The Foundation of RAGE

The Foundation of RAGE

The Foundation of RAGE is best described in the proceedings of the British Parliament. This offers some background to the foundation of RAGE and how the “Breast Radiation Litigation” became inevitable.

At the outset RAGE consisted of two groups of patients. One group treated with radiotherapy for breast cancer, the other for pelvic malignancies. The injuries that they had sustained were so severe that they were the subject of multiple questions and debates in the Houses of Parliament.

RAGE Radiotherapy and the British Parliament

HC Deb 17 June 1994 vol 244 c689W

http://hansard.millbanksystems.com/written_answers/1994/jun/17/radiotherapy#S6CV0244P0_19940617_CWA_197

Mr. Barry Jones

To ask the Secretary of State for Health

  1. if she will set up specialist centres to look at all aspects of radiotherapy injuries; and if she will make a statement;

  2. if she will meet members of the Radiotherapy Action Group Exposure; and if she will make a statement;

  3. what action she has taken to ensure that radiotherapy in the NHS is properly supervised; and if she will make a statement.

§Mr. Sackville

I am very concerned that patients receiving radiotherapy should have confidence in their treatment. My noble Friend the Parliamentary Under-Secretary of State for Health, Baroness Cumberlege, has met recently representatives from Radiotherapy Action Group Exposure, together with Government's Chief Medical Officer, to discuss how best to consider their concerns. We are also working closely with the Royal College of Radiologists.

Radiotherapy Overdoses (Compensation)

HC Deb 24 June 1997 vol 296 cc507-8W

http://hansard.millbanksystems.com/written_answers/1997/jun/24/radiotherapy-overdoses-compensation#S6CV0296P0_19970624_CWA_432

Mr. Corbyn

To ask the Secretary of State for Health what proposals he has for a compensation plan for those suffering as a result of receiving the wrong dosage of radiotherapy; and if he will make a statement. [4764]

§Ms Jowell

The Government have every sympathy with women who have suffered adverse side-effects as a consequence of radiotherapy treatment. Where people have been harmed by clinical treatment and negligence can be shown to have caused this, compensation may be sought through the courts. However, it is a longstanding principle that compensation should only be paid by the NHS when there is evidence that negligence has been involved.

The following action has been taken to help women with damage as a result of radiotherapy for breast cancer: In May 1994 the Department issued guidance entitled "Quality Assurance in Radiotherapy—A Quality Management System for Radiotherapy".508WThe Royal College of Radiologists at the Department's request, convened a small group of professionals and lay people in Autumn 1994 to consider guidelines for care of women who have suffered tissue damage following radiotherapy for breast cancer. This report was issued to the NHS by the Department in October 1995.The Royal College of Radiologists carried out a confidential clinical review of 126 women who had suffered injury following radiotherapy treatment for breast cancer at 15 centres in the period 1980–93. The report makes recommendations on the management of breast cancer, particularly on radiotherapy, and for further research.

With regard to those suffering adverse effects following pelvic radiotherapy for gynaecological cancers, in 1996, a Working Group, which includes representatives from a number of Royal Colleges, voluntary organisations and the Department, was set up to consider the preparation of patient information leaflets concerning possible adverse effects following pelvic radiotherapy and to raise awareness generally. A sub-group is also considering issuing guidelines for health professionals on the care of women suffering adverse effects as a result of pelvic radiotherapy.

§Mr. Corbyn

To ask the Secretary of State for Health what discussions he has had with representatives of those suffering as a result of radiotherapy overdoses; and if he will make a statement. [4763]

§Ms Jowell

Representatives of those suffering as a result of radiotherapy treatment-both RAGE BREAST and RAGE NATIONAL have asked to meet Ministers to outline their aims and concerns. I am glad to report that my Noble Friend the Minister of State, Baroness Jay has agreed to see a joint representation from both these organisations.

Plans to investigate totals and percentages of the instances of harmful effects from radiography treatment.

