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Bob Spink: In those sad cases in which the condition is terminal and palliative care is needed, the child may eventually go to a children's hospice. The Minister will know that Government funding for children's hospices is dire. On average, the Government provide only 5 per cent. of funding for children's hospices, and they provide only 1.5 per cent. of the funding, which is far too low, for the Little Haven children's hospice in my constituency. Funding for children's hospices should at least be on a par with that for adult hospices, which receive an average of 18 or 20 per cent. of their funding from the Government. Will the Minister take that message back to his Department, and not give the usual answer that it is up to primary care trusts and strategic health authorities to make those decisions? He should make sure that funds are directed to those important caring services.
Dr. Ladyman: I accept that those services are important, and wish that I could magically provide a pile of extra money for them. I also wish that I could avoid saying what the hon. Gentleman asks me not to say, but I cannot. Under "Shifting the Balance of Power", the reality is that we give the vast majority of the money for the national health service to local PCTs. We expect PCTs to commission services locally according to the needs of their local populations, which includes palliative services for both adults and children. It is important that those who run children's hospices, as well as those who run adult hospices, engage with their local PCT to ensure that it understands the services that they provide locally and to encourage it to fund them. That said, I am happy to give further thought to the hon. Gentleman's words, but I cannot promise that I will somehow come across a pile of money in the Department of Health to fund palliative services.
Mr. Bercow: I know that the Minister would not seek to abdicate responsibility for that which properly falls within his bailiwick. First, if he is confident that real and worthwhile progress is being made, there can be no argument against the establishment and promotion of public service agreement targets for what the Government intend to do. Secondly, support for bereaved or affected families is a political matter, not a clinical matter—will he undertake to provide the additional support craved by those affected?
Dr. Ladyman: We are currently writing a national service framework for children.
The national service frameworks are the way in which we at the centre set the standards that we expect to be delivered locally. The national service framework for children is the most complex that we have yet written. It is occupying a great deal of my time, because I am determined to have it published as soon as possible. I assure the hon. Gentleman that all the comments made in the debate—
It being Ten o'clock, the motion for the Adjournment of the House lapsed, without Question put.
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Motion made, and Question proposed, That this House do now adjourn.—[Joan Ryan.]
Dr. Ladyman: I will ensure that all the comments made in the debate are used to inform the final preparation of the national service framework. Perhaps I can give the hon. Gentleman some comfort by saying that the national service framework is used to help us to create the performance framework for the national health service. In other words, it will be used to identify the factors that we set as the targets against which we expect to measure the NHS in future. Obviously, I cannot predict what the national service framework for children will contain, but it may well be that during the progression of the national service framework, and the creation of the planning frameworks that follows, we will be able to move forward on a lot of what the hon. Gentleman is asking for.
We expect the NICE guidance that I mentioned to be published in February next year, but a draft version will be available for consultation in July this year and will give the NHS a clear indication of the type of services that NICE thinks should be provided.
The hon. Gentleman suggested, as did my hon. Friend the Member for Waveney and as have charities working in this field, that further work needs to be done on screening programmes to identify brain tumours in children. The National Screening Committee advises the Government about all aspects of screening policy. It assesses proposed new national screening programmes against a set of internationally recognised criteria covering the condition, the test, the treatment options, and the effectiveness and acceptability of the programme. Such assessment is intended to ensure that programmes do more good than harm, and at a reasonable cost. Although screening has the potential to save lives and improve quality of life through early diagnosis of serious conditions, it can never be 100 per cent. accurate. It should be seen therefore as a process of risk reduction.
We can screen only when there is the evidence to do so. There is currently insufficient evidence to support screening for brain tumours. Any screening activity would involve children having an image taken by using computerised tomography or magnetic resonance imaging. It is difficult to ensure that those procedures are carried out satisfactorily for children even where problems are already suspected. As the hon. Member for Castle Point said, such facilities are not necessarily child friendly; they can be rather frightening.
Even greater problems would be involved in attempting to screen all children—hon. Members did not suggest that, but some charities have—where there is no evidence of problems and no guarantee that we could make an accurate assessment. Such a move would absorb a disproportionate amount of professional expertise and staff time, with little to show for the child. Using computerised tomography would also involve significant radiation exposure. By screening children irrespective of whether they have symptoms, we run the real risk of identifying things that would never have caused a problem, but cause great worry to parents and perhaps even to older children and young people. In addition, many of the children would need to be sedated or given general anaesthetic, with all its associated risks, to ensure a satisfactory image when using those
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technologies. I am sure that those who call for these measures would appreciate the logistical difficulties involved in carrying out this procedure for hundreds of thousands of children.
In summary, screening for brain tumours would place tremendous pressure on services that are needed for people with already-suspected problems. Not only that, but unnecessary worry may be caused to some parents and there is little, if any, evidence that the programme would have any benefit. However, these issues are always kept under review by the National Screening Committee and should new evidence emerge it would of course reconsider its position. I would certainly want to receive its advice as soon as such evidence was available.
At this point, I should like to set out my own personal support for the invaluable work and support carried out by the hundreds of charities dedicated not only to children with cancer but to those in the rest of the population who have been diagnosed with the disease. The voluntary sector and patient groups play a crucial role in raising awareness of cancer, and also in providing patients and their families with emotional and physical support. They also facilitate a stronger user voice, improve the experience of care and enable greater choice and responsiveness of the service for users.
Improving the prevention, detection and treatment of cancer and the care of people with the disease is a key priority for the Government. Through the hard work
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and dedication of staff working in the national health service and voluntary sector, and through record amounts of investment, we have made significant improvements since the NHS cancer plan was published. I know that there is work still to be done to improve services for children with cancer, but we have come a long way. I am confident that we can make even further strides forward in the coming years, and if we receive the same kind of co-operation that has been shown tonight on both sides of the House in future debates and when further initiatives to address this problem are announced, I have no doubt that we shall make rapid strides. I hope that, when the national service framework for children is published, we shall have another opportunity to debate these matters in much greater detail and that, in particular, we shall be able to look at that document to see what benefits it could bring to the children who have been mentioned in tonight's debate.
Once again, I should like to thank the hon. Member for Buckingham for securing this debate, and my hon. Friend the Member for Waveney and the hon. Member for Castle Point for their valuable contributions. I look forward to having further opportunities to debate this matter in the future.
Question put and agreed to.
- Adjourned accordingly at six minutes past Ten o'clock.
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