§ 2.30 p.m.
§ Mr. Alan Beaney (Hemsworth)
I beg to move,That this House recognises the valuable work of Governmental and voluntary agencies in promoting research into the causes of and cure for cancer, but, in view of the heavy toll on human life and happiness caused by this disease, urges Her Majesty's Government still further to increase financial aid to, and facilities for, research in this field.I am aware that this has been the subject of many Questions tabled by many hon. Members of this House and that invariably the Govermenal replies have repeatedly stated that promising leads in cancer research have not been held up for lack of money. In a Written Reply to me on 23rd April, 1964, the then Secretary of State for Education and Science, referring to the Medical Research Council, said:I am assured that the Council have not been hampered by lack of funds in their support of proposals for cancer research which have come before them:"—[OFFICIAL REPORT, 23rd April, 1964; Vol. 693, c. 201.]On 23rd November last year, in a Written Reply to my hon. Friend the Member for Carlisle (Mr. Ron Lewis), my right hon. Friend gave a somewhat similar answer of assurance. When, as one often does, one reads in the Press the pathetic appeals by various organisations for donations towards cancer research, I become more than a little worried as to the worth of such assurances.
More than 2½ million people die every year of cancer. In the United Kingdom the number has steadily risen every year. In 1951 the number of persons dying of cancer was 98,020; in 1963 the number had risen to 116,489, which, in effect, means that 18 out of 100 deaths were caused by this disease—and this despite the great strides which have been made in the treatment of cancer. And yet today hundreds of thousands of cancer sufferers are walking around alive and comfortable having benefited from the 2070 advances which have been made in surgery, radiotherapy and in drugs which help to control cancer.
These great advances we owe to research workers, and it is to research workers that we shall owe the final conquest of this disease. I appreciate that there is a very wide field involved when we discuss research for the solution to the cancer problem. It involves the work of biologists, physicists, chemists, and virologists. I am none of these, but I am aware also that the work involves the politician and the legislator. The politicians and the legislators have a part to play. They have a part to play in providing the necessary finances for the health of the nation.
The financing of cancer research is a most complex web. It would appear that the great part of the money spent on research is raised by voluntary means even though the Government's own expenditure has been steadily rising. The Medical Research Council"s expenditure on cancer research in 1962–63 was £0.75 million; in 1963–64 it was £0.95 million; and this last year it was a little over £1 million. I appreciate, and it is most encouraging to learn, that some of the activities previously supported by the Medical Research Council have now been taken over by the universities and hospitals. Nevertheless, the fact still remains that the amounts allocated for medical research, in general, and to cancer research, in particular, are paltry in comparison with the expenditure on other kinds of research. To take two or three examples, in 1963–64 expenditure on research in agriculture was more than £14 million; research in industry and communications was more than £41 million; and the money spent on nuclear science research was more than £52 million.
I want to submit that the amount for cancer research could be doubled or even trebled without making any appreciable impact on Government finances as a whole. I believe that the voluntary organisations are attempting something which it is the duty of the Government to provide. I appreciate also that we shall all pay tribute to the voluntary agencies for the noble and magnificent work which they do. The British Empire Cancer Campaign, which carries out no research work of its own but whose sole function is to raise money 2071 towards the work, has done a great job of work. The Imperial Cancer Research Fund combines the two functions both of raising money and carrying out its own research.
Then there is the Institute of Cancer Research and the Royal Cancer Hospital, the largest single cancer research centre in the country. It has a total current expenditure—for 1963–64—of £657,640. It received grants from the Medical Research Council of £340,670 and from the British Empire Cancer Campaign it received £172,418. It is rather remarkable to note that among other grants there is one of over £50,000 from the United States of America"s public health service. The hospital has expressed its grateful thanks for such a donation, and I am sure it is grateful, but, nevertheless, I believe it to be a shameful national disgrace that our nation should be dependent upon the charity of America in this most important field of research work.
I also believe it to be a disgrace that the voluntary or part-voluntary organisations which are responsible for such a great part of the research work now carried out should lead a hand-to-mouth existence. I say this because in their annual reports they have from time to time expressed concern about their financial future. Professor Haddow, Director of the Chester Beatty Institute, as far back as May four years ago, in a letter to The Times, was pointing out that the combined financial support from the charitable public and Government sources had proved insufficient and that the gap had to be bridge by grants from the United States. He went on to say:From all these and other sources it is doubtless correct to say that current projects are being just adequately supported. We are, however, rather less successful in providing for what I call "marginal growth" and in anticipating the needs of the future.I said earlier that I was wondering what Ministerial assurances are worth. I would quote one appeal which regularly appears in the national newspapers:There's no quick way to a cancer cure. The final defeat of this awful disease will come from long, painstaking research. Yet a lot of that research has been done already—and has produced some remarkably hopeful results. Today, we can definitely treat certain types of cancer. The British Empire Cancer Campaign wants to help research until it can cure all types of cancer. That's why it needs 2072 money. Money to finance scientists and Institutes. Money to buy the intricate machines and equipment so urgently.A few months ago an advertisement in the Observer stated that the Institute of Cancer Research required a research worker on micro-organisms. It said:Experience in biochemical or microbiological fields advantageous. Minimum qualifications A levels in Chemistry and a biological subject.The beautiful salary that it was proposed to pay was a niggardly £600 per annum.
