Written evidence from Breakthrough Breast
Cancer (COM 100)
1. Breakthrough Breast Cancer welcomes the
opportunity to comment on the Health Select Committee's Inquiry
into the implementation of policies for commissioning outlined
in the Government's White Paper "Equity and Excellence: Liberating
the NHS".
2. Breakthrough Breast Cancer is a pioneering
charity dedicated to the prevention, treatment and ultimate eradication
of breast cancer. We fight on three fronts: research, campaigning
and education. Our aim is to bring together the best minds and
rally the support of all those whose lives have been, or may one
day be, affected by the disease. The result will save lives and
change futures—by removing the fear of breast cancer for
good.
3. This submission is based on our response
to the Government's White Paper "Equity and Excellence: Liberating
the NHS". Our submission to the White Paper followed consultation
with members of our Campaigns & Advocacy Network (Breakthrough
CAN) for their views on a range of breast cancer issues. Breakthrough
CAN brings together over 1,300 individuals, regional groups and
national organisations to take action locally on our national
campaigns to secure important improvements to breast cancer research,
treatments and services. Through supporting and training members,
Breakthrough CAN aims to increase the influence of breast cancer
advocates in decisions regarding breast cancer issues.
4. Breakthrough recognises that the last
substantive report of the Health Committee in the last Parliament
reviewed the progress of commissioning in the NHS. Among its conclusions
was the that weaknesses in commissioning are due in large part
to PCTs' lack of skills, notably poor analysis of data, lack of
clinical knowledge and the poor quality of much PCT management.
5. Breakthrough understands that the Coalition
Government regards more empowered and more effective commissioning
as the key to successful delivery of its objectives for the NHS.
Breakthrough is keen to ensure that all breast cancer patients
benefit from highest quality service commissioning.
6. In its response to the recent White Paper,
Breakthrough expressed its concern that in the proposed changes
to GP commissioning consortia and an autonomous NHS Commissioning
Board, GPs may not currently possess the level of knowledge required
or appetite to commission services for health conditions such
as cancer. GPs will need training and support to ensure that they
are aware of the different needs of the various patient groups
and the consortia will need to work closely with the NHS Commissioning
Board to ensure cancer services are joined up across primary,
secondary and tertiary care.
7. While GP consortia will commission services
based on the needs on their local communities, and must use robust
data to do so, it is essential that significant variation in the
quality of services provided across the country does not occur.
The NHS Commissioning Board must play a key role in ensuring consistency
of care provision. Clarity is also needed on how GP consortia
will work with local authorities on public health issues. It is
also essential that appropriate patient and public involvement
is embedded into new commissioning structures, for example ensuring,
as a minimum, lay representation on commissioning boards.
8. Breakthrough would particularly like
to bring to the Health Select Committee's attention that it is
not currently clear what the role of cancer networks will look
like under these proposals. Cancer Networks provide vital expertise
and play a key role in bringing together relevant professionals
involved in the delivery of cancer services and in providing advice
to commissioners—this advisory role should be protected.
9. In greater responsibility being transferred
to the NHS, Breakthrough also believes it is essential that government
Ministers and parliamentarians maintain accountability for performance
and can be held to answer. It is also vital that the NHS Commissioning
Board takes a strong lead in ensuring national consistency of
standards in health care and that the devolvement of power does
not lead to wide variation in levels of care.
October 2010
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