Tuesday Volume 512 29 June 2010 No. 23 HOUSE OF COMMONS OFFICIAL REPORT PARLIAMENTARY DEBATES (HANSARD) Tuesday 29 June 2010 £5·00 © Parliamentary Copyright House of Commons 2010 This publication may be reproduced under the terms of the Parliamentary Click-Use Licence, available online through the Office of Public Sector Information website at www.opsi.gov.uk/click-use/ Enquiries to the Office of Public Sector Information, Kew, Richmond, Surrey TW9 4DU; e-mail: [email protected] 697 29 JUNE 2010 698 almost identical to the chances in the rest of Europe. House of Commons Does the Secretary of State therefore believe that a one-year survival indicator is a good idea both for Tuesday 29 June 2010 encouraging early diagnosis and for matching the survival rates of the best in Europe? The House met at half-past Two o’clock Mr Lansley: My hon. Friend makes an extremely good point. When we set out proposals for an outcomes PRAYERS framework, I hope that he and others will respond, because that is one of the ways in which we can best identify how late detection of cancer is leading to very [MR SPEAKER in the Chair] poor levels of survival to one year. I hope that we can think about that as one of the quality indicators that we shall establish. Oral Answers to Questions Diana R. Johnson (Kingston upon Hull North) (Lab): I welcome the Secretary of State to his new position and wish him well in his role. I understand that he is keeping HEALTH the two-week target for seeing a cancer specialist, but abandoning the work that the Labour Government did on the one-week target for access to diagnostic testing. The Secretary of State was asked— Professor Mike Richards stated in the annual cancer reform strategy that improving GP access to diagnostic Cancer tests is essential to drive for early diagnosis of cancer. Can the Secretary of State spell out some of his current 1. Lilian Greenwood (Nottingham South) (Lab): thinking on what the alternative would be if we no What steps he is taking to improve rates of early longer have the one-week target? detection of cancer. [4459] Mr Lansley: Let me make it clear to the hon. Lady The Secretary of State for Health (Mr Andrew Lansley): and the House that only 40% of those diagnosed with Late detection of cancer is one of several reasons why cancer had actually gone through the two-week wait. our cancer survival rates are below the European average. Establishing a better awareness of symptoms and earlier That is why we will focus on improving those outcomes presentation across the board is, as we have been discussing, and achieving better awareness of the signs and symptoms important to achieve. I am afraid that the hon. Lady is of cancer. These aims will be part of our future cancer wrong: I have not said that we are abandoning any of strategy. the cancer waiting-time targets at the moment, but that we have to be clear about what generally constitutes Lilian Greenwood: Over half the men who receive a quality. For example, seeing a cancer specialist without testing kit under the national bowel cancer screening having had prior diagnosis is often pointless, whereas programme throw it away. What action is the Secretary getting early diagnosis is often a serious indicator of of State taking to improve the take-up of screening, quality. particularly by men, and what provision has he made within the NHS budget for the extra costs of increased NHS Targets take-up? 2. Derek Twigg (Halton) (Lab): What assessment he Mr Lansley: I am grateful to the hon. Lady for that has made of the effects on NHS waiting times of NHS question, and I have had the privilege of twice visiting targets in the last 10 years. [4460] the national bowel cancer screening programme at St Cross hospital in Rugby—it looks after people in parts of the The Minister of State, Department of Health (Mr Simon midlands and the north-west—and indeed, I have visited Burns): Targets focused the NHS on bringing down the Preston royal infirmary, which deals with bowel waiting times, but also put process above clinical judgment cancer screening follow-up. As I said in my first reply, and patient choice. Changing the way in which we one of the things we aim to do is to increase awareness manage waiting times will empower both patients and of the signs and symptoms of cancer. It is unfortunate clinicians. NHS targets have dictated clinical priorities that, as a recent study established, only 30% of the and harmed patient care. Focusing on long waits has public had real awareness of what the symptoms of meant less progress on reducing average waits than cancer would be, beyond a lump or a swelling. We have could otherwise have been achieved. very high rates of bowel cancer, so it will be part of our future cancer strategy to increase awareness of those Derek Twigg: I noticed that in his answer the Minister symptoms and to encourage men in particular to follow did not say that any assessments had taken place. How up on them. many representations has he received from clinicians, people working in the NHS and the public demanding Mr John Baron (Basildon and Billericay) (Con): The the removal of the 18-week target, for instance? Targeting recent inquiry of the all-party parliamentary cancer is about making people better and getting them seen group into cancer and equalities heard expert evidence more quickly, so is not the real reason for dropping to suggest that if people can survive the first year of targets the fact that the Minister wants to undermine cancer, their chances of surviving for five years are the NHS again? 699 Oral Answers29 JUNE 2010 Oral Answers 700 Mr Burns: I am sorry, but the hon. Gentleman, for Andy Burnham: I shall take that as a no, because the whom I have considerable respect, is just plain wrong. Minister did not answer the question; he could not give There have been a number of representations over the that guarantee. He says that we must put people and last seven weeks or so. In addition, as my right hon. patients first, yet at a stroke he has taken power away Friend the Secretary of State and his shadow team went from patients and handed it back to the system, turning round the country over the past five years, they were the clock back to the bad old days of the Tory NHS. Let constantly told by GPs and clinicians from hospital to me quote some comments by Jill Watts, chair of the hospital that politically motivated targets were distorting NHS Partners Network, which represents private providers. clinical decisions and patient care. In the Financial Times on 18 May, she is reported as saying the following about the loss of targets: Mr Stephen Dorrell (Charnwood) (Con): Does my “Waiting times will go up and if people want a procedure they hon. Friend agree that by far the most important way of have a choice: they can wait or they can look to pay”. improving the service delivered by the NHS is to focus Is that not always the Tory choice on the NHS: wait or on the three key indicators of clinical outcomes, patient pay? experience and value for money? Can he assure the House that the Government will pursue those, particularly Mr Burns: The right hon. Gentleman is not right. We against the background of increasingly scarce resources, have not taken that attitude; we never have taken that in order to deliver the objective we all have: a better-quality attitude. We want to have a system whereby the health NHS? service is not in a straitjacket of targets that disrupt and distort clinical decisions. We want to empower clinicians Mr Burns: I am extremely grateful to my right hon. and GPs to take decisions about who should be treated Friend, who is absolutely right, and I can give him the when according to their clinical judgment. categorical assurances he is seeking, but I would also like to add one more: we need information to empower Andy Burnham: Waffle! patients, because if patients are going to be at the heart of the NHS they must have the information to take the Mr Burns: It is not waffle. The right hon. Gentleman decisions that are important to their health care. is clinging to an outdated philosophy, and he is in denial about the need to change it. Mr Speaker: Order. May I gently ask the Minister to NHS Dentists (Chesterfield) face the House? I am sure that Opposition Members will want to see his face. 3. Toby Perkins (Chesterfield) (Lab): If he will take steps to increase the number of dentists providing NHS Andy Burnham (Leigh) (Lab): We do, Mr Speaker, services in Chesterfield; and if he will make a statement. very much; we want to see him squirm. [4461] First, let me say that we welcome the Minister back to the Department of Health; he was a Minister in the The Parliamentary Under-Secretary of State for Health Department 13 years ago. As I have said before, we trust (Anne Milton): I assure the hon. Gentleman that the that he finds the NHS in much better condition than Government have committed to improving access to when he left office. Last week we had an independent NHS dentistry, and the introduction of the new dental verdict on those 13 years.