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Lord Clement-Jones: My Lords, I thank the Minister for that reply. I also congratulate him on his choice of buttonhole. I welcome the Prime Minister's direct personal interest in cancer services through his hosting of a summit last Thursday on the subject, relating in particular to the on-line connection between cancer BACUP and its telephone information service-- I declare an interest as a trustee--and NHS Direct. As a result of the prime ministerial summit, will there be further resources for more oncologists and drugs for cancer treatment in order to bring the United Kingdom up to the standard of other western European countries in terms of survival rates?

Lord Hunt of Kings Heath: My Lords, I thank the noble Lord for his commendation of my buttonhole; it is to mark a cancer charity's initiative this week. My right honourable friend the Prime Minister has taken a particularly close interest in these important issues. As the noble Lord said, he held a summit on 20th May where a number of issues were considered, including the research needed by the service in this country and the question of resources. In that regard we have already made a start by investing £60 million into services for the three most common cancers--breast, bowel and lung. A further £150 million will be available over the next three years from the National Lottery New Opportunities Fund. That will be particularly focused

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towards new equipment. I should mention here the extra £21 billion that the Government are also putting into the NHS during that period.

Earl Baldwin of Bewdley: My Lords, will the Minister do all that he can to widen the actual research agenda beyond the usual surgery, radiation and drugs, which have had a sadly limited impact--despite what we are sometimes told in newspaper reports--on mortality figures for many years? Does the noble Lord recognise that there are other, shall we say, less orthodox approaches, such as herbal medicines, healing, nutritional medicine and mind/body approaches, which are well worth investigation?

Lord Hunt of Kings Heath: My Lords, the NHS research and development programme is always open to suggestions of proposals for research. Perhaps I may take the general point about the availability of homeopathic and herbal medicines. We want the development of cancer services to be patient centred, but the clinical judgment of the clinician in respect of individual patients and decisions made at local level on priorities are matters which must be taken into account.

Baroness Pitkeathley: My Lords, does my noble friend the Minister agree that the holistic approach to cancer is what we seek? I declare an interest as the chair of the New Opportunities Fund. Although much of that money will be spent on equipment, it will be part of projects which develop that holistic approach to cancer treatment, keeping, as my noble friend said, the patient at the centre.

Lord Hunt of Kings Heath: Yes, my Lords; I very much agree with what my noble friend has said. The holistic approach is very important. However, it is also important that we look at the general availability of services throughout the country to ensure that there is less inconsistency than there has been in the past. In particular, we need to ensure that the various parts of the health service--be it primary care, local district general hospitals and the specialty centres at regional and national level--all work together to provide a comprehensive service.

Earl Ferrers: My Lords, when the lottery fund was first introduced, I thought it was decided that such funds would not be used to replace funds which are normally the responsibility of the Government. Is that not now the case?

Lord Hunt of Kings Heath: My Lords, I believe that the Government have shown their commitment to the NHS by investing £21 billion in it over the next three years. The money coming from the lottery fund will be in addition to that sum. If we were to ask members of the public whether they thought that improving cancer services in this country was a good use of such money I think that they would say that they support it.

Earl Howe: My Lords, does the Minister accept that new cancer drugs will need to pass the test of

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cost-effectiveness set by the national institute for clinical excellence before they can be put on to the market, but that for palliative cancer treatments, which are designed principally to enhance the quality of life, cost-effectiveness is something which simply cannot be measured? Therefore, does that mean that NICE will become a de facto mechanism for rationing the availability of treatments within the NHS, even in cases where clinical effectiveness is not in doubt?

Lord Hunt of Kings Heath: No, my Lords. The noble Earl is absolutely right to point to the valuable role that NICE will play in the future in enabling the NHS to make the most cost-effective decisions about drugs and treatments. However, the real benefit of what NICE is doing is not to take away decisions which will still fall to be dealt with at local level, but to enable those at local level who have to make those decisions make them on the best available clinical evidence.

Lord Clement-Jones: My Lords, will the Minister have a further crack at answering my original Question? Professor Karol Sikora said that, without more cash, the prime ministerial summit of last Thursday would simply be window-dressing. Therefore, can the Minister tell us what further cash will be available for cancer services, as a result of that summit?

Lord Hunt of Kings Heath: My Lords, I thought that my first Answer was rather good. Nevertheless, I shall have another go. I believe I said that the Government have already started to ensure improvements by investing an extra £60 million directly into the most common cancer services. We have said that a further £150 million will be available from the National Lottery New Opportunities Fund. Moreover, as a result of the additional money that the health service will receive over the next three years, health authorities, together with NHS trusts and primary care groups, will have to decide where to spend that money. I am sure that many of them will decide that cancer services do warrant some further investment. However, those decisions are quite rightly left to local level.


11.25 a.m.

Lord Avebury asked Her Majesty's Government:

    Whether, as a permanent member of the Security Council, they will ask the Secretary-General of the United Nations to report on the shelling by India and Pakistan across the cease-fire line in Kashmir.

The Parliamentary Under-Secretary of State, Foreign and Commonwealth Office (Baroness Symons of Vernham Dean): My Lords, we have no plans to ask the Secretary-General to report on the shelling across the line of control in Kashmir. As a friend of both India and Pakistan, we continue to urge both countries to work together, in the spirit of their talks in Lahore in February, to resolve the issues between them, including Kashmir. We have raised our

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concerns about the recent fighting with the Indian and Pakistani governments and will continue to follow developments closely.

Lord Avebury: My Lords, has the noble Baroness noted the concern expressed by the UN Secretary-General about the use of jet aircraft and helicopters in the military action across the line of control, which I believe is unprecedented in peacetime? Will the Security Council at least discuss this crisis so as to obtain an immediate cease-fire and, preferably, ensure that the report of the UN observers, who are on this cease-fire line, is published so that the responsibility for the military action which has developed over the past few weeks can be identified?

Further, would the Government also be able to suggest in a resolution to the Security Council that the artillery units, which are kept by both sides adjacent to the line of control, be withdrawn to a distance of at least 20 kilometres from that line? Should we not also suggest that a representative of the Secretary-General visit Islamabad and New Delhi at the invitation of those governments to see what further steps the UN can take, in pursuance of its peace-keeping function, to ensure that the conflict is brought to a quick end?

Baroness Symons of Vernham Dean: My Lords, the noble Lord has put forward these suggestions before; indeed, he was kind enough to share them with us in a debate that we had on the issue on 20th April. However, any offers of help in this situation, whether they come from the UN or from the friends of both countries who wish to help, must be acceptable to both countries if they are to stand any chance whatever of success. I am bound to point out to the noble Lord that his suggestions certainly strike Her Majesty's Government as being unlikely to find favour with either India or Pakistan. Her Majesty's Government are focusing on encouraging both sides not to escalate the military action, while seeking to find new ways of reducing the tensions and continuing the dialogues that both prime ministers began in February and which, I believe, received general support from the House when we discussed the matter on 20th April.

Lord Ahmed: My Lords, is my noble friend the Minister aware that since the recent air strikes with MI17 helicopter gunships backed by MiG fighters, aircraft from the Indian Air Force have caused more than 10,000 people from Dras and Kargil to leave the area and go to Ladakh because they have nowhere to go? Is she also aware that last year, when violations of the line of control took place, over 50,000 people moved from that line because of the continuous shelling from both sides? As a consequence, the people who suffer are the Kashmiri people. Does my noble friend agree with me that the showing of excessive force would lead to a nuclear conflict between India and Pakistan and that only by resolving the issue of Kashmir, in accordance with United Nations resolutions, will this dispute be settled?

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