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2.20 pm

Mr. John Wilkinson (Ruislip-Northwood): I pay warm tribute to my hon. Friend the Member for Rayleigh (Dr. Clark) and his Select Committee for their outstanding report. I served on the Science and Technology Committee almost 30 years ago, but do not remember any of our reports offering such a wide range of potential benefits to the community as that which is before the House.

I shall point out how the admirable recommendations of the Select Committee relate to the work of Mount Vernon hospital, Northwood, in my constituency, which is one of the premier cancer treatment and research centres in the south of England and, indeed, the whole country. Recommendation (e) states:

We recommend that the Government and the National Screening Committee evaluate high speed and precise techniques with a view to commencing large-scale trials for CT cancer screening. This would require the NHS to purchase state-of-the-art diagnostic equipment.

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Mount Vernon is pre-eminent in that field. Recommendation (g) states:


We recommend that the Government address the service problems in the delivery of radiotherapy and actively encourage research into radiotherapy.

Mount Vernon hospital has worked in this field since the second world war.

Recommendation (n) states:

We believe that cancer care networks should also provide an essential resource for clinical research and that research based on cancer networks should be given more emphasis than was evident in the Calman-Hine report itself. Clinical research should be an explicit part of the remit of both cancer centres and their associated units.

This is precisely what Mount Vernon is all about--the co-ordination and integration of medical treatment with cancer research. Recommendation (z) states:

There is widespread agreement that the poor state of the infrastructure for cancer treatment and research in the NHS is a serious barrier to clinical research. The Government must act quickly to address this through investment in the necessary staff, training, equipment and buildings.

Mount Vernon's work is second to none and the intellectual quality of all who work there is outstanding, but the fabric of many of its buildings is declining and needs to be addressed.

Last, but not least, recommendation (oo) states:

We recommend that annual NHS R and D funding for cancer research support be increased by £100 million immediately. This extra funding should be spread across the UK to ensure that approximately twelve large centres of cancer research excellence are developed, capable of delivering a volume of clinical research similar to or greater than that currently being delivered at the Royal Marsden Hospital.

Mount Vernon is in the Royal Marsden hospital league already, but it needs more money. Its research is largely supported by extremely generous donations, but the Government can and should do more.

Mount Vernon was established in 1930 as a cancer hospital, having begun operation before the first world war, and it quickly established a reputation in surgery and radiotherapy. The Radium Institute, which was originally established in central London in 1911, moved entirely to Mount Vernon in 1939. The radiotherapy department of the Middlesex hospital became established at Mount Vernon during the war. With the establishment of the national health service, a centre for radiotherapy for the north-west Thames region was established at Mount Vernon under the direction of Professor Sir Brian Windeyer.

To general medicine and surgery--well established on the site since the war--was added the centre for plastic surgery in 1952. Hon. Members are aware that in many cases, plastic surgery is an essential element in cancer treatment and rehabilitation. Sad to say, it is planned that the plastic surgery unit at Mount Vernon might be moved away from the site to Northwick Park in the not too distant future. I regret the move and have resisted it, but it does not mean that the excellent work of the cancer centre cannot continue.

The Gray laboratory was established in 1957 on the Mount Vernon site by the British Empire Cancer Campaign, now the Cancer Research Campaign. It was initially a unit for radiobiological research, but after the death of its first director, Dr. Gray, it was called the Gray laboratory and soon gained a premier position in research

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in its field. Now responsible to the Gray laboratory cancer research trust, with a staff of almost 100, it continues to play a leading role in radiation and tumour biology. The work performed in collaboration with the clinical oncologists of the cancer centre has received widespread international recognition. In many areas of research, the laboratory is ahead of the field worldwide.

In 1967, the Marie Curie hospital--established in 1926 in Hampstead for the care of women with cancer--was transferred to the Mount Vernon site and became part of the cancer centre. In 1977, Michael Sobell house, a hospice for terminal patients, was built adjacent to the site and later expanded to give out-patient as well as in-patient services.

The cancer centre at Mount Vernon is long established as a regional centre caring for a population of 1.8 million living in Hertfordshire, south Bedfordshire, adjacent areas of Berkshire and Buckinghamshire, and the suburbs of north-west London. Sixteen consultant medical staff visit 15 general hospitals in the area, where patients with cancer are initially seen and screened. Patients who are to receive radiotherapy or intensive chemotherapy go on to attend the cancer centre at Mount Vernon for their treatment, and return closer to home for follow-up treatment.

