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14 Jan 2008 : Column 989Wcontinued
We take the issue of the 36-month standard between screens very seriously. That is why Professor Mike Richards, the national cancer director, wrote to the chief executives of all 10 strategic health authorities in England on 9 February 2007 highlighting the importance of maintaining the 36-month interval.
Mr. Lansley: To ask the Secretary of State for Health what cancer networks there are in England; and, for each, what their constituent primary care trusts are. 
Ann Keen: The information requested has been placed in the Library.
Mr. Lansley: To ask the Secretary of State for Health what estimate he has made of the likely number of cases of cancer in each of the next 10 years. 
Ann Keen: Estimates of the likely number of new cases have not been made for every one of the next 10 years. However, they have been made of the likely number of new cases in each of the following years 2011, 2016 and 2020. This information is shown in the following table.
Projected number of cancer cases (rounded to nearest 100)
|Number of cases|
Mr. Lansley: To ask the Secretary of State for Health how many emergency in-patient admissions for cancer there were in each year since 1997-98; what proportion of these were emergency readmissions in each year; and if he will make a statement. 
Ann Keen: The following table gives the finished admission episodes (FAE) for emergency admissions with a primary diagnosis of cancer for all years since 1997-98. There are no data available for readmissions for cancer.
|Finished admission episodes for emergency admissions|
A FAE is the first period of in-patient care under one consultant within one healthcare provider. Admissions do not represent the number of in-patients, as a person may have more than one admission within the year.
Diagnosis (primary diagnosis)
The primary diagnosis is the first of up to 14 (7 prior to 2002-03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was in hospital.
HES are compiled from data sent by over 300 national health service trusts, and primary care trusts (PCTs) in England. Data is also received from a number of Independent sector organisations for activity commissioned by the English NHS. The Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain.
Assessing growth through time
HES figures are available from 1989-90 onwards. During the years that these records have been collected from the NHS there have been ongoing improvements in quality and coverage. These improvements in information submitted by the NHS have been particularly marked in the earlier years and need to be borne in mind when analysing time series. Changes in NHS practice also need to be borne in mind when analysing time series. For example a number of procedures may now be undertaken in out-patient settings and may no longer be accounted in the HES data. This may account for any reductions in activity over time.
Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed).
HES, The Information Centre for health and social care.
Mr. Lansley: To ask the Secretary of State for Health what the (a) elective and (b) emergency bed occupancy rates for cancer patients in the NHS as described in figure 13 of his Department's Cancer Reform Strategy were (i) for all cancers in total and (ii) for each cancer type in each year since 1997. 
Ann Keen: Information on bed occupancy rates for cancer patients is not available.
The title to Figure 13 on page 97 of the Cancer Reform Strategy is incorrect. As described in paragraph 7.24, Figure 13 shows the number of beds by cancer type rather than the bed occupancy.
The number of elective and emergency bed days for all cancers since 1997 is shown in the following table.
National Cancer Services Analytical Team, www.canceruk.net
Information on the number of elective and emergency bed days broken down by cancer type since 1997 has been placed in the Library.
Mr. Lansley: To ask the Secretary of State for Health if he will place in the Library a copy of the analysis referred to in paragraph 7.22 of his Departments Cancer Reform Strategy on projected cancer in-patient costs. 
Ann Keen: The information requested has been placed in the Library.
Mr. Lansley: To ask the Secretary of State for Health how many specialist diagnostic units, referred to in paragraph 7.14 of his Department's Cancer Reform Strategy, there are; where they are situated; and if he will make a statement. 
Ann Keen: Information on the number and location of all specialist diagnostic units is not held centrally.
Over 99 per cent. of patients with suspected cancer are now seen by a specialist within two weeks of referral, and over 99 per cent. of patients receive their first treatment within 31 days of diagnosis, while over 97 per cent. of patients begin treatment within 62 days of being urgently referred.
As part of the Cancer Reform Strategy, these targets will be extended to more patients and by 2010, the 31-day target will apply to all treatments, not just the first.
Mr. Lansley: To ask the Secretary of State for Health who the members are of his Departments Cancer Action Team. 
Ann Keen: The Cancer Action Team works with and supports the national health service nationally. In particular, it works with cancer networks to implement the Governments strategy for improving cancer and end of life care services. It is not a part of the Department.
Teresa Moss is the Director of the Cancer Action Team and she has 24 members of staff.
