Prostate Cancer: National Screening Programme

Debate between Baroness Merron and Lord Bishop of St Albans

Thursday 27th February 2025 Lords Chamber

[The Lord Bishop of St Albans]

To ask His Majesty’s Government what plans they have to introduce a national screening programme for prostate cancer.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, we are investing £16 million in the Prostate Cancer UK-led TRANSFORM trial to look for better tests than we have currently. Evidence shows that the current best test available, the PSA test, is not accurate enough to use in men without symptoms. As noble Lords will appreciate, policies must be evidence-based, so the UK National Screening Committee is actively reviewing the evidence for prostate screening programmes and will complete its review this year, to be followed by consultation.

[The Lord Bishop of St Albans]

My Lords, I declare an interest, in that just a year ago I was unexpectedly and rapidly diagnosed with prostate cancer and received wonderful treatment from the NHS, to which I pay tribute today. Some 12,000 men die each year, many needlessly, because of late diagnosis. It is a postcode lottery. It is quite clear that in areas of socioeconomic deprivation, and among black men between the ages of 45 and 70, there is a much higher incidence. When can we expect to hear news about a national screening programme? What assessment is being made of the new tests that are being reported at the moment, which are much more successful in diagnosis?

[Baroness Merron (Lab)]

My Lords, I am glad to hear that the right reverend Prelate had such good care in the NHS. His comments are appreciated, and we are very pleased that things have out turned so well for him. The issue, as I know he will he understand, is that we cannot offer an inaccurate test to high-risk groups, not least because that increases the risk of adverse effects, unnecessary treatment and misdiagnosis. We are not yet in a scientifically and evidence-based position to offer the national screening programme, and that is why we are taking the action that I outlined in my Answer.

National Cancer Plan

Debate between Baroness Merron and Lord Bishop of St Albans

Monday 10th February 2025 Lords Chamber

[Baroness Merron (Lab)]

As my noble friend is aware, the NIHR very much welcomes funding applications for research into any aspect of human health, including all cancers. As with other government funders of health research, it does not allocate funding for specific disease areas. My noble friend is well aware that applications are subject to peer review and judged in open competition—in other words, to make awards on the basis of the importance of the research to patients and on value for money. I appreciate his observation about investment. It is an area to which we are committed and will continue to be.

[The Lord Bishop of St Albans]

My Lords, a year ago this very afternoon, this very moment, I was in a surgery having a radical prostatectomy. I pay tribute to Professor Vasdev and his amazing team at Lister Hospital for the exceptional treatment I received. He is one of many fabulous people working in our NHS. The discrepancies, though, of diagnosis and treatment are stark in different parts of the country. Having worked in some of the more disadvantaged areas in the past, I am acutely aware of those. What are His Majesty’s Government’s going to do, as the plan is developed, to ensure that we look at the religious, social and ethnic barriers which are stopping groups coming forward to receive diagnosis and treatment? Will they particularly focus on how we can address these to try to support those in the most disadvantaged parts of our country?

[Baroness Merron (Lab)]

This is an extremely important point which will very much feature in the cancer plan. I am sure all noble Lords will join me in being glad to see the right reverend Prelate in rude health. I share his comments about the quality of care that is offered. I was fortunate enough to visit the Royal Marsden NHS Foundation Trust and Institute of Cancer Research on the day of the launch of the national cancer plan and the AI-assisted trial for women to tackle breast cancer. I assure the right reverend Prelate that that is crucial. I say from the Dispatch Box that I would expect any plan and work to take account of inequalities. I mentioned earlier targeting lung cancer; that is exactly what it does, and we need to see more of that.

Health and Adult Social Care Reform

Debate between Baroness Merron and Lord Bishop of St Albans

Tuesday 7th January 2025 Lords Chamber

[Baroness Merron (Lab)]

I understand the wish of many, myself included, for more urgent action. However, the reality is that acting in haste will not solve the problem, not least because of the depth of the difficulties we are looking at. The noble Lord is right that many promises have been made—a number by his own Government—but not fulfilled regarding what should happen on the cap. I reiterate the point I made earlier: while I appreciate that there are Members of your Lordships’ House who believe that Dilnot is the answer, it deals with just one aspect, and that is not what we need. As my noble friend just said, we need a comprehensive look at creating a more joined-up service that will work around people, rather than focusing on institutions or one particular problem.

