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Shona McIsaac (Cleethorpes) (Lab): I have been listening carefully to the debate. I recently received a
complaint from a constituent about a new form of cold calling—automatically calling many numbers at once. A person's phone may continue to ring all night, but whenever they pick it up the line is dead. Would the Bill cover that sort of activity?
Mr. Truswell: It would not prevent cold calling from being conducted by a telesales firm. We are trying to combat those who turn up on the doorsteps of vulnerable people, inveigle their way into their homes, then proceed to rob them, at best, or sometimes to assault or even to kill them.
I realise that the Government—even this Government, and even given the caveats attached by the right hon. Member for Bromley and Chislehurst—are loth to introduce bans and will do so only as a last resort. However, those who work at the sharp end day after day, week after week, and month after month to deal with these villains feel that every other legal avenue, including those mentioned by the OFT, would be insufficient to tackle the problem.
I shall give an example of the type of case that we are dealing with. It is rather graphic and extreme, but it gives some idea of the scale of the problem. During Brian Steele's period as head of the West Yorkshire murder squad, he unfortunately had to investigate the murder of an 82-year-old lady called Isobel Gray. Isobel was severely disabled with curvature of the spine. She was a serial victim of bogus property repairers, and was eventually murdered by distraction burglars who knew that she had paid those people in cash, which was her big mistake. They forced their way violently into her home, tortured her to discover the whereabouts of the cash that they knew she kept in the house, broke her back and left her to choke on her own vomit. That is an extreme and graphic case, but an important one.
Mr. Sutcliffe: Would my hon. Friend also like to describe the way in which Detective Steele spoke to the individual responsible and what he had to say?
Mr. Truswell: My hon. Friend pre-empts me—I was about to speak about that. Any Bill that deals with such matters deserves the title "Isobel's law". My hon. Friend the Minister and others know about the Home Office-funded research that Brian Steele conducted into distraction burglaries. It involved interviewing several perpetrators in prison. Anyone who has heard Brian speak on the subject or read his research will be aware that he describes graphically how the perpetrators did not show the slightest remorse for their crimes and viewed older people merely as the impersonal objects of their cunning and proud trade. They said that they could smell money in an older person's home. They also told Brian that they were prepared, if thwarted and if all else failed, to do what they called a "naughty one" and use violence to achieve their ends. They described the way in
which they bought and sold the names of their victims—victims, presumably, such as Isobel Gray.Tackling the problem is not easy. That is why those who are responsible for trying to deal with the villains have reached the conclusion that only a Bill such as the measure that the hon. Member for Blaby is promoting will work in practice.
Dr. Andrew Murrison (Westbury) (Con): Does the hon. Gentleman agree that it is not simply a problem of people trying to sell something on the doorstep but of people trying to buy things from vulnerable people on the doorstep? In welcoming the important measure that my hon. Friend the Member for Blaby (Mr. Robathan) is promoting, perhaps the Minister will extend his cross-cutting, joined-up approach with the board that he has announced to cover those who wish to buy from vulnerable and elderly people.
Mr. Truswell: The hon. Gentleman makes a good point. Perhaps my hon. Friend the Minister would like to intervene to give such a commitment from the horse's mouth. I know that he is covering the whole issue of cold calling and doorstep crime.
As the hon. Member for Blaby and I have reiterated, the Bill is narrowly targeted on a specific aspect of cold calling. If the hon. Member for Westbury (Dr. Murrison) reads the Minister's response to my Adjournment debate last week, I am sure that he will find the reassurance that he seeks.
It is not easy to deal with the problem. The hon. Member for Blaby mentioned last year's Trading Standards Institute survey, which involved interviewing 9,000 people. Worryingly, approximately 62 per cent. of householders reported receiving cold calls in the previous month. It is therefore prevalent in our society. Even more worrying, 21 per cent. reported a recent bad experience. It is clear from such research that the hon. Gentleman is right to point to the fact that the existing official figures for cold calling probably dramatically under-represent its prevalence.
Another worrying aspect was the low level of household security. Only 13 per cent. of people reported asking for identification and only 1.3 per cent.—a pathetic handful—would ever check them.
It is tempting to continue but I shall truncate my speech to give my hon. Friend the Minister a few minutes to respond. He knows the points that the hon. Member for Blaby raised and that people such as me will continue to grind away at him. I know that he accepts that the extent of the problem is far greater than the official statistics suggest. I therefore emphasise that it is not only time to act but to do it soon and courageously. If we do that, perhaps Isobel Gray will not have died in vain.
