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Hospital Closures (Sudbury)

4. Mr. Tim Yeo (South Suffolk) (Con): What representations she has received about the closure of Walnuttree and St Leonard's hospitals in Sudbury. [30512]

The Secretary of State for Health (Ms Patricia Hewitt): To date, more than 5,000 letters have been received from hon. Members and members of the public on the matter as well as six related parliamentary questions. I also met the hon. Gentleman on 19 July when the issue was discussed.

Mr. Yeo: Is it Government policy to close community hospitals and force patients to travel 40 miles to overstretched general hospitals? Is it Government policy for primary care trusts to issue grossly misleading consultation papers, which omit costings of replacement services, and to withdraw existing hospital-based services before even the most rudimentary community alternatives are in place? If none of those is Government policy, why is the Secretary of State allowing the West Suffolk primary care trust to do all three in my constituency now?

Ms Hewitt: Walnuttree hospital has a building that was constructed in 1836 and has already had £300,000 invested in it to bring it up to the standard required by fire safety regulations, albeit temporarily. West Suffolk PCT is dealing with that and it does not believe that the hospital can offer the quality of care that the modern NHS should provide. As the hon. Gentleman said, it is consulting about alternative proposals that will offer modern intermediate care and ancillary care to his constituents and others in the locality. The consultation has been extended at the request of the local overview and scrutiny committee until 12 December. No final decisions have therefore been made.

Herceptin

5. Ann Winterton (Congleton) (Con): If she will make a statement on the availability of the breast cancer drug Herceptin to recently diagnosed women. [30513]
 
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The Minister of State, Department of Health (Jane Kennedy): As the hon. Lady knows, Herceptin is not yet licensed for women with early breast cancer but, as with other unlicensed drugs, it can be used in some cases. It is for clinicians to decide, in discussion with patients, whether Herceptin is appropriate, taking into account potential risks and medical history. I appreciate that the hon. Lady is an assiduous campaigner on behalf of one of her constituents. She may like to know that, following last Friday's decision by the 14 primary care trusts of Greater Manchester to provide funding to support the wider prescribing of Herceptin in their area, the Central Cheshire PCT, which covers her constituency and is in the Greater Manchester and Cheshire cancer network area, is meeting this afternoon to consider the matter.

Ann Winterton: Will the Minister accept that that reply is good news for my constituent, Joanne Leese? Will she also examine postcode prescribing—the postcode lottery? If the Central Cheshire PCT does not go along with the Greater Manchester group, my constituent will be further disadvantaged. It is wrong, when a clinician has said that a person should have Herceptin, that cost should prevent the prescription of that good medication for her condition.

Jane Kennedy: PCTs will need to take a range of factors into consideration when reaching these decisions, including the appropriateness of the treatment for an individual patient, and its cost-effectiveness. The drug will not be appropriate for all women. The important thing is that PCTs do not refuse to fund the drug for early breast cancer on principle, and that they take into account all the considerations relating to each case.

Mr. David Crausby (Bolton, North-East) (Lab): After months of struggle, my constituent, Alyson Cooper, has been allowed to use Herceptin by the Bolton primary care trust. But why should she have had to fight for her treatment? Was it not bad enough to have cancer in the first place, without being forced to campaign for her life? Will my hon. Friend ensure that no other woman is put through such agony?

Jane Kennedy: It is important to remember that, as with other cancer drugs, Herceptin can have side effects. For example, it can cause heart damage in some patients. That is why we need to ensure that it will be safe for routine use. That is the role of the licensing process, and the reason why that process is so important in regard to the considerations that must be taken into account. The House might like to know, however, that the National Cancer Research Institute is producing guidelines on the use of Herceptin for early breast cancer prior to licensing. I am sure that that will be of great help to primary care trusts in considering these decisions.

Mrs. Iris Robinson (Strangford) (DUP): I was delighted that the Northern Ireland Minister with responsibility for health has said that he will make Herceptin available for specific breast cancer sufferers in the Province. However, we have just had the disturbing disclosure that a radiographer in Northern Ireland has been suspended pending inquiries into whether the correct information was given to women after breast
 
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screening. Will the Minister tell the House what checks and balances are in place throughout the United Kingdom to prevent the unnecessary experience that 1,300 women in Northern Ireland are now facing in waiting to see whether they have been given the correct diagnosis?

Jane Kennedy: It would clearly be inappropriate for me to comment on the particular case that the hon. Lady has highlighted, but I hope that she will be reassured that the NHS, whether here or in Northern Ireland, always takes great care to ensure that the right results are returned to patients. Occasionally, however, mistakes are made and the steps that she has described need to be taken. This is an extremely important issue, and it is absolutely right that the proper procedures should be in place to ensure that the right diagnosis is communicated.