I hope that the Government will now fully meet and fill this need, for there must be something wrong with our system of society, something wrong with our sense and standards of values, something wrong with our priorities, when we can find hundreds of millions of £s for the destruction of life, hundreds of millions of £s for the protection of property and wealth, despite the fact that there are no pockets in shrouds, and yet all that we can scrape together to combat this enemy of mankind, an enemy that knows no national boundaries or class barriers, is a niggardly and paltry £1 million in the last year.
It appears to me that we cannot afford the medical facilities which cancer clinics would give our people, such as they do in Russia, clinics where cervical cancer could be detected and cured, so saving many of the 3,500 women who die in this country each year. The following article appeared in The Guardian on 3rd November, 1964:In Britain 3,500 women die each year from cancer of the neck of the womb, also called cervical cancer. These mortality figures have led to a growing public demand for a nationwide cytological screening service. This demand has received added impetus from the somewhat unusual source of the Trades Union Congress. This year's congress joined many women's organisations by demanding that this service be introduced "forthwith". Townswomen's Guilds and Women's Institutes have both passed resolutions urging 'that Her Majesty's Government treat as a matter of urgency the provision of comprehensive facilities for routine smear tests for cervical cancer'.It would appear that we cannot afford to purchase the Betatron machine in Great Britain so that cancer victims might live, but we can afford a machine like the TSR2, the cost of which would install a Betatron machine in every hospital in the country.
The same sorry tale can be told of public education in cancer. In a Written 2073 Reply to me on 27th April, 1964, the then Joint Parliamentary Secretary to the Ministry of Health said:… the advice given in 1953 to local health authorities about local cancer education campaigns will be reviewed in the light of the Report of the Joint Committee on Health Education …"—[OFFICIAL REPORT, 27th April, 1964; Vol. 694, c. 4.]We have had that Report for almost a year. It was reviewed in the New Statesman on 15th May last by my right hon. Friend who is now the Minister of Health, but we are still awaiting action, particularly some action on cancer education.
The Report said:On cancer education, we are aware of the divided views currently held on this subject. We are convinced, however, that education aiming at a truer understanding of cancer and the methods for early detection can do nothing but good. Unreasonable fear of cancer is caused by ignorance, not by knowledge. We have been impressed by the work of the Educational Project of the Manchester Committee on Cancer and by their evidence that cancer education when properly carried out yields worthwhile results and does not create anxiety neurosis.The World Health Organisation's Report on the prevention of cancer, No. 276, says that:the majority of human cancer is potentially preventable",and goes on to state that theorganisation of cancer prevention in the first place lies with the central Government.It follows, therefore, that legislation and action are necessary to prepare and sustain the educational programme which is certainly needed. The International Union against Cancer holds much the same view.
I believe, therefore, that there is a need for a more complete utilisation of the medical knowledge we already have. This is because of the public's lack of awareness of recent developments and techniques of prevention and treatment. I pay tribute to the local authorities and to those organisations who are doing what they possibly can in cancer education, but, to be effective, such education should and must reach every section of the population. For far too long cancer has been wrapped in a blanket of taboos and superstitious nonsense. I call on the Government to conduct an immediate and sustained cancer education campaign. Let us have a national cancer year. Let us utilise all the media that we possess, Press, posters, radio, television and our 2074 educational system, so that people might learn that cancer is not synonymous with an automatic death sentence. If this were done, it would dispel fear and give hope to many who still believe this. If, as some have said, it might create some hypochondriacs, what do a few hypochondriacs matter if it means that the thousands who are now dying might live?
I believe that no Government, whatever their political persuasion, have ever tackled this grave problem with the urgency and seriousness which it warrants and requires. In making this appeal I have spoken not only as one who has had to learn to live in the shadows of this disease, but also as one who has experienced the exquisite joy of emerging into the sunshine of deliverance.
§ 2.48 p.m.
§ Mr. Ted Leadbitter (The Hartlepools)
I think that my hon. Friend the Member for Hemsworth (Mr. Beaney) has done a service in the House this afternoon by following an interesting debate on the university of the air and adding to the general principles advocated there by dealing with this serious problem of cancer. I am certain that my hon. Friend spoke with feeling. He spoke from experience, and the information that he gave no doubt fell on the ears of my hon. Friend the Member for the Minister of State for Education and Science in such a manner that he and his colleagues will give due notice to my hon. Friend's appeal.
