Vaccinations and Health Screening Services

Baroness Barker Excerpts

Tuesday 14th May 2019 Grand Committee

[Baroness Barker (LD)]

My Lords, I thank my noble friend Lady Walmsley for the opportunity to take part in this extremely well-informed debate.

As chair of the All-Party Parliamentary Group on Sexual and Reproductive Health, I start on a sad note. Some Peers are aware, but others are not, that the FPA—formerly the Family Planning Association—has gone into insolvency this week. This means that a charity which for many years has been the source of important information and advice for women, and men, about sexual and reproductive health, screening and all that has ceased to function. I say to the Minister that I am sure there are other professional bodies, such as the royal colleges and the Faculty of Sexual and Reproductive Healthcare, which will have to look in coming months at how the work which was done by the FPA can be covered.

As the figures we have on cervical screening—particularly from Jo’s Cervical Cancer Trust—show, it remains extremely important to have informed, accurate messaging systems to the public. Sometimes the NHS does a good job, but sometimes it is not the body to talk to people, particularly young people, in ways they understand in order to make them understand the importance of screening and prevention services in particular.

The figures for women attending cervical screening are going down. This is worrying. It is even worse in some minority communities. I want to take the opportunity to focus on my minority community. I am worried because I hear of instances of lesbians and bi-women being wrongly told that they do not need to go for screening and that they cannot get cervical cancer. This is not true. When someone is told that, it is not unreasonable that they might not go along and take part in a procedure which is not particularly pleasant. However, that has potentially fatal consequences. Having said that, there are other women who register really good treatment. When they have come out and been open about their sexuality, their doctors have been fine and open with them. This is a hopeful sign that we have moved on, but it should not be a matter of luck for a patient to be treated well. It should be system-wide. I commend some NHS staff who, in the absence of leadership from the top of the NHS or their professions, have tried to take matters into their own hands. They have their NHS rainbow badge initiative —100,000 of them are now wearing the badge—to give a direct indication to patients that if you happen to be LGBT it is safe to talk to them—not to everybody, but to them. I hope we shall see some more of that.

We are very lucky to have our National Health Service and national screening but, looking at the papers that my noble friend Lady Walmsley referred to, we do not seem to allow very much for variation. In particular, we have either a national screening programme or nothing. We do not seem to be able to concentrate some of our efforts among people who are perhaps more likely to be at risk than others. For example, I think of the work Macmillan Cancer Support has done on lung cancer screening. We do not have a national lung cancer screening programme, but Macmillan Cancer Support has been trying to identify ex-smokers to try to give them check-ups and to catch cancers early. I hope that through the reorganisation and sustainable transformation projects, the NHS might get to be much cannier about the way it uses the resources it has to begin to focus them.

I will make one final point about variation. I understand that there is a new test for bowel cancer screening called FIT—faecal immunochemical test—and that it will come in in Northern Ireland in 2020 but will not come to England. Will the Minister say why, if in Northern Ireland it has been identified as a more accurate test, it is not being rolled out here? We have a national service; we could use the resources in it in a far more targeted way to greater effect.