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The Parliamentary Under-Secretary of State for Health (Caroline Flint): Thanks to improvements that we have made to detection and treatment, we have seen a 19 per cent. decrease in breast cancer mortality rates in England in women aged under 75 since 1997. We are seeking to build on that by further improving screening, helping GPs better identify the symptoms of cancer, speeding up the time in which a patient with suspected cancer is seen and treated by a specialist and increasing the availability of the latest treatments.
Mrs. Hodgson: I pay tribute to my hon. Friend for her answer and to the sterling progress made by the cancer campaigns and the Labour Government in boosting research, diagnosis and treatment rates for breast cancer. Does she recognise that a cancer is likely to be more advanced by the time it is diagnosed in poorer areas, and that there are worrying regional disparities between survival rates, especially in the north-east, where there is only a 68 per cent. five-year survival rate as compared with 76 per cent. in the south-east? Will she outline the Government's proposals to tackle that health deficit and prevent needless deaths in the north-east?
Caroline Flint: I thank my hon. Friend for her question and welcome her to the House. It is pleasing to see hon. Members who take the issues around breast cancer seriously. She is right. We have to look not only at the national figures but at what is happening in local communities. We know that half of all women diagnosed with breast cancer are not referred urgently by their GP. That is why we have made a commitment that, by 2008, every woman referred by her GP for any breast problem will be seen by a specialist within two weeks.
We also have to do more to make women aware of their health and of where they can seek support. Primary care trusts, charities and Members of Parliament can play a role in raising awareness. We are also looking at how we can develop screening. We have some research being carried out on screening for those aged over 40. Screening is currently available to those over 50. We hope that those reports will give us some added ideas about developing screening in this important area.
I thank the hon. Lady for raising that matter. I have had some discussions in the Department on it. Herceptin is not yet licensed for early breast cancer in England, but there have been positive trial results and we are considering referring it to the National Institute for Health and Clinical Excellence for urgent appraisal. We have made it clear that newly licensed treatments should not be withheld because guidance from NICE is not available. We have asked a group of experts chaired by the national cancer director Mike Richards to advise on the implications of introducing herceptin more widely in the NHS and on the issue of licensed products that PCTs could take up if trials show that they could have an impact and positive results.
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Ms Dari Taylor (Stockton, South) (Lab): Does my hon. Friend acknowledge that, while we have invested in this area and produced some excellent services, if we are now to widen this service to women who are 75 years of age or women who are 45 years of age, there are problems? In my constituency, North Tees hospital is telling me that it needs more space and is desperate for an investment that would ensure that that could be provided; but it also needs additional investment for digital mammography. Is my hon. Friend considering how and in what way that investment can be put in place to keep and enhance an already excellent service?
Caroline Flint: My hon. Friend makes a valid point. It is not enough to agree to screening. We have to talk about how it will be implemented, the staffing implications and, very importantly, the environment in which screening would take place. I assure her that any further developments would take into account all those issues, but she would agree that the enormous investment that we have made in relation to cancer services, growing from an extra £280 million in 2001-02 to an extra £570 million in 2003-04, demonstrates our commitment not only to providing the resources but to coming up with the ideas to tackle these serious illnesses, which can lead to death.
Mr. John Baron (Billericay) (Con): Conservative Members naturally welcome the continued reduction in premature mortality rates for breast cancer, which has been in large part due to the introduction of the national breast screening programme in 1988. The Minister will be aware that breast cancer often involves a lengthy course of treatments and yet there is growing evidence that the Government's two-week and one-month targets are pushing resources to the front end of the system at the expense of those subsequent treatments. Given that, for example, the Royal College of Radiologists' latest figures show a significant lengthening in waiting times since 1998 for both radical and palliative radiotherapyfigures that the Government cannot contest because they do not collect such figureswhat are the Government going to do to put right this worrying situation?
Caroline Flint: The hon. Gentleman again raises an important point about how all the different services interact with one another. There is no doubt that demand for radiotherapy has increased markedly in recent years. Perhaps that has something to do with the fact that women are coming forward and that we are diagnosing and identifying their cancer and providing the subsequent treatment. We are working hard to retain and recruit more staff. The Modernisation Agency is leading a programme to disseminate good practice in redesigning services. I have heard the points that the hon. Gentleman raised and will consider them.
