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The Minister of State, Department of Health (Jane Kennedy): This has been a very interesting and useful debate, which the hon. Member for Billericay (Mr. Baron) opened very disarmingly. It is much easier to respond to a straightforward political discussion across the Dispatch Box, but this has been a very thoughtful debate and, in the short time available, I shall try to respond in a way that reflects that fact, and to answer as many questions as I can.
The cancer plan is a 10-year national strategy of investment and reform, the purpose of which is to reorganise, standardise and rejuvenate cancer services. We are just past the halfway point in implementing it, and looking backit is appropriate that we do soI challenge anyone not to acknowledge the clear and impressive story of real improvement. The hon. Member for Northavon (Steve Webb) asked when the next cancer plan will come along. There have been three reviews of the current plan and we may or may not have a further one. I take his point about wanting early warning of when another cancer plan will be considered, but that is some way down the track.
My right hon. Friend the Secretary of State spoke of the importance of prevention, detection, treatment and care. I do not want to repeat what she said, other than to say that unprecedented investment in new and replacement equipment is helping to improve reliability and access to diagnosis and treatment. We are expanding the cancer work forceI will not repeat the figures, which are in the amendmentand there are more cancer specialists. New training programmes for specialties such as radiography and endoscopy are increasing capacity. Such investment is going hand in hand with reform. Specialist teams have been established across the country that bring together surgeons, radiologists, pathologists, nurse specialists and many others to deliver co-ordinated care to patients in hospitals.
That brings me to the Opposition's motion, and I have to say that I agree with a lotindeed, almost allof it. It is very much in keeping with the opening speech of the hon. Member for Billericay, but I disagree profoundly with the suggestion that we now need a different approach if we are to make further improvements in cancer services. It is appropriate that I deal with this issue specifically. We are close to being the world leader in developing the multidisciplinary approach that I have just described. All these advances are due largely to the cancer plan and to the work of Professor Mike Richards, as my right hon. Friend the Secretary of State said.
The hon. Member for Billericay discussed at length how the guidance and appraisals of the National Institute for Health and Clinical Excellence should be enforceable, and a number of Members referred to Herceptin and the role of NICE. When I first came into
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post last summer, the question arose of the length of time that NICE is taking on this issue. We issued a written statement today outlining the exact process for herceptin, but we must remember that the licensing processwhich is very important for this treatment and its applicationand the NICE appraisal process are absolutely critical in allowing the health service to take proper decisions on how it uses its resources locally to provide the proper available medicines and treatments. We trust NICE, as an independent organisation, to make those appraisals and to assess the new treatments. It does so in a way that is very efficient and highly regarded throughout the world.
Mark Pritchard (The Wrekin) (Con): Will the Minister give way?
Mr. Liddell-Grainger : Will the Minister give way?
Jane Kennedy: I hesitate to give way, as I am very pressed for time, and there is a lot that I must respond to. I must tell the House that I resist the call to give NICE more powers and to change how it works, especially before it has had the opportunity to go through the appraisal process.
I very much welcomed NICE's willingness to embrace a new, single-technology appraisal process, especially given the strong defence made for its solid work in the past. My hon. and learned Friend the Member for Redcar (Vera Baird) asked whether that meant that all new cancer drugs will be subjected to the new, single-technology appraisal process. My quick answer is no: some new drugs will be taken alongside other treatments and medicines, and their numbers mean that they will have to go through the slightly longer process.
However, the process is critical for a drug such as Herceptin, which has serious side-effects. Quite rightly, the NHS needs the best possible advice that it can get in respect of such medicines.
Mr. Baron: I do not disagree with much of what the Minister says, but the bottom line is that the postcode lottery will still apply if the system continues to be run as it is at present. Cost assessments running alongside the appraisals would ensure that what was recommended could be afforded. That is what happens north of the border, for example, but the postcode lottery will continue to operate in the absence of such assessments
Jane Kennedy: The so-called postcode lottery applies only in the period when we are waiting for a treatment to be licensed. Once NICE approval has been given, the NHS has 90 daysthree monthsto make arrangements for provision of the medicine. I shall look in detail at the example to which the hon. Gentleman has drawn my attention, and see what can be done.
