Hansard

I have listened with great interest to the debate and will attempt to pick up some of the points that have been raised. The interest and participation that there has been demonstrates the importance of this issue to members, particularly—although by no means exclusively—to women members of the Parliament.

As the first ever woman to be Scottish health minister, I am pleased to have the opportunity to add my voice to those of my colleagues here today. I commend Pauline McNeill on bringing this matter to Parliament and commend other members on speaking in the debate.

Breast cancer, and the fear of breast cancer, casts a real shadow over the lives of women across Scotland. Many members who have spoken have demonstrated how real that is to all of us in our family experiences. I am aware of what a diagnosis of breast cancer can mean for a woman and her family. I give an assurance that I am determined to ensure that we work hard in the Scottish Executive to reduce the risks, fears and anxiety that breast cancer can cause.

It is important that we take a balanced approach to this issue and have as full as possible a discussion of the facts—if members gather together on a cross-party basis to discuss the issue, that is a good opportunity to do so. We must talk about survival as well as suffering. We must celebrate the improvements that have been made in recent years as well as continue to demand further improvements. When we discuss why interventions are sometimes not made, we must be honest about the reasons. I endorse Richard Simpson's point about screening. Decisions may be taken on the basis not of cost, but of clinical effectiveness. By all means let us discuss how we can make improvements, but let us do so in an informed way.

It is important to say that, although our focus is on breast cancer, I note the impact that cancer in all its forms has in Scotland. One in three people will suffer from cancer at some time in their lives and one in four people will die because of it. However, in many ways breast cancer is a success story, because it is no longer a death sentence—far from it. As many members have said, we are identifying it earlier, treating it more effectively and, as a result, more Scots women are living longer.

Breast cancer, with some 3,000 cases each year, is the most commonly occurring cancer in Scottish women but, over the past 10 years or so, there has been a significant and encouraging improvement in what happens to those women. More women than ever before are surviving breast cancer. Today, three out of four women who are diagnosed with breast cancer are still alive after five years. However, as welcome as that news is, we cannot afford to be complacent. The fight against cancer, including breast cancer, remains a war that we have not yet won, but the tide is turning for women.

There are many reasons why women today are surviving breast cancer for longer. Part of the success is down to earlier detection of breast cancer through the national screening programme. I give an assurance that our national cancer screening programmes, for both breast cancer and cervical cancer, are constantly under review in our discussions with expert clinicians on how we can make those programmes more effective.

We are also making progress in quicker diagnosis and faster treatment. Nevertheless, there are still about 1,200 deaths each year because of breast cancer, which is 1,200 deaths too many. That is why we must grasp every opportunity to encourage women to attend for

breast screening when called. At present, about 70 per cent of women invited will attend. I want that percentage increased. I am pleased that health boards across Scotland are taking initiatives at a local level to encourage women to attend for screening when they are invited to do so.

Breast screening services are effective and are getting better. As women, we must all be better at using those services. I take the point that that is particularly important for women in some of our poorer areas. The emphasis that the Executive places on addressing health inequalities and social inclusion is evidence of our determination to reach out to women in all parts of our community and to get those services to them.

The problem lies not just in screening. When a woman finds a lump in her breast, or has other breast symptoms causing her concern, she needs to know one thing—does she have cancer or not? We need quicker and better diagnosis to minimise the waiting and worry.

In Scotland 22,000 women are referred to breast clinics each year and 19,000 of those referrals will be false alarms. Unfortunately, as we know, approximately 3,000 cases each year will be cancerous; in those cases, speed of diagnosis and treatment are paramount. Huge progress has been made in that area and it is important that we recognise that progress. We should also pay tribute to staff in the national health service for the work that they have done in making that progress.

We are tackling the issue on two fronts. First there will be more one-stop clinics. Our programme for government pledges that 80 additional one-stop clinics will be developed by 2002. These new facilities will speed treatment and will reduce waiting times. People with cancer will be among their major beneficiaries.

Pauline McNeill said that the best way in which to get a sense of the real issues on the ground is to go and examine them at first hand. Members should do as I was lucky enough to be able to do: they should take the opportunity to go and see one-stop breast clinics in action; they should go and see that women are being diagnosed and treated more quickly than ever. Treatment that might previously have taken weeks or months has been reduced to days. That reduces the waiting and wondering and reduces anxiety. Women are getting treatment more quickly. That is the kind of progress that we are making throughout Scotland. More than 90 per cent of Scottish women live in areas in which one-stop breast clinics have been established.

We are also reducing waiting times for women who have cancer. We are committed to speeding up treatment and to reducing waiting times throughout Scotland. I have made detailed announcements on that in recent weeks and I will say more in this chamber in the weeks ahead.

We are working with the Scottish Cancer Group and the waiting time support force to identify achievable targets that will bring most benefits to patients in Scotland. We will set targets for taking the improvements forward before the end of this year. Better prevention, more detection and faster treatment will be at the heart of those developments.

We are also taking action on research. I stress that the Scottish Executive chief scientist's office always welcomes robust proposals for research and also welcomes collaborative proposals from voluntary organisations as well as from other bodies. We are working together to make a real difference.

Some of Maureen Macmillan's points had particular resonance for me. As well as investing in improvement and developing the bricks and mortar of one-stop clinics, we must ensure that we listen to women and that we respond to their concerns. If we are to provide a modern health service that is fit for the 21st century, we must make sure that high-tech services also have a human touch.

The points that Maureen and others have made about the human element are as valid as what has been said made about service improvements. We must listen to women and we must respect their dignity, their sensitivities and their concerns throughout their journey through the service, whether during screening, diagnosis or treatment.

The Executive is committed to doing that. It is making record investments in the service to reduce waiting times and to listen to patients as never before. We can always do more and I look forward to working with members of all parties and voluntary organisations to ensure that we can do better still for women in Scotland during the years ahead.