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11.3 pm

The Minister of State, Department of Health (Ms Tessa Jowell): I am grateful to the hon. Member for Tiverton and Honiton (Mrs. Browning) for raising this subject this evening. I am glad to echo both her feelings of outrage and the regret expressed by my right hon. Friend the Secretary of State last week about what happened in Devon. This debate gives us the opportunity to say once again how sorry we are for the women and their families and friends who have been affected in a variety of ways--and in particular, those close to the two women who died because of the events that gave rise to the inquiry.

Mr. Paul Tyler (North Cornwall): As the hon. Member for Tiverton and Honiton (Mrs. Browning) said, one of those concerned was a constituent of mine. It was a tragic case of misdiagnosis at the Treliske hospital in Cornwall. As the hon. Lady said, it is not just people in Devon who are affected by what happened at the Wonford House hospital--there is anxiety throughout the west country.

The failure of information between one hospital trust and another raises important questions about the relationship between trusts in different parts of the country. I hope that the Minister will deal with that point.

Ms Jowell: I entirely accept the hon. Gentleman's point and, of course, we regret the distress, further illness, and in two cases the deaths, of patients who had the right to expect better. That is why we have taken rapid action to

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establish precisely what happened in that dreadful business and to learn, as quickly as we can, any lessons that that horrifying story has to teach us.

I wish briefly to set out the facts as we currently understand them. In February this year, concern was expressed by medical staff about the work of two consultant radiologists, one employed by the Royal Devon and Exeter Healthcare NHS trust and the other by the South Devon Healthcare NHS trust at Torbay.

Contrary to the impression given by some reports in the media, the consultants undertook diagnostic mammography for women with symptoms of cancer, as well as more routine breast cancer screening. Twelve sets of mammograms, including both symptomatic and screening cases, were sent for an external review to an independent consultant who worked in Nottingham. Nine of those mammograms were found to be faulty.

The review concluded that further assessment should have been undertaken in nine of the cases. It recommended that the doctors concerned should undergo formal retraining and that further audits should be undertaken of the mammograms of all women identified as requiring early recall for screening, and of all cancers that have occurred between screenings in the past five years.

The doctors concerned are not currently working in the NHS and management action is under way locally to review the management of the breast screening service and the provision of symptomatic services. An audit will be undertaken of the films of women who have been scheduled for recall earlier than the normal three-year screening interval, the films of women recalled for assessment after screening during the previous two years and the films of women with cancer that has occurred between screening invitations.

There will be a meeting shortly between the trust and representatives from other screening centres to make the necessary arrangements for the audit. I should add that both screening and services for breast cancer are continuing to be provided in Exeter, as locum arrangements have been made.

I assure the hon. Member for Tiverton and Honiton that the Government are determined to get to the bottom of what happened at the Royal Devon and Exeter trust. We would welcome any information to help the inquiry from hon. Members who may be able, through constituency cases or other representations, to shed further light on the events that led to the tragedies.

As my right hon. Friend the Secretary of State announced yesterday, the Government's chief medical officer is undertaking an urgent review of breast services in Exeter, to establish the facts and to report his findings to the Secretary of State, and, in the light of those findings, to consider the implications for breast cancer services as a whole, again reporting his conclusions to the Secretary of State. We hope that his report will be available by mid-July. An interim and immediate report on the inquiry so far will be available by the end of this week and my right hon. Friend will happy to brief the hon. Lady about the interim findings.

The chief medical officer has assembled a distinguished independent team to assist him, including the president of the Royal College of Radiologists, a consultant surgeon from Huddersfield, a cancer nursing specialist, who is also a member of the expert advisory group on cancer,

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the chief executive of the Royal Marsden hospital, and Miss Polly Toynbee, who will represent lay interests. The team has already started work--it visited Exeter yesterday and began by interviewing a wide range of staff to collect detailed information.

The hon. Member for Tiverton and Honiton mentioned the need to take representations from staff who may be reluctant to come forward. It is important that the views and information that staff gain in clinical practice are made available. We realise that some trusts make that task more difficult for staff than others, but we will provide every assistance to staff members, so that their representations aid the inquiry.

Mr. Ben Bradshaw (Exeter): I should like to express my gratitude to my hon. Friend the Minister and to the hon. Member for Tiverton and Honiton for the constructive and tripartisan approach that hon. Members have adopted in dealing with the crisis. I am grateful also for the swift and open way in which the Government and the Royal Devon and Exeter hospital have responded.

Will my hon. Friend the Minister please continue to encourage women in my constituency to come forward for testing, which is incredibly important? Today, can she tell those women that they can have full faith in the results of current hospital tests? Will she also confirm that the Government's commitment to women's health and the £10 million that Ministers have earmarked to speed up the breast screening process will help to resolve some of the problems that the hon. Member for Tiverton and Honiton mentioned and our poor record nationally in dealing with breast cancer?

Ms Jowell: I thank my hon. Friend and I entirely endorse his call to women, not only in his constituency but in all constituencies, to continue to attend for breast cancer screening, because screening remains the single most effective way in which to identify breast cancer at a very early stage.

The Government will not rest until we have applied in practice every lesson that the inquiry shows must be learned and applied. Women should realise not only the importance of regular screening but the fact that screening services will be subject to regular review and quality checks. Those services will be supported and developed further in the light of the best possible information on developments in treatment and screening technology.

It is therefore important that we identify specifically what happened in a dreadful set of circumstances and ensure that those lessons are applied locally, to restore and rebuild women's confidence. We must also ensure that the lessons learned are applied across the screening service and on a national basis.

Sir Peter Emery: I cannot do other than praise the Minister for the action that the Government are taking for the future; but how shall I respond to women who write to me saying, "Sir Peter, I have been there; what do I do? I had a test two years ago or 18 months ago--am I at risk? What action should I take? How should I react to this great problem?" Reassurance of those people is of very considerable importance to all constituents, whether they are in Exeter, Totnes or any other local constituency.

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I had hoped that we would find a way in which to give such reassurance to those women as soon as humanly possible.

Ms Jowell: It is obviously a matter of concern. I advise the right hon. Gentleman to refer his constituents who may have those concerns to the helpline that was established immediately after the events were disclosed. I also assure him that a further audit of mammograms and diagnostic investigation is being conducted to establish that no further mistakes were made. I would in the first instance suggest that the right hon. Gentleman refers his constituents to the helpline, so that they get the reassurance and information that they might want.

We shall certainly continue supporting the implementation of the Calman/Hine model of cancer service, which we believe provides the best and safest basis for the delivery of cancer services in Devon and Exeter, as well as across the country. We also intend to produce a series of evidence-based guideline documents responding to some of the points raised by the hon.

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Member for Tiverton and Honiton in relation to the importance of lessons learned in practice being applied to future clinical development. We are determined to ensure that those lessons are applied for the benefit not only of her constituents but of people across the country.

The hon. Lady asked about local cancer centres. The Plymouth Hospitals NHS trust and the Royal Devon and Exeter Healthcare NHS trust have both been designated as cancer centres, but it was agreed that the Plymouth Hospitals trust would take responsibility for clinical leadership.

The hon. Lady will also be aware that we are moving to the implementation of clear treatment protocols, which will be a very important step in ending the geographical lottery and ensuring that there is a national breast cancer service for all women-- The motion having been made after Ten o'clock, and the debate having continued for half an hour, Mr. Deputy Speaker adjourned the House without Question put, pursuant to the Standing Order.

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