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Lord Rea: My Lords, in listening to the exchanges so far, the question that is uppermost in my mind is why the Government did not consult the dental profession in order to understand its position before agreeing to the directive.
Lord Chesham: My Lords, we were concerned about the possible dangers involved. We must go back to the thought that a 3.7 per cent. concentration of hydrogen peroxide taken orally can have some very nasty effects on people.
Baroness Masham of Ilton: My Lords, I thank the Minister for her reply. Is she aware that both these forms of cancer are on the increase? Is it not good news that the death rate from testicular cancer is going down but bad and worrying news that about 10,000 men a year in the United Kingdom die from prostate cancer?
Baroness Cumberlege: Yes, my Lords, they are serious cancers. But lung and colorectal cancers kill more people than prostate cancer. Even when all the cancers are put together, coronary heart disease is still the greatest killer in men.
Lord Ashley of Stoke: My Lords, I appreciate that the noble Baroness is willing to help. However, if it is a fact that a screening programme saves lives; if it is a fact that a screening programme is cost effective; and if it is a fact that Germany has had a screening programme since 1979, the year this Government took office, why are the Government making such heavy weather of creating a screening programme?
Baroness Cumberlege: My Lords, before we introduce any screening programme we have to be certain that it will increase the length and quality of life. There is no evidence that this would be achieved in relation to prostate cancer. We also have to ensure that the screening tests are specific and sensitive. That is not the case with this cancer. Furthermore, there is not yet a professional consensus about how to treat men who have positive screening tests. Our view of experience in both the United States and Germany is that their screening programmes are not effective and do not achieve what we would set out to achieve if we were to introduce a programme.
Lord Walton of Detchant: My Lords, does the Minister agree that whereas there is a close correlation between high levels of prostate specific antigen in the circulating blood on the one hand and prostate cancer on the other, in individuals who have a slight or very moderate increase in this antigen in the circulating blood this may be associated with benign enlargement of the prostate? Is it not the case that much more research is needed before a widespread screening programme is introduced because of the risk of raising needless anxiety in those who have slight or moderate increases in this antigen in the blood?
Lord Rea: My Lords, does the noble Baroness agree that an indicator of the seriousness of prostate cancer is that your Lordships' House has lost three of its Members from this disease in recent years, including two medical Peers? Is it not the case that the disease often spreads, usually to the bones, before a diagnosis can be made, whether it is made by a blood test, as my noble friend Lord Walton said, or by a clinical examination? Does she not agree that, while present screening methods may well result in more cases being
Baroness Cumberlege: My Lords, if we had a good test and if we knew what to do about the cancer once it was detected, and if it met the criteria for screening that I have outlined, we would introduce a national screening test. I believe that it has been well explained that that is not the case with this particular cancer. The noble Lord is right: we do need more research in this field. In fact, two projects have been commissioned to review the available evidence both on the cost effectiveness and also on the clinical benefit of different methods of detecting and managing this cancer.
The Countess of Mar: My Lords, is it not the case that testicular cancer is more a disease of young men and that it is often associated with undescended testes? Can the Minister say whether it is possible, through self-examination and by dealing with backache when it is found very early on, to save lives? I understand that if this disease is caught very early there is something like a 95 per cent. cure rate.
Baroness Cumberlege: My Lords, deaths from testicular cancer are indeed very rare. The noble Countess is right in saying that it is a disease of young men. We believe that we are tackling it well at the moment and, as the noble Countess said, 95 per cent. of the patients are cured.
Baroness Masham of Ilton: My Lords, is the Minister aware that there are enough cancer specialists throughout the country to enable GPs, when they detect prostate cancer, to send the patient to a specialist? Will she press for more research into this very worrying condition?
Baroness Cumberlege: Yes, my Lords. As regards research, I believe I explained that there are two projects under way at the moment. As to the number of cancer specialists, there are very different types of cancer consultants. We are aware that the National Health Service could do with more cancer specialists; indeed, we have allowed for that in our budgetary proposals.
Baroness Cumberlege: My Lords, the Department of Health issued a leaflet for the public in October which gave advice on how to avoid influenza, what to do if they caught it and who should be vaccinated. Posters and leaflets are routinely displayed in GPs' surgeries.
Lord Campbell of Croy: My Lords, I am grateful to my noble friend for her reply. I understand that epidemic status has now been reached. After the previous visitations of the Asian and Hong Kong versions, is there any reason for naming this year's variety "Johannesburg 'flu", other than similarity to symptoms of acute anxiety over cricket there last week? As I understand from my noble friend's reply that inoculations are being advised, has the vaccine improved since the helpful words of caution in 1986 from my noble friend Lady Trumpington, whom we all hope to see back soon fully restored to robust health?
Baroness Cumberlege: My Lords, I understand that the various strains of influenza are named according to where they start. I am not quite sure what the correlation is with cricket on this occasion, but I know that Atherton was declared "Man of the Match" so he must have been fit and well. As regards vaccination, that has improved since 1986. I am sure that what my noble friend Lady Trumpington had to say on that occasion was correct. It would have to be a very brave and virulent virus to take on my noble friend.
Lord Mackie of Benshie: My Lords, is the noble Baroness aware that in Scotland we make a medicine which, taken with a little lemon and sugar at bedtime, ensures that the influenza will at least be pleasant?
Lord Tordoff: My Lords, can the noble Baroness advise the House whether vaccine is available? Having attempted to obtain vaccination myself over the past fortnight, I have been told by my GP that there are only 50 doses left in the country and that he is unable to obtain any.
Baroness Seear: My Lords, is the noble Baroness aware that I was one of the fortunate people to get some of this rare vaccine? Is she further aware that I then contracted a condition which I would have been certain was influenza if I had not known that I could not have it?