Breast Cancer
We now move to members' business and motion S1M-162 in the name of Pauline McNeill on the subject of breast cancer. The debate will last for 30 minutes. Members who want to speak in the debate should press their buttons as soon as possible so that we can see how many want to participate—I see that quite a lot do. Those who are not taking part in the debate should leave as quickly and quietly as possible to allow the debate to begin.
Motion debated,
That the Parliament notes that breast cancer is the most commonly occurring cancer amongst women in Scotland; notes that early detection has saved many lives; and supports the work of Breakthrough Breast Cancer and the establishment of an all-party group on breast cancer, and encourages all MSPs to join it.
I have lodged this motion because this is our first meeting in October and October is Breast Cancer Awareness Month. The pink ribbon and its tartan counterpart are symbols of the Scottish Breast Cancer Campaign and I know that those who run the campaign are delighted that we have chosen to debate the subject this evening.
I believe that there is support for the formation of an all-party parliamentary group on breast cancer awareness and I welcome the involvement of my colleague Malcolm Chisholm, who is the former secretary of the Westminster all-party group on breast cancer. I hope that he will offer us his expertise.
Breast cancer is the most common malignancy experienced by women in Scotland. It is different from other types of cancer in that there are few known ways of preventing the disease. The Scottish Breast Cancer Campaign has pointed out that the chances of winning the national lottery are one in 14 million, but that the number of women who will suffer from breast cancer is one in 12.
Breast cancer is the leading cause of death for British women aged between 35 and 49. In total, 3,000 Scottish women each year are affected by breast cancer, accounting for a quarter of all newly diagnosed cases. International figures show that Scotland has the highest rate of breast cancer among developed nations. Surprisingly, the incidence appears to be higher in women from affluent areas than in women from deprived areas. Although nothing can yet be concluded from those statistics, the message is that breast cancer cuts across the class divide. The reasons for that cannot be easily explained.
The statistics for breast cancer are endless. They serve a useful purpose in illustrating the need for action but, in language that everyone can understand, they mean that breast cancer threatens all women. The only scientific certainties are that the risk of breast cancer threatens women more the older they get, and that there are few known ways of reducing the incidence of the disease.
We can tell smokers that quitting smoking can help reduce their chances of contracting lung disease, and we can tell those of us who are unhealthy eaters that a low-fat diet can reduce the risk of heart disease. However, such known factors do not seem to exist in a way that would allow us to reduce the incidence of breast cancer simply by encouraging people to change their lifestyle. Changing one's lifestyle is important, but it will not necessarily reduce the risk of breast cancer.
The strategy must be based on pinpointing the age at which women become most at risk and screening them regularly to catch the disease as early as possible. Breast cancer screening and self-awareness are the only real ways of allowing our doctors to manage breast cancer and attempt to cure it with the least invasion and with a fully supported, high-quality service.
Yesterday, I visited the west of Scotland breast screening service, which is based in my constituency, conveniently close to my office. It is always easier to understand the complexities of an issue if one has seen the service at first hand. I told the staff at the centre that the whole Parliament has an interest in breast cancer screening and would be debating the subject this evening.
There are seven centres covering the whole of Scotland. Women over 50 years of age are screened and, increasingly, a number of women now refer themselves to the service. That is to be welcomed. More women than ever before are becoming aware of the need for early detection.
Although I said that the disease cuts across the class divide, sadly I have to report that the service providers in the west of Scotland are concerned that more women from poorer areas do not come for screening. If a way of dealing with that is not found, many women will not benefit from the ideas that are behind the screening programme. One notable fact about the centre that I mentioned is that it is away from an acute hospital setting—an idea that should be encouraged, as it will help to attract more women to the early detection schemes.
I could say much about the need to move to digital equipment, or about the decisions that need to be made regarding whether women should have two diagnostic views taken rather than one, but those matters can be discussed if we decide to form an all-party group.
We all know of someone in our lives who has suffered from breast cancer, and we know the devastation that it has caused to many women and their families. I sponsored this motion with my colleague Margaret Curran. We knew that the Parliament would welcome this debate, and we seek support from men as much as from women. It would give women in Scotland a morale boost to know that there are issues over which we can discard our party lines and set an example for other groups.
