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Madam Speaker: Order. What is the point of order for me?

Mr. Bruce: Have you had a request for a statement on this matter, Madam Speaker?

Madam Speaker: No. If there was to be a statement, we would all know about it because it would be on the Annunciator.

Mr. Andrew Robathan (Blaby): On a point of order, Madam Speaker. In answering questions, the Deputy Prime Minister urged us all to rally behind the Government. Could you rule that this House--of all places--must be a place where people are allowed to express reservations about Government policy in good faith?

Madam Speaker: It is not for me to indicate what Ministers or Back Benchers should say in this House. We are all free to express our opinions. The hon. Gentleman, as a Back Bencher, is entitled to his point of view just as much as much as any Front Bencher.

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Cancer Care

3.32 pm

Mr. Paul Marsden (Shrewsbury and Atcham): I beg to move,


Cancer has been called the greatest health care challenge of the 21st century. Britain can boast some of the finest cancer treatment centres in the world, but the disease still affects one in three people. That means that about 440 sufferers die every single day, with an annual total of 160,000 deaths.

In Britain, we have one of the worst cancer mortality rates in the world; worse than Germany, Italy, Switzerland, France, the Netherlands, the United States, Spain and Japan. It is a growing problem. People are living longer--which is to be well received--but that presents greater problems, as people are then susceptible to cancer in old age. We have improved treatments that improve survival rates, but we have specific increases in lung and skin cancers.

The Calman-Hine report has said that provision is a cancer lottery, especially in rural areas. The Government clearly see the fight against cancer as a priority, and I welcome that. Following the Calman-Hine report's recommendation that services should be made more patient-centred, and dovetailed together, we have seen various papers, including "Our Healthier Nation" and "The New NHS", which make cancer a priority. There is a new two-week deadline to see a consultant for all cancer patients. The National Cancer Forum has recently been established.

I welcome the announcement only last month by my right hon. Friend the Secretary of State for Health of £150 million of new national lottery money, which will result in better education of the public, new cancer screening, new treatments and improved technology.

The Bill is backed by the main cancer charities, and especially Macmillan Cancer Relief, which is devoted to caring for people with cancer. It provides about 1,700 nurses nationwide and has invested about £70 million in building projects to provide the tender loving care that is needed by cancer patients and their families. I want to express my gratitude to Macmillan for its support and advice on the Bill and to other cancer charities and organisations such as the Cancer Research Campaign, the British Association of Cancer United Patients, Marie Curie, Breakthrough Breast Cancer, Sargent, the Royal Marsden hospital and the Institute of Cancer Research.

I was astonished to find that, at present, there is no central register or directory of cancer care services. The information is fragmented by type of cancer or by region or is simply non-existent, especially for the rarer cancers. From speaking to patients, carers, nurses, doctors, consultants and researchers I believe that there is overwhelming support for such a directory.

The Bill would require the Secretary of State for Health regularly to review cancer services and to produce a guide to identify the type of cancer care provision; areas of

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greatest need; the range of treatment; information for patients on the different strains of the disease; performance statistics for cancer care centres, in particular, the number of patients treated; the facilities available; and the survival rates--and to place it on an internet website and disseminate it through NHS Direct so that it is widely available. The directory would need to be maintained, reviewed and evaluated.

The directory would allow patients access to current information on the cancer that affects them, the specific details of the treatment that they can expect to receive, the quality of the cancer care at their local or referred centre and contact information for charities and support groups. For the primary care groups to which we can look forward, it would give information on availability and extent of treatment locally and nationally, on the results of on-going trials, on new technology and on points of contact. It could be used by many organisations worldwide.

I salute the courage of all cancer sufferers and their families. Day in, day out they battle under enormous mental and physical strains. They have to take the good and the bad news from doctors and battle through sickness, tiredness, pain and fear. They dread the surgery, the chemotherapy and the radiotherapy that can cure them.

I know the damage that can be done by cancer. My father, Tom Marsden, died of the disease 14 years ago. I have also seen it at first hand in the Shropshire and Mid-Wales hospice, which I have visited regularly and on behalf of which I hope to complete the Flora London marathon on Sunday. I sincerely look forward to other hon. Members being present, in mind if not in body.

We must celebrate the courage of those affected by cancer and remember that survival rates are 50 to 60 per cent. on average, and much higher for specific types of cancer. I have seen the professionals in the front line at the Royal Shrewsbury hospital. In particular, I thank Dr. Rajiv Agrawal and Tim Cooper, the manager of the radiotherapy unit. They have given unstinting support, advice and help in the preparation of the Bill and they and their team of nurses are dedicated professionals helping and caring for cancer sufferers every day.

We should support the medical professionals through more funding for research and better information in the effort to find new cures for cancer. The Bill would go a small way towards helping everybody--patients, carers and medical professionals--and I urge the House to support it.

Question put and agreed to.

Bill ordered to be brought in by Mr. Paul Marsden, Dr. Evan Harris, Miss Julie Kirkbride, Mrs. Helen Brinton, Mr. Kevin Barron and Dr. Doug Naysmith.

