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National Cancer
3.31 pm
Dr. Ian Gibson (Norwich, North): I beg to move,
- That leave be given to bring in a Bill to make provision for cancer services and to establish priority for the treatment of cancer in the allocation of resources within the national health service.
Mr. Speaker: Order. Will hon. Members leave the Chamber quietly please?
Dr. Gibson: There are those who argue that even if the diagnosis rate of one in three becomes one in two, given the increased longevity of the population in this country, we will be covered by current plans. It is also possible that cancer will become a chronic disease, we will live longer with it and advances in medical science will allow us to contain it for longer.
The Government reacted with determination to the Select Committee's July 2000 report on cancer services. They invested in radiotherapy equipment and set up the National Cancer Research Institute, incorporating charities, industry, research councils and Government Departments in a new, exciting partnership that has concentrated on a national strategy to improve cancer services, set up new research programmes, scrutiny of those programmes, advance clinical trials and arrange treatment in our cancer centres and hospital departments.
The Select Committee report also said that long-term continuity of purpose underwritten by an Act had served cancer research well in the USA. On the other side of the big pond, the National Cancer Act 1971 is now the subject of a campaign for revision by the US Senate. It is a robust Act that has stood the test of time. It has ensured that, year in, year out, the US health budget for cancer services and research is ring fenced and given bypass budget status. It has ensured long-term planning independent of bureaucratic delays and battles over funding.
The Bill would, I hope, provide the same in the UK and ensure that we have a truly national cancer programme. It would strengthen and solidify the authority of the National Cancer Research Institute, placing its funding on a statutory basis, thereby enabling it to tackle current problems of the postcode lottery, drug approvals, clinical trials and cancer registration, which is a thorny problem.
To ensure delivery, we might take a leaf from the USA, which is setting up a network of tsars—cancer quarterbacks, as they are called over there—whose remit is to ensure that each patient throughout the nation is guided through the cancer journey, from diagnosis to treatment and care. The success of the USA's programme—to which the need for this Bill is related—involves paying off the debts of medical and nursing
students to get them into the system; the training of new researchers, nurses and other groups; further regulation of tobacco sales; and new screening programmes for breast, cervical and colorectal cancer. The list goes on and on.Although it is true that the financing systems in America are different, I do not mention America because it has a different system of health care provision. Such an initiative should prove easier in this country, because we have just one system: our national health service. American legislation ensures research and clinical development, so treatment and care merge into one another to give better patient benefits. Bill Clinton says that cancer deserves the same respect as the war in Afghanistan, the war against terrorism and the war effort at home. We might decry his use of military terminology in respect of cancer, but the House will get the message.
Year on year, we need to address the problems and to match the excellence achieved in cancer hospitals such as the Royal Marsden and the Christie. As an ex-medical colleague said to me the other day:
- "The best cancer services in this country are provided by dedicated cancer hospitals, such as the Marsden, the Christie, etc. In these hospitals people get faster and better investigation and treatment, usually with newer drugs and types of treatment than are available elsewhere. The physicians at these hospitals are the engine room of clinical cancer research in Britain. They provide treatment which cannot be bettered anywhere in the world.
At present, UK clinicians cannot compete with their US colleagues because they are working with their hands tied. It is hard to enter patients into trials."
There is now great confidence—precipitated by the activity of this Government—in the cancer movement and community in this country. What is required is the surety of an ongoing funding mechanism, which would result in the better survival rates and treatments for which we are aiming.
The Bill would provide the necessary stability to ensure that existing cancer structures are funded, and that new initiatives are encouraged year on year. I commend it to the House.
Bill ordered to be brought in by Dr. Ian Gibson, Joan Ruddock, Miss Julie Kirkbride, Jane Griffiths, Dr. Desmond Turner, Mrs. Patsy Calton, Jonathan Shaw and Sandra Gidley.
National Cancer
Dr. Ian Gibson accordingly presented a Bill to make provision for cancer services and to establish priority for the treatment of cancer in the allocation of resources within the National Health Service: And the same was read the First time; and ordered to be read a Second time on Friday 21 June, and to be printed [Bill 137].