We have tentatively set a date for a breakfast for Breakthrough Breast Cancer, which is to be held in the members' lounge at 09:30 during the last week in October. The idea is to encourage women to change their lifestyles—and perhaps ourselves, at the same time. We will have more details about that.
As the Scottish Breast Cancer Campaign pointedly says, do not be afraid; be aware. Today, we can show that women make a difference in this Parliament.
Pauline McNeill is to be commended for bringing this matter to the attention of the Parliament, as are the organisers of Breast Cancer Awareness Month.
In Scotland, there is an unacceptably high rate of mortality from breast cancer. It is therefore appropriate to raise awareness among politicians and to express our concern about the issues. I support the campaign that is calling on the Government to match charity investment in breast cancer initiatives pound for pound. At present, charities such as the Scottish Breast Cancer Campaign contribute more than £15 million a year to breast cancer research—75 per cent of the total investment—whereas the Government commits only £4.3 million, despite having stated that cancer is one of its priorities.
Greater investment would undoubtedly help to develop more effective treatments and improve public understanding of the disease. The first research centre for breast cancer has recently been established in the UK. However, we read in the newspapers today that the cancer treatment research service in Tayside has acknowledged that it is having trouble meeting the demand for its services as a result of its lack of staff and resources. Cancer beds have been closed.
Because screening is routinely available only to women over 50, it is worth taking the initiative to
ensure that that screening is not unduly delayed— because of the date on which one's birthday falls, for instance. Within a few months of one's 50th birthday, rather than waiting for almost three years to be called for the next round of locally available screening by a mobile unit—which happens in some areas of Scotland—it is worth insisting on being examined earlier. I am assured that any such individual referral will be actioned, although that often involves personal expense and a greater journey distance. There should be no barriers to access.
Much more must be done to stop the suffering and heartache of women and their loved ones. That is why the Government must increase its investment in focused breast cancer research initiatives.
From Ruth Picardie's moving columns in The Observer to our everyday experiences, we are becoming aware of the reality of breast cancer and the key issues that surround it—screening, diagnosis and care. Breast cancer is now properly a key component of the health agenda of Scotland. That prominence has been achieved thanks to the campaigns in the charity and voluntary sector, the dedication and professionalism of health service staff at all levels, and the experience and testimony of women themselves. All that work is, at times, inspiring, although at times it is quite terrible.
Most of us, through personal experience or the experience of a family member, a friend, neighbour or associate, have become aware of the significance of the disease to the health profile of women in Scotland. We have become aware of the critical strands that demand our attention: awareness, screening, diagnosis, treatment and care. We know that 14,080 women died of breast cancer in Britain in 1995—270 women each week. Eighty per cent of breast cancers occur in postmenopausal women. Equally, we know that we must pay attention to younger women who suffer. My own friend died tragically at the age of 39. She left not only a grieving husband and two young children, but lonely friends, stunned colleagues and children in care in Glasgow who were denied their fierce advocate.
There can be no room for complacency as we try to tackle the disease. In the 1980s, Scotland's survival rates compared unfavourably with those of many European countries, although there is now some evidence that survival rates in Scotland are beginning to improve. Screening attendance rates must be tackled. The breast cancer awareness group quoted the clinical resource and audit group report, pointing out that
"high attendance rates are achieved in rural areas whilst in urban areas the minimum standard for attendance is seldom reached—Lanarkshire, Lothian and Greater Glasgow do not meet the minimum standard, despite considerable local effort".
We will always make demands of our medical services, but breast cancer must be considered medically and socially. How are women first told of their diagnosis, and how do they hear it? We must ensure that the complex world of cancer care is made less frightening, less daunting and more responsive to the needs of women. We have their experience and testimony to guide us. Above all else, and particularly in this Breast Cancer Awareness Month, we must not frighten women unduly. We must send out signals of hope, encouragement and support and stress the significance of awareness and of early intervention.
I am delighted to join Pauline McNeill in making a small contribution by sponsoring a breakfast for Breakthrough Breast Cancer in the Parliament and by ensuring that this Parliament reinforces the message of awareness and early diagnosis.
I welcome the opportunity, as previous speakers have, to highlight the impact of breast cancer on the health of Scottish women. It impacts not only on women who suffer from the disease, but on their partners, children, families and friends. I know that we will all have been touched by it at some point in our own lives.