2.29 pm
The Parliamentary Under-Secretary of State for Trade and Industry (Mr. Gerry Sutcliffe): I cannot deal with all the points that have been made but I congratulate the hon. Member for Blaby (Mr. Robathan) on raising important issues. We have spoken about them several times and I have also discussed them with my hon. Friend the Member for Pudsey (Mr. Truswell). Although we believe that there are deficiencies in the Bill, we want to implement its spirit. We shall examine the Office of Fair Trading report and we have already made an announcement. I believe that the hon. Member for Blaby makes a genuinely valid point and that we need to examine all the points that he raises.
Yesterday, I was in Birmingham—
It being half-past Two o'clock, the debate stood adjourned.
Debate to be resumed on 26 March.
Remaining Private Members' Bills
HEALTH AND SAFETY AT WORK (OFFENCES) BILL
Order for Second Reading read.
To be read a Second time on Friday 14 May.
CIVIL SERVICE BILL
Order for Second Reading read.
To be read a Second time on Friday 14 May.
NOMINATION OF SELECT COMMITTEES
- That the Standing Orders be amended as follows:—
(1) In Standing Order No. 15 (Exempted business), line 18, leave out from 'committees' to 'which' in line 20 and insert 'to which that paragraph applies'.
(2) In Standing Order No. 121 (Nomination of select committees), line 10, leave out from 'under' to ', or' in line 13 and insert 'the Standing Orders of this House (with the exception of the Liaison Committee, the Committee of Selection, the Committee on Standards and Privileges and any Committee established under a temporary Standing Order).'.
As an Amendment to Mr Peter Hain's proposed Motion (Nomination of Select Committees):—
Mr Eric Forth
Line 7, leave out from first 'Committee' to end and add 'and the Committee of Selection).'.—[Margaret Moran.]
Prostate Cancer
Motion made, and Question proposed, That this House do now adjourn.—[Margaret Moran.]
2.31 pm
Dr. Howard Stoate (Dartford): Thank you, Madam Deputy Speaker, for giving me the opportunity to raise this debate in the House. This is a subject of great importance to many hon. Members and to many of our constituents across the country. This debate is timely because prostate cancer is highly relevant to two of the main themes that have dominated the policy debate on health care over the past year. They are the concepts of extending patient choice and of promoting greater engagement by the public in their health care.
Today I would like to focus on the potential benefits that extending choice can bring to prostate cancer patients, as well as on some of the challenges that we will face if this goal is to be delivered effectively. The undoubted opportunity presented by choice is that it can, in a way that is consistent with the values of the NHS, give a patient and his family a greater range of treatment options throughout the patient journey, allowing him to become more involved in decisions on his own care. The challenge is that, if all men are to benefit, these treatment options must be readily available to all, regardless of where a patient lives, and that accessible and understandable information setting out both the benefits and risks of different treatment approaches should be readily available.
In fact, men have been quietly exercising choice in regard to prostate cancer for a considerable time. Should they have a prostate specific antigen—PSA—test? If they are diagnosed with the condition, what course of treatment should they have? What impact will this have on their quality of life? What will be the impact on life expectancy? Should they, in fact, have any treatment at all? Unfortunately, in the past, these choices have often been exercised without adequate support or advice. The challenge that we all face is to change that, and I am pleased to report that good progress has been made, although there is still a lot to do.
The Government took an innovative step forward on choice, even before the concept assumed its current high political profile. The prostate cancer risk management programme was introduced following the publication of the NHS prostate cancer programme in 2000. It introduced the principle of informed choice for men thinking about taking a PSA test. As a practising GP, and chair of the parliamentary all-party group on men's health, I know only too well that the issue of PSA testing is a controversial one. Last year, I chaired a debate on the subject and it was clear that there were strong feelings on both sides. The issue lies in the reliability of the test, which unfortunately throws up many false positives and negatives. This obviously has implications both for men and for the health service as a whole. In my view it is therefore right that a man's decision on whether to take a PSA test should be a personal choice. However, for choice to work, accurate and impartial information is essential. The prostate cancer risk management programme, which is intended to enable a man to discuss both the advantages and potential drawbacks of taking a test in an impartial way with his GP, is a welcome step forward.
