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Mr. Nick Hurd (Ruislip-Northwood) (Con):
On that point, convenient access to care becomes increasingly
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important. I hope that the Secretary of State is aware of the decision to close cancer services at Mount Vernon hospital from 2012. Is the best that the British Government can offer the million or more people in the west London cancer network, for whom that site is the most convenient, a journey time of an hour and a half on public transport for cancer care?
Ms Hewitt: The hon. Gentleman knows that a review of services across north-west London is taking place. The proposal is part of that review and an appropriate consultation is under way. I am sure that his points will be taken into account.
The aims of the cancer plan can be summed up very simply: prevent more, diagnose early and treat fast. I want to say something about what we have already done and what we must do on each of the three elements.
We all know that smoking is the largest single cause of cancer deaths in the United Kingdom. The ban on smoking in enclosed public places, on which the House recently decided by an overwhelming majority, will be perceived as one of the landmark Acts in the protection of public health. It builds on our work on tackling tobacco smuggling, banning tobacco advertising, placing tougher warnings on cigarette packets, and our successful NHS smoking cessation services. My hon. Friend the Under-Secretary of State for Public Health recently launched our latest advertising campaign against smoking. I am especially grateful to Trudi Endersby, who was diagnosed with lung cancer at the age of 38, and had the courage to appear in that television campaign describing how she went with her daughter to choose a plot for her own grave, thus bringing home to people the dangers of smoking.
I think that all hon. Members will agree that we need to do far more to alert young people, many of whom are gambling with their future health and happiness as they turn to smoking, binge drinking and risky sexual behaviour. I particularly want to commend the work of Professor Iain Hutchison, one of our leading oral and maxillofacial surgeons and a professor of surgery at St. Bart's hospital, who founded the Saving Faces charity. He has described to me how he and his colleagues have gone into schools to show teenagers in horrifying and graphic detail what it means to have oral cancer, and to explain the impact of smoking and binge drinking on the risk of contracting oral cancer. I agree with the hon. Member for Billericay that we need more of those public awareness campaigns, and we will ensure that there are more of them in future.
So we need to do more on prevention. However, we cannot prevent every cancer, at least not with our present state of scientific and medical knowledge. It is therefore essential that we keep doing even more to detect cancer early. In 1996, 1 million women were screened for breast cancer. This year, nearly 1.5 women will be screened, and we can be proud of the fact that the breast cancer screening programme that we operate is widely regarded as one of the best in the world. The number of breast cancers detected through our screening programme has increased from some 8,500 a year to 12,000 a year, which will lead to further
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improvement in survival rates. The latest estimate is that that one screening programme alone is already saving the lives of about 1,400 women a year.
Mr. Khan: My right hon. Friend has talked about the importance of detection and early diagnosis. Will she commend the network of pilot clinics that has been set up at St. George's hospital to examine the links between family history and the diagnosis of cancer? The project is already a success in south London. Does she think that it could be extended further around the country?
Ms Hewitt: I commend the excellent work that is being done at St. George's. The targeted identification and screening of individuals whose family history suggests that they are at greater risk than the rest of the population will play an increasingly important part in the early diagnostic work that we do.
Mr. Gray: Is the Secretary of State saying, therefore, that, rather than screening women for breast cancer automatically when they reach 50, she might move towards automatic state-funded screening at an earlier age—possibly 40 or 45? Is that a possibility for the future?
Ms Hewitt: At this point, the evidence does not really support the case for what would be a substantial investment in universal screening for all women in their 40s. However, we are of course looking at the research on that—indeed, we are funding much of it—and we expect further results from it later this year.
Dr. Stoate: Every time in the past few years that I have referred someone with a suspected cancer, they have been seen and dealt with within two weeks. Does my right hon. Friend agree that it is a fantastic tribute to the enormous amount of work being done by doctors, nurses and others in the health service to achieve such tremendous results, reassuring patients who do not have cancer and dealing rapidly with those who do? That work greatly reduces the burden of anxiety felt by patients and their families.
Mr. Deputy Speaker: Order. Before the right hon. Lady replies, may I say that ever longer and more frequent interventions are having their own impact on the time available for debate? I am sure that everyone will be conscious that the Chair is trying to fit in a maiden speech today as well.
Ms Hewitt: My hon. Friend the Member for Dartford (Dr. Stoate), who speaks with enormous authority on these matters, has saved me some time by making that point. In 1997, only two thirds of patients who were referred by their GP were seen by a cancer specialist within a fortnight. So, thousands of people every year were being told by their GP that they might have cancer, but were being forced to wait in agonising uncertainty for weeks on end before they could see a specialist. The fact that, today, 99 per cent. of patients see a cancer specialist within two weeks or less is hugely important.
I know that the Conservative party does not like targets, and the hon. Member for Billericay has made that point again. The right hon. Member for Witney
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(Mr. Cameron) told the Health Service Journal that he wants to scrap national targets. The hon. Gentleman appeared to be arguing this afternoon that those targets, by concentrating on the early part of the patient journey, are distorting clinical priorities. I have to say that I do not understand how it can be a distortion of clinical priorities to ensure that a patient whose GP fears that they might have cancer is seen by a cancer specialist within two weeks. The people involved cannot begin to worry about the late stages of the patient pathway for somebody with cancer if they have not taken the trouble to diagnose the cancer rapidly in the first place. I believe—
David Tredinnick: Will the Secretary of State give way?
Ms Hewitt: No, I shall make progress. I believe that we were absolutely right to set that target. I believe it has relieved anxiety for thousands of patients with suspected cancer. In achieving that early diagnosis, it has contributed to saving lives.
Of course, we also have to treat people fast. That is why we set a further target—perhaps another that the Conservative party would abolish if it had the chance—that no patient should wait longer than a month from diagnosis to treatment, or more than two months from urgent referral by a GP to the start of their treatment. That is particularly important because, as the hon. Member for Billericay said, people in England—indeed, people across the UK—are more likely than those in other countries to be in an advanced stage of their cancer by the time they are treated, so getting patients not only diagnosed early, but through to their treatment as quickly as possible, is critical if we are to save people's lives and improve those survival rates.
Mr. Baron: I take on board what the Secretary of State is saying, but she seems to forget that those targets relate to first treatment. Radiotherapy, for example, is first treatment in no more than 15 to 20 per cent. of cases. The risk is that these targets ignore the fact that the cancer journey can be long. Pulling resources into the front end means that radiotherapy waiting times look set to continue to lengthen at this rate.
Ms Hewitt: We have never claimed that the patient pathway ends with the first treatment, but we have said that we must start by setting as a priority not only early diagnosis, but getting the patient through to that first treatment. The hon. Gentleman is quite right that at this stage we do not currently measure the waiting time for radiotherapy as a second treatment—in other words, after the initial surgery. We might need to do that next, which is one issue we will consider, but at this point we are seeking to ensure that we meet the one-month and the two-month targets. I believe we are absolutely right to do so.
No one in the House should underestimate the challenge posed by meeting those targets to get patients very rapidly indeed to their first treatment for this very simple reason: the NHS has never before proactively had to manage patients—each individual patient—throughout their pathway of care.
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