NHS Breast Screening
It is a pleasure to serve under your chairmanship, Mr Vickers. I congratulate Gemma Reeves on bringing forward the petition and the hon. Member for North Ayrshire and Arran (Irene Campbell) on introducing this important debate. It has been very moving to hear so many stories from hon. Members on both sides of the House reminding us of the human cost of this disease. Breast cancer is very common, as other Members have said, affecting one in seven women during their lifetime. The Minister and I have had a number of debates in this Chamber about various diseases and forms of cancer. One of the core principles we often discuss is that early diagnosis saves lives. Cancer Research UK says that 85% of women who live more than 10 years after a diagnosis of breast cancer were diagnosed at stage 1 or 2 —the earlier stages to be diagnosed at. It was for that reason, and on that principle, that the UK introduced the world’s first national screening programme for breast cancer in 1988. Since then, much has changed. In particular, survival rates have improved dramatically. Now, 76.6% live more than 10 years; the figure was very much lower in the 1980s. There are still some issues with screening, however, as hon. Members have said. One is that women with denser breasts find it more difficult to locate lumps, and when doing mammograms, it can be more difficult to locate cancerous tumours. Will the Minister update the House on what work has been done on using ultrasounds and MRIs to identify tumours in women with denser breasts? I understand that the National Screening Council is looking at this subject in detail. When is it due to report its findings to the Minister, and when does she intends to bring them to the House? The effectiveness of treatment has improved, but the risk of overtreatment is higher in younger women. The incidence of the disease is increasing in younger and older women: the Cancer Research UK website says that the rate has increased by 12% in women aged between 25 and 49, and by 72% in women aged between 65 and 69. Should younger women therefore now receive screening, and should older women receive more frequent screening? The cancer plan, which the Government published earlier this year, said that they will engage with manufacturers to look at mammograms that are more accessible to those with a physical disability, who at the moment struggle to receive their screening. Will the Minister update the House on the engagement she has had with manufacturers and on the progress that has been made? The age trial in Oxford is looking at women aged between 47 and 49, and between 71 and 73—the ages just outside the current range of screening. I understand that early results are due in December 2026. Has the Minister had any indication of the results yet, and is she preparing for any results that come forward? Has she engaged with the people running that important trial? Community diagnostic centres, which were initiated by the previous Government and rolled out across the country, provide screening close to people’s homes, which makes it much easier for them to attend. Will the Minister update us on how she is improving the number of CDCs available across the country? The Government have talked about the shifts that they want to produce in healthcare, one of which is about prevention. According to the Cancer Research UK website, 23% of breast cancer cases are preventable. Will the Minister update us on what she is doing to reduce the number of preventable cases of breast cancer? Many hon. Members have talked about attendance at screening tests. The hon. Member for Epsom and Ewell (Helen Maguire) spoke about some of the reasons why women do not attend screening. It is important that we understand why about a third of women do not attend. It is only by understanding what puts women off and makes them not attend that we can improve the services so that more women do attend. It was sobering to hear how many lives could be saved if more women attended screening. How are we making screening more accessible for women? Are we ensuring that women know that it is happening and that they need it? Do they understand the benefits of it? I would be interested to hear the Minister’s thoughts. Another shift relates to the digital NHS. AI provides us with a number of ways to improve breast cancer screening and treatment. It could help us to understand who should be invited to screening and how often, and it can help when looking at mammogram scans. A few years ago, the Health and Social Care Committee visited Stanford in California and looked at the AI there. We saw a study comparing two radiology consultants looking at a scan, two AI computers using two different programmes, and a person and an AI computer. It discovered that the person and the AI computer were the most accurate. That can help to reduce the number of people we need in the workforce and, importantly, can improve the accuracy of screening results. That brings me on to the workforce. We know that the Government have a workforce plan, although its publication has been much delayed. We have been told repeatedly over the past few weeks that it has moved to “imminent” status—imminent being quicker than soon—but we do not know when imminent is. Does that mean it will be published before the summer, or do we need to wait for the new Prime Minister to make a decision? It would be helpful to know that from the Minister. As we heard about radiology and radiotherapy, the workforce is incredibly important. We need a thorough plan, otherwise we will have recommendations from the NSC for screening and no people to provide that care. I also wanted to raise with the Minister the Lobular Moon Shot Project. We have discussed before the importance of research into lobular breast cancer, which is more difficult to diagnose and treat. The last time we spoke about this, the Minister was looking at research projects that the Government could fund to identify new treatments and ways of screening for this disease, hopefully saving lives. Will she update us on how she is getting along with that? Much of my time at the moment is spent with another Health Minister—the Minister for Secondary Care, the hon. Member for Bristol South (Karin Smyth)—in Committee Room 9, debating the Health Bill. That is where I will be tomorrow. The Bill relates to one of the important organisational factors in screening. At the moment, screening programmes are generally organised by NHS England, which is being abolished. NHS England and the Department of Health and Social Care wrote a letter in March saying that commissioning responsibility will be directly delegated to ICBs, in the same way that they are currently delegated to NHSE, by the Secretary of State. Does the Minister expect that to cause any disruption to the breast screening programme? Integrated care boards have had their budgets cut by 50% just as they are asked to take on this work. We know that they are merging and reorganising in cells. The Government’s plans are that they should follow the mayoral authority boundaries, but the mergers that have taken place so far do not follow those boundaries. There is therefore a risk that we will need reorganisation all over again. Does the Minister think that that will have an effect on the screening programme? If so, what is she doing to mitigate that effect to ensure that as many people as possible get the very best screening and we can reduce the number of people suffering from the disease? The screening programme offers a real opportunity to diagnose, treat early and save lives, but it needs to be delivered well. We need to ensure that the right people get the right type of screening at the right age, and at the right frequency. I will be interested to hear the Minister’s response.