I have a train to catch, so I shall not be too long, Mr. Deputy Speaker.
I rise with some trepidation as a woman from the north, a category with which the Minister has not been too pleased. Women from the north have suffered some abuse of the past few years. I hope that the guilt that many women in the north have had laid upon them will not emerge in any way in my speech. I try not to behave in that way. As I have said, I rose with some trepidation.
One of the issues on which the Minister and I have corresponded on several occasions has been covered already in the debate, so I shall try to be brief about it. Cervical screening in my area is an issue that has been brought to my attention on numerous occasions. I have frequently found that the Minister's loose talk does not help. I ask her to examine again some of the reasons why women suffer from this form of cancer. I ask her to take on board the fact that there is a reason to which she has not alluded.
The incidence of cervical cancer is not necessarily because women have a number of partners. There are women who have a partner with whom they sleep who has a job which is normally classified as dirty—in coalmining or the steel industry, for example. The incidence of cervical cancer in areas where these occupations predominate is higher than elsewhere in the country. I assure the Minister that I and others are convinced that that is the major reason for the incidence of cervical cancer in my area.
As there are no longer any coalmines or steelworks in my constituency, the world may begin to change. Women in my constituency have been working hard to organise and improve the services that are available, and it is not exactly helpful to tell them that they suffer for the reason that the Minister has given. That does not encourage them to continue to strive for better services.
I ask the Minister to examine the priority age for screening. There seems to be evidence that more attention should be paid to it for those in a younger age group. I accept what she has said about breast cancer screening, but I do not think that that is true of cervical cancer screening. What is the cost of putting work out to private clinics?
Last year I wrote to the Minister about a particular case. A friend of mine was screened in November and did not hear until the end of March that she had had a positive test. It is exactly a year ago this week—I remember it well, because it was the week of the general election—that she eventually had an appointment at the clinic to have her condition dealt with. It was well into August before she knew that she was clear. It is not enough just to stand here and say that that is appalling. The effect of that on women is devastating. My friend was a nurse, but that did not seem to help her. It was a devastating experience, and she was almost agoraphobic. She managed to continue to work, but little else. It has had a devastating effect on her confidence in having tests and on her future life.
I was interested in what the Minister said about the rate of screening and the Government's objectives. In 1986, we knew that 60 per cent. of women with cervical cancer had never been screened. We know that elsewhere there is an effective screening programme which reaches 80 per cent. of all eligible women. At that stage, we could not say what percentage of women was reached by our programme, and I should be interested to know what progress has been made on that
I was interested in the speech of the hon. Member for Winchester (Mr. Browne). He represents a town which in a league table drawn up by a local northern university is shown to be the most prosperous town in Britain. That same table puts Consett, a town in my constituency, at the bottom. The problems that the hon. Gentleman identified in recruiting medical laboratory scientific officers are exactly the same in my constituency. We have enormous problems, particularly because of salary scales, so they are not just created by success and a high wage economy. Consett is at the bottom of the league table because, despite new jobs, we are a low-wage economy. Even then, it is incredibly difficult to recruit MLSOs in the area.
In a recent letter, the chair of the Northern Regional health authority states of north-west Durham:
Latterly the service has been affected by staff illness and this resulted in a reporting delay of around ten weeks by the end of December 1987, but again by the use of a private laboratory that interval is now down to around six weeks.
He tells me that, in the other district health authority that covers my constituency, the same sort of problems exist.
I know, partly because I was chair of the union which recruits MLSOs, that the recruiting problem in both areas was acute, as was the difficulty of retaining them. They feel that they are not recognised as part of a health care team, that their work and contribution is devalued, and that that is reflected in their salary. Everyone who works in the Health Service has a vital role to play. To see the whole work force as a health care team is crucial if we are to get our preventive health care and responses right. Some health care workers feel not only that their contribution has been devalued, but that they are played off against workers whom the Government see as the hands-on, face-to-face workers. In fact, the contribution of the other workers is equally important. I am not saying that the work of nurses and doctors is not important; of course it is. Others, however, have a vital role to play, and we look to the Government to recognise that.
How do we enable and encourage more women to know, and be confident in, their health services? One of my local community health councils recently carried out a detailed survey, which found that the most disturbing fact about cancer screening was that some 27·6 per cent. of those tested were never informed of the results. The majority presumably assumed that no news was good news, but for some, as I have said, that was very much the wrong assumption.
The survey also discovered that many women did not know or feel confident about finding out when and where to go. Working with women's health projects in the Tyneside area, I found that they were largely able to overcome the problem, vitally affecting the number of self-referrals. The atmosphere and the campaigning nature of the clinics gave women confidence, as they knew that they could go along, meet some of their friends and be dealt with by a woman who would not only do a test but talk to them, listen to their problems and ensure that there was a comprehensive response.
Another group who have been to see me, and who are very distressed about what they see as a breakdown in the service, are the community nurses. Those in one patch of my constituency say that exactly the same number of staff as 10 years ago deal with a caseload 70 per cent. higher. Given that sort of increased pressure on community nurses and on those who try to provide a more holistic approach to health care, is it any wonder that women feel unsure about where to go and what to do? It is partly because they do not want to put additional stress on those whom they know are already overstretched.
Whatever label is attached to the service—well woman clinics, or community health care—I think that the Minister knows what we are talking about. I hope that she will work carefully to ensure that opportunities are provided, particularly in areas in which health care is especially important, because the figures show women to be at higher risk. Cuts in the number of well woman clinics, and the reduction in spending on health education, are not what I see as a positive commitment to support.
I should like to mention many other matters, but I shall be brief. The community nursing problem affects specific issues, which the Minister mentioned and which I had meant to say something about—mental health. Community nurses have a crucial impact on that problem, and I hope that the Government will take it on. Let me also stress the importance of an effective occupational health service. There are now many more women at work; many more now have to work. There is clear evidence from Sheffield that an effective occupational health service improves not just attendance and sickness rates, but the general well-being of employees—and therefore I trust, that of employers. Moreover, it has increased productivity. The International Labour Organisation has suggested how specifically to encourage the development of a good occupational health service.
There are many other issues on the agenda and I believe that the Government know what they are. I press the Government not to lecture women about what they are not doing properly, but to ensure that women can meet their health worries and those of their families.
I remember when I spoke to one of the Minister's colleagues in the canteen downstairs. I noticed that he was having an extremely unhealthy lunch with lots of chips and other fried things. I said that a member of his Government would not be happy about that and he replied, "The trouble is that every time I hear her, it pushes me to have more chips." The Minister should learn from that. Lecturing people about what they should do frequently pushes them the other way.
The Government need to encourage and support good practices, and I accept that I must also do that. The Government must consider first how to give women positive support and encouragement rather than just lectures.