Cancer is a leading priority for the national health service in Scotland and it figures in our Executive programme. That is quite right; cancer should be a leading priority and at the forefront of the health agenda. This coming year, 3,000 Scottish women will be diagnosed with breast cancer. I have said before, and I will say again, that those women are mothers, sisters and grandmothers—real people living real lives.
At the moment, every woman between 50 and 65 is routinely called for breast screening. Beyond that age—and we know that breast cancer gets worse with age—women must request screening. I hope that the minister will look at that again and see whether it is possible to expand the screening programme. We all know that early detection is critical.
I would like to offer a word of caution on the screening issue, which is not straightforward. Mass screening is not necessarily the answer for people over 65—that is why the parameters are set between 50 and 65. We all have a terrific desire to make improvements, but we should be a little cautious about extending screening in either direction
without the evidence that doing so would be worth while.
I take those comments on board. I think that what I did was to ask the minister to look at the issue. In September, the minister answered a written question from Bristow Muldoon, which shows that we are generally moving that way. Nobody wants to do anything that is counterproductive, but screening is an issue, and one that is being raised by the Scottish Breast Cancer Campaign. I have raised it in the past for Age Concern because it is concerned about the position of older women in society.
Eventually, we must be aware of the fact that there is a problem with regard to women attending for screening. In some cases, only 65 per cent of women who are eligible to attend for screening under the present regime do so.
We must send out a challenge, not only to practitioners and to ourselves as politicians, but to the women of Scotland and their partners to ensure that women take responsibility and come forward for screening. We must try to ensure that they have the best information on what screening involves and what the benefits are. Screening reduces deaths by up to 30 per cent. We must do everything that we can to ensure that screening is effective.
In my constituency in Edinburgh, I have a world- renowned oncology department in the Western general hospital and the well-known Maggie's Centre. The work of people in the health service in Scotland, particularly on breast cancer, but also in other cancer-related fields, is tremendous, and we should put on record our thanks to all of them. We should examine the points that Irene McGugan made on research.
To widen the debate slightly, over the past few years, breast cancer awareness has been heightened, and it is right that that is so, but I am always aware of the fact that while women are taking a much more vocal interest in breast cancer and other cancers that afflict women, our male counterparts do not spend as much time focusing on male cancers. I hope that at some point in the coming year we will have a chance to speak in this Parliament about testicular cancer and other cancers that affect men. Women have said, "This is something that we must address and we shall do so in this Parliament." It is time for men to do the same.
I thank Pauline McNeill for enabling me to speak on this subject.
I concur with the points that Irene McGugan made on screening. I fall into the category where I do not get breast screening for several years. When I mentioned that in the past, I was told that I could go to the top of the list. However, I do not wish to do that just because I have made a fuss: I should not have to make a fuss.
I will address the point that was made about deprived areas. I was concerned when Professor Graham Watt, a professor of general practice, visited the Health and Community Care Committee recently and pointed out that in deprived areas, patients present themselves later and with bigger lumps. They do not access support groups and, as has been said, do not turn up for screening. I find that alarming. When they access care, of course, there is equality of treatment, but when the cancer is much more progressed, the prognosis is much poorer.
Several members have referred to information. The 1960s, 1970s and part of the 1980s were a patient information desert. When a relative had cancer and we had to visit them in hospital, we put on a brave face and pretended that they did not know. That was insulting and wrong. I am concerned that in the 1990s we have entered an era in which, because of developments such as the internet, we have so much information that we have information overload. At times, that can cause confusion and alarm.
I welcome the NHS Direct on-line and telephone services, but practitioners have raised concerns with me that that should not be seen as a hurdle to providing important health care.
I was pleased to find that so many organisations are involved in research, supporting cancer patients and so on, but the one that greatly impressed me was CancerBACUP, which has a freephone helpline. Many cancer patients listen to what doctors say to them, but because they are under such emotional trauma, they do not hear it. The helpline is staffed by specialist cancer information nurses and is to welcomed in this era of information overload and confusion.
