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“in the past, prostate cancer has not received the attention that it deserves”.
So what has changed? The Government have produced the NHS cancer plan, the report “Making Progress on Prostate Cancer”, the NHS prostate cancer programme and the prostate cancer risk management programme. Moreover, NICE has finally published guidelines on the optimum treatment for urological cancers, six years after details of best practice in breast cancer treatment were announced, and both the NAO and the PAC have issued a plethora of reports. Direct Government funding of research has increased from £200,000 in 1999-2000 to £4.2 million in 2003-04, but prostate cancer lacks the historical investment from which other cancers have benefited significantly.
Some progress has been made, but further advances depend largely on strong political leadership from the Government. If we are to have the same success in identifying and treating prostate cancer as we have achieved with breast cancer, the level of political support must also be equal.
I implore the Minister to ensure that the Government move from their current passive approach and go on the offensive in the battle against prostate cancer. Here is a chance to demonstrate clear and motivational political leadership, and I urge the Government to seize the opportunity.
10.28 pm
The Minister of State, Department of Health (Ms Rosie Winterton): I begin by congratulating the hon. Member for South-West Norfolk (Mr. Fraser) on his success in securing this debate. As he says, it is important that we continue to raise awareness of prostate cancer. He mentioned that he raised this matter in 1998, and it is clear that he has been assiduous in keeping up his interest in it.
The hon. Member for South-West Norfolk is right that the Government have always acknowledged that
there was a time when prostate cancer did not receive the attention that it deserves. He asked what had changed since 1998. In September 2000, the Government published the prostate cancer programme, which set out the action that the we proposed to take to tackle the disease. In addition, the report “Making Progress on Prostate Cancer” was published in November 2004, outlining some of the good progress that had been made to that date. The momentum has been maintained. Now 99.8 per cent. of patients with suspected urological cancers are seen by a specialist within two weeks of being urgently referred by their GP—up from 98.7 per cent. in 2004.
NICE has published service guidance for urological cancers on how best to organise services to deliver quality care. A third of cancer networks have fully implemented that guidance, and we expect full implementation in all networks by December 2007. The number of consultant urologists has increased by nearly 46 per cent. since 1997. We are also looking at how we can increase training through master classes—as they are called—on prostate surgery.
The hon. Gentleman raised the issue of funding. I assure him that tackling all forms of cancer obviously continues to be a key priority for the Government, and the NHS is spending about £4 billion on cancer services every year. I can also assure him that gender is not an issue in any of the Government’s decisions on cancer funding. We make funding decisions using the best available clinical evidence. In fact, prostate cancer is the only cancer with a Department of Health spending target for research of £4.2 million a year, which is a 20-fold increase in funding compared to 1999. That target was met in 2003, as promised. It rose to £4.3 million in 2004 and I can assure the hon. Gentleman that that level of funding will be maintained in future years, but some of it will, of course, be subject to the quality of the research proposals received.
The hon. Gentleman is right to say that we always need to do more. I want particularly to draw attention to the work that we have been able to do with some of the key stakeholders. We supported the prostate charter for action, launched in 2003. To ensure collaboration between the stakeholders who signed the charter and the Government we set up the prostate cancer advisory group, chaired by Professor Mike Richards, our national cancer director. The group includes representatives from the charter and allows us to combine the expertise of the voluntary sector with that of the NHS, to the benefit of patients.
The hon. Gentleman’s point about giving patients information is extremely important. As he may know, we have pilots for information prescriptions and so on—exactly the sort of things he mentioned. We are looking at the information patients need, but it is important that we work with patient groups to find out what will enable patients to make choices. That work is ongoing.
We have been discussing screening, which the hon. Gentleman also mentioned. As he knows, we are committed to introducing a screening programme, if and when screening and treatment techniques are sufficiently well developed. As he said, there is no conclusive evidence from any country that screening for prostate cancer would reduce the death rate.
However, the UK national screening committee is keeping the matter under review. We look carefully at developments in testing techniques or in technology that would make a screening programme effective.