In the absence of a more reliable test—and I welcome the Government's commitment to introduce universal screening when such a test becomes available—informed choice offers many potential advantages, and I know that it is generally welcomed throughout the field of prostate cancer. Inevitably, some teething problems exist, but I am sure that those can be overcome. The focus is mainly on awareness and the understanding of the risk management programme, on which I will touch later.
The NHS prostate cancer programme, which incorporates the risk management programme, has been widely welcomed, and has led to real service improvements. The two-week maximum waiting time between a GP suspecting that a patient has cancer and that patient being seen by a consultant has offered timely reassurance to many men at a time when they face great uncertainty. Many of my patients have benefited from that, and it is difficult to overestimate its importance both in boosting confidence and in giving reassurance to people at a very difficult time.
We are now some four years on from the launch of the programme, and as we seek to take the next step forward in prostate cancer policy, it is important to assess exactly what impact the risk management programme and the wider NHS prostate cancer programme has had. Certainly, I would welcome a commitment by the Minister to producing an interim report on the prostate cancer programme, including an appraisal of the risk management programme. Clearly, substantial progress has been made in terms of waiting times and investment, but we now need a clear and realistic assessment of exactly what has been achieved, and what remains to be done, so that we can move forward in a constructive way that benefits patients.
The case for action is clear. Prostate cancer is now the most common form of cancer in men in the United Kingdom, with more than 27,000 men being diagnosed every year. It is also a major killer: prostate cancer kills about 10,000 men each year in the UK. That is approximately one man every hour. The political desire for action is also overwhelming. The prostate cancer charter for action, which has been very effective in making the case for action on prostate cancer, has the support of 232 parliamentarians on both sides of the House, including Front-Bench health spokesmen in each of the major parties. An early-day motion that I tabled back in January now has more than 130 signatures, and I know that the charities involved in prostate cancer are very grateful for this clear demonstration of support.
Effective action requires a joint commitment from the Government, health professionals and the voluntary sector. All stakeholders need to work together in partnership to share ideas and expertise and, where necessary, to pool resources to deliver improvements in services for men. In this sense, the establishment of the prostate cancer charter for action, which brings together the key organisations with an interest in prostate cancer, is a vital step. I take this opportunity to thank the prostate cancer charter for action for the briefing that it provided for me ahead of this debate, as well as the efforts that it takes to keep me informed about its work. I know that the signatories to the charter, which now number 21 different organisations, all undertake a great
deal of good work on behalf of men and their families, and I am sure that the whole House will join me in thanking them for their efforts.The Minister is no doubt aware that the prostate cancer charter for action was both facilitated and funded by the GUS charitable trust—an organisation that has no commercial interest in prostate cancer and yet has recognised the pressing need for action to tackle this high-incidence male cancer, as well as the potential that is offered by greater collaboration. I am sure that the Minister will join me in congratulating the GUS charitable trust—the charitable arm of GUS plc—on its commitment. I can only hope that other charitable trusts and organisations will follow its lead in promoting greater collaboration among the many voluntary sector organisations that do such valuable work.
I know that the charter signatories were very encouraged by the Government's decision to act on their call by establishing the Prostate Cancer Advisory Group, chaired by Professor Mike Richards, to facilitate collaboration and advise Ministers on the development of policy. It seems to me that both the advisory group and the charter for action have a great deal of potential for improving collaboration—both within the voluntary sector and in the formulation of Government policy—for a wide variety of diseases and conditions. I have previously heard Professor Mike Richards praise this model, and the Minister may wish to outline her vision for rolling it out to other disease areas.
Since the advisory group's establishment, it has taken on an ambitious programme of work, all of which, if delivered, will help to extend choice in a positive way. The group has proposed the establishment of a national prostate cancer website. That completely independent site will create a focus of information for patients, professionals and policymakers, providing intelligent signposting to all sources of information. The Prostate Cancer Advisory Group agreed that, in the spirit of partnership, and to ensure genuine independence, the voluntary sector should make a contribution to the costs of developing the website. I understand that this contribution has now been secured by the prostate cancer charter for action. I would therefore welcome a commitment from the Minister that her Department will indeed fund the remainder of the development costs for the national prostate cancer website.
The group is also developing a decision-making tool to enable men to make an informed and independent choice about what form of treatment is best for them, taking into account the trade-off that may have to be made between quality of life and eradication of the cancer. At present, no such tool exists, and this often leads to a patient having to rely on the advice of a clinician, which may be based more on what the clinician knows or believes than on what will necessarily suit the individual patient's circumstances.
