 Baroness Morgan of Drefelin
    
        
    
    
    
    
    
        
        
        
            Baroness Morgan of Drefelin 
        
    
        
    
        
To ask Her Majesty’s Government what assessment they have made of the effectiveness of the cancer drug fund.
 The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)
        
    
    
    
    
    
        
        
        
            The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) 
        
    
        
    
        My Lords, since October 2010, more than 7,500 patients in England have benefited from the additional funding we have provided for cancer drugs. The £600 million we have committed over three years will improve the lives of many thousands more cancer sufferers, giving them precious extra time with their loved ones.
 Baroness Morgan of Drefelin
    
        
    
    
    
    
    
        
        
        
            Baroness Morgan of Drefelin 
        
    
        
    
        My Lords, I remind the House of my interest as chief executive of a cancer research charity. Can the Minister share with the House thoughts on plans for the fund, following the abolition of strategic health authorities which are currently responsible for administering the fund? Will he share with us any thoughts the department has about emerging patterns of variation in access to the fund? I appreciate that it is a new fund and that patterns are difficult to see in a field where there are small numbers. I would, however, be interested to know what steps the department is taking to issue further advice on that question.
 Earl Howe
        
    
    
    
    
    
        
        
        
            Earl Howe 
        
    
        
    
        My Lords, I pay tribute to the noble Baroness for her work in this area. She asked what would happen when strategic health authorities are abolished. Arrangements from 1 April 2013, which is the planned abolition date, and beyond will be the subject of discussions between my department and the NHS Commissioning Board Authority. So I cannot give her definite news yet on that front.
I know that the regional clinical panels are using their own judgment to come to decisions, and it is entirely right that they should. At the same time, they are alive to apparent variations in the drugs that are being made available through the fund in different regions, and I understand that the SHA clinical panels are working collectively now to better understand the reasons for those differences.
 Lord Clement-Jones
        
    
    
    
    
    
        
        
        
            Lord Clement-Jones 
        
    
        
    
        My Lords, I welcome the fact that thousands of cancer patients have benefited from the cancer drugs fund, but can the Minister give an assurance that those cancer treatments currently available through the fund will continue to be available when value-based pricing is introduced in 2014?
 Earl Howe
        
    
    
    
    
    
        
        
        
            Earl Howe 
        
    
        
    
        One of our aims for value-based pricing is to give patients better access to innovative and clinically effective drugs, which, unfortunately, has not always been the case until now, hence the need for the cancer drugs fund. That is certainly one of our ambitions for value-based pricing.
 Baroness Pitkeathley
        
    
    
    
    
    
        
        
        
            Baroness Pitkeathley 
        
    
        
    
        My Lords, does the Minister agree that one of the problems with this very welcome fund is that still too few patients know about it? Is his department planning any information campaign to ensure that patients know more about it so that they can ask for access to the fund themselves, particularly in view of the more complex structure that they will face in the NHS when the Bill currently before the House is law?
 Earl Howe
        
    
    
    
    
    
        
        
        
            Earl Howe 
        
    
        
    
        My Lords, the noble Baroness makes a good point. We endeavoured to publicise the fund in April when it was created. We have reminded the health service to make the fund’s existence known wherever possible. The specific answer to her question is no, we do not plan a publicity campaign. However, we wish to ensure that clinicians in the service are as fully aware of the fund as they should be. I believe that they are, certainly at the level of secondary care.
 Baroness Gardner of Parkes
        
    
    
    
    
    
        
        
        
            Baroness Gardner of Parkes 
        
    
        
    
        My Lords, I have read in the paper that some very expensive cancer drugs will now be approved by NICE on the understanding that DNA testing will assess whether the patient will benefit from them. This was one of the arguments to do with giving terribly expensive drugs. Will these drugs also now be available from the same source after 2013?
 Earl Howe
        
    
    
    
    
    
        
        
        
            Earl Howe 
        
    
        
    
        We plan to ensure that value-based pricing will take care of the gap that currently exists in the availability of cancer drugs, which the cancer drugs fund is trying to address. In theory, until then any drug that a clinician wishes to prescribe for a cancer patient is available under the cancer drugs fund. There is no restriction that we have set; it is a clinical judgment.
 Lord Roberts of Llandudno
        
    
    
    
    
    
        
        
        
            Lord Roberts of Llandudno 
        
    
        
    
        My Lords, many patients from north Wales go to Christie’s Hospital in Manchester or Clatterbridge on Merseyside. How will this fund be available to them? How does Wales come out of the complexity of this situation?
 Earl Howe
        
    
    
    
    
    
        
        
        
            Earl Howe 
        
    
        
    
        My Lords, it is of course for the devolved Administrations to make their own decisions about their individual needs and budgets. It will depend on whether commissioners in Wales are willing to accept the cost of treating a patient with a drug that is not normally available in Wales. I cannot generalise but it is up to Welsh commissioners to take that decision.
 Baroness Howarth of Breckland
    
        
    
    
    
    
    
        
        
        
            Baroness Howarth of Breckland 
        
    
        
    
        My Lords, I am aware that 2013 is approaching very fast. Does the Minister’s department have a timetable for the strategy that will be in place once the strategic health authorities have gone? Will there be consultation on those plans?
 Earl Howe
        
    
    
    
    
    
        
        
        
            Earl Howe 
        
    
        
    
        My Lords, as I told the noble Baroness, Lady Morgan, discussions are ongoing as to the arrangements that will be in place after the abolition of strategic health authorities. I cannot say that we have definite plans in place but I hope that we will be able to announce our plans soon.
 Baroness Farrington of Ribbleton
    
        
    
    
    
    
    
        
        
        
            Baroness Farrington of Ribbleton 
        
    
        
    
        My Lords, cancer treatment drugs are often used in a range of measures to treat people suffering from cancer, including both chemotherapy and radiotherapy. Is it not the case that concern is being expressed about the closure of access to radiotherapy in some hospitals, and that people are having to travel for up to three hours? I understand that this is a problem in Essex and other parts of the country. Does the Minister share the concern about people not being able to get the treatment they need if these centres close? Who is responsible now, and who would be responsible in the future under the Government’s proposals, for ensuring that reasonable access is maintained?
 Earl Howe
        
    
    
    
    
    
        
        
        
            Earl Howe 
        
    
        
    
        We are concerned to ensure that patients have reasonable access to the treatments that they need, including radiotherapy. I can tell the noble Baroness that part of the additional funding that we are making available under the strategy for cancer that we published earlier this year will go towards widening access to radiotherapy—not only better utilising the facilities that we have but commissioning new facilities. However, I am afraid it is the case that we increasingly see specialised units being concentrated in fewer locations. Unfortunately, this will mean that some patients have to travel a little further than they otherwise would have.