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Cancer Treatment

My Lords, I was about to come on to the issues of capacity and investment, which I know are of great concern to my noble friend and other noble Lords. I am not sure whether I will be able to satisfy him on the precise way in which the partnership that he has delineated between the independent sector and the NHS will work, but I will look into that issue and write to him. But as I move on to the capacity and investment issues, I will be able to explain the approach to partnership working between the independent sector and the NHS that we have in mind. The department’s national framework will dovetail with the working group’s report and provide comprehensive guidance to the NHS. I cannot say much more on these two documents at this point, but I will ensure that all noble Lords have access to them and that my noble friend is sent copies as soon as they are published. We expect them to be published in the very new future. I turn to the issue of investment in PET scanning, which my noble friend has encouraged me to talk about. This is the concluding part of my remarks. Currently, around 10,500 PET scans are undertaken in the NHS each year. We estimate that around 40,000 PET CT scans will be needed each year by 2007–08. We anticipate that this demand will rise rapidly when further evidence of the benefits becomes available. It is likely to be a moving target, so to speak. To help meet this demand, we will make capital available to the NHS to build new PET CT facilities. This is in addition to the funding that we have allocated to primary care trusts in their baselines from 2006–07 onwards to develop and provide PET scanning services for their local populations. However, it takes a long time to plan and build major facilities such as PET CT scanners. As in other areas of rapid expansion of diagnostic facilities, we will, therefore, be making a greater use of the independent sector by purchasing additional scans to meet the anticipated demand. We will ensure that this additional independent sector capacity is delivered where it is most needed and in support of local plans. I think I have made it clear already that I do not share the hostility of the noble Baroness, Lady Tonge, to seeing the independent sector involved in providing these additional services for the NHS. They are provided under the same terms; that is, being available to people on the basis of clinical need and free at the point of use, and we will require them to meet the specifications and the price that the NHS requires. But NHS patients are benefiting from access to these services and will continue to benefit from them if we can make PET CT scanning available faster through these means. I accept that there were some initial teething troubles in the work that was done by Alliance Medical, but we also have a survey which shows 96 per cent satisfaction rates among the patients who have been involved. We will publish by the autumn some very good evidence, from a large-scale study, on the effects on quality of using the independent sector in these diagnostic services. Despite the fact that, in some cases, things have not worked as well as they might, the evidence is that the independent sector is providing diagnostic services that are at least as good as those provided in the NHS. Without being too smart about it, we cannot all acknowledge that nothing ever goes wrong in the NHS and that mistakes are never made. The level of service which is being provided for diagnostics by the independent sector is comparable with that which is provided through NHS means. This approach will build on our recent initiatives to use the independent sector to create, as I have said, enough diagnostic capacity to deliver the new, 18-week GP referral-to-treatment target that we set out in our manifesto, as well as help improve our performance in treating cancer and coronary heart disease. I can assure my noble friend that we see partnership with the independent sector as an important part of developing PET CT scanning in this country, but the precise way in which we do that will to some extent depend on the circumstances in particular parts of the country and how that is best done. The major contracts that we have made with the independent sector providers have enabled us to draw in international best practice in service design, use of new technologies and workforce redesign. They have spearheaded the provision of more convenient access to services, as close as possible to where patients work and live. Before the independent sector was involved in this area, no mobile scanners were being used for NHS patients, and this has provided an opportunity to cut waiting lists. An announcement giving details of these new additional PET/CT scans from the independent sector and the extra capital funding for NHS-provided services will be made at the same time as the publication of the national PET framework that I described earlier. We are very close to an announcement on the publication of the framework and the other reports and to giving a picture of investment in extra capability in this area. In conclusion, through the investment in the new CT and MRI scanners and linear accelerators, this Government have shown their willingness to support the NHS in expanding its capacity and enabling it to adopt the latest technologies. We shall build on that with investment in PET/CT scanning and with the publication of the national framework, the procurement of scans from the independent sector and the extra funding for new NHS PET/CT services. That will help us to meet demands in the short and medium terms as well as to plan for longer-term needs and provide greater and better geographical distribution of services. I am confident that in the near future we shall see far greater numbers of patients with cancer and other diseases benefiting from greater access to PET/CT scanning, regardless of where they live. I am grateful to my noble friend for giving me the opportunity in this debate to set out the Government’s approaches in this area.