| Previous Section | Back to Table of Contents | Lords Hansard Home Page |
The Countess of Mar: My Lords, is there not some liability on the part of the owners of the oil depot? Do they not have insurance, and cannot claims be made against the owners' insurance? Why are the Government paying?
Lord Bassam of Brighton: My Lords, that is absolutely right. Again, I am informed that a number of lawyers are in the area working carefully with affected residents to advise them.
Lord Bassam of Brighton: Look, this is not the time or place to be cynical. Of course, it has been the policy of successive governments not to pay compensation to householders or businesses for any losses that are insurable. We expect the insurance system to work well in this situation, and I am sure that it will.
Baroness Trumpington: My Lords, I do not believe that the Minister has answered my Question. Is he aware that I totally disagree with the noble Countess? What is needed is cash now. Having had absolutely no heating myself, I would not put my trust in lawyers or in British Gas, whose representatives do not come when they say they will and make a mess of it when they do.
Lord Bassam of Brighton: My Lords, those are private companies with public responsibilities that they are expected to meet. The local authority and the Jobcentre Plus officials working locally have done everything that they reasonably could to assist those families and households, who have, I know, been getting good help and assistance from the local citizens advice bureau. There may well be some cases that have slipped through the net. If the noble Baroness would like to approach me personally with examples of those, I shall make sure that they are dealt with as promptly as possible.
Lord Skelmersdale: My Lords, emergency help is available in many instances from the Social Fund. Can the Minister say whether that fund has been operating in the Buncefield area, especially for those people on limited incomes to whom my noble friend has just referred?
Lord Bassam of Brighton: My Lords, the advice that I have is that Jobcentre Plus has received 50 benefit
9 Feb 2006 : Column 774
claims related to the incident and has paid six crisis loans. Of the new claimants, 13 have now come off benefits, thankfully. As I said earlier, all fire-related claims were processed and paid on the same day.
Lord Oakeshott of Seagrove Bay: My Lords, does the Minister know what proportion of households in this country has no contents insurance? If not, could he again find out and let us know? He will find that it is significant in the lower income groups.
Lord Bassam of Brighton: My Lords, I do not have specific figures on that, as the noble Lord may perhaps expect on a matter related so closely to one particular incident in one place. However, the point made by the noble Lord is very reasonable. I know, from my local government experience, that we used to try to assist low-income households—particularly those living in council housing—to get into insurance schemes. We ran a scheme in my local authority that gave tenants the option of having insurance cover for household contents through their rental.
Breast Cancer
11.27 am
Lord Forsyth of Drumlean asked Her Majesty's Government:
Whether they will respond to recent representations by taking steps to ensure that appropriate drugs are made available to patients for the treatment of breast cancer in cases where general practitioners have confirmed the need.
The Minister of State, Department of Health (Lord Warner): My Lords, breast cancer patients should be managed by specialist cancer multi-disciplinary teams. It would be a doctor in that team who would decide, in consultation with the patient, the most appropriate treatment for their condition, having regard to NICE guidance. The NHS should not refuse to fund treatment simply because NICE guidance is unavailable.
Lord Forsyth of Drumlean: My Lords, I am grateful to the Minister for that answer, but are the Government aware of the "Panorama" poll of 390 oncologists that was carried out recently in England and Wales? It found that 28 per cent were always allowed to prescribe Herceptin for the early treatment of breast cancer but that 58 per cent were only sometimes allowed to do so. How can it be right that access to treatment for NHS patients who have no insurance for what is, after all, a life-threatening condition depends on where they live and on decisions taken by administrators and accountants, rather than clinicians?
Lord Warner: My Lords, there is a general issue of access to cancer drugs and a specific one in relation to breast cancer drugs. It is for individual clinicians to consider with patients, taking into account risks and
9 Feb 2006 : Column 775
their medical history, whether a particular drug is an appropriate treatment choice. We have made it absolutely clear to primary care trusts that they should not rule out treatments on principle but consider individual circumstances in reaching their decision. We have equally made it clear that, in the case of Herceptin, PCTs should not refuse it solely on grounds of cost.
We can do no more at this stage, and I suggest that we must not take any steps that undermine either the licensing process for drugs, which have patient safety at their heart, or the NICE appraisal process.
Baroness O'Cathain: My Lords, is the Minister aware that on 27 October last, in evidence to the Health Select Committee in another place, the Secretary of State said that women who had been refused Herceptin on the ground of cost should return to their doctor and ask again to be prescribed the drug.
She told the Committee that she,
the prescribing of Herceptin to eligible women,
Has the Minister any idea of the impact on an individual of the news that they have breast cancer? The last thing that they want to do is to go back and forth to doctors on the odd chance that they may or may not get Herceptin.
Lord Warner: My Lords, there are two sets of issues here: Herceptin in relation to advanced breast cancer and Herceptin in relation to a proportion of women who have early breast cancer. Herceptin is not licensed for the purposes of women who have early breast cancer. The noble Baroness may shake her head, but that is the factual position. The Secretary of State has said that no PCT should rule out the decision by a clinician to prescribe a particular drug on grounds of cost; but there is a wide range of considerations to be taken into account.
Lord Tebbit: My Lords, does the Minister not agree that it would be particularly unfortunate if any of the factors that he has set out regarding the suitability of the drug, which is a matter for doctors, and possibly of its cost, which is a matter for the health service, were to be settled in court by judges who are not doctors and are not responsible for providing the funds to meet what might be their judgment?
Lord Warner: My Lords, if the noble Lord is referring to the case currently before the courts, I do not think that I can comment on it, as it is sub judice.
Lord Addington: My Lords, there is a real problem here given that you can be clinically prescribed a drug that you are not going to get. We have been through this before and it is looking again like a postcode lottery. Will the Minister give us some idea of when the Government will introduce a system that will stop this happening?
Lord Warner: My Lords, I have said that there are two sets of issues. One is the use of Herceptin in
9 Feb 2006 : Column 776
relation to women with advanced breast cancer, for which it is licensed and for which there is NICE guidance. There is little evidence that the drug is not being provided where it is thought to be clinically appropriate. The argument seems to be over the use of Herceptin in relation to women in the early stages of breast cancer. The drug is not licensed for that purpose; it is down to the individual clinician, with the patient, to make a judgement whether it is appropriate in those circumstances. It is then for the PCT to weigh those issues in relation to those patients. That is the system that we have and that system has stood us in good stead over many years in relation to many drugs.
Lord Walton of Detchant: My Lords, would the Minister accept that not every case of breast cancer is suitable for treatment with Herceptin; it depends upon the genetic constitution and the nature of the tumour? But is it not the case that individuals with breast cancer and who have a genetic constitution that makes them sensitive to the drug are not always receiving it through their primary care trust? Are the Government making it clear to primary care trusts that such individuals should be given priority for the prescribing of this drug?
| Next Section | Back to Table of Contents | Lords Hansard Home Page |