Select Committee on Science & Technology Minutes of Evidence

Examination of witnesses (Questions 1-19)




  1. Welcome, Minister. It is nice to have you back. It is your first time in your new position.
  (Ms Blears) Indeed, it is.

  2. Congratulations. I am sure we will have a very pleasant time.
  (Ms Blears) Indeed.

  3. Can I say we have had the Government's response to our follow up report which was published in June and really we do appreciate the positive tone in it but we have still got this doubt in our mind about justifying where the money comes from and goes to, and that is what we are trying to unravel. We are very grateful to you for coming to see us. I just want to give you the opportunity to open up and make any statement you would like to make at this point before we go into the questions.

  (Ms Blears) Thank you, Chairman and Members of the Committee. I would just like to begin by thanking you for inviting us back for another opportunity to expand, perhaps, on any of the elements which are in our response to your original report. I have been following the chronology of this inquiry quite closely and it has been going on for quite some time, I think, with your original report in 2000. I think it is fair to say that many of the recommendations in that original report have really helped us in setting up a good infrastructure for cancer research: the National Cancer Research Institute together with the cancer research networks which we are able to map on now to the cancer service networks and, very importantly, the NTRAC centres of excellence where we will be able to really, I hope, make a push on translating the research. I think the phrase is from bench to bedside, which I think is a lovely phrase, but actually really to get the benefits of the scientific research into the clinical services for the patients absolutely key on our agenda. I am very conscious that Members are concerned about the funding: where has it gone and what is it doing. I share those concerns and I am pleased that the Committee has raised those issues. Also, I note the Committee was very concerned about the regulations to be laid under Section 60 of the Health and Social Care Act, trying to ensure that cancer registries could still continue to operate and provide the essential data for us to look at incidence and surveillance and prevention work too. I am delighted now that those Regulations have been laid and approved by both Houses. They were not without their controversy, as I am sure you will appreciate, they were fairly controversial Regulations but those are now through. Just by way of update, I am pleased to be able to inform the Committee that the cancer registries themselves are looking at perhaps further ways in which they can anonymise data which may help with patient confidentiality in the future, so that agenda is continuing to move on. I know you were impatient about those Regulations, and rightly so, but we have managed to achieve that now. I think there is a range of recommendations here in your follow-up report which, again, will be very useful to us in Government to enable us to press on with what is one of the most important areas certainly of my portfolio.

  4. Thank you very much for that. I take it there is nothing specific in the spending review. I heard it myself in the Chamber. I did not hear cancer mentioned but no doubt it will benefit from the general increase to the Health Service anyway, there is nothing specific?
  (Ms Blears) Not at this stage but clearly Members will know that we have had a historic increase in funding for the National Health Service over the next five years which will give us a good long term planning base in which to improve all our services. Clearly cancer is one of our top priorities—cancer, coronary heart disease, mental health, older people—and therefore we have seen, already, tremendous increases over the last spending review. I think a 30 per cent increase over the 1999 base line, investment in equipment, staff, consultants and facilities, all of which were under-funded. I am sure the extra investment announced a little while ago for health will flow in fact through into cancer as it will into all of our other priorities for the health of the community.

  Chairman: As you know, this Committee has been very excited by the identification of cancer as a priority and has supported it and made suggestions to make sure it moves on. Can I move on to you, Bob, to ask the next question.

Bob Spink

  5. Certainly. You mentioned the 2000 Report, our predecessor Committee's Report, and the recommendations they made.
  (Ms Blears) Yes.

  6. There was a recommendation to spend £200 million on cancer research and we note that you told us in February that your Department spent £190 million on cancer research in 2000-01 but we note also that still included up to £30 million by the Higher Education Funding Council for England and about £5 million on the NHS R&D. So we just wonder when you are going to actually get down to achieving the target of £200 million? Do you have any particular time frame in mind?
  (Ms Blears) I do not have specific information on that. What I would say is that I know the £190 million was a concern of the Committee on the last occasion, as to what the component parts were of that £190 million, whether it was pure NHS money, whether it included the Higher Education money and the R&D support money as well. I think that all the statements which have been made on this issue are prefaced, usually, with the phrase that comparisons of cancer research funding are fraught with difficulty, that is the phrase which has come up time and time again. I think it is right to say that, that trying to drill down into the service to look at what are pure cancer research monies and what relates to other multi-purpose dual kinds of research is quite difficult. Certainly I have been keen to pursue some examples. There was a concern of the Committee that this was rebadging, if you like, of some monies. Therefore I have been quite keen to see what are the kinds of examples of where there might be dual research going on which benefits not just cancer but, for example, coronary heart disease as well. It is quite difficult to say this is just for cancer and that is just for coronary heart disease. One of the examples which has been outlined to me is a programme to look at the development of comprehensive gene sets for mice and humans and to dissect shared genetic pathways. What that means really is looking at the genetic make up of mice and humans to see what genes they have got in common which may well have an impact not just on cancer but also on coronary heart disease. To say that was a pure research programme on cancer would not be the right thing to say but clearly neither is it just a research programme for CHD, it is actually multi-based scientific research. Really I do want to say at the outset there is no intention on the part of the Department or Government to have a cynical exercise in rebadging this expenditure. It is genuinely the case that it is difficult to put it simply into one pot or another. The £190 million is the figure that I am able to say to the Committee today. I do not know whether my colleague wants to go into any further detail about the timescale for the extra investment?
  (Dr Hamilton) The additional investment that we have laid out is an extra £20 million over three years, which we mentioned to you last time, for NCRN, an extra £4 million for prostate cancer research. That will take us in excess of £190 million, as you know, that we have laid out already in the figures that we presented to you last time.