The Minister of State, Department of Health (Jane Kennedy):
It is important to ensure that patients are provided with safe, sustainable and, where possible,
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local services. Professor Darzi's review must be allowed to be carried out thoroughly, and should report only when it is ready to do so, which is expected to be this summer.
Mr. Wright: I congratulate my right hon. Friend on her appointment to her present post. Obviously, I want Professor Darzi to undertake his review correctly rather than quickly, but will she acknowledge that the delay has caused fear and uncertainty? The bottom line is the future viability of health services in Hartlepool. The Prime Minister and the previous Health Secretary, my right hon. Friend the Member for Airdrie and Shotts (John Reid), pledged that services in Hartlepool will improve and not be downgraded. Will the new Minister make a similar pledge?
Jane Kennedy: I have learned this much about North Tees and Hartlepool NHS trust: it has received three stars every year since 2001, it sees 98 per cent. of all A and E patients within four hours and, as at March 2005, fewer than 1 per cent. of operations are cancelled. My hon. Friend met my predecessor, my right hon. Friend the Member for Barrow and Furness (Mr. Hutton), on 31 January and secured an Adjournment debate on 8 February and I compliment him on the tenacity with which he is pursuing his case. He rightly says that commitments were given by the previous Secretary of State and, of course, by the Prime Minister, that Professor Darzi has been asked to see how the fullest possible range of services could be maintained in Hartlepool. My hon. Friend can be assured that this Minister is not about to countermand assurances given him by a Member of a higher rank.
The Secretary of State for Health (Ms Patricia Hewitt): NHS Direct has handled more than 29 million calls since the service was launched in March 1998 and currently deals with about 500,000 calls every month. NHS Direct Online was launched in December 1999 and has seen rapid growth in the number of visits to the website, totalling nearly 10 million during 200405.
Ed Balls: Will my right hon. Friend join me in congratulating staff at the award-winning NHS Direct call centre in my constituency, which last year saw a 10 per cent. rise in the number of calls taken? Does she agree that NHS Direct shows that we can deliver a personalised and flexible service to patients in the NHS, in the public sector, with rising public investment? Does she further agree that that public investment would be put at risk if we were to go down the road of privatisation and the patient's passport plans proposed by Opposition Members?
I strongly agree with all the points made by my hon. Friend and join him in warmly congratulating the staff of the charter mark winning NHS Direct call centre in his constituency. I am particularly impressed by the way in which that west
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Yorkshire call centre integrates its work with that of the Pennine doctors out-of-hours GPs co-op and local dentists so that patients using NHS Direct can have access to the full range of NHS services and adviceall of it, of course, free at the point of need.
Julia Goldsworthy (Falmouth and Camborne) (LD): Since NHS Direct and walk-in centres were introduced, there has been an increase in accident and emergency attendances of 3.5 million a year, and a survey in Nursing Times has reported negative repercussions on A and E staff recruitment. Will the Secretary of State undertake an evaluation of the impact of both NHS Direct and walk-in centres on other NHS services?
Ms Hewitt: We have already commissioned precisely that evaluation. The evaluation of NHS Direct that has been carried out showed that, even where there was not full integration with local GP services, NHS Direct reduced demand for GP out-of-hours services and, where there was clinical integration, it reduced demand for those services by between 25 and 40 per cent. In the case of A and E departments and ambulance services, the evaluators found no evidence at all to support the argument that NHS Direct was increasing demand. The reality is that NHS Direct is increasing the availability of health care advice and good-quality health treatment to all the public. It is a good example of how we are modernising and improving the NHS on the basis of its founding values.
Angela Eagle (Wallasey) (Lab): Will my right hon. Friend undertake not to listen to the siren voices from both Opposition parties, which seem to be churlish about the development of easier access, out-of-hours access and new ways of getting access to health treatment in both walk-in centres and NHS Direct? Such services would apparently be under threat if, in some awful parallel universe, Opposition Members were on the Government Benches. Will she continue to develop those services, which are greatly welcomed by my constituents who use NHS Direct regularly and visit the local walk-in centre at Victoria Central hospital in their thousands every year?
Ms Hewitt: My hon. Friend is absolutely right. Both walk-in centres and NHS Direct are examples of the investment and reform strategy that we have been following to ensure that our national health service delivers the quality of care that the public and patients are entitled to receive. I readily give her the assurance that she seeks: we will continue on that path of investment and reform, even though the Opposition will no doubt continue to complain.
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