Breast Cancer Screening — House of Lords, 2018-05-03
Topic: Health
James O’Shaughnessy (Conservative, Centre-right): First, if I may, I express my thanks to the noble Baronesses, Lady Thornton and Lady Maddock, for their constructive questions and the offer of working together to make sure that we get to the bottom of the situation and put it right. I also thank the noble Baroness, Lady Maddock, for sharing her own experiences with us. I am glad that she got good care, as, of course, the vast majority of people do, and we are indebted to the NHS staff who provide it. She made an incredibly important point about self-referral. One thing we must emphasise throughout this is that screening is one part of a much broader programme for spotting cancer early, and women’s awareness of their own body is absolutely at the front line of those efforts I want to add my own apology to those of my right honourable friend and the Government to the women affected, and to express my personal sympathies to them and to their families The noble Baronesses asked excellent questions and I will attempt to answer all of them. Key questions included early warnings, whether public concerns were expressed but not picked up on, and whether technology could have looked for trends in uptake in this age group—an example of technology coming to our help rather than being a problem. These are all very good questions that must be and will be the focus of the review. The review will, I am sure, also look at issues around variation. There are attempts to address falling screening rates, including national information campaigns, but whether or not those are adequate is a reasonable question given what we know about uptake The noble Baroness, Lady Thornton, asked specific questions about the analysis from Public Health England on the flaw in the algorithm. Indeed, my right honourable friend the Secretary of State committed to sharing that yesterday, which we will do. Since finding out about this problem, we have been in close conversation with NHS England to make sure that there will be additional resources, such that all women can be seen within six months for an extra screening if they want one. The vast majority would be seen much sooner than that and in a way that does not interrupt the normal screening programme, which is critical. The department and NHS England will provide additional resource to make that happen, including using temporary independent sector resource as necessary The noble Baroness, Lady Maddock, asked about case notes taking a long time to be assembled. That can happen, and it is critical for any woman or her family who think that they may have been affected negatively by this, with her cancer not being spotted. We will go through case note reviews for each of the women who may have been affected in that way—and if the NHS is shown to have been at fault, they will be eligible for compensation The noble Baroness asked a very good question about the location of screening. Choice is embedded in the system. I believe it was the noble Baroness, Lady Jolly, whom she was talking about and who had that experience. I looked into this: the 2016-17 guidance from NHS England provides flexibility and choice for women to say where they want their screening, which is one of the ways of driving uptake. If that has not happened in this case, and it does not sound like it has, I will be happy to raise that directly with NHS England at the highest levels I hope that I have been able to answer the questions from the noble Baronesses. I agree with them that this is a dreadful outcome of administrative incompetence and that we need to make sure, as we are reassured at the moment, that it is not affecting either other screening processes or other countries. One reason for that is that the particular clinical trial—the AgeX trial—applied only in England in its interaction with the screening database. The trial is not taking place in Wales or Northern Ireland, which share the same system—which is why the Welsh case seems to be different We will at all times in the process of the review and as we find out more be at great pains to make sure that we are as transparent as possible and to share information with the House.