  7. You reckon that £20 million a year for three years will take you above the £200 million mark?
  (Ms Blears) Yes.
  (Dr Hamilton) Yes.


  8. The Wellcome Foundation when it does its research says it does not fund cancer research, it does actually very basic genetics and so on so it does not badge it as cancer or whatever, it says we do not fund cancer research. Are you classifying basic research as cancer research is the question? Is that what you are saying to us?
  (Ms Blears) What we are saying is there will be some examples of that. As I understand it, the NCRI currently is going through a process of actually validating what projects are going to be known as cancer research. What is important about that is that all the different parties will have a role, the voluntary sector as well as Government and the MRC in coming to an agreed consensus as to what constitutes cancer research because it is a wide variety of things. I think it is very important in this that there is honesty and openness. Therefore, having a dialogue with all the parties to say "We think this is cancer research, would you agree it is" and then to get that validated by NCRI is really important to us.

Bob Spink

  9. When will the NCRI study results be published?
  (Ms Blears) In the autumn, as I understand it.

  10. The autumn of this year?
  (Ms Blears) The autumn of this year.

  11. If can just go back to the earlier comment made. You mentioned that there was £25 million and £5 million being spent in other areas which would be additive to the £190, does that mean that the target we are looking at now is £225 million over 2001-02? Is this a new target we can consider or what? What is the target for the current year? Do you have the figure or is it just as much as you can get?
  (Ms Blears) I think our original target was to be contributing the same as the voluntary and charitable sectors. That was where we were aiming to be. As it has turned out, as we have analysed what the spend is, we have got up to that level before we needed to and we will be beyond that level, as we understand it, because, again, we are saying that the amount of spending in the voluntary sector is about £180 million. That might be a movable feast, as ours is a movable feast, I was going to say it is not a science but clearly it is. In terms of trying to fix on it, where we want to be is that we are an equal partner in Government with the voluntary and charitable sectors and we are there already. The extra £20 million that is going in is really as well about trying to fund the cancer research networks properly with their proper infrastructure too.

  12. Do you think it would help if the Government published a report with some real meaty detail on definitions of where the money is spent detailing what money is being spent in cancer research, under what heads of terms, so that we do have total transparency and we build trust and get away from this rebadging question which is rather murky? Do you think that would be helpful?
  (Ms Blears) I think that is exactly what NCRI actually embarked upon by having this dialogue with all the partners to get transparency and agreement as to what the situation is.
  (Professor Richards) Can I just add to that. Absolutely, as the Minister says, it is trying to get that transparency in a level of detail that we have never had before, looking at all the major partners in cancer research, from the Government point of view that is obviously the Department of Health and the Medical Research Council but also the charity partners. I think what is important to say is that there is an independent panel made up of members from all those partners actually looking at this database. They are adjudicating on what goes into the database and not and if there are any disputes there is going to be an external adjudicator from the National Cancer Institute in the United States. I think we can be sure this is as transparent a process as you can possibly have.

  13. The Government will be publishing figures with these definitions at some stage because in your response to our Report, which was very positive and very welcome, you avoided giving us a specific answer on that so I am trying to squeeze you now for one.
  (Ms Blears) The NCRI will be doing that.

  14. That will be the Government setting out exactly what is spent in what projects so that everybody can see over and above board that this is real cancer research money.
  (Ms Blears) Absolutely. I think the added value to that is that it will not just be the Government saying it, it will be our key partners saying it together.