The hon. Member for Billericay mentioned the length of time that people have to wait for radiotherapy. He made far too many points for me to answer in the time remaining, but I can tell the House that the Royal College of Radiologists published an audit on 23 February that showed that the situation is improving. However, I accept the criticisms that have been made, and much remains to be done in this regard.
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Even so, I am pleased to be able to tell the House that the Department of Health has exceeded its target of recruiting an extra 1,000 radiographers. More than 1,400 additional radiographers and radiography assistants are now working in the NHS, compared with 2003. That is still not enough: a lot of progress has been made, but we recognise that more remains to be done.
The hon. Member for Northavon raised a number of points, and asked about the cost of herceptin. He will be interested to know that the new pharmaceutical price regulation scheme agreement that started in January 2005 will save the NHS more than £1.8 billion on branded prescription medicines over a five-year period. The detail of his question concerned whether the company Roche was offering anything at the moment. Although I cannot comment on that, it is an interesting thought, and I shall be happy to write to him about the matter. Many hon. Members said that the process was arbitrary, but in the long run I do not believe that tinkering with what happens before NICE gets involved will benefit the NHS in any way.
My right hon. Friend the Member for Oxford, East (Mr. Smith) works tirelessly for his constituents. As he said, quite rightly, he holds the health staff in his town in very high esteem, and I want to answer a couple of the specific points that he raised. He asked whether the tariff applied to cancer services. Under the payment by results programme, hospitals are paid according to the number and complexity of the cases treated. Chemotherapy, radiotherapy and, indeed, palliative care will eventually be included, but they are not included at present, and are treated as specialist services for the purpose of commissioning. I would be happy to talk to my right hon. Friend about the deficits that he described in Oxford on another occasion.
The hon. Member for North Wiltshire (Mr. Gray) tempted me to be party political, but I shall just echo the words that have been said about his wife and the fact that she has made a full recovery. I am also pleased to hear that her personal experience of the service provided by the health service was good. My hon. Friend the Member for Norwich, North (Dr. Gibson)
Mr. Patrick McLoughlin (West Derbyshire) (Con) rose in his place and claimed to move, That the Question be now put.
Question, That the Question be now put, put and agreed to.
Question put accordingly, That the original words stand part of the Question:
The House divided: Ayes 228, Noes 294.
Question, That the proposed words be there added, put forthwith, pursuant to Standing Order No. 31 (Questions on amendments), and agreed to.
Mr. Deputy Speaker forthwith declared the main Question, as amended, to be agreed to.
That this House recognises that the Government has made the improvement of cancer services a key priority through the implementation of the NHS Cancer Plan which sets out to reorganise and rejuvenate cancer services and has provided the NHS with investment to modernise these services; welcomes the achievements set out in the recent Public Accounts Committee report, the NHS Cancer Plan: a progress report, which acknowledged that significant progress has been made across the country; notes that the total death rate for cancer in people under 75 has fallen by 14 per cent. since 1996; acknowledges that under this Government unprecedented investment in equipment is helping to improve both access to, and reliability of, diagnosis and treatment; further notes that specialist teams have been established across the country to help deliver co-ordinated care to patients in hospitals; further welcomes the fact that the National Institute for Health and Clinical Excellence is introducing a new fast track assessment process to enable them to issue binding advice to the NHS on the most important new drugs within weeks of them receiving a licence; further notes that this Government has commissioned research to enable initiatives to raise awareness of the symptoms of cancer to be targeted on people most at risk; further notes that there has been a 43 per cent. increase in cancer consultants since 1997; acknowledges that there has been a 40 per cent. increase in cancers detected through breast screening; and further welcomes the Government's commitment to continuing to deliver the commitments in the NHS Cancer Plan.
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