Once again, one of the best and most important debates in the Parliament is taking place at the end of the day. The shocking figures about breast cancer have already been mentioned. However, the statistic that has made a deep impression on me is that more than twice as many women between 30 and 54 die from breast cancer as from any other single cause. When the Westminster all-party group on breast cancer was formed in 1994, we heard from many experts about the lottery of care; about the way in which fewer women developed breast cancer in this
country than in some other countries, but more of those women died from it; and about the fact that only a quarter of research money came from public funds.
Since then, some progress has been made. We have a good opportunity today to make sure that the issue becomes a priority for the Scottish Parliament. I look forward to hearing from the Minister for Health and Community Care about on-going initiatives. It is obviously important that all women, wherever they live, get the best available care and that one-stop clinics should be developed, so that diagnoses are made as quickly as possible. I also hope that we can support the Breakthrough Breast Cancer campaign and aim towards every pound from charities for breast cancer research being matched by a pound from public funds.
I thank Pauline McNeill and Margaret Curran for raising this important issue.
Some years ago, I became one of the many women to go through a breast cancer scare and I know how petrified with terror such women feel. However, we have to stop scaring women away from tests by making them aware of the vital statistic that there is only a one in nine chance of having a malignancy. I was indeed one of the women who did not have a malignancy—I had a blocked milk duct from having far too many babies in too short a time. When I heard the news, I positively skipped down Great Western Road and promised to be angelic for the rest of my life, which was a promise that did not last long. We need to get across the message that women must have those tests with as much confidence as possible.
The Parliament should consider how little it costs to save a woman's life and how saving a woman can very often save a whole family. Often these days, that woman might also be the family's sole breadwinner. It costs about £7,000 to treat each woman with breast cancer from diagnosis to hospitalisation, and unfortunately sometimes to hospice care as well. The Parliament has to get its priorities right. There appears to be plenty of money for certain things. For example, it will cost £100,000 a year to provide secure psychiatric treatment at a planned special unit at Stobhill hospital in Glasgow. Local people have complained about the unit, and the other night I attended a protest meeting in Springburn about the matter. I repeat: it costs £7,000 to treat a woman with breast cancer compared with £100,000 for a patient in a so-called mini-Carstairs in Glasgow. We have to invest more in innocent women.
The same Greater Glasgow Health Board has one of the worst survival rates in Europe for breast cancer; taken over a five-year term, the figure for the greater Glasgow area is 72 per cent. In Lothians, there is a more than 76 per cent survival rate at five years, and Fife—which used to be a very bad survival area—has improved dramatically with a 79 per cent survival rate. That is postcode medicine, but this time not for poor areas, but for whole health board areas.
Scotland has a severe shortage of experienced radiologists; if one retires, it is difficult to find a trained senior replacement. Furthermore, about a third of the radiology equipment in Scottish hospitals is more than 10 years old. That is not good enough. We compare badly not only with other European countries, but with Canada and Australia. In Scotland, more than 15,000 women of all ages have the disease and, as we heard, 3,000 new cases are treated each year.
Sometimes the victims are very young. I remember Bernadette Mowbray, the wife of the footballer Tony Mowbray. Very gallantly, Tony helped me to launch Breast Cure Scotland three years ago. His bride was only 26 years old when she died. At an age when Bernadette and Tony should have been out shopping for furniture for their first home, poor Tony Mowbray was out shopping for that young woman's coffin.
We must all pay tribute to Audrey Jones, the gallant campaigner from East Lothian, who started a great patient-led movement to invest charitable money. We must back that campaign. Since she was diagnosed as having breast cancer six years ago, Audrey Jones has raised a fortune. The Parliament has a great chance to offer women a better future. Please do not let us cheat and shortchange our women.
I will keep my speech brief. I welcome the opportunity that Pauline McNeill has given us to raise awareness of breast cancer.
Given that breast cancer is the most common type of cancer among women in Scotland, it is extremely important that the protection and treatment on offer are as effective as possible.
I want to raise one issue in particular. In recent months, I have heard from breast cancer sufferers in my constituency, who, although generally happy with their treatment, have raised the issue of inconsistencies in prescribing practices by GPs in respect of repeat prescriptions. The drug tamoxifen is well established in treating breast cancer and is prescribed for up to five years. In addition, trials are in progress, in which tamoxifen is given to women at high risk, in order to assess
the preventive qualities of the drug. The success of that project depends on more women coming forward to take part.