Mr McWalter

  15. Can I just say on that, first of all I think the example you have given about genetic susceptibility to cancer is a very good one. I think clearly the Committee is very strongly of the view that sort of work should go on. Clearly the Government then announces £5 million or whatever for such a project, we would welcome it, we would look it and so on, that is fine. What worries us is the Government on Monday announces £5 million for that project, then it thinks it is quite relevant to say ten areas of its activities and so there is a half a million of it potentially to be ascribed to cancer, as it were, and then on Tuesday it announces a cancer figure which includes that £0.5 million which it has announced on Monday already as part of this more generic programme. That is the kind of confusion that we feel has been in the system. We want to make quite clear that while we welcome a general programme which has got a cancer component, we want to see, firstly, funding that is clearly cancer directed and, secondly, a clear statement of the resources which are being applied to areas of study which have a recognisable cancer component also. Do you think you will be able to do that?
  (Ms Blears) Yes. I think that is exactly the direction where we want to go. We have no interest in not having a clear picture ourselves as to what expenditure is being made, what projects it is being made on and what programmes are part of it. There is absolutely no intention on the part of the Government to double count and seek to deceive.

  16. There is an interest because it makes for better headlines. If you have one headline on Monday saying "We have this fantastic programme about genetic susceptibility" and then you have another announcement on Tuesday saying "We have devoted all this money to cancer", there is an interest in doing that. I am pleased to hear you are taking ruthless steps to distance the Government from any such shenanigans, that would be correct, would it not? You looked as if you were worried about what I was saying there, Professor Richards?
  (Professor Richards) Not at all. I think we are going for openness, exactly as the Minister has said. We are going for openness for your benefit but also for our benefit so we know exactly what is happening too.

Dr Turner

  17. Minister, as you are aware, cancer clinicians have been coming to me feeling very concerned because they wonder where the money to fund the cancer plan has got to. You are very familiar with the plan. Their understanding is the same as mine which is there is a plan for service growth to be funded. You have identified new money and they have not seen it. I can tell you all they have seen is their share of the £76 million which was earmarked for this financial year. Now your answer to our criticism or the comments in our report which the Department took great exception to says it went into general allocations. Our original criticism had been that clearly it had not been passed along with any sort of label or structure or earmarking to make sure that health authorities spent it on cancer services because the situation, as I said we all know, is that health authorities' finances have been so stretched that any new money, if it does not have a clear label on it, is soaked up immediately in meeting their cost pressures. So I have checked with these massive volumes which I understand to be the way in which the Department communicates with health authorities and tells them what their budget is about and for the first year of the cancer plan it makes no mention whatsoever of any cancer allocations. I have managed to find about £20 million in the pink pages on the centrally funded initiatives but of the rest it has presumably just gone into the global pot, as far as I can tell from this, with no identification whatsoever. Do you have any other way of communicating this intention because it is not in the regular format?
  (Ms Blears) Right. I think this is an extremely important area and I know the Committee was very concerned that money for cancer from reports that you were getting, and indeed I was getting, was not getting to the front line of the service to fund the improvements which we wanted to see happen. The situation for 2001-02 was there was an extra £255 million in the base line with £25 million centrally allocated for the network so that is the £25 million you have identified there. I will come back to deal with how we are trying to follow through what happens to the base line monies shortly but for 2002-03 there will be £76 million earmarked and therefore more tightly controlled than was the previous case in the previous year. There will as well be another £51 million central allocation again to the networks in that way.

  18. I found that.
  (Ms Blears) You will have £76 million central, £76 million earmarked and then the base line allocation. It is important that we try and follow the money through to see what has happened. Therefore what will happen is we have been meeting with all the heads of the cancer networks to really ask them "From last year's money what did you get for it" because it is clear that some of the best ones spent something like 80 to 100 per cent of their base line allocation actually on achieving improvements, and some of the others did not. Therefore we have to follow through what exactly it was that they got for the money we put in there. Now we have agreed a template for each of the networks to report to us on that so we will at least have a follow through for them.


  19. Is that list available? Is that transparent in all of this?
  (Ms Blears) That is only just being developed as we speak to go through that process so we can follow through what was done there. The final point I want to make on this is that obviously we are shifting the balance of power. There is a tension between devolving money to the organisations to achieve improvements and for us to look at, if you like, what the outputs are. Are they meeting the waiting times? Are they meeting the targets? Are they improving their services? That is not going to be directly correlated to identifying a spend on each item but we need to keep that tension and that balance and that dynamic going at the same time as drilling down and finding what they have spent it on.

previous page contents next page

House of Commons home page Parliament home page House of Lords home page search page enquiries index

© Parliamentary copyright 2002
Prepared 12 August 2002