There is no doubt that throughout the country some of the best people in our land are giving up much of their time to the solution of a problem which brings heartache and misery to so many people. There is no doubt that many people with skilled knowledge of this disease have given much to the solution of the problem. Nevertheless, there is evidence to show the need to canalise what is being done in order to achieve a purposeful aggregate result. My hon. Friend the Member for Hemsworth produced alarming statistics and I hope to add to them, but several questions arise from the statistics impinging on the problem of finance which somehow or other always rears its ugly head when the question of conducting a campaign against this disease arises.
Before referring to specific evidence I wish to express my gratitude to my right 2075 hon. Friend the Secretary of State for Education and Science and to his Parliamentary colleagues as well as to his predecessor, now the Foreign Secretary, for the patience which they have displayed in the face of the number of Questions which have already been raised on this issue. My hon. Friend the Member for Hemsworth referred to the Answer on 23rd November given by the Under-Secretary of State to my hon. Friend the Member for Carlisle (Mr. Ron Lewis). The Minister said that the amount spent on the Medical Research Council for 1964–65 in connection with this disease was approximately £1,029,000. He went on to say:This does not include capital expenditure. The Government also support cancer research through their financial grant to universities and medical schools through the University Grants Committee; and at hospitals within the National Health Service. In addition a great deal of basic research which may well throw light on the problems of this disease is supported out of public funds."—[OFFICIAL REPORT, 23rd November, 1964; Vol. 702, c. 143-4.]I was impressed by the number of bodies which are involved in research and education in connection with this matter, and by the limited amount of money which is available. There is the Medical Research Council, the universities, medical schools, hospitals within the National Health Service and voluntary organisations. There is the British Empire Cancer Campaign and the Imperial Cancer Research Fund. All of these organisations are carrying out excellent work. It is an indication of the British character that we have this wonderful voluntary and professional support. With this expressed desire for standards in research and national concern for progress in this important matter, I wonder why it has not been possible, at this point in the twentieth century, to utilise all these organisations and canalise them in such a fashion as to provide an integrated service.
I wonder whether the amount of money available is enough, but I need not wonder too long, because my hon. Friend the Member for Hemsworth has made clear that the money available is a dismally small and discouraging amount. On 11th March of this year the Secretary of State helped us when he informed the House that the total grant in aid 2076 of the Medical Research Council for the coming financial year would be increased. I should like to include him in my congratulations and say that this is a welcome positive step from the Government. I hope that the increases made are not on the basis of meeting the increasing costs of existing services, but will take into account the margin which should be available for the provision of more research equipment and training.
I hope that the Minister will take into account the concern expressed in this House about the problem of cancer, and enable the Medical Research Council to achieve further expenditure on cancer research which should be made possible from the promise of an increased grant in aid. I wish to remind the House that hon. Members are worried about the incidence of cancer as it affects women. The facilities available for the screening of women make it possible to test 39,000 each month principally through the hospital clinics. This may sound encouraging. The available information indicates that 200 pathologists and 150 laboratory technicians are helping in this connection.
This impressive figure of 39,000 screening tests per month leads one to feel that there is some heartening progress, but about 4,000 women die each year from cancer, particularly of the cervix and the uterus. We must not allow the figure of 39,000 screenings per month to lead us into a state of complacency. The task is immense and our determination to meet it ought to be clear.
My hon. Friend the Member for Hemsworth referred to an important article in The Guardian on 3rd November, 1964. Because of the importance of this aspect of the disease, I ought to read the concluding paragraph of that article. It says:Whatever is being done, it seems we shall yet have to wait some years before a widespread service is available. Successive Ministries have dragged their feet. There may have been a genuine doubt as to the need and the efficiency of general screening which is not, even now, fully dispelled. Many feel that the financial factor, threatening to swell an already inflated National Health Service budget, has been the major cause of delay. Yet it is preposterous that a country which has produced Harvey, Jenner, Simon and Fleming, should play second fiddle to Hungary and, possibly to China. Sadder still is the fact 2077 that, while the delay continues, 3,500 women will continue to die each year from a disease which could in many cases be prevented. Cervical cytology is probably one of the simplest yet most effective contributions to preventive medicine. There is a sense of urgency in the diagnosis of cancer and intelligent women fret at interminable delay in introducing a scheme.The important point of this paragraph is the following:It is men who commonly advance and administer these services. One wonders what these people might do if cancer of the prostate could be detected by a reliable screening test and occurred on a scale similar to cervical cancer? Be assured that there would be a diagnostic clinic in every village and a special unit at the Ministry.We ought to draw our own lessons from that paragraph. We men must not underestimate the serious frustration, anxiety and, I would suspect, suicidal rate among women who have to suffer this terrible disease in this part of their bodies.