Given the potential of the drug to reduce the incidence of breast cancer and the possibility that it might also kill cancer cells directly, it is difficult to understand the variations in the repeat prescription periods. Some GPs prescribe for three to six months, yet others will provide repeat prescriptions for only one month at a time. That increases the cost and inconvenience to women who need the drug to save their lives.
In its September 1999 report, "Supporting Prescribing in General Practice", the Accounts Commission for Scotland highlights variations in prescribing practices and calls for better management of repeat prescriptions. Better management would be to ensure uniformity in the prescription of tamoxifen, and to issue guidelines recommending that the care of breast cancer sufferers come before cost savings in prescribing.
I urge members to take whatever opportunities are available during Breast Cancer Awareness Month—this month—to ensure that issues related to prevention and treatment are highlighted and addressed.
On Friday, in my constituency surgery in Fort William, I was consulted by a 35year- old woman who is suffering from breast cancer. She is brave woman, not only because of her fight against cancer, but because she has gone public in a campaign in the Highlands to raise awareness of breast cancer and the problems associated with it. She has been supported in that campaign by her Westminster MP, David Stewart. Her campaign, which I take the opportunity to raise today, is that she feels that it is unfair that cancer sufferers have to pay the full prescription charge—assuming that they are not on income support. I was interested to hear Elaine Smith's remarks, which relate to similar issues.
The lady is called Carolyn Stewart. I spoke to her this afternoon, to ask whether she had any objections to her name being mentioned. She said that she wanted her name to be mentioned because she wants awareness of the issue to be raised. She has campaigned for two years and she asked me to raise her case today, so that the Minister for Health and Community Care, Susan Deacon, can give her view.
Does the minister—like David Stewart—feel that there is a strong case for reviewing the full prescription charge for cancer sufferers? Perhaps, as my constituent believes, there is a strong case for extending the exemption from the prescription charge that applies to diabetics and those who suffer from epilepsy or thyroid problems to all cancer sufferers who are on expensive treatments for long periods. There must be a strong case to review the current practice. I hope that the minister will consider that in her reply to the debate.
Many of the points that I was going to make have been covered in the debate, but there are one or two that I want to add.
First, genetic profiling could help us to identify women who are at risk. Professor Haites of the University of Aberdeen is piloting a managed clinical network for Scotland on the clinical genetics of breast cancer and ovarian cancer, which may be one way forward. We also need more non-clinical well woman centres where breast care is one of many strands of work to encourage women to look after their health. However, such centres are difficult to set up in sparsely populated areas. It may therefore be necessary to consider a well woman touring bus, along the same lines as the sexual health bus organised by Reach Out Highland.
I want, also, to highlight women's experiences of breast cancer. A recent focus group study for Highland Health Board, comprising women from Inverness, Lochaber and Wick, found that women often felt seriously disempowered and unsupported through the process of surgery, radiotherapy and chemotherapy. Women often felt that there was a lack of honesty about what was in store for them. They wanted not to be shielded from the reality of their prognosis, but to receive the information that they needed to know what their options were. Such information was not always made available.
A couple of days ago, I spoke to a friend of mine—a young woman in her 30s—who has discovered that she has breast cancer. It took a week for her diagnosis to come through, because she lives in Inverness. She, too, felt that she was not given enough information about what was in store and about what could be done—whether she should have a mastectomy, a lumpectomy, reconstruction or other treatment.
The women in the focus group complained also about insensitive attitudes. One of them said that she had been treated like a slab of meat, made to lie half-naked as she waited to see the surgeon for the first time. Another woman complained about the insensitivity of being allowed to see cupboards piled high with breasts when she went to be fitted with her prosthesis.
The women felt that they were not being treated as human beings. They wanted proper breast care
units with breast care nurses—there is one breast care nurse in Inverness; the women want more. The women wanted proper support. Highland Health Board is taking such views on board, as it is concerned about what was discovered through the focus group.
All of these points have implications for how we train the medical profession to treat patients in this sensitive area.
I did not intend to speak in this debate, but as we went along, I realised that I am one of those women who are over 50, who get the recall and who defer going for screening. I am ashamed to say that I have deferred going for the test often, when I am one of the people who should not. What made me eventually go for the check-up was the fact that another woman in the office where I work was diagnosed with breast cancer.