I understand that the Prostate Cancer Advisory Group is planning to convene a workshop for experts on prostate cancer and other diseases from around the world to help develop such a tool. Hopefully that will enable the NHS to lead the world in terms of treatment decision-making tools for patients. I ask the Minister to use her influence to enable the conference to be convened as soon as possible, and to ensure that all the relevant experts are invited. I also ask her to commit
herself, once it has taken place, to early piloting of the tool so that NHS patients can benefit from it as soon as possible.The advisory group is considering public awareness. Information and awareness are an important precursor to informed choice. It is very difficult for a patient to decide whether to have a PSA test, or indeed what course of treatment to opt for, if he does not even realise that he has a prostate. Public awareness of the prostate, however, is a difficult issue to tackle owing to the problematic nature of the disease and our relative lack of knowledge about it. There is no definitive form of treatment, and, as I said earlier, the poor reliability of the PSA test remains an obstacle. What should be the message or call for action contained in any campaign is therefore a matter for debate.
In his recent report, Derek Wanless made a number of helpful observations. In particular, he said that any campaign would have to have clear and measurable objectives, and that we would need to ensure that public awareness or information campaigns reached all sections of society, not just those who could be considered "health-literate". Those issues must obviously be resolved if public awareness of the prostate and its function is to be effective.
The work on public awareness will be an important test of the ability of the Prostate Cancer Advisory Group model to develop accepted solutions to difficult problems, and advance the quality and effectiveness of policy. I ask the Minister to throw the Department's weight behind the principle of public awareness of prostate cancer, and to urge all parties involved to work together to develop solutions.
National men's health week between 14 and 20 June, which will focus on men and cancer, will give us an ideal opportunity to raise public awareness of prostate cancer. A men and cancer manual featuring a section on prostate cancer, produced in the same format as a Haynes car manual, will form the centrepiece of this year's men's health week. I am grateful to the Minister for her Department's contribution of £30,000 towards the production of the manual.
I also welcome the Prostate Cancer Advisory Group's plans to develop multidisciplinary training mechanisms for the whole health care team. Improving the team's understanding of each other's roles can only help to improve the quality of impartial advice given to the patient, so increasing the ability to make an informed choice as well as enhancing the quality of care ultimately delivered.
I was speaking to Dr Nav Chana, a fellow GP, earlier this week. He made the important point that patient choice will only ever work if the NHS has the necessary capacity to provide a full choice of treatment options, underpinned by high-quality impartial information, for every man throughout the patient journey. I know that that sentiment is shared by the vast majority of patients and health professionals.
The sustained increase in investment provided by this Labour Government is building the capacity necessary to deliver a world-class health service for all, fit for the 21st century. That is vital to everything I have raised today. I know how committed the Minister is to sustaining the investment, and I hope that she will take
this opportunity to reaffirm that the Government will not waver in their determination to build the necessary capacity to achieve that goal.I hope that in a few years I shall be able to stand in the House and praise this Government for successfully developing a cure for a disease which, after all, affects the lives of so many men and their families. I know that we are still some way from achieving that, but then again I know that I shall be in the House for a considerable time! The large increases in funding for research into prostate cancer that the Government have already delivered are a very important step in the right direction. I hope very much that it will deliver results, both in moving towards a cure and, in the meantime, in providing more effective treatment options and therefore greater choice. A commitment from the Minister that the increases in funding for research that have been delivered so far will be sustained would be welcomed by stakeholders.
Let me end by reaffirming that patient choice presents a number of promising opportunities to improve the deal for men with prostate cancer. As a GP and as one who is committed to improving men's health, I am greatly encouraged by the progress that the Government are making, in partnership with voluntary and professional organisations, in taking practical and positive steps to extend choice. Although there is still much to be done, I am sure that the mature and constructive attitude taken by the Government and the prostate cancer charter for action, working together through the Prostate Cancer Advisory Group, will pay dividends.
As the voluntary sector seeks to work with the Government to deliver on the important calls to action embodied in the charter for action and the terms of reference of the advisory group, I am sure that it would welcome the Minister's comments on the issues I have raised today. It would particularly welcome the possibility of an interim report on the NHS prostate cancer programme, an update on the progress being made in securing funding for the national prostate cancer website, and the Minister's support for an expert conference to advance thinking on patient decision-making tools.
I thank the Minister for her ongoing commitment to improving public health, and in particular for the part that she has played in tackling this disease, which disrupts the lives of so many men and their families.
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