The latest figures show, as my hon. Friend the Member for Hemsworth has mentioned, that in 1963, 116,489 deaths resulted from this disease. I draw the attention of the House to the siting of this disease and the incidence of deaths arising from it. Figures for cancer of the stomach between 1951 and 1963 show a slight fall, from 16,869 deaths to 15,556. Figures for cancer of the intestines and rectum for the same two years fell from 18,249 to 16,805. I should be happy to feel that a reduction in the number of deaths caused by this malignant growth on this siting is indicative of progress.
I am not led to believe that that kind of progress is a reality because of the following statistics. Where the disease is sited in the trachea, the bronchus and the lung, deaths rose, over the same two years, from 14,858 to 27,620. In the breast, for the same two years, the number rose from 9,033 to 10,683. There was a very minor fall where it is sited in the uterus, from 4,621 to 4,454. The figures for leukaemia and aleukaemia are almost static, and other variations of the disease show an increase from 32,199 to 38,191. The percentage of total deaths caused by cancer was 15.5 in 1951 and 17.8 in 1963.
Over a period of just more than a decade the percentage of deaths arising from cancer has risen. In total, therefore, we have not made much progress. It seems from the following figures that the 2078 problem as it affects men is just as serious as that which affects women. The death rate from cancer figures per million living in 1963 was 2,417 for men and 1,952 for women. It is as serious for men as for women. We know that the nature of cervical cancer is an exceptionally serious problem for women, but numerically cancer is equally a serious problem for men, and it is not unreasonable to point out that the largest number of deaths apparently arise from lung cancer.
When we consider how best to deal with this devastating disease we ought to have some aims in mind. We must try as a nation to invade the frontiers of a scourge which attacks the human race. That ought to be the first aim—to decide that this is a war. Secondly, we must ensure that an adequate share of our resources is devoted to determining the nature of the disease. Unless we are prepared to go all out and to allocate a satisfactory apportionment of our resources to understanding the disease, we shall never be in a position to attack and defeat it.
The third objective ought to be to create new information and education services and to multiply the instruments needed to attack the disease—instruments such as laboratories, trained men and women and an adequacy of modern equipment. Fourthly, we should integrate the various services and provide a centre large enough to determine the power and the direction of the forces aligned with cancer.
I recall very early in this Parliament raising a question about the de Gaulle proposals. Hon. Members will recall that the United States, Britain, Italy, the Federal Republic of Germany and France had a meeting which arose out of the proposals originated by France, and that President de Gaulle wrote as follows:The idea of promoting cancer research within the framework of an international institution springs from a generous inspiration and I consider it desirable that France should be associated with it. It does, indeed, appear to conform with France's tradition that she should enter upon a venture with this threefold aspect—co-operation between peoples, human progress, and the advancement of science. Accordingly, I have entrusted the Minister of Health with the task of taking all the initiatives necessary in this respect. I would ask you to make this known to other 2079 personalities who, with yourself, signed the message which you sent to me.I would add that while the President felt that it was in conformity with the traditions of France that such a project should appeal to the countries enumerated, it is also in conformity with the British character that we should respond in like manner, and I am pleased to say that in response to my question to the Joint Under-Secretary of State for Education and Science I got a very favourable answer, which shows that the present Government are willing and anxious to co-operate with France to deal with this troubled, angry, vexing question of cancer in accordance with the general principles outlined last autumn.
May I add, in connection with the idea of working together to try to create an integration of the various services which I mentioned, that the second point is even more appealing and is one which will gain the acceptance of our countrymen, in that during the course of these discussions last autumn in order to make the plans effective it was suggested that ½per cent. of the 1963 defence budget in France would be an adequate means of financially supporting the proposals. The estimate on this basis would be £7 million. As a matter of interest, I applied the same formula to the defence budget of this country of £2,000 million, and I found that on the basis of ½per cent. our contribution would be £10 million.
This is an amount which would be less effective in terms of defence—too little, in fact, to add one tittle to any sophisticated weapons of today of the kind that the hon. Member for Hemsworth outlined; but it is an amount which is significant enough to contribute in waging a war on an enemy which is ignorant of political philosophy but death-dealing to the human race.
During the course of this Parliamentary Session we are trying to deal with many major policy decisions involving this country. Often we politicians cannot see the wood for the trees. But I believe that when we are dealing with the question of preserving and saving life, when we are thinking in terms of what is best for the individual, we must turn our backs on some of the current major issues and confront things which 2080 are more important to the human race. This question of cancer is such a case. I am satisfied that this House is determined to bring a new health, a new status, a new dynamic to this country by allocating more of our resources to the kind of things which we are discussing today.
I hope that in reply to the debate the Under-Secretary will indicate what new steps have been taken to enable us to align ourselves with the proposals of de Gaulle, what new initiatives are being considered in order to deal with the increased expenditures in aid to the Medical Research Council, and what steps he may propose in order that we can have an integration of the services that I have mentioned so that we can have the massive amount of support that is necessary to attack this dreadful disease successfully.
§ 3.15 p.m.
