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House of Commons

Tuesday 21 December 1999

The House met at half-past Eleven o'clock


[Madam Speaker in the Chair]


City of London (Ward Elections) Bill (By Order)

Order for consideration, as amended, read.

To be considered on Tuesday 11 January.

Oral Answers to Questions


The Secretary of State was asked--

Coronary Heart Disease

1. Mr. Lindsay Hoyle (Chorley): If he will make a statement on the development of coronary heart disease services. [102260]

The Secretary of State for Health (Mr. Alan Milburn): The White Paper "Saving Lives: Our Healthier Nation" set a target to reduce the death rate from heart disease, stroke and related illnesses by at least 40 per cent. by 2010. Modernising cardiac services is one of the Government's top health priorities.

Mr. Hoyle: Does my right hon. Friend accept that more investment is needed for coronary heart disease services, both locally and nationally and especially in the north-west, as there is a dire need to ensure that lives are not lost at the rate that they were in the previous 18 years? When will he provide details of authorities' allocations for 2000-01?

Mr. Milburn: I agree with my hon. Friend that there is a need to modernise our cardiac services, in his part of the country and elsewhere, because they suffered years of neglect under the previous Government. That is precisely why we have made the modernisation of cardiac services one of our top priorities. Today, I have placed in the Vote Office details of health authority allocations for the year beginning April 2000, and the average cash increase is 6.8 per cent. compared with 6.6 per cent. for this year. That is sensible sustained investment, which will continue the Government's 10-year programme of modernisation,

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and it includes extra money for cardiac services so that thousands more heart patients can get the early access to heart surgery that they need.

Mr. Nick St. Aubyn (Guildford): Does the Secretary of State recall promising the House that hospital consultants would

How does he reconcile that promise with a letter from the senior cardiologist at the Royal Surrey hospital--a copy of which I sent him two weeks ago--saying that there has been a 20 per cent. cut in the budget for heart tests at the Royal Surrey and in the region since the Government came to power as a direct result of his reforms and the transfer of responsibility for that budget from local doctors to the local health authority?

Mr. Milburn: On the specific issue, I am aware of the correspondence and some of the cases that the hon. Gentleman and the right hon. Member for South-West Surrey (Mrs. Bottomley) have raised, but I understand that those allegations are not wholly substantiated. I shall be meeting the right hon. Lady this afternoon to talk about some of the issues, but the hon. Gentleman has to be very careful: it is not true that, somehow or other, the problems with cardiac surgery began on 1 May 1997. We acknowledge that there are problems, but the truth is that cardiac services in our country suffered years if not decades of neglect when his party was in office. We have the appalling coincidence of Britain having some of the highest rates of cardiac heart disease and some of the lowest rates of cardiac intervention in the developed world. We are putting that right by investing more money, which his party opposes.

Mr. Dale Campbell-Savours (Workington): Although there is a crying need for resources for coronary heart disease services throughout the country, may I, on behalf of my constituents, congratulate the Government on allowing a rate of increase to health authorities that is triple the rate of inflation? That is almost unprecedented in British history.

Mr. Milburn: My hon. Friend is absolutely right--we are putting more money into the national health service and today we are paying the second instalment of the record cash injection that my right hon. Friend the Chancellor of the Exchequer announced a year ago. That is money for modernisation and it is opposed by the Conservative party, which described it as reckless, mad and irresponsible. Conservative Members cannot have their cake and eat it--even their Christmas cake, at this time of year--and, even though my remarks are not seasonal, they cannot get away with complaining about the state of cardiac services and opposing extra investment in our public services at the same time. They have to come off the fence. It is about time that we had honesty in the debate from the Conservative party: does it support or oppose extra investment in our key public services?

Mrs. Marion Roe (Broxbourne): Can the Secretary of State confirm whether the promised extra money for cardiology is new money or part of the extra £21 billion

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that has already been allocated over the next three years? If it is part of that £21 billion, which other services will be cut to fund it?

Mr. Milburn: The hon. Lady needs to understand that that is extra money on top of the extra money that is already going in this year. There is extra new money this year, extra new money on top of that next year and extra new money on top of that the year after. She should also understand that all that extra investment is opposed by the Conservative party under its tax and spending plans because its priority is tax cuts for the privileged few, which would be achieved at the expense of public services for the many.

Mrs. Caroline Spelman (Meriden): In this "year of delivery", how does the Secretary of State square his announcement of an increase in the number of heart specialists by more than 400 with the fact that, according to the chairman of the British Medical Association, those specialists are already on the NHS training ladder? In the new Labour lexicon, does the word "extra" mean the same in relation to the number of doctors as it means in relation to the number of police on the beat?

Mr. Milburn: That was a tricky one! As the hon. Lady knows fine well, there is a difference between doctors in training and doctors in post. I decided that there would be extra consultant posts.

There is a difference between being in training and being in post. The Opposition are in training; we are in post.

Cancer Treatment

2. Mr. James Clappison (Hertsmere): What recent representations he has received about the availability of cancer treatment. [102261]

The Parliamentary Under-Secretary of State for Health (Yvette Cooper): The Government receive many representations about the availability of cancer treatment from the public, and from professional organisations.

The Government have made cancer one of their top priorities, and have appointed Professor Mike Richards national cancer director. Professor Richards has already started to meet professional groups to discuss future developments in the improvement of cancer care.

