Vol. 730 Monday No. 197 3 October 2011 PARLIAMENTARY DEBATES (HANSARD) HOUSE OF LORDS OFFICIAL REPORT ORDER OF BUSINESS Retirements of Members Questions Health: Breast Cancer Railways: Theft House of Lords: Reform EU: Credit Rating Agencies Sovereign Grant Bill Second Reading (and remaining stages) London Olympic Games and Paralympic Games (Amendment) Bill Second Reading Written Answers For column numbers see back page £3·50 Lords wishing to be supplied with these Daily Reports should give notice to this effect to the Printed Paper Office. The bound volumes also will be sent to those Peers who similarly notify their wish to receive them. No proofs of Daily Reports are provided. 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All prices are inclusive of postage. © Parliamentary Copyright House of Lords 2011, this publication may be reproduced under the terms of the Parliamentary Click-Use Licence, available online through The National Archives website at www.nationalarchives.gov.uk/information-management/our-services/parliamentary-licence-information.htm Enquiries to The National Archives, Kew, Richmond, Surrey, TW9 4DU; email: [email protected] 951 Retirements of Members[3 OCTOBER 2011] Health: Breast Cancer 952 Earl Howe: My Lords, the noble Baroness, with her House of Lords expert knowledge in this area, is absolutely right that access to appropriate treatment, delivered to a high Monday, 3 October 2011. standard, is critical to improving outcomes. We have made a commitment to expanding radiotherapy capacity 2.30 pm by investing around £150 million more over the next four years. That is intended specifically to increase the Prayers—read by the Lord Bishop of Oxford. utilisation of existing equipment, establish additional services and make sure that all patients who need the Retirements of Members therapy can get it. We are investigating a tariff for IMRT; that is part of our work towards the aspiration Announcement to ensure that IMRT is available in at least one centre per cancer network by 2012. It is a matter for local 2.35 pm decision-making, but an IMRT development programme The Lord Speaker (Baroness D’Souza): My Lords, I is now in place. have to notify the House that the noble and right reverend Lord, Lord Habgood, and the noble Lord, Lord Alderdice: My Lords, would my noble friend Lord Hutchinson of Lullington, have both indicated agree that progress in this important area of breast their wish to retire permanently from the service of the cancer is likely to be found in the identification of House, and their retirements take effect today. I am molecular markers and the design of appropriate sure that the House will wish to join me in recognising targeted medications, as has been the case in breast the service of both noble Lords to the House and cancer with HER2 and Herceptin, for example? Would wishing them well in their retirement. he acknowledge that it is a very expensive treatment? Although it really improves quality of life as well as mortality and outcome, the expense of not only the Health: Breast Cancer medication but the tests themselves is considerable. Question How will the NHS cope with this important but very expensive progress? 2.36 pm Earl Howe: My noble friend makes an extremely Asked By Baroness Morgan of Drefelin important point. That is why we need a body such as NICE, the National Institute for Health and Clinical To ask Her Majesty’s Government what assessment Excellence, to advise the health service on what treatments they have made of the impact Improving Outcomes: represent cost-effective value for money. The tendency A Strategy for Cancer, issued by the Department of of drugs to impose considerable cost on the NHS is Health, has had on women with breast cancer. very great, as he points out. It is important that clinicians focus on those drugs that really do the best The Parliamentary Under-Secretary of State, for patients. I am aware that a number of drugs are Department of Health (Earl Howe): My Lords, our currently being assessed by NICE with regard to breast cancer outcome strategy sets out our ambition to cancer. improve outcomes for all cancer patients and save an additional 5,000 lives every year by 2014-15. Specifically Baroness Thornton: My Lords, I apologise for my on breast cancer, the strategy outlined commitments conference throat—it is all the cheering I did last on local awareness campaigns, expanding breast cancer week. The Government published a strategy for cancer screening, measuring the prevalence of metastatic breast in January 2011 and set a target of improving cancer cancer, and one-day stays for breast surgery. Good survival rates, so that by 2014-15 an extra 5,000 lives progress is being made in all these areas and the will be saved each year. What progress has been made strategy’s first annual report will be published in the towards meeting the target that was expressed in Improving winter. Outcomes: A Strategy for Cancer and saving those extra 5,000 lives a year? Baroness Morgan of Drefelin: My Lords, may I Earl Howe: My Lords, there are broadly three ways remind the House of my interest as chief executive of in which we can attain that target. The main way is the research charity Breast Cancer Campaign? I thank through early diagnosis—in particular, by making sure the Minister for his response. I have two brief that women are aware of the signs and symptoms that questions. We know that radiotherapy is a very cost- could indicate breast cancer—but also by improving effective treatment, improving outcomes for people access to screening and to radiotherapy, which has with cancer at 5 per cent of the NHS cancer spend. already been covered in the question from the noble Can the Minister explain to the House what progress Baroness, Lady Morgan. To support the NHS to is being made to ensure that the additional investment achieve earlier diagnosis of cancer, the strategy has set out in the outcomes strategy is actually being been backed by over £450 million over the next four converted into improved outcomes rather than lost in years. That is part of over £750 million additional the bottom line? Can the Minister say what steps are funding for cancer over the spending review period. being taken to improve access for women to IMRT radiotherapy, which is, of course, the modern version Lord Patel: My Lords, we know that one of the of this treatment and which can be so beneficial for reasons for the poor outcomes on cancers is the late appropriate referrals? referrals of patients who suffer from cancers. We are 953 Health: Breast Cancer[LORDS] Railways: Theft 954 [LORD PATEL] I am pleased that the Government appear to be now likely to have performance management of primary taking the problem of metal theft seriously. Is the noble care doctors being based on their referral patterns. Lord aware—I am sure he is—that ACPO reckons Can the Minister confirm that there will be no financial that the cost to the United Kingdom economy last incentive for reducing referrals of suspected cancer year of this crime was something in the order of patients for treatment? £770 million and that the problem is getting worse with the rise in the price of scrap metal? I doubt Earl Howe: Yes, I can, my Lords. It is very important whether there are many Members of your Lordships’ that doctors should feel absolutely free to refer patients. House whose trains have not been delayed as the result I remind the noble Lord that it is a right for patients, of the theft of signalling cable, which is adding thousands under the NHS constitution, to expect to be referred of hours of delay to train schedules. Does the Minister within the laid-down waiting time maximum periods, agree that the Scrap Metal Dealers Act 1964 is now so we are very clear that there should be nothing to out of date and that it needs to be replaced by new interfere with doctors’ clinical judgment in this area. legislation that increases maximum penalties, eliminates the payment of cash as a means of settling transactions Baroness Fookes: My Lords, am I right in thinking and moves to a system of licensing in place of the that screening comes to an end after a certain age for registration that exists at present? women? If that is correct, does it make any sense when the incidence of breast cancer increases with age? Lord Henley: My Lords, I join the noble Lord in expressing regret at the departure of my noble friend.