§ The Minister of State for Education and Science (Mr. R. E. Prentice)
The House should be grateful to my hon. Friend the Member for Hemsworth (Mr. Beaney) for raising this subject. It does not need any words from me or anyone else to stress that he has raised a matter of tremendous human importance. As has been said already, the proportion of people dying from cancer in this country in recent years has been increasing. It is a figure now of over 17 per cent.
This is a matter which naturally causes fear and worry to many people. There is a sense of impatience and of frustration at the failure to cope with the causes and to find cures, in the way in which cures have been found in recent years for diseases which have so long defied the medical world and which have been conquered in our time. The contribution of my hon. Friend the Member for Hemsworth was all the more powerful because of his personal experience as a victim of cancer. Everyone would wish to respect the way in which he put his case. My hon. Friend the Member for The Hartlepools (Mr. Leadbitter) also should be complimented on the way he put his case to the House and on the care he had taken in his research into this problem.
I will deal with the points which both my hon. Friends raised. My hon. Friend 2081 the Member for The Hartlepools raised earlier a number of points about the treatment of women, particularly those who have become victims of cancer of the cervix and the uterus. I shall pass his comments on to my right hon. Friend the Minister of Health. I cannot give my hon. Friend information now. The subject of the debate is the need for increased Government aid in research and public education in cancer rather than the treatment of it, but the matter which my hon. Friend raised is one for my right hon. Friend and he will take note of what has been said.
I accept the terms of the Motion, but I should make it clear that I accept them in the sense that whereas the last words of the Motion ask for further financial aid and facilities for research, and the Government certainly accept that and our plans involve further finance, this does not necessarily mean that we can go all the way with the points raised by my hon. Friends. In particular, when we talk about extra finance, we do not mean that we see in the foreseeable future that public money should supersede contributions made by voluntary funds. But we see the need for an increasing amount being spent from public funds and in that sense I accept the words of the Motion.
I should like to make absolutely clear, as I did at Question Time quite recently, that the Medical Research Council has not been hampered by any lack of funds for research into any proposal which has commended itself to the Council. It would have been a paradox if this had been so at a time when such a great contribution is made by voluntary fundraising in addition to the amount spent from public funds. As to the extent to which contributions from public money have been increasing in this field, in 1950–51 the total amount spent on cancer research from Exchequer funds was £157,000. It has risen over the years since then, reaching about the half-million mark in 1958, and, in the financial year which ended the day before yesterday, it exceeded a total of £1 million.
In the next financial year, the Medical Research Council will be receiving a considerable increase in its recurrent grant for research work of all kinds. The Council itself, in the light of priorities, will decide the precise amount which goes on cancer research as distinct from other 2082 kinds of research, so I cannot give a specific figure for cancer research in the next financial year. However, for the total research effort I can give these figures. The M.R.C. grant for the year which has just ended was originally £7,883,000, there was a Supplementary Estimate during the year, and the total came to £8,151,000 for medical research during that year. This is to be increased in the next financial year to £9,584,000, in other words, from just over £8 million to about £9½ million, a considerable increase, having regard to the economic situation confronting the country, in the money to be spent on medical research generally in the 12 months ahead.
My hon. Friend the Member for The Hartlepools is quite right to say that the money spent on cancer research is spent in a number of different ways through a number of different institutions. There is a strong case for saying that this research should be diversified. Work going on in different universities, research centres and hospitals can have value simply because it is done by small, intimate teams, not in one vast institution. But, of course, it is the job of the Medical Research Council to co-ordinate the effort, and this it is concerned to do.
The money the Council is spending at the moment is disbursed in this way. It makes block grants to four major institutions, to the Institute of Cancer Research in London, to the Cancer Research Department of the Royal Beatson Memorial Hospital in Glasgow, to the Christie Hospital and Holt Radium Institute in Manchester, and to the Strangeways Laboratory in Cambridge. In addition, the Medical Research Council has about 20 research establishments of its own which are doing work directly under the Council's control, notably the National Institute of Medical Research at Mill Hill. Because it is doing part of the work directly as well as financing other work, the M.R.C. is in a very strong position to co-ordinate the whole effort.
There is a good deal being done in the universities and teaching hospitals, partly with funds provided by the Medical Research Council, partly with funds provided by the University Grants Committee as part of its normal financing of teaching institutions. In addition, there 2083 is the research carried on in hospitals where the main task is the treatment of patients but where there is also a research element, and this is financed through the National Health Service.
In other words, the total amount being spent on cancer research is a good deal more than the £1 million to which I referred earlier, and, in the final analysis, it is difficult to say precisely what the sum is because it shades off into other related work.
A good deal of work is going on directed not specifically to cancer but to more general problems which can be of great importance in the battle against cancer. I am thinking particularly of basic biological research, research into the nature of living matter, into the processes which go on within living cells and so on, all of which can be of great indirect value. Researches in genetics, in virology and other subjects also are relevant here and make important contributions.