Mr. Clappison: As prostate cancer is set to become the commonest male cancer in the next millennium, is there not a strong case for a prostate screening programme for men of the appropriate age? When can we expect such a programme?

Yvette Cooper: Prostate cancer kills about 10,000 men each year, and we take it extremely seriously. Population screening is not currently recommended, on the advice of the national screening committee, but, as I have said, we take the issue seriously, and have asked the committee to re-examine it in the new year. It will be doing so.

Mr. Win Griffiths (Bridgend): We have the Calman- Hine guidelines relating to cancer services, but we know that they have not been followed in all parts of the NHS.

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Will my hon. Friend take it on herself to ensure that best practice is observed throughout the health service, so that all cancer sufferers are given the best possible treatment regardless of where they live?

Yvette Cooper: I entirely agree with my hon. Friend, and we are committed to ending the unacceptable lottery of care--the postcode lottery--throughout the country. Even more unacceptable is the fact that those who are least likely to survive cancer live in low-income areas. We have appointed Professor Mike Richards as national cancer director so that he can examine exactly those issues, and improve cancer care across the board.

Mr. Nick Harvey (North Devon): The Government's new priority on cancer is welcome, but are they not putting the cart before the horse in establishing the policy of a two-week wait between referral and consultation? How many trusts are meeting that target? Is the World Health Organisation not correct in saying that the policy is flawed unless the necessary resources are provided to ensure that it can be delivered?

Yvette Cooper: I can tell the hon. Gentleman for a start that, according to the most recent figures, 95 per cent. of women who are referred urgently in connection with breast cancer are seen within two weeks. That has been the first roll-out of the two-week wait; we will extend it in regard to other cancers over the next two years.

I am surprised by Opposition Members' objection to the two-week wait. Patients with suspected cancer are extremely anxious. Will Opposition Members go into the next election promising to end the two-week wait?

Mr. David Taylor (North-West Leicestershire): I congratulate the ministerial team on the launch of the cancer services collaborative. It includes nine national networks, one of which is in Leicestershire and involves the north-west Lancashire primary care group and Glenfield hospital. Is my hon. Friend aware of the cloud of uncertainty that hangs over that hospital, and especially over the breast care unit, which was opened by the last Secretary of State for Health? Will she give careful consideration to any proposals from the area health authority that would downgrade the hospital and jeopardise the excellent work done by the breast care unit and by the hospital in general?

Yvette Cooper: I shall certainly look into those points. My hon. Friend is absolutely right that the introduction of cancer collaboratives is an example of superb and best practice in introducing and improving cancer care across the country. The collaboratives will smooth patients' experience, so that they no longer have to wait and are able to book admissions and receive care when they want it.

Dr. Liam Fox (Woodspring): The director of the Cancer Research Campaign's education group says that the Government's cancer initiative has led to a waste of resources and a waste of specialist time. The professor of cancer medicine at Imperial college says that the whole approach is flawed. He also said that we have a shortage

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of more than 500 cancer specialists, a £1.2 billion backlog in radiotherapy equipment, and need £170 million a year more for chemotherapy. Which of those figures does the Minister think is wrong?

Yvette Cooper: As the hon. Gentleman raises those points, I assume that he will welcome the 6.8 per cent. cash increase to health authorities across the country, which allows them not only to improve treatment for cancer care and treatment, but to address all health issues. Whereas the Government are committed to ending the unacceptable lottery of care, Conservative Members want to replace it with a new lottery which is based on patients' ability to pay.

Dr. Fox: That was an appalling evasion even for a Minister in this Government. Although the Minister has decided to give the soundbite of the day rather than answer any questions in the House, will she say why--when we are supposed to have a national health service, and the cancer initiative is under way--the proportion of patients seen within two weeks varies so hugely across the country? The fact is that 98 per cent. of patients in the south-west have been seen within two weeks, whereas the percentage is only 61 per cent. in the north-west. Why?

Yvette Cooper: As I said, we are determined to end the unacceptable lottery of care. Who does the hon. Gentleman think introduced the lottery of care in the United Kingdom? It was introduced by the previous Government. They introduced the internal market, which has created unacceptable variations in care right across the country. This Government are determined to do something about the situation, and we are implementing policies to do exactly that.

Dr. Fox: We have a Health Minister who cannot answer the basic questions asked by the professor at Imperial College and who does not know why cancer outcomes in the north-west are so bad. We also have huge regional variations in access to care; poorer outcomes than comparable countries in cancer treatment; staff shortages; and, now, rationing of medicines and half a million people simply waiting to get on the waiting list. In other words, we have a national health service that is not national, and in which health targets are not being met and services are well below par. Is it not true that, in Labour's so-called year of delivery, the Government's health policies are a complete and unmitigated disaster?

Yvette Cooper: The hon. Gentleman refers to international comparisons, but the most extensive international comparisons date from the mid-1990s. I am therefore still wondering who he thinks is responsible for the condition of cancer care in the United Kingdom. The Government have made delivering on cancer our top priority, and that is exactly what we shall do. That is why we have spent an extra £70 million on improving cancer care since the general election, and why we shall spend an additional £80 million on it in the next two years. How would Conservative Members afford any of those improvements, given that they believe that our increased health spending is reckless and irresponsible?

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