The hon. Gentleman asked what we were doing to find better a diagnostic test for prostate cancer. The Department of Health has been supporting the development of screening technology for prostate cancer by a comprehensive research strategy for all aspects of prostate cancer. Together with partners at the National Cancer Research Institute, we are funding two cancer collaboratives on prostate cancer. That has already generated the groundbreaking discovery of the overactive E2F3 gene in prostate cancer tumours. The discovery has not only provided the opportunity to identify those at risk of developing the disease, but has allowed for the first time a prediction to be made of how aggressive the cancer will be. As I am sure the hon. Gentleman knows, that is extremely important, especially with regard to the decisions that people might want to make about the treatment that they need. We have also funded a £20 million trial of treatments for prostate-specific antigen—PSA—screen-detected early prostate cancer.
The hon. Gentleman rightly raised the important issue of public awareness of prostate cancer. We jointly funded a pilot public awareness programme on prostate cancer with our partners in the prostate cancer charter for action. The pilot took place in Coventry in October and it is being independently evaluated so that we can learn from it and determine the best way forward to raise public awareness of prostate cancer. We have also examined how we can raise public awareness through our section 64 grants. Some of the money has gone to the Prostate Cancer Charity to increase the amount of information available about prostate cancer, and especially, to improve awareness among men from African and Afro-Caribbean communities, who are at increased risk of prostate cancer.
The hon. Gentleman also talked about the prostate cancer risk management programme. As he said, the programme was put in place to help general practitioners to advise men who wanted a PSA test and to allow them to point out the pros and cons of having the test. As he said, this is about enabling men to make an informed choice. The packs that we initially sent out have been evaluated. We are considering reviewing the contents to ensure that they help men as effectively as possible.
The hon. Gentleman raised the important point of engaging GPs in the process. During the review, we will also be looking at how we can improve the engagement of GPs. We will want to do that when the packs are
relaunched. The work that we are doing on information prescriptions is an important aspect of ensuring that we can raise awareness. We are making sure that the work that we are doing is fully aligned with the development of NICE clinical guidance on prostate cancer because, obviously, the two policies are complementary. We want to make sure that they result together in the best outcomes for men.
I turn to the services for people with prostate cancer. We do not collect data on the number of prostate cancer nurse specialists. However, the overall increase in the number of nurses working in the NHS has assisted the recruitment of additional cancer-site- specific nurse specialists. NICE guidance on improving outcomes in urological cancer reinforces the role of nurse specialists. As the hon. Gentleman said, the guidance identifies them specifically as members of the multidisciplinary team who should be in place.
It is for cancer networks to work in partnership with strategic health authorities and work force development directorates to assess, plan and review their work force needs and to ensure that the education and training of all staff linked to local and national priorities for cancer takes place and takes account of the implementation of NICE guidance.
NICE has also issued interventional procedure guidance on brachytherapy and also on cryotherapy and high-intensity focused ultrasound, confirming that these treatments are safe for use in the NHS. However, I am sure the hon. Gentleman will recognise that there is no clinical consensus on the best form of treatment for early prostate cancer. As I said, we have asked NICE to produce clinical guidance on the diagnosis and treatment of prostate cancer. That will consider the main types of treatment in relation to each other. We expect it to be published around 2007.
I am pleased to confirm that earlier today we issued advice to the NHS on the development of prostate brachytherapy services in England, in advance of the NICE clinical guidance. I will make sure that the hon. Gentleman receives a copy of that. The advice confirms that each cancer network should be able to refer appropriate patients to facilities, not necessarily always local, which offer such brachytherapy. Advice is also provided on what high-quality prostate brachytherapy services should look like. I will encourage the NHS—
The motion having been made after Seven o’clock, and the debate having continued for half an hour, Mr. Deputy Speaker adjourned the House without Question put, pursuant to the Standing Order.
Adjourned at nineteen minutes to Eleven o’clock.
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