We have now reached the frustrating stage—this, I suspect is why a good deal of frustration was expressed by my hon. Friends in their speeches—where medical progress has reached the point of curing a large number of illnesses which baffled previous generations but the remaining illnesses present increasingly difficult problems. Answers to many of the problems in cancer and in some other conditions do not necessarily depend now on a frontal attack on the particular disease but, rather, on a general advance in our knowledge of human biology which can then, we hope, be related, in ways which we do not yet quite recognise, to the problem of the disease itself.
This rate of progress obviously depends partly on resources, but here I repeat the assurance that at this stage no worthwhile project which the Medical Research Council recognises as of medical value is being held up through lack of funds. This is where I would take a slightly different line from my two hon. Friends who have spoken. My hon. Friend the Member for Hemsworth spoke of doubling or trebling the amount of money available. My hon. Friend the Member for The Hartlepools wanted to adopt the idea of ½ per cent. of the national defence budget being devoted 2084 to this subject. Unfortunately, it is not as simple as that. The increase in funds available would not produce a comparable advance, or necessarily any material or significant advance, in the rate of research work and, therefore, in the treatment of cancer. If it were so, our solution to this terrible problem would be relatively easy. Unfortunately, it is not so. All the scientific advice available to the Government leads to that conclusion.
If I may paraphrase this in layman's language, having tried to understand it, but being very much an amateur, the view is that the approach to this subject at the moment and in the years immediately ahead must be what the, doctors call "a multi-disciplinary approach". They must attack cancer—they have been trying to do so over the last few years—by a number of different approaches simultaneously. One approach is that of chemo-therapy, of trying to discover new ways in which drugs can be used for this treatment. Here we have had in recent years a certain amount of progress, limited progress but progress which has been beneficial to large numbers of patients who have been cured in cases where the disease has been diagnosed early enough but who would not have been cured some years ago.
There is another line of attack into the causes of cancer, which are very baffling and complicated, in trying to identify the cancer-producing agents which lead to the disease. Here a good deal of research in industry has, I understand, been of considerable value. There are certain kinds of cancer which can be identified with certain industrial processes. Hon. Members will know that certain types of cancer are scheduled as industrial diseases under the Industrial Diseases Act. There the research has led to the identification of agents which cause cancer, research which has been of value outside the immediate field concerned.
A very interesting development in recent years has been the discovery that certain viruses can cause cancer, something which was unsuspected until comparatively recent years.
Another line of attack is in the field of immunology, the extent to which perhaps the growth of tumours can be 2085 attacked by immunising the people concerned. This is another aspect on which it is hoped to make progress, but at the moment, I understand, the matter is at an elementary stage.
Again, there is the relationship of cancer with the environment. In this sense, the relationship of smoking with lung cancer has been the subject not merely of research but of a great deal of controversy and discussion in recent years. Studies are going on at the moment in relation to gastric cancer and leukaemia to discover whether there are environmental causes or personal habits which can have a relationship of the same kind.
In all this effort, as my hon. Friends have pointed out, the research is being financed partly by Exchequer funds and partly by voluntary funds. The voluntary money, it is true, amounts to larger totals than the public money. The two biggest organisations in this field are the British Empire Cancer Campaign and the Imperial Cancer Reasearch Fund, both of which, according to the latest figures that I have available, are able to provide a greater amount of finance than the Exchequer for research in this field. The British Empire Cancer Campaign spent more than £1,300,000 in 1963 and the Imperial Cancer Research Fund spent £1,200,000 in the financial year 1962–63. I should point out that these organisations in practice work very closely with the Medical Research Council to secure the most effective deployment of the resources.
But the question that I have to face up to, and the question which previous Governments have had to face up to, is whether or not Government money should supersede the voluntary money, whether there should be so much extra Government money put into this that the voluntary fund-raising bodies become redundant. This is a matter which people have discussed over a period. There are two main reasons why we do not think this would be the right course to adopt. One is simply that there really are a large number of people who would like to make a voluntary contribution. In this field, as in others, besides the expenditure of the money taken compulsorily from all citizens, there ought to be scope for those who choose voluntarily to contribute to the effort by giving something 2086 extra. There are very often people with personal family reasons for wanting to make a contribution to the fight against cancer, people who welcome this opportunity.
The second reason is one connected with the scientific aspects of the fight against the disease. The point is that here we are in a field which is so baffling and complicated that professional opinions will often differ as to the merits of different lines of research. The Medical Research Council is spending taxpayers' money and, therefore, it has a duty to decide in each case that the research which it is going to finance, very often at very great expense, has, in its professional view, a reasonable chance of succeeding. It does not mean that it is not able to take certain risks. Of course it ought to take certain risks in such a field. Nevertheless, it has a responsibility to the taxpayer and it has to take that into account.