Mr. Lansley: To ask the Secretary of State for Health what the evidential basis was for the statement in paragraph 1.9 of his Departments Cancer Reform Strategy, that England has the highest national per capita rate of cancer trial participation in the world; and if he will make a statement. 
Ann Keen: The number of cancer patients entering trials in the United Kingdom has grown since 2001 to the point where it is almost the same as the number entering trials in the United States of America (USA). The USA and the UK have the largest number of cancer trial participants in the world. These facts, and the difference in population size between the two countries, form the basis of our assessment of the relative level of the current per capita participation rate in the UK.
Mr. Lansley: To ask the Secretary of State for Health when he expects cancer networks to agree local cancer mortality reduction targets for 2012, as described in paragraph 6.9 of his Department's Cancer Reform Strategy; what definition of cancer mortality he intends to use; how achievement against cancer mortality targets will be assessed; whether each local cancer mortality reduction target will be published; and if he will make a statement. 
Ann Keen: Local mortality reduction goals will be developed and finalised during 2008. It is important to note that these are goals and not targets.
The details, include definitions, assessment and publication, are yet to be decided.
Mr. Lansley: To ask the Secretary of State for Health what the evidential basis is for the statement in paragraph 10.8 of his Departments Cancer Reform Strategy, that there is significant variation in cancer drugs approved by the National Institute for Health and Clinical Excellence (NICE) between cancer networks; what the levels of expenditure on NICE-approved cancer drugs by each cancer network is; and if he will make a statement. 
Ann Keen: The evidential basis for the statement that there is variation in expenditure on cancer drugs approved by the National Institute for Health and Clinical Excellence (NICE) between cancer networks is set out in two reports published by the National Cancer Director:
Variation in usage of cancer drugs approved by NICE, June 2004
Usage of Cancer Drugs approved by NICE, September 2006
Both these reports are available on the Department of Health website at:
respectively). Copies of both reports are available in the Library.
The Department does not collect the actual levels of expenditure on NICE-approved cancer drugs by network. However, Figure 17 in the Cancer Reform Strategy sets out the estimated cost per head of NICE-approved cancer drugs used in hospitals between January-June 2005. This chart was based on data from the National Cancer Directors 2006 report plus estimates of drug prices. The chart is anonymised because the data on which it is based has many limitations and the error range is large. It provides a useful indication of the likely spread of spend across the country but is not deemed accurate enough to provide a fair comparison between named networks.
Progress has been made in reducing variation in usage of cancer drugs across the country but there is scope for further reductions. The National Cancer Director recommended in his 2006 report repeating his evaluation of cancer drug usage periodically to ensure that the level of variation is reduced as much as possible. The Cancer Reform Strategy confirmed that the next evaluation will take place during 2008.
Mr. Lansley: To ask the Secretary of State for Health whether the National Cancer Director intends to conduct an evaluation of usage of cancer drugs approved by the National Institute for Health and Clinical Excellence, as stated in paragraph 4.51 of his Departments Cancer Reform Strategy, in the years after 2008. 
Ann Keen: The National Cancer Director recommended, in his 2006 report Usage of cancer drugs approved by NICE, that such evaluations should be repeated periodically. No decision has yet been taken about when it would be most appropriate to repeat the exercise following the one due in 2008.
Mr. Lansley: To ask the Secretary of State for Health whether he intends to issue national guidance to clinicians to assist them in discussing with their patients drugs which are not available on the NHS, as described in paragraph 4.50 of his Departments Cancer Reform Strategy. 
Ann Keen: The Department has no plans to issue national guidance on this matter. However, the National Institute for Health and Clinical Excellence (NICE) publishes information targeted specifically at service users (Understanding NICE Guidance) to explain its appraisals. Clinicians could use these documents to help discuss drugs which NICE has concluded are not clinically or cost effective for a particular patients condition.
Mr. Lansley: To ask the Secretary of State for Health if he will make it his policy that primary care trusts should publish their individual criteria for determining which patients should access treatments for cancer drugs in those cases where guidance on the use of the drug has not been issued by the National Institute for Health and Clinical Excellence. 
Ann Keen: The Department has no plans to issue guidance or revise policy on this matter.
Mr. Lansley: To ask the Secretary of State for Health how frequently the surveys of cancer symptom awareness, referred to in paragraph 3.47 of his Department's Cancer Reform Strategy, will be conducted. 
Ann Keen: As set out in paragraph 8.6 of the Cancer Reform Strategy, the first survey is likely to be in late 2008 or 2009. It will then be repeated at least every two years.
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