[The Lord Bishop of St Albans]

My Lords, I am grateful to His Majesty’s Government for trying to get cross-party agreement on this really important issue; it is important that it does not get lost in party politics. It is good to hear about the improvements to the NHS app, which is working quite well in some areas already. However, some people are digitally excluded, and there is a lack of connectivity in rural areas. How are we going to ensure that these groups are not excluded as we go forward with this important work?

[Baroness Merron (Lab)]

The right reverend Prelate is correct to mention—I have raised it myself—not just the digital exclusion of individuals but connectivity. It is one of the reasons that we will approach this in a cross-government fashion. However, on our move from analogue to digital—the noble Lord, Lord Kamall, rightly mentioned the capacity of the NHS—our view is that it can do so much more than it is doing currently. The Secretary of State said in the other place that restaurants, for example, have been texting customers for many years, have they not? They remind customers about their booking and give them a chance to cancel or change it. That is the kind of connectivity and service that we need from the NHS. I assure the right reverend Prelate that, where people are unable to use whatever the digital solution might be, they will be able to deal with it person-to-person or on paper. We will be flexible enough and actively seek out those who are not, as he described, immediately connected.

National Insurance Contributions: Healthcare

Debate between Baroness Merron and Lord Bishop of St Albans

Tuesday 19th November 2024 Lords Chamber

[Baroness Merron (Lab)]

What I would say to each sector, including pharmacists, about the services they provide and what is expected in return from any contract is that, as in previous years—I emphasise that it is business as usual in this respect—employer national insurance contributions are dealt with as part of the process. We are very appreciative of the pharmacy sector’s contribution, not least because it will assist with one of the three pillars in moving from hospital to community services. I encourage all pharmacists to work with us to achieve what I believe they and we in government want: a service that is fit for the future.

[The Lord Bishop of St Albans]

Can the noble Baroness help us understand the huge impact this is having on the hospice movement, which is an extraordinary sector? We get an incredible service from it but, ironically, while we are having a national debate on assisted dying—some of us prefer to call it assisted suicide—this will make it even more difficult to provide this much-valued service. Is there not a case to be made for special support for those independent hospices which have to raise massive amounts of money from charitable sources, so that we are not penalising them?

[Baroness Merron (Lab)]

As the right reverend Prelate is very aware, most hospices are indeed charitable. They are independent organisations that receive some statutory funding for providing NHS services. As we discussed in a recent debate in your Lordships’ House, the amount of funding that charitable hospices receive varies by integrated care board area, and that will depend in part on population need and the breadth and range of palliative care and end-of-life care provision within the ICB footprint. With NHS funding being provided on a tariff basis, as is usual every year, there is NHS planning guidance, a local government finance settlement and consultations with independent providers. That will happen this year as it has every single year under every previous Government.

Pharmacies: Rural Areas

Debate between Baroness Merron and Lord Bishop of St Albans

Tuesday 10th September 2024 Lords Chamber

[The Lord Bishop of St Albans]

To ask His Majesty’s Government what plans they have to ensure that pharmacies are accessible to those living in rural areas.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, pharmacies are key to our plans to make healthcare fit for the future, as we shift healthcare out of hospitals and into the community. We will expand the role of pharmacies, including the introduction of prescribing services. People’s experiences of accessing pharmacies differ across the country; we will look closely at this. There are dispensing doctors in areas where pharmacies are not viable, and online pharmacies delivering medicines free of charge to patients.

[The Lord Bishop of St Albans]

I thank the noble Baroness for her response. However, analysis by the Independent Pharmacies Association has identified a £1.2 billion funding gap in this sector, which is leaving, in particular, pharmacies in rural and deprived areas very vulnerable indeed, at the very point when, as she said, we are looking for them to deliver more services. Given that 90% of their income comes from the NHS contracts and that most are unable to fill the funding gap through a retail outlet, what else can His Majesty’s Government do to ensure that we have adequate coverage in rural areas?

[Baroness Merron (Lab)]

I take on board the point that the right reverend Prelate makes. The analysis to which he refers shines a light on the fact that funding for community pharmacies was either cut or held flat over the last eight years, which amounted to a funding cut in real terms of some 28%. We are seeing the result of that. It is also worth saying that the consultation with Community Pharmacy England on the national funding and contractual framework arrangements for 2024-25 was not concluded by the previous Government, so I can say to your Lordships’ House that we are looking at this as a matter of urgency. We look forward, through my colleague Minister Kinnock, to how community pharmacy can be best set to deliver on the ambitions that I have already outlined.