But, of course, the official bodies, as we would all recognise, do not have a monopoly of wisdom, and it may well be that they might want to turn down an idea which seemed unlikely to succeed but might have merits in it. This, of course, is precisely the kind of research which could and should be financed by voluntary funds and for which the money being committed is not the money taken compulsorily from all citizens, but that given voluntarily.
This is a very good thing in a matter like this because of its complications, for sometimes what might be called offbeat ideas can be developed and financed in a way which would not be justified when the taxpayers' money was involved.
The basic point is that we are at the stage and for some time have been at the stage when the Medical Research Council is able to assure us that no project which is worth while from a medical point of view is being held up for lack of funds. When I say "lack of funds" I appreciate that they are funds which are partly public money and partly money raised on a voluntary basis. It could be argued that all of it should be public money and I hope that I have dealt with that argument, but it is not the position that an increased amount of public money at this stage would of itself have the results 2087 which some people hope that it would have in dealing with the disease.
§ Mr. Alfred Morris (Manchester, Wythenshawe)
I am sure that my hon. Friend would agree that, in opening clinics without financial assistance from the Government, Manchester took an important step forward in the treatment of cervical cancer, and that it is felt by many people that, with our increased knowledge about curing certain forms of cancer, this sort of development is not sufficiently used. Before he leaves the subject of finance, I wonder whether he could say what might be done to see that there are clinics in every locality where they are needed to deal with cervical cancer. Some people feel—they may be wrong—that there has not been the progress in this respect which there should have been because of the shortage of funds. That would be regrettable if it were true.
§ Mr. Prentice
A similar point was raised by my hon. Friend the Member for The Hartlepools and I explained then that I would reply on the Motion which was drafted in terms of research into cancer and public education about it rather than the treatment of cancer, which raises many other issues, primarily for my right hon. Friend the Minister of Health. I will draw the attention of the Minister of Health to what has been said, but at the moment I am not equipped to deal with it in detail. Obviously, treatment and research overlap in this respect, but I am dealing specifically with the financing of research rather than the provision of clinics whose main job is clearly treatment, although there is a research result from what is done in clinics.
I want briefly to mention the international agency for research on cancer which was mentioned by my hon. Friend the Member for The Hartlepools. As we were able to announce at Question Time on 4th February and again on 30th March, the Government are supporting the concept of establishing an international agency of this kind. This was originally suggested by the French Government and there has now been agreement among France, the United Kingdom, the Federal Republic of Germany, Italy and the United States to sponsor a resolution at the World Health Assembly, which is due to meet in May.
2088 The resolution will be to establish, under the auspices of W.H.O., this new international agency for research into cancer. The purpose is not to duplicate national efforts already taking place, but to co-rdinate them and to provide any service which will be of international value. For example, there will be considerable value in co-ordinating research into problems connected with environment and incidence of cancer in many countries, and this project has the Government's wholehearted support.
Both my hon. Friends spoke about the public education aspects of this problem and made a powerful plea for a more positive policy from the Government in this connection. I can tell the House that my right hon. Friend the Minister of Health is now considering this problem and has a Standing Advisory Committee on Cancer and Radiotherapy which is considering it, and I hope that he will be able to make a pronouncement before very much longer.
As the House will know, this is a matter on which the medical profession has had divided views for a long time. On the one hand, it has been argued that public education and the dissemination of information about cancer and its symptoms would lead patients to report to their doctors earlier, which would lead to earlier diagnosis and therefore the treatment in time which is so tragically often not possible if people report to their doctors too late. On the other hand, it has been argued by other doctors that this would lead to unnecessary anxiety and that people would worry about the wrong set of symptoms and that such a policy would do more harm than good.
I think that it is fair to say that in recent years the balance of the argument has shifted in favour of public education. This led the Ministry of Health in 1963 to encourage a number of larger local authorities to initiate local schemes of education in connection with cancer, regarding this as a pilot project for a possible wider scheme. A number of local authorities have been doing that, and some voluntary bodies have been doing it in co-operation with local authorities. The biggest is in South Lancashire—the education project of the Manchester Committee on Cancer—which covers in South Lancashire and in Cheshire an area with 2089 about 2,500,000 people. It has been engaged in a public education campaign for some years now with results reported to the Ministry of Health, results which have been successful.
This led in April 1964 to some comments which have already been quoted by my hon. Friend the Member for Hemsworth. He quoted from a report on health education by the Joint Committee on Health Education under the chairmanship of Lord Cohen. I need not repeat the quotation, but the gist of it was that the time had been reached for a national effort on public education in this matter. This is the matter being studied in the Ministry of Health by the Standing Advisory Committee, and my right hon. Friend will hope to tell the House about that in due course.
There is the very important public education campaign being conducted at the moment about the risks of excessive cigarette smoking. This is something which has been given new impetus in recent months by the Government. There has been the decision to ban cigarette advertising on television. New short television films have been produced which are now being shown on B.B.C. and occasionally on I.T.V. warning about the danger of excessive smoking. We have had the very effective poster campaign. Hon. Members will have seen the new very striking posters recently about the dangers of excessive smoking.