At Mount Vernon, about 4,200 new patients a year with cancer receive treatment by radiotherapy and/or chemotherapy. The centre currently has five linear accelerators for radiotherapy, but work is proceeding on two further accelerator housings, which should be installed this year, bringing the total number of high energy machines to seven. With the new building which is being constructed, a new treatment simulator is to be added to the two at present in action, and there will be an extension of the research facilities of the Marie Curie research wing.

There are 65 in-patient beds in three wards, together with a unit for high-dose chemotherapy. Complementing in-patient facilities is a hostel, a CHART--continuous hyperfactionated accelerated radiotherapy--lodge, which was constructed in 1990. It contains comfortable hotel rooms, which are extremely useful for patients undergoing chemotherapy or for their relatives to stay nearby.

The Paul Strickland scanner centre was opened in 1985 and has been extended on three occasions. The centre is supported by voluntary donation and is now equipped with a spiral computed tomography, two magnetic resonance imaging units and a positron emission tomography scanner. That equipment provides an excellent service for the radiological investigation of patients attending the centre, facilitating diagnosis, treatment planning and the assessment of response. During 2001, a cyclotron will be built in collaboration with industry, so as to allow further advance in the care and research that the PET has facilitated.

I must inform the House that a most imaginative scheme, the Lynda Jackson Macmillan centre, was opened in 1993 to provide support and information to cancer patients being treated at the Mount Vernon cancer centre and to the area served by it. Approximately 4,000 patients per annum use the service, and a psychological research team has undertaken several studies which show improvement in the quality of patients' lives and demonstrate that the centre is instrumental in giving them

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and their families invaluable support. The centre has recently gained an NHS beacon award, which is a Government recognition of high-quality cancer care.

The cancer centre provides comprehensive care in the treatment of patients with cancer. There are special groups concerned with breast cancer; cancer of the upper and lower gastrointestinal tract; gynaecological cancer; urological cancer; germ cell tumours; head, neck and lung cancer; and haematological malignancies, including myeloma and lymphomas. A traditional strength of the centre is close integration of clinical care and research, which is at the heart of the Select Committee's recommendations. The translation of laboratory advances into clinical practice has long been a feature of the work at Mount Vernon, which is built on the strong links with the Gray laboratory.

The Cancer Research Campaign's tumour biology and radiation therapy group is sited in the Marie Curie research wing at the cancer centre. Professor Saunders, Dr. Hoskin and Dr. Makris have established an international reputation for its work on the physiology of tumours and the importance of their oxygen supply, together with programming radiotherapy to improve tumour responses and decrease the changes in normal tissues. The clinical trials group at the centre, under the direction of Dr. Rustin, has established an international reputation for its work in ovarian cancer. It is also engaged in original work looking at vaso-active drugs that shrink tumours by attacking their blood supply. A new clinical research group headed by Dr. Rob Glynne-Jones has been established to investigate the role of combination chemotherapy in the treatment of intestinal cancer.

The cancer centre at Mount Vernon plays a prominent role in the pan-London training scheme for doctors training in clinical oncology. Again, the Select Committee is adamant that we need to do more to train more specialists in that field. There are 24 junior medical staff at the cancer centre, whose registrars are trained in clinical oncology and medical oncology. Seventy nurses, including clinical nurse specialists and nurse practitioners, are responsible for the care of the patients on the ward, while 40 therapy radiographers operate and treat patients on the treatment machines. Postgraduate training for nurses and radiographers is continued at the centre, and they are encouraged to take part in research projects. Six clinical physicists and two radiographers are responsible for patient planning, together with the running of machines, quality assurance and the commissioning of new equipment.

There are difficulties at present. Organisational changes have been made and medical and surgical services have been shifted away from the Mount Vernon site. There has been a change in ownership of the site as a whole, which comes under Hillingdon health authority, whereas regional specialist services in cancer, burns and plastics are the responsibility of the eastern region to the north of the hospital. That dichotomy does not make administrative sense. It is accepted that the everyday working of the cancer centre has been made more complicated by those transfers.

As a consequence, the cancer centre is now a lodger in its own home. Maintenance standards of property have fallen and it is often difficult to get improvements to basic support services without making an enormous effort.

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Nevertheless, it is remarkable that, despite all those problems, the number of patients treated at the Mount Vernon cancer centre continues to rise. The standard of care continues to improve, while morale and staffing levels have been maintained. The centre's popularity among the patients attending remains high, and its national and international reputation continues to rise. Those performing clinical research, together with their colleagues in laboratory science, have performed well. The work of established research groups has been assessed by teams of doctors and experts from the United Kingdom and overseas and has always been given a high rating.

Funding has been maintained and, in some cases, increased. New proposals for research have a high success rate. I am convinced that the Select Committee proposals, which I wholeheartedly applaud, can only help the admirable work of the Mount Vernon cancer centre and its related research institutes.

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