Health: Cancer

Baroness Wall of New Barnet Excerpts

Thursday 11th November 2010 Lords Chamber

[Baroness Wall of New Barnet]

My Lords, I thank the noble Baroness, Lady Finlay of Llandaff, for giving us the opportunity to debate this important subject. It is a subject which, in one way or another, touches the life of every member of our society. My husband was diagnosed four years ago with an aggressive, inoperable tumour on his tonsils but manages to have quite a good life and is looked after very well within the NHS. There can be few, if any, members of our community, rich or poor, young or old, who do not know someone who suffers from one of the many forms of this diverse condition or, sadly, has suffered, or suffers, from it themselves, for cancer in its various forms is no respecter of class or status.

Even among those of us who have not been touched in these ways, the fear of this condition has probably been with us for some time. We hear much about the war on cancer, but in truth the treatment of these conditions is a campaign, one in which the outcome may be determined at many stages, sometimes, sadly, by the disease itself, but increasingly and positively by the exertions of staff at all levels within our health service. I declare an interest in that I am the chair of Barnet and Chase Farm NHS Trust, which delivers the greatest volume of cancer-related healthcare of any trust in north London. It is clear to those who work in the NHS that enormous strides have occurred in the management of cancer, aided by the investment in funding and purpose of the NHS by the previous Administration. There is therefore both a heavy burden and an expectation on the new Government to maintain and, indeed, increase this commitment. When he responds to the debate, I am sure the noble Earl will assure us that this will be the case.

It is of vital importance in the maintenance of services to our patients, particularly in the present economic climate, that these resources are used wisely and are not dispersed on ill-considered schemes of centralisation, which, while appropriate for some areas of management, often provide an expensive service of no greater quality—often the quality is less good—at a place remote from the patient’s community and friends. Noble Lords are aware of these issues, which are mentioned in the White Paper.

As we seek to improve the lot of those who suffer from this disease, it is important to realise that the greatest possible impact that we as a society can make in improving outcomes is by investing in the education not only of our clinical staff but of society as a whole. As many noble Lords have said today, early diagnosis is undoubtedly the key to better prognosis. In this, much may be gained by ever closer integration of primary and secondary care services that fit together “like a jewelled bracelet”, as Winston Churchill said of the services at D-day. Will the noble Earl assure us that this is the Government’s policy and that it will continue to be so?

However, this will be of little avail if we do not continue the previous Administration’s investment in high technology diagnostic techniques and continue to press forward with the new and innovative surgical and oncological methods now available. It is the experience of my trust, which is among the UK leaders in the application of minimal access and robotic technologies, that these can be applied safely, economically and effectively in the setting of a large district general hospital, with improving patient outcomes and reduced length of hospital stay.

It is impossible to overstate the importance that our patients ascribe to maintaining the highest quality of care for these conditions. However, contrary to the views often expressed by those on committees charged with organising services, our patients are clear that for them one of the most important aspects defining quality of service—let us not forget that they constitute both consumer and paymaster—is local provision. It seems to me that too often current agendas display an arrogance which serves to cover for the self-interest and vested interests of some central institutions in that they believe the service they provide is more important to patients than patients themselves believe.

I should be failing if I did not bring to the attention of the House the concerns felt by our clinicians and patients about the lingering effects of postcode prescribing. We have discussed that in the House before. Nothing can be more corrosive to the local community and its health services than the fear that the quality of your treatment is determined not by your clinician but by your postcode. I therefore welcome the recent announcement by the Secretary of State with regard to the setting up of a limited fund to allow the prescription of some of the recently introduced and very expensive pharmaceutical agents. However, in the individual prescribing, I ask that we make sure that the bureaucratic opportunity is removed and that the clinician is the absolute and ultimate person to ensure that the treatment is applied wherever it properly needs to be.

Other noble Lords have referred to the hospice movement and the choices that people are sometimes able to make at the end of their lives. I endorse and encourage whatever our Government and the noble Earl can assure us about the hospice movement being supported in many ways.