Health: Spending Review 2010

Earl Howe Excerpts

Tuesday 26th October 2010 Lords Chamber

[Baroness Thornton]

To ask Her Majesty’s Government whether, in the light of Spending Review 2010, they will meet the commitment to free prescriptions for people with long-term conditions, the right to one-to-one nursing for cancer patients and the target of a one-week wait for cancer diagnostics.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, following the spending review, some of the programmes announced but not implemented by the previous Government will not be taken forward. We will, however, explore options for creating a fairer system of prescription charges and exemptions, taking into account the financial context. We are committed to improving early diagnosis of cancer and to ensuring that cancer patients have the care and support they need. Our updated cancer strategy, published later this winter, will set out the future direction for cancer care.

[Baroness Thornton]

I thank the noble Earl for that Answer, which goes some part, but not definitively, towards answering my Question. According to the Conservative Government’s own figures, waiting lists to detect cancer and other serious conditions have almost doubled since Andrew Lansley scrapped the 18-week target and other targets. We know that the quicker cancer can be detected, the better the likely outcomes. How does the Minister justify this growth in waiting lists, made worse by the CSR, and what do the Government intend to do to get back to a situation of reduced and reducing waiting lists that previously existed during the Labour Government? How long does the Minister think that that will take?

[Earl Howe]

My Lords, the noble Baroness is completely misinformed and wrong. The Government have not scrapped the cancer waiting time standards. Therefore, the figures that she referred to can have no bearing on the scrapping of the 18-week target, which is quite separate. People with suspected cancer will still benefit from the two-week waiting time target. That is clinically underpinned and we are keeping it. The statistics for those waiting for diagnosis on cancer are down very sharply over the longer term. There are, of course, fluctuations from quarter to quarter. The median waiting time at the moment is just under two weeks, and 95.5 per cent of people are seen within two weeks. That is an acceptable figure, although we of course maintain a close watch on the trends.

[Lord Walton of Detchant]

My Lords, part of the Question refers to the exemption of prescription charges for people suffering from long-term conditions. In my professional capacity as a neurologist, I looked after many such patients. Is the noble Earl aware that, as a result of recent research in molecular biology and genetics, many people with previously incurable conditions which are genetically determined are facing the prospect of drugs becoming available to treat their condition—so-called orphan or ultra-orphan drugs? Because these drugs need to be taken on a long-term basis, can we have an assurance that, as they come on stream, they will be made available to patients who will then be exempted from prescription charges when receiving this kind of treatment?

[Earl Howe]

The noble Lord raises two issues: access to new medicines for sufferers from cancers, particularly rarer cancers; and prescription charges. On the first, he will know that we have already created a cancer drugs fund to enable those people who cannot access cancer drugs to apply for funding for those drugs. That was part of the spending review announcement made last week. On the issue of prescription charges, we are looking for ways to make the system fairer than it is at the moment. We have not implemented the previous Government's plan to exempt all people with chronic conditions. Frankly, it was not affordable in the current context. However, we are looking at other means of creating fairness in the system.

[Lord Naseby]

Is my noble friend aware how important it was that he re-emphasised that there had been absolutely no change in the targets for dealing with cancer patients? Is it not surprising to him that the opposition spokesman was not aware of that fact? If we are to have a further report before the end of the year, will it include a review of NICE’s attitude to all cancer drugs, and of their availability to NHS patients?

[Earl Howe]

My Lords, we believe that there is a long-term role for NICE, not least in the area of assessing the clinical effectiveness of drugs. In the longer term, we believe that the problem that my noble friend identifies can be addressed more satisfactorily by a system of value-based pricing for medicines, which will mean that the price of a medicine will reflect its value to the patient, as assessed. That is a longer-term exercise that we cannot bring in in a hurry, but we are extremely conscious of the problem that my noble friend alludes to. Having said that, I stress that NICE will remain at the centre of our plans to roll out quality in the NHS.

[Lord Wills]

My Lords, the Minister has just accepted that early diagnosis is key to the survival rates for cancer. Can he confirm that his Government is indeed scrapping the Labour Government's commitment to reduce to one week the wait time for test results for cancer? If he can confirm that, does he seriously believe that extending the prescribed time for diagnosis results is going to help the health outcomes of those living with cancer?

[Earl Howe]

My Lords, there is no question but that timely diagnosis of cancer is extremely important. I do not think that anyone would argue with that. However, we believe that there may be more cost-effective ways of improving access to diagnosis than just imposing a blanket prescription—which, incidentally, has a very high price tag attached. The spending review settlement includes funding for improving early diagnosis in the context of the cancer reform strategy that we are reviewing, and we will set out our plans on that in more detail later in the year.