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Lord Mackenzie of Framwellgate: My Lords, while, of course, we accept that speed kills, is my noble friend aware of the interesting fact that the Chief Constable of Durham has a policy of not using fixed speed cameras at all and that the accident figures in Durham compare very favourably with those in other police areas?

Lord Davies of Oldham: Well, my Lords, Durham has many claims to fame. Other chief constables of course take a different view. We are evaluating the fourth year of the speed camera programme to measure the effect of the cameras, and that will enable us to make a judgment on what at times appear to be alternative views of what is best for the safety of the road travelling public.

Lord Bishop of Chelmsford: My Lords, I accept all that the Minister says about the importance of controlling speed and traffic control, but will he help me with a temptation that I face on the A12? In 2.5 miles of serious road repairs outside our house, we have no fewer than 14 cameras, two of which are situated just at the point of deregulation. Would he help me with the temptation that I might believe that this is as much about revenue raising as it is about speed control?

Lord Davies of Oldham: My Lords, it is not about revenue raising, but it is the case that we are particularly concerned about areas in which there are roadworks, because the statistics establish that that is where a number of accidents occur. If the right reverend Prelate is saying that there is an excessive degree of warning on that particular stretch, I shall certainly look into it. But the right reverend Prelate is safely here, so at least we can thank the speed cameras in that respect.

Lord Rotherwick: My Lords, does the Minister believe that speed cameras are conditioning drivers to
 
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drive more slowly, in the light of the fact that the Minister of State at the Department for Transport last night on "Top Gear" admitted that he had nine points on his licence for speeding?

Lord Davies of Oldham: My Lords, everyone is vulnerable when in control of a vehicle. For a large percentage of the time we are all perfectly secure, but everyone can make a mistake; but we all know the consequences of accumulated mistakes. One offer that we make to those who make mistakes is a speed awareness course which sounds, I know, to many of the general public like an easy option. The only thing that we can attest to is that all members of the public who have undertaken such a course have been very sharply reminded of the dangers of speed and have taken the course very seriously, and it is working to cope with the issue of accumulated points.

Lord Stoddart of Swindon: My Lords, have the Government made any evaluation of the effectiveness of the roadside speed indicator devices, which show motorists what speed they are doing in a controlled area? If so, could the Minister say what the results have been?

Lord Davies of Oldham: My Lords, I am grateful to the noble Lord, who has identified another important road safety aspect—not the cameras that lead to fines but the cameras or signals that give a warning and are effective in reducing speeds. I believe that he is referring to those signals which flash up the speed at which the approaching car is going. They appear to be very effective indeed, but they are expensive to employ, and where they should be employed is up to local consultation. But the noble Lord has identified an important contribution to road safety.

Mouth Cancer

2.59 pm

Baroness Gardner of Parkes asked Her Majesty's Government:

What action they are taking to improve the prevention, detection and treatment of mouth cancer, in view of the link with alcohol and tobacco consumption.

The Minister of State, Department of Health (Lord Warner): My Lords, oral cancer is largely preventable through the promotion of smoking cessation and sensible drinking, which are both areas that we are tackling. We have also funded the Cancer Research UK campaign, Open Up to Mouth Cancer, launched earlier this month to alert people to the signs and symptoms of oral cancer. The National Institute for Clinical Excellence has published guidance on improving outcomes in head and neck cancers, which includes mouth cancer, to ensure that high-quality services are provided throughout the country.

Baroness Gardner of Parkes: My Lords, I thank the Minister for that Answer, and I am grateful that the
 
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campaign has been launched. Is he aware, though, that one of the specialists at the top cancer hospital in this country said that most of the cases they see are already far advanced? The difficulty has been that these people have attended their GP, said they had a sore throat and asked for an antibiotic. That has cured the symptoms without recognition of the disease. Is it not important that more mouth examinations are carried out by doctors or dentists, or even by people themselves? If they have any persistent discomfort or doubt about their mouth or throat they should be looking, in the same way that those who have breast cancer are able to self-diagnose and refer for treatment.

Lord Warner: My Lords, the noble Baroness is quite right. Cancer Research UK's campaign, which I mentioned, is providing material for every GP, dentist and pharmacist, helping them to recognise the early signs of mouth cancer and prioritise referrals. The Department of Health has also commissioned a computerised distance-learning programme to update dentists' knowledge of the symptoms. The new dentist's contract will also promote prevention and give dentists more time to undertake examination of the mouth.

Lord Chan: My Lords, what is the Department of Health doing about vulnerable groups who can get mouth cancer, such as men in low-skilled jobs and some ethnic minority groups?

Lord Warner: My Lords, this is the focal point of Cancer Research UK's campaign. It is targeting these particular groups that are most at risk.

Baroness Neuberger: My Lords, given that we know there is a hugely increased risk of mouth cancer from excessive drinking or tobacco consumption, will the Minister now look at whether we might label alcohol products with the danger of mouth cancer, in the same way as we label tobacco products about, in particular, the risk of lung cancer?

Lord Warner: My Lords, we keep all these issues under review, but we are taking a lot of action to tackle the problems around excessive alcohol consumption, and the noble Baroness is quite right that heavy drinkers and smokers have 38 times the risk of mouth cancer compared with abstainers from both products.

Baroness Morgan of Drefelin: My Lords, does the Minister agree that mouth cancer is one of the less common cancers, and that the provision of and access to high-quality services for patients with mouth cancer is to a large extent reliant on the existence of high-quality cancer networks? What steps are being taken to promote the role of cancer networks in the commissioning of cancer services?

Lord Warner: My Lords, we know that NICE published guidance on improving outcomes in head and neck cancers, including mouth cancer, in November 2004. This will ensure that services are
 
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configured to provide the appropriate high quality. Cancer networks are producing action plans setting out how they will implement this guidance over a three-year period.

Baroness Sharples: My Lords, is the Minister aware that in my local surgery in the country there was a large notice warning you about mouth cancer and telling you to see your doctor if you had a problem? It was very prominent.

Lord Warner: My Lords, I am very pleased to hear about that.

Lord Colwyn: My Lords, according to the latest figures I can find, 44.6 per cent of adults are registered with an NHS dentist. Does the Minister agree that for the 50 per cent-plus of patients who are not registered, early detection of mouth cancer—a disease that has risen by a quarter in the past 10 years—is just not possible?

Lord Warner: My Lords, as I said earlier, we are not just relying on dentists, although the noble Lord will know we have announced that we have exceeded our target of recruiting the whole-time equivalent of 1,000 more dentists within a year. We are also relying on pharmacists and doctors to help with the detection—including the early detection—of oral cancer.

Earl Howe: My Lords, does the Minister agree that it is above all in economically disadvantaged areas that registration with dentists is low, but that it is exactly in those areas that public houses are to be exempt from the proposed ban on smoking? Does that not point up a major shortcoming in the Government's policy on smoking?

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