Opposition Day
[13th Allotted Day]
Post Office Closures
Mr. Speaker: I inform the House that I have selected the amendment in the name of the Prime Minister.
3.38 pm
Dr. Vincent Cable (Twickenham): I beg to move,
- That this House is deeply concerned that, with 10 months left for the transition to automatic credit transfer for the Post Office's 16 million benefit and pension customers, there is great uncertainty and confusion hanging over the network; believes that, in the absence of new sources of income to replace the lost £400 million, many post offices will close, including a third of all urban post offices; is alarmed by reports that new initiatives promised under the PIU Report are failing, in particular that the Your Guide programme is being downgraded and that planning of the Post Office Card Account is well behind schedule; has little confidence that the commercial banks have the ability or motivation to meet the financial needs of many of those Post Office customers expected to migrate to the use of bank accounts; notes that the network's problems coincide with growing losses in Consignia and the threat to its mail services and to the universal service obligation; and calls on the Government to set out a clear policy and timetable for heading off a potentially disastrous collapse of the rural and urban network.
A big national project is looming—in 10 months, there will be a changeover to the automated credit system. I do not want to be melodramatic, but the project is very big. The technical and commercial challenge is probably on the scale of metrication, or of the millennium bug. It is appropriate for the House to take stock of where the Government have got to with their planning, and of what the consequences will be.
In my business career I was taught never to predict the future but to think in terms of scenarios. I do not know whether the project will be a success or not. It could be a brilliant success, but we need to think of alternatives.
The optimistic view was set out in the performance and innovation unit report at the end of 2000. I supported it, as did most other hon. Members. It was ambitious and forward looking, and dedicated to finding alternative sources of income to make up for the £400 million that will be lost to the network as a result of the introduction of ACT. If the PIU report is implemented in full, or something approaching that, the changeover will have a relatively positive outcome.
According to a different scenario, however, that £400 million in income to the network will not be replaced. Hon. Members who are new to the House might be interested to learn that the consequences of that were set out most graphically in a parliamentary answer three years ago to the former hon. Member for Birmingham,
Erdington, now Lord Corbett. He achieved what no one else, before or after, has been able to achieve: he secured a constituency breakdown of the number of post office branches, and got the Post Office—and the Government, I guess—to analyse the implications of a loss of income from the post office network of £400 million.The overall conclusion was that there would be 40 per cent. fewer branches, but results were very skewed. Constituencies such as mine would lose very few branches, but rural constituencies—especially in Wales, Scotland, Devon and Cornwall—would lose a great many. The biggest casualties would be the urban post offices in areas predominantly represented by Labour Members. In some cases, such areas would lose between 70 and 80 per cent. of their post offices.
That was the bleak, doomsday scenario, but a lot has happened since. The PIU report has been published, and we need to take stock of where we have reached.
A problem with the PIU report, and its follow-up, is that it is rather unclear about what is happening. When the Select Committee on Trade and Industry evaluated the PIU report, it gave the rather pithy summary that "much remains unclear". Almost everything that the Select Committee found unclear—the amount of income that the Post Office will get, the way in which the Post Office card account system will be phased in, and the nature of the contract and of the technology—remains unclear and uncertain today. I shall take the Ministers present today through the various steps indicated by the PIU report, and I hope to be able to ask them questions about the matter.
The first point concerns the most interesting, ambitious and forward-looking idea—the "your guide" scheme. Under the scheme, postmasters and postmistresses would become general practitioners dispensing advice and help to customers. They would have the advantage of advanced technology. They would be properly trained and have access to a computer system that would give them local and national data, and they would help people with their transactions.
The system was tested, quite properly, by means of a pilot scheme centred on the constituency of the Secretary of State for Trade and Industry, among others. The feedback has been rather positive, and shows that some 130,000 people have used the system over the six months during which the pilot has been in operation.
In the past few days, however, I have heard a report that the "your guide" scheme is being ditched because the Treasury has pulled the plug on it. I am anxious to hear the Government's reaction to that.
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