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House of Lords

Monday, 28th April 2003.

The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.

Prayers—Read by the Lord Bishop of Truro.

Prostate Cancer: NHS/Voluntary Sector Co-operation

Baroness Pitkeathley: My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I declare an interest as patron of the Prostate Cancer Charity.

The Question was as follows:

    To ask Her Majesty's Government what steps have been taken to improve co-operation between the National Health Service, the voluntary sector and professional organisations in tackling diseases such as prostate cancer.

Baroness Andrews: My Lords, the Prostate Cancer Advisory Group will meet for the first time on 10th June. A joint NHS and voluntary sector national partnership group has also been set up to develop proposals for a new approach to planning and funding specialist palliative care. In those and other ways the Government place a high value on extending partnership with the voluntary sector across the whole of health and social care.

Baroness Pitkeathley: My Lords, I thank my noble friend for that Answer. The advisory group set up to bring together the prostate cancer charities is popular and I believe will be successful. Does my noble friend think that the model could be replicated among the many other groups in the cancer field as both campaigners and service providers? If so, perhaps she could extend her Answer a little and say what the Government are doing to promote that.

Baroness Andrews: My Lords, we are delighted that out of the Prostate Cancer Charter for Action came the Prostate Cancer Advisory Group. That is a welcome step. The group exists to help government to determine how to raise public awareness. It will help to inform the policy programmes and to monitor progress. It is a very good model. We should like it to be replicated in terms of sharing information and collaboration. There are other models in the field on which we want to build, for example, the palliative care partnership, which I mentioned, which is considering ways of planning and funding palliative care, and is an important development. The National Centre for Volunteering is about to set up a new group to support volunteering policy and practice in health and social care. We are very keen to develop such models.

Lord Clement-Jones: My Lords, the formation of the Prostate Cancer Advisory Group is extremely

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welcome. However, there are a number of questions surrounding its formation, which are pertinent. Will the group consider the charter for action, how it can be implemented and the resources that will be available from government to do that? In particular, will it consider the question of the information database and whether that will be formed and adopted by the Government in due course? These are important issues.

Baroness Andrews: My Lords, we shall have to wait and see what the meeting on 10th June brings forth. The terms of reference are to review the progress and implementation of the prostate cancer elements of the National Cancer Plan and the NHS Plan; to advise on future policy programmes; to emphasise the importance of raising awareness and to find better ways to do that. Presumably, it is to consider, too, the progress of the prostate cancer risk management programme and how best to develop it. The noble Lord can rest assured that, having been put in position, the group will do a jolly good job.

Lord Brookman: My Lords, notwithstanding the forward programme on this serious issue, have the Government any information on how long it takes before someone with prostate cancer is operated on?

Baroness Andrews: My Lords, as regards waiting times, 95.7 per cent of people who are referred urgently get to see a specialist within that time. That is an important statistic. Part of the problem with prostate cancer is the difficulty in telling how fast it develops. We do not yet have a test which allows us to measure the difference between slow-growing cancers and aggressive cancers. That is one reason why we are spending 20 times more on research into prostate cancer than we were four years ago.

Baroness Oppenheim-Barnes: My Lords, does the Minister agree that awareness is an important factor but that equally important is easily accessible testing on the National Health Service which, although it may not be completely definitive, can be carried out quickly?

Baroness Andrews: My Lords, yes. The science is not yet sufficiently well advanced for us to have a test which is entirely reliable. The current testing throws up false negatives and false positives. The purpose of the prostate cancer risk management programme is to be sure that men who are worried about prostate cancer go to their GPs and get as much information as they can possibly absorb in order to make a judgment about whether they should have the test. Such information also helps GPs to make that judgment. We are doing a great deal of research into the test. As of March this year all the PSA tests will have to be calibrated with the WHO tests. We are looking to improve the tests all the time.

Earl Howe: My Lords, can the Minister tell the House what is being done to increase the number of

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trained prostate pathologists to cope with the rising demand for diagnosing prostate cancer? Similarly, how many specialist nurses are in training to support prostate cancer patients and GPs?

Baroness Andrews: My Lords, my extensive briefing was not extensive enough. I shall write to the noble Earl on both those questions as I do not have the figures in front of me.

Baroness Gardner of Parkes: My Lords, I, too, declare an interest, as a sponsor of the prostate cancer group. Despite the fact that such tests are still giving false negatives and false positives, can the Minister tell the House whether there is now a greater presentation of men for tests? Women have been very much better at presenting for breast cancer screening than have men for prostate cancer screening. Can the Minister tell the House whether that has changed?

Baroness Andrews: My Lords, the reasons for introducing the prostate cancer risk management programme include not only trying to increase the amount of information in the field which would enable men to make sensible decisions and not be embarrassed, but also to enable us to measure the effect of such a programme on the take-up of testing. We are evaluating the programme and I hope that in a few months we shall be able to give the noble Baroness the information she seeks.

Lord Ezra: My Lords, can the noble Baroness indicate what progress has been made in devising a more reliable test than the PSA test?

Baroness Andrews: My Lords, as I have said, much of our research relates to refining and developing the test itself. The "protect" trial, which involves many thousands of people, will look not only at the test but also at the best forms of treatment. So we are doing a lot of research, but we must keep watching the signs. I shall certainly keep the noble Lord informed of any breakthroughs.


2.42 p.m.

Lord Peyton of Yeovil asked Her Majesty's Government:

    Why no decision has yet been made on the Crossrail project and how the delay will affect the London infrastructure plan.

Lord McIntosh of Haringey: My Lords, in February, Cross London Rail Links Limited, a joint Strategic Rail Authority/Transport for London company, submitted to Ministers an interim business case for Crossrail. Given the importance of the project for the future development of London and beyond, and the costs involved, it is essential to ensure that the

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proposals are soundly based, financeable and deliverable. An announcement will be made as soon as is practicable.

I assume that the Question refers to the Mayor's Spatial Development Strategy, his draft London plan. The final plan should be published towards the end of this year or early next year. There will certainly be more about the prospects for Crossrail during that period.

Lord Peyton of Yeovil: My Lords, does the noble Lord agree that Crossrail is somehow symbolic of our national processes and indicative of our plight? The project has been around for some 15 to 16 years now. It is very much needed and yet it seems to have become bogged down in a welter of committees, consultants—about the only beneficiaries—and reports. The time has arrived for decision. The Department for Transport must be well aware of every argument for and against the issue. I hope that the Minister will push the department to solve this problem as soon as possible, instead of letting it drift on indefinitely and get nowhere while the solution becomes more expensive.

Lord McIntosh of Haringey: My Lords, the noble Lord, Lord Peyton, does a fine line in scorn. I always enjoy being the butt of it. But really this is going a bit too far. The Crossrail project was first proposed in 1989. It was killed off in the Railtrack privatisation by his government. The present project was revived only in December 2000. Yes, of course we take a long time on many of these projects. But when I look back at past projects—the first Channel Tunnel proposal took 15 years to come to nothing; the second Channel Tunnel proposal took 15 years and escalated in cost from £2.6 billion to £12 billion; and the Jubilee Line was late and 67 per cent above cost—is it not better to get it right even if it takes a little longer?

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