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3.46 pm

The Parliamentary Under-Secretary of State for Health (Yvette Cooper): I join hon. Members in congratulating members of the Select Committee on Science and Technology on their report into cancer research, and on today's debate. The report and the debate have been far-reaching on the subject of cancer, which is extremely important because lives are at stake. I congratulate the hon. Member for Rayleigh (Dr. Clark) on his able and expert chairmanship of the Committee in complex scientific and medical territory, and on producing a well-informed and thoughtful report.

The Committee's deliberations, hearings and conclusions have contributed to the Government's developing work on cancer, particularly in the run-up to the publication of the national cancer plan. I believe that today's debate will also make a contribution, as it is an area where a considerable amount of work is under way.

The national cancer plan was published after the report and, for the first, time drew together as part of a single strategy work on prevention, screening, treatment, support for patients, palliative care and research. It is the first time that this country has had a national overarching strategy on cancer. We should not underestimate the significance of that because, although it does not sound like rocket science to draw together all those strands, it is fundamentally important, to improve treatment, care and

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research across the board, that we co-ordinate properly our work on cancer, which is one of Britain's biggest killers.

It is in the context of the national cancer plan that I want to reply to many of the issues raised today. The Committee's report makes it clear that we face a serious problem. Each year, 200,000 people are diagnosed with cancer and 120,000 die of it.

This country's strengths include research, children's cancers, rapidly developing prevention services such as smoking cessation, national health service screening programmes and palliative care, particularly as a result of the tradition of the hospice movement and the voluntary sector. However, the Committee and the House are right that some aspects give cause for concern. Survival rates for some cancers do not match those in the rest of Europe. We have huge inequalities in who gets cancer and who survives it. Those on low incomes are more likely to get cancer, and they are also less likely to survive it. The quality of care varies across the country and there is a long legacy of underinvestment in cancer infrastructure, equipment and staffing, which reduces the quality of care.

The national cancer plan aims to produce a turnaround--to build on progress that has been made so far but to go further and deliver the fastest improving cancer services in Europe, and to push our survival rates up to match the best in Europe.

We have already made considerable progress in cutting waiting times, in new international standards, new investment, new equipment and in bringing new services on stream, but it is absolutely right, and the Committee is right to say so, that we have much to do.

We have set out in the national cancer plan proposals for extra spending of £570 million on cancer each year by 2003, expanding capacity with 1,000 extra cancer specialists in the pipeline; new equipment; extra services, such as extending breast cancer screening; new prevention and palliative care services; new research programmes; reform of cancer collaboration to speed up care; and new national standards and guidelines to improve the way in which we provide services and raise quality, too. That is the greatest focus on cancer in the history of the NHS, and it provides a huge opportunity. Today's debate reflects the priority given to cancer in the House as well as by the public.

We have had a good debate. The hon. Member for Rayleigh kicked off by referring to the importance of increasing investment and the importance of the National Cancer Research Institute. Concerns about the cancer registries were raised by many hon. Members. My hon. Friend the Member for Middlesbrough, South and Cleveland, East (Dr. Kumar) referred to the importance of patient involvement and the geographical spread of research, and of ensuring that research takes place throughout the country.

The hon. Member for Ruislip-Northwood (Mr. Wilkinson) spoke in detail and with expertise about the work being done at Mount Vernon. My hon. Friend the Member for Norwich, North (Dr. Gibson), who has done much in the House to promote the debate on cancer, described articulately the need to improve cancer survival rates and to cut waiting times. The hon. Member for Isle of Wight (Dr. Brand) referred to the importance of basic research and proper networks for research and cancer care.

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My hon. Friend the Member for Birmingham, Selly Oak (Dr. Jones) rightly referred to the excellent work under way in Birmingham, which I have seen for myself and applaud. She also raised concerns about the cancer registries, with which I shall deal later. The hon. Member for Bosworth (Mr. Tredinnick) spoke of the potential for complementary and alternative medicines in helping patients to deal with cancer.

My hon. Friend the Member for Brighton, Kemptown (Dr. Turner) spoke in detail about the importance of the national cancer research institute and of further co-ordinating cancer research. My hon. Friend the Member for Bolton, South-East (Dr. Iddon) referred to the need to spread new technology and to ensure that staff are properly trained to deal with it. The hon. Member for Runnymede and Weybridge (Mr. Hammond) referred in detail to a series of matters, including research on the cancer registries and treatment, to which I shall attempt to respond.