As I have a responsibility for schools, may I say that a lot of teachers have felt for a long time that they have been lectured by my Department, by local authorities and others to warn their pupils about the danger of excessive smoking. Many of them have been doing this conscientiously, but have felt that for far too long their efforts have been undermined by the tenor of public advertisement in this field. I hope that the steps taken recently will give them some encouragement, because what we have to do is to warn young people of the dangers of smoking. It it not sufficient merely for teachers to give them a lecture. The whole of society must be aware that it must not undermine this lesson.
May I conclude by once more thanking my hon. Friend the Member for 2090 Hemsworth for raising this subject. This is a very baffling, very complicated and very difficult subject in which we are engaged against a terrible scourge which has always afflicted mankind but which is not yielding to the progress of medical science in the way that other illnesses have done. However, the Government's resources are engaged in this struggle and will be engaged to a greater extent. We must all hope and do everything that we can to promote the possibility of making a breakthrough in the not too distant future.
§ 3.42 p.m.
§ Mrs. Joyce Butler (Wood Green)
I had not intended to intervene in the debate and I shall do so for only a few minutes. However, I wish to support the action of my hon. Friend the Member for Hemsworth (Mr. Beaney) in bringing the Motion before the House, particularly because he and the Government spokesman and other hon. Members have brought this subject out into the light of day. This is tremendously important.
We have all been distressed at the rather coy way in which cancer has been referred to in the past. It has been cloaked under various other terms which have disguised its severity. It is all to the good that we are now talking about cancer, talking to the public about it, and demanding more education. I am entirely in agreement with the view that the more we can make the facts known to people and urge them to go for early diagnosis, the better it is for everybody.
As cancer may take a very long time to develop—up to as much as 30 years—it is essential that we give publicity to the need for early diagnosis, particularly in two sections of the community. The first is among women, who are particularly at risk, not only from cervical cancer, but from cancer of the breast and other parts of the body and who, very often, because as mothers of families they are busy and occupied with the needs of their family, do not pay enough attention to themselves when they have symptoms. The second section is in industry. In many parts of industry there is a risk to which, unfortunately, not sufficient attention has been paid, partly from fear, which one 2091 understands, on the part of manufacturers that if the risk is publicised workers may not want to go into that industry. We have reached the point when we cannot afford to have that any longer, and we must go ahead with education in this respect.
I am concerned about the question of research. My hon. Friend the Minister of State, who replied for the Government, made the point that the Medical Research Council and other medical advisers may not regard the examination of some of the off-beat cures or methods of diagnosis as being suitable for the expenditure of public money. My hon. Friend made the point that voluntary contributions can be used for some of these schemes. I have, however, been in correspondence with my right hon. Friend the Minister of Health about a scheme which has caused me some disquiet, for the following reason.
An eminent doctor, who believes that he has discovered a method of diagnosing cancer, wanted to carry out research into this method. To do so, he needed funds. He advertised his scheme and was immediately struck off the Medical Register. Now, because he is not on the Register, he cannot have access to a doctor's patients and he cannot carry out the research that he wants to undertake. This seems to me to be completely wrong.
That man happens to be a doctor. There are others who are not doctors but who probably have views and knowledge about the subject which might represent a breakthrough. Hon. Members who have spoken have indicated that the field is so difficult and complex that we cannot afford to ignore any possible breakthrough from any source.
This type of case is not approved by the Medical Research Council and does not fit into any of the usual categories, but if, with the specialist advice available to the Government and with the know- 2092 ledge that they can obtain, they could see a glimmer of hope in such a scheme, I suggest that they could in some way provide money or the facilities to enable the person concerned to obtain funds from voluntary sources without incurring professional disapproval.
The difficulty is a real one, because there must be many other people in the category which I have mentioned and I am certain that the public, many of whom have suffered losses in their own families and have experienced unspeakable tragedies, are not prepared to see any possible line of research overlooked and not investigated because of this kind of red tape and restrictive practices within the medical profession. That is my fear. I ask my hon. Friend to consider it and see whether there is any way of overcoming the difficulty by providing either Government funds or a means of securing agreement about this with the medical profession.
There are many other things that I should like to say, but time is short and another important debate is to follow to which we must give short attention. I welcome very much what has been said today. I hope that, although the debate has been only a short one, the Government will pay attention to the need for providing research funds and also a nation-wide screening service on cervical cancer which is increasingly being demanded and screening services wherever there is an industrial, atmospheric or any other local risk which it is particularly necessary to investigate.
§ Question put and agreed to.
That this House recognises the valuable work of Governmental and voluntary agencies in promoting research into the causes of and cure for cancer, but, in view of the heavy toll on human life and happiness caused by this disease, urges Her Majesty's Government still further to increase financial aid to, and facilities for, research in this field.