continues in order to minimise the number of deaths and illnesses caused by that tragic condition.
Ms Jowell: Last year, the Secretary of State asserted in the House:
- "To talk about a waiting list for cancer surgery is to talk about a waiting list that does not exist".--[Official Report, 3 December 1996; Vol. 286, c. 784.]
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Will the Minister tell the House how he squares that claim with figures provided by his Department that show that more than 10,000 women had to wait more than two weeks for breast cancer surgery in 1994-95?
Ms Jowell: Answer the question.
Mr. Burns: I shall answer the question if the hon. Lady will listen. She knows that the Labour party's commitment is bogus because no one waits for cancer treatment unless the doctor makes a clinical decision to that effect. There are times when cancer patients are not medically able to undergo an operation. To talk of a waiting list in the terms that the hon. Lady uses is scaremongering and despicable.
Lady Olga Maitland: I congratulate my hon. Friend on the Government's excellent record on tackling cancer. Will he join me in paying tribute to the Cancer Research Institute and to the Royal Marsden hospital in my constituency, which have contributed considerably to that success? Will he also encourage women to take advantage of breast screening opportunities so that the success may continue?
Mr. Burns: I am extremely grateful to my hon. Friend for the constructive way in which she asks her question. I pay full tribute to the contribution of all charities and of the pharmaceutical companies, which do much good work in seeking to reduce and minimise the evils of cancer. I pay tribute also to the Royal Marsden hospital and to the fantastic work done by nurses and doctors in an attempt to eliminate that terrible source of suffering.
Mental Health Services
4. Mr. Barnes: To ask the Secretary of State for Health when he last met the Association of Directors of Social Services to discuss services for mentally ill people. [14730]
The Secretary of State for Health (Mr. Stephen Dorrell): I last met the Association of Directors of Social Services informally on 4 February. Services for mentally ill people were among the issues discussed at that meeting.
Mr. Barnes: Is the Secretary of State aware that emotional and conduct disorders affect 20 per cent. of adolescents, and that in 1995 a NHS advisory service survey showed that mental health provision for children and adolescents was patchy and inadequate? Why did he not confront that problem in his recent Green Paper and advance proposals for handling the difficulties that children and adolescents face?
Mr. Dorrell: I have never believed that those who are concerned about mental health problems serve their interests by inflating the number of people who suffer from mental illness. Some people suffer from acute and serious mental illness, and we need to improve the quality of service provision for them. That is why the resources
committed last year to improving mental health services totalled £90 million, why a further £50 million was allocated in this year's public expenditure survey settlement to expand mental health services in the next financial year, and why we are looking to health and social services departments to expand their provision using the extra money that the Government are providing.
Mrs. Roe: Does my right hon. Friend agree that the increase in the provision of medium-secure beds from none in 1979 to nearly 1,200 today is evidence of the Government's real commitment of resources to those who suffer from mental illness?
Mr. Dorrell: My hon. Friend is on to a very important point. Medium-secure bed provision is an important part of the total spectrum of care in mental health services. The need for identifiable medium-secure mental health beds was described by the Glancy committee in 1974; Labour in office did absolutely nothing about it, but this Government have delivered the total number of beds that Glancy--too many years ago--determined was necessary.
Ms Coffey: In view of the recent reports of problems at Broadmoor, is the Secretary of State satisfied that the commissioning and monitoring arrangements established with the high-security psychiatric commissioning board are adequate to ensure proper inspection of care and control in special hospitals? Will he agree to widen the terms of the inquiry into Ashworth to enable the inquiry team to examine the adequacy of current arrangements for inspections of all three special hospitals and to make recommendations?
Mr. Dorrell: No. The Fallon inquiry into Ashworth was set up to examine the background to a very precise set of circumstances that need to be properly examined. When I set up the inquiry, I made it very clear that Mr. Fallon would be free to follow up any linkages with the failures that occurred in the personality disorder unit at Ashworth--either linkages to the rest of the hospital or linkages to places outside Ashworth hospital. Clearly, if they lead to Broadmoor, Mr. Fallon is free to follow up such linkages, but at the moment there is no evidence of any such linkage.
Sir Roger Sims: Does my right hon. Friend agree that there is a distinction to be drawn between mentally ill people, who are normally the responsibility of health authorities, and people with learning disabilities, the services for whom lie within the ambit both of local authorities and of health authorities? Is not that an area that lends itself to joint commissioning? Is my right hon. Friend aware that, in the London borough of Bromley, plans are currently under consultation for just such joint commissioning of services? Will he commend that and suggest that others might follow suit?
Mr. Dorrell: My hon. Friend is right to say that social services departments and health authorities have a key role to play in the delivery of services to mentally ill people and people suffering from a learning disability. The Green Paper that the Government published two weeks ago is designed precisely to improve the linkage between health and social services
in the delivery of services to mentally ill people--a weakness that certainly needs to be addressed. Various options for strengthening the linkages between health and social services are canvassed in the Green Paper; one of those options will be followed up, because it provides the key to an important improvement in mental health care.
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