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Urology Services (East Kent)

Part of the debate – in Westminster Hall at 4:52 pm on 20th July 2005.

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Photo of Caroline Flint Caroline Flint Parliamentary Under-Secretary (Department of Health) 4:52 pm, 20th July 2005

I thank the hon. Member for Canterbury for warning me which issues concern him most.

I want first to say something about the significant progress made towards the objectives set out in the NHS cancer plan to reorganise, standardise and rejuvenate cancer services so that we can compare to the best in Europe. We are delivering better treatment more quickly to more people than ever before. Cancer mortality in the under-75s has fallen by over 12 per cent. in the past six years, which equates to around 33,000 lives saved. Some 99 per cent. of patients with suspected cancer are seen by a specialist within two weeks of being referred by their GP, and in the hon. Gentleman's area nearly all suspected cancer patients—99.9 per cent.—received an appointment within two weeks at the East Kent Hospitals NHS trust. I am sure that he agrees that cancer services must continue to modernise to improve the service to patients.

We need to establish in Government how clear national standards and securing unprecedented increases in resources can contribute to empowering local health communities to deliver high-quality cancer services for their population. One way that we are doing that is to ensure that the NHS has clear guidance, and the NHS cancer plan set out the intention to make available authoritative guidance on all aspects of cancer care. The guidance is aimed at helping those involved in planning, commissioning, organising and providing cancer services to ensure that those services are organised to ensure appropriately high-quality care.

In September 2002, the National Institute for Health and Clinical Excellence issued guidance on improving outcomes for urological cancers, which is being used as a framework for the NHS to ensure delivery of high-quality services for patients with those cancers. The guidance recognises that the diagnosis, treatment and care of a person with a urological cancer can be complex and is best provided by bringing together people with all the necessary skills, knowledge and experience. My understanding is that the patients requiring radical surgical management of bladder and prostate comprise less than 5 per cent. of the urology patients treated at the Kent and Canterbury hospitals.

There is, generally, an increasing demand for urology services. Therefore, it is highly likely that we will need at least to maintain the level of consultant cover, to ensure support both for all urological services and for the hospital in general. It is for that reason that the guidance recommends that all patients with urological cancer should be managed by multidisciplinary urological cancer teams. Another key recommendation, which was mentioned by the hon. Gentleman, is that radical surgery for prostate and bladder cancer should be provided by teams typically serving populations of 1 million or more and carrying out a cumulative total of at least 50 such operations per annum. I take on board the point that the hon. Gentleman made about there being 60 operations per annum at his hospital.

The NICE guidance is based on sound evidence, which is available on our website. It is supported by a wide range of key stakeholders, including the prostate cancer advisory group and signatories to the prostate cancer charter for action. It has been widely supported throughout the cancer network and community. The guidance is not about recommending change for change's sake but about considering how outcomes can be improved for future patients by centralising expertise in highly specialised fields. As I mentioned, there will be an increased need for other services in the area at local level.

As the hon. Gentleman is aware, responsibility for delivering cancer services rests with the 34 cancer networks that have been established throughout the country. In Kent and Medway, there is a local commitment to bringing specialist urological cancer services up to national standards. As he knows, specialist urological services are provided by East Kent Hospitals NHS trust, Maidstone and Tunbridge Wells NHS trust, Medway NHS trust and the Dartford and Gravesham NHS trust.

Following the publication of the NICE guidance in 2002, the Kent and Medway cancer network agreed to undertake an external review to test the feasibility of centralising specialist urological cancer services for more radical treatments at one or two sites. The review was chaired by Mr. Mark Fordham from the Royal Liverpool and Broadgreen Hospitals University NHS trust. He is one of Britain's leading authorities on urological cancers. The panel also included specialist urologists, oncologists, pathologists, radiologists, clinical nurse specialists and local service users.

I am aware that concerns have been raised locally about the review process. The hon. Gentleman has added his voice to those concerns. However, I am assured that the process was both thorough and objective and that the criteria used by panel members, and their relative weightings, were agreed by medical and surgical specialists from all local trusts providing that service.