I shall deal first with research, as that formed the core of the Committee's report and has been referred to in detail today. Many forms of research are needed. Laboratory research helps us to understand the genetic and cellular changes. Genetics research is needed into who is at risk of cancer; epidemiological studies are required into the causes of cancer; and clinical trials are needed to find better ways of treating cancer.

This country makes a major contribution to all aspects of cancer research. We have world-renowned scientists, doctors and many others, working in centres of excellence funded by the Government, the cancer research charities and the pharmaceutical industry. Although we should be proud of the excellence in place across the country, three major concerns about cancer research emerge from the Committee's report: first, the research needs greater co-ordination and strategic direction, given the many different organisations involved; secondly, improved research infrastructure is needed; and, thirdly, there are concerns about the level of investment. I shall deal with each of those concerns in turn.

We very much recognise the need for greater co-ordination. The initial step in tackling that was the setting up of the Cancer Research Funders Forum in 1999. The forum includes the Department of Health, the Medical Research Council, the Imperial Cancer Research Fund, the Cancer Research Campaign, the Ludwig Institute and Marie Curie Cancer Care. It has been a considerable success in starting better to co-ordinate cancer research across the country. It has done a lot of work in developing the national cancer research network. We asked it to conduct a review not only of the gaps in prostate cancer research, but of the direction that should be taken in the key areas and the overall strategy for prostate cancer research.

That is an example of the potential to take forward research through the Cancer Research Funders Forum, but the Committee was absolutely right to say that we need to go further. That is why we set out in the national cancer plan proposals to create the national cancer research institute, picking up the Committee's work on the subject. Like the Committee and most of the charities and researchers, we agree that a single bricks-and-mortar facility would not be the best way to make progress in co-ordinating cancer research. However, it will be an organisation in its own right, with staff and the weight to

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work consensually with all the different organisations to develop an over-arching strategy and to ensure that all cancer research is properly co-ordinated.

The Government would disagree with the Committee in that all Government funding needs to flow through that organisation. We believe that the institute can co-ordinate the funding from the different organisations and that there are advantages--for example, for the Medical Research Council--in linking basic cancer research with other forms of basic research. For example, the human genome project will be beneficial to cancer research as well as having considerable benefits for other research.

The second concern that has been raised about research is the importance of improving the infrastructure. We strongly believe that we need to improve the clinical research infrastructure in this country. That is why we have announced the creation of a national cancer research network. Two groups will work together to achieve the overall aims. A consortium involving the universities of Leeds and York and the MRC clinical trial unit will concentrate on operating a network for controlled trials.

Professor David Kerr will lead the NHS contribution to early studies translating advances in basic science into promising new treatments for cancer through a network of centres. That research network will be integrated into, and work closely with, the National Cancer Research Institute. That approach has been broadly welcomed by the charities and represents a huge step forward, and we are putting an extra £20 million into it.

We strongly agree on the need to boost investment. That is why we are boosting the investment through the science budget by an average of 7 per cent. a year in real terms over the next three years. It is also why we are increasing the money specifically for cancer research. In 1995-96, £50 million was spent on directly commissioned cancer research from the Department of Health and the MRC. That spending increased to £73 million in 1998-99, before the plan, and it will be £105 million by 2002-03, doubling the direct investment since the election. Of course, as we set out in the plan, we are increasing the overall Government funding to match voluntary sector funding.

I shall briefly deal with the cancer registries. Clause 59 of the Health and Social Care Bill includes a regulation-making power, which will allow the Secretary

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of State to require information to be passed on for important purposes. That will provide a legislative solution to the problem of the cancer registries. It is important, however, that the cancer registries also recognise issues of patient confidentiality. That is why work is under way to consider the use of anonymised data and to develop technical solutions to the problems of linking records, which may help us to find alternative ways to deal with patient confidentiality. It is certainly true that clause 59 will provide a legislative solution, and there will be time to discuss that in detail in Committee.

Let me deal briefly with the other treatment and care issues that have been raised. We set new targets for waiting times across the board, not simply those to see a specialist, but those for diagnosis and treatment. Those targets are coming into place this year. There is a one-month target for the wait between diagnosis and treatment for breast cancer. If the hon. Member for Runnymede and Weybridge remains so opposed to the two-week target for the wait to see a consultant, does he plan to state in the Conservative manifesto that he would abolish it?

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