There needs to be a major education programme for people, including professionals, who, like myself, are as guilty as anybody of deferring going for a check-up against all the odds.
When women who have been for a check-up get a recall, I understand that it is quite often the case that a faulty plate has been taken. I had a friend who had to wait a week after being told that she had a recall to find out that it was only another check-up. For the whole week, she did not eat and was worried sick—she imagined herself in a coffin.
We must do something about the procedures for recalls, so that further scans are taken as quickly as possible and women's minds are put at ease.
I thank Pauline McNeill for securing this debate which allows the Parliament to highlight the problem.
As Christine's contribution was so brief, we can just about squeeze in one last speaker. I call Hugh Henry.
Like other members, I congratulate Pauline McNeill on her initiative in securing this debate and on her work.
I am aware of some of the issues surrounding breast cancer through the lobbying—if we can still use that word—done by Nancy Allison, the past provost of Renfrewshire Council. A member of Nancy's family suffered from breast cancer. Nancy became an advocate of some of the issues involved. She raised funds and took part in awareness-raising. Her experience was first hand—and I knew the family member who suffered—and she felt the suffering personally. It was harrowing to listen to the ups and downs—the emotional rollercoaster ride—that she and her family went through. No one should have to face that, at least not without full support and attention.
I am also aware of other issues, through my experience as a family member. While it was right for Pauline McNeill and others to say that breast cancer is not a class issue, because it affects women of every class—Christine Grahame said that sometimes women from professional backgrounds are as guilty of ignoring the signs and procedures—there is still a class issue that we should not ignore. In poorer communities, women are more likely to suffer the adverse consequences for whatever reason.
I am worried that, when women discover a lump, they are sometimes constrained by their circumstances—I saw that at first hand. I do not know what the situation is now—the minister could perhaps bring me up to date—but I know from first-hand experience the worry that a woman experiences when the lump is discovered, and when she has to wait to have the test done.
I saw someone who is fundamentally opposed to private medicine not only having to suffer the fear and anxiety caused by discovering the lump, but having to put herself through the torture of saying, "Should I go to private medicine in order to get the test done? I cannot wait the time that it takes for the test to be done." No woman should have to wait that length of time. Every woman, after a lump is discovered, should have the right to immediate access to tests, whether they have the financial wherewithal to have that done or not.
Therefore, there is still a class issue: some women in impoverished circumstances do not have the immediate access that other women who can afford it have.
By all means, we could have an awareness programme and start to examine some of the broader issues, but, for God's sake, we must not let any woman go through one day of anxiety more than she has to.
I am conscious that this is a debate that many more members than usual have stayed behind for. If I closed the meeting now, I would be excluding one member who wishes to participate. There is just about time—if you are able to be fairly brief, Richard.
I will be very brief. Most of the points have already been made. I wanted to end on a good-news story.
The west of Scotland breast screening service had come to my practice area, and one of the last
patients I treated in my practice was one of the people who was recalled. Dorothy is quite right: it is difficult for women to be recalled, not knowing what is then going to happen. However, the support that she received, and that other patients have received, from the west of Scotland team has been first-class medicine: better than anything offered in the private sector.
That medicine allowed that woman to feel supported, through a process which indeed ended up with her having a mastectomy. However, that process gave her the opportunity to have counselling by the same nurse, who was in the counselling system on the screening side, and to go through with her to the hospital side, with Professor George's unit, and have her operation done. She had the time between the diagnosis and the procedure being undertaken to make a number of decisions about the type of treatment that she wanted and about the possibility of reconstructive medicine. She was able to consult that same nurse on a continuing basis.
Nurses have an enormous role to play in the support of the management, diagnosis and treatment of cancer. I agree with Maureen Macmillan that doctors need to understand this: that patient was able to come back to me, consult me, get a second opinion and tease out the issues. That is the sort of support that every woman in Scotland should have. The commitment of the Scottish Executive to 48-hour screening—I do not want to steal all Susan Deacon's thunder— will perhaps be the most important thing that this Parliament will have done, if we achieve it before the end of this period.
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.
I thank members for their co-operation this evening and I now close the meeting.
Meeting closed at 17:50.