Cancer Care

Mr. Paul Marsden accordingly presented a Bill to make provision about cancer services in the United Kingdom; to make provision for monitoring and improving the quality of cancer treatment and care provided by the National Health Service; to require the Secretary of State to undertake a new review and report on cancer services in the United Kingdom; and to provide for making such information available to the general public: And the same was read the First time; and ordered to be read a Second time on Friday 30 April, and to be printed [Bill 82].

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Orders of the Day

Access to Justice Bill [Lords]

Order for Second Reading read.

Madam Speaker: I have selected the amendment in the name of the Leader of the Opposition. I have had to impose a 15-minute limit on Back-Bench speeches between 7 pm and 9 pm.

3.40 pm

The Minister of State, Lord Chancellor's Department (Mr. Geoffrey Hoon): I beg to move, That the Bill be now read a Second time.

The Access to Justice Bill is the most important legal reform of the past 50 years. It is radical and innovative. It is a significant step in restructuring our legal services better to protect the rights of our citizens. It will focus legal services on people's real needs. It presents a considerable opportunity and a considerable challenge to all who work in the law.

Few people who have been through our justice system would argue that it does not need fundamental reform. It is slow, expensive and unpredictable. We are determined to deliver a modern justice system that meets the needs of all our citizens in the modern era. The public demand, and we must deliver, a justice system in which they have the utmost confidence. We will not be diverted from that task by reactionary elements in the legal professions. The legal system is not an end in itself; it is for and about the protection of people and of society. It protects our basic rights. Our legal services must serve the users and society generally, rather than the needs of those operating the system.

The one attempt at reform by the previous Government, the Courts and Legal Services Act 1990, was a half-hearted effort which, ultimately, failed to deliver the changes needed to make the legal world serve the needs of its clients and society. Our intention with the present Bill is to go much further--to reorient legal services away from the interests of lawyers towards the needs of customers and the wider public. That is the central ambition of our reforms and the central aim of this modernisation.

Before dealing in detail with the Bill's provisions, the House will want to examine carefully the content of the Opposition's reasoned amendment. I hesitate to describe the amendment as "reasoned" because, despite its length, it gives little insight into what--if anything--the Conservatives really think about these proposals. They seem to be against them, no doubt for cynical and opportunist reasons, but what do they actually believe in?

Can the Conservatives, who presided over a 20 per cent. cut in eligibility for legal aid while they were in office, and who in 1993 cut more than 25 per cent. of the population out of the green form scheme, really claim now to be the guardians of access to justice? Can members of a party whose Government introduced conditional fees allowing 100 per cent. uplifts now complain four years after the event that that was wrong in principle as it supposedly increases the cost of litigation?

Are the Conservatives against the concept of the Legal Services Commission in principle? Are they against the criminal defence service? Does their concern about

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imposing statutory restrictions on the Crown Prosecution Service mean that, not unsurprisingly, they are lining up with those reactionaries who want to maintain, or even extend, restrictive practices in the law?

What is most worrying about the reasoned amendment, however, is that the official Opposition do not appear to have read the Bill very carefully. There is no suggestion in the Bill that there will be a system of wholly state-employed prosecutors or defenders. Moreover, the powers that the Bill grants to the Lord Chancellor to alter the rules of the legal professions, far from being unilateral, can be exercised only with the approval of Parliament. Are the Opposition really claiming that that is an insufficient safeguard?

Let me now explain what the Bill actually does. It creates the community legal service which will be responsible for considering the need for civil and family legal services. It will build up a pattern of legal services to meet that need as far as resources will allow. It creates a criminal defence service which will replace criminal legal aid. Publicly funded criminal defence services will continue to be available in all cases where the interests of justice require it.

The Bill makes the success fee in conditional fee arrangements and insurance premiums recoverable in costs; that will greatly extend the use of no win, no fee agreements, ensuring that the successful claimant is not punished by a reduction in damages.

The Bill extends full rights of audience in principle to all lawyers, and sets up a system for regulating the legal profession with a dynamic for further change. It will ensure that civil appeals are heard at the right level and that they are dealt with in a way proportionate to their weight and complexity. It will change the organisation and management of magistrates courts so that they can better serve the public and help with our plans to make the criminal justice system more co-ordinated and speedy.

Why are we introducing the Bill at this time? It is essential that the United Kingdom maintain an effective justice system. Our system of justice has many admirable features--in particular, the many lawyers who work, sometimes without payment, for the disadvantaged and on cases that do not always meet with popular approval.

Access to justice is far from perfect, however. Services available from lawyers can be disproportionately expensive. Instead of predictable prices, those with potential legal cases are intimidated by the prospect of an open-ended bill drawn up after the event. That can discourage not only those with limited means, but the relatively well-off. The system is biased towards court-based solutions, even when alternatives to court may work better.

We have a patchwork quilt provision of legal advice, which has been stitched together over time by solicitors and the funders and providers of advice in the voluntary sector, without any thread of co-ordination. Nor is the quality of legal services always as good as it might be. The volume of complaints that the Law Society's Office for the Supervision of Solicitors receives shows growing dissatisfaction with the services of some solicitors.


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