Dr. Doug Naysmith (Bristol, North-West) (Lab/Co-op): As my right hon. Friend has already said, some 20 per cent. of women with breast cancer have tumours that are susceptible to treatment with Herceptin, and this can be tested for with the HER2 test. Can she assure me that everything possible is being done to ensure that HER2 testing accompanies diagnosis as closely as possible?

Jane Kennedy: I hope that my hon. Friend will be reassured to hear that Professor Mike Richards has been working very closely with the directors of the cancer networks across England and Wales to ensure that HER2 testing is made available to women who are diagnosed with early-stage breast cancer.

Mrs. Nadine Dorries (Mid-Bedfordshire) (Con): Bedfordshire Heartlands primary care trust will have a £19.5 million deficit by the end of this year. The recovery plan put in place to deal with that is restricting the work of our emergency services. I do not know what kind of battle a constituent of mine would have in attempting to obtain Herceptin. Does the Minister agree that, if we cancelled the much-failed choose and book system, which cost £6.2 billion and which general practitioners are failing to use, we could use the money to provide Herceptin to everyone who needs it?

Jane Kennedy: No, I do not. The cost of Herceptin will need to be met from the existing settlement agreed for the national health service. We understand that some trusts are already under financial pressures and might have to make difficult decisions to achieve that. However, we have greatly increased the amount of money going into the health service, and those trusts with deficits now have financial recovery plans in place. It is far better to be working in an environment in which NHS resources have more than doubled in three years than to be working in the environment that the Conservative party would have created.

Mrs. Sharon Hodgson (Gateshead, East and Washington, West) (Lab): Will my right hon. Friend join me in congratulating the Northern cancer network, which has agreed to allow the drug to be prescribed for HER2-positive women in the north and north-east? As that movement is growing throughout the country, is it
 
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not about time that the National Institute for Health and Clinical Excellence approved use of the drug throughout the country? Will my right hon. Friend put pressure on NICE to speed up that process?

Jane Kennedy: Of course I join my hon. Friend in congratulating the North-East cancer network. The directors of the cancer networks have played a key role in ensuring that the right decisions are made, and that Herceptin is prescribed only for patients for whom it is appropriate. As I have said, the drug is believed to have serious side effects, and it is too early to judge its full effectiveness, its overall cost-effectiveness and all the risks involved. That is why licensing remains so important, along with the NICE appraisal that will be carried out.

I have announced, with NICE, the new procedure that NICE is introducing. Herceptin and four other potentially life-saving drugs will be subjected to a single appraisal, which we hope will be completed within a few weeks of the announcement of the licence. The whole process will become much swifter. Let me record my appreciation of the institute's efforts to bring about a change that will benefit many patients enormously.

Steve Webb (Northavon) (LD): Does the Secretary of State have the power to guarantee Herceptin to women whose clinicians believe that it is appropriate for them now? If she has that power, why has she not used it? If she does not have that power, is there not a danger—I put this gently—that false hopes will be raised among women who are in a desperate situation? They will hear an announcement that suggests that Herceptin will be available, on which the Secretary of State will then be unable to deliver.

Jane Kennedy: No. We rightly decided to give primary care trusts—the local organisations that understand local circumstances best—authority to make the necessary decision when a drug that has not been licensed is being offered to a patient, or when treatment with the drug is being discussed with a patient. We have said, however, that the decision making should not constitute a blanket policy of not prescribing, but should take place on a case-by-case basis. Decisions involving an important drug such as Herceptin must take all the circumstances into account; they must not be made simply on the basis of cost.

Mr. John Baron (Billericay) (Con): The Minister will be well aware that because of deficits, many primary care trusts are struggling to implement NICE guidance and fund the provision of Herceptin for late-stage breast cancer. Given that experts such as those working for Breakthrough Breast Cancer believe that 1,000 lives a year could be saved if Herceptin were available for early-stage breast cancer, and given the Government's recent announcement that Herceptin should not be withheld for reasons of cost alone, what additional funding will the Government provide so that PCTs can implement that direction? They need to ensure that other local services do not suffer, and also that the shameful postcode lottery that exists in relation to Herceptin and late-stage breast cancer is not replicated in the case of early-stage breast cancer.
 
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Jane Kennedy: I do not accept that there is a serious problem with late-stage breast cancer. I will look into the matter and respond to the hon. Gentleman, but I do not recognise the circumstances that he has described.

It is important to acknowledge the huge amount of extra resources that the health service has received. It is perfectly possible for PCTs and hospitals to manage their resources properly, and the vast majority are doing so. Professor Mike Richards wrote to the NHS in mid October, advising it that it would need to make arrangements to provide Herceptin for women for whom it was appropriate. It is appropriate that the NHS organises its budgets locally, gets its priorities in place and then makes payments where appropriate for particular patients.

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