Radiography - Mr Paul Boateng - Written Answers — June 5, 1997

http://hansard.millbanksystems.com/written_answers/1997/jun/05/radiography#S6CV0295P0_19970605_CWA_174

Mr. Flynn

To ask the Secretary of State for Health what plans he has to investigate the totals and percentages of the instances of harmful effects from radiography treatment. [1958]

§Mr. Boateng

We have no plans currently to collect centrally, information on those who have suffered adverse effects following radiotherapy treatment, although we are keeping these issues under review. It is more appropriate for monitoring to be undertaken at a local level where local problems can be identified. Cancer centres are expected to audit their results, including adverse effects.

The following action has been taken to help women with damage as a result of radiotherapy for breast cancer. In May 1994 the Department issued guidance entitled "Quality Assurance in Radiotherapy—A Quality Management System for Radiotherapy".The Royal College of Radiologists at the Department's request, convened a small group of professionals and lay people in Autumn 1994 to consider guidelines for care of women who have suffered tissue damage following radiotherapy for breast cancer. This report was issued to the NHS by the Department in October 1995.The Royal College of Radiologists carried out a confidential clinical review of 126 women who had suffered injury following radiotherapy treatment for breast cancer at 15 centres in the period 1980–1993. The report makes recommendations on the management of breast cancer, particularly on radiotherapy, and for further research.

243W

With regard to those suffering adverse effects following pelvic radiotherapy for gynaecological cancers, in 1996, a Working Group, which includes representatives from a number of Royal Colleges, voluntary organisations and the Department, was set up to consider the preparation of patient information leaflets concerning possible adverse effects following pelvic radiotherapy and to raise awareness generally. A sub-group is also considering issuing guidelines for health professionals on the care of women suffering adverse effects as a result of pelvic radiotherapy.

Radiotherapy - Mr Paul Boateng - Written Answers — June 16, 1997

http://hansard.millbanksystems.com/written_answers/1997/jun/16/radiotherapy#S6CV0296P0_19970616_CWA_150

Mr. Laurence Robertson

To ask the Secretary of State for Health if he will make a statement regarding his Department's policy towards compensation payments to women who claim to have been injured through receiving radiotherapy treatment; and what steps his Department is taking to investigate the causes of this problem. [3394]

§Mr. Boateng

The Government have every sympathy with women who have suffered adverse side-effects as a consequence of radiotherapy treatment. However, it is a longstanding principle that compensation should be paid by the National Health Service only when there is evidence that negligence has been involved.

The following action has been taken to help women with damage as a result of radiotherapy for breast cancer: In May 1994 the Department issued guidance entitled "Quality Assurance in Radiotherapy—A Quality Management System for Radiotherapy".The Royal College of Radiologists at the Department's request, convened a small group of professionals and lay people in Autumn 1994 to consider guidelines for care of women who have suffered tissue damage following radiotherapy for breast cancer. This report was issued to the NHS by the Department in October 1995.The Royal College of Radiologists carried out a confidential clinical review of 126 women who had suffered injury following radiotherapy treatment for breast cancer at 15 centres in the period 1980–1993. The report makes recommendations on the management of breast cancer, particularly on radiotherapy, and for further research.

With regard to those suffering adverse effects following pelvic radiotherapy for gynaecological cancers, in 1996, a Working Group, which includes representatives from a number of Royal Colleges, voluntary organisations and the Department, was set up to consider the preparation of patient information leaflets concerning possible adverse effects following pelvic radiotherapy and to raise awareness generally. A sub-group is also considering issuing guidelines for health professionals on the care of women suffering adverse effects as a result of pelvic radiotherapy.

Proposals to compensate female patients who have suffered serious physical damage following post-operative radiotherapy to treat breast cancer;

Radiotherapy- Ms Tessa Jowell - Written Answers — June 24, 1997http://hansard.millbanksystems.com/written_answers/1997/jun/24/radiotherapy#S6CV0296P0_19970624_CWA_412

Mr. Willis

To ask the Secretary of State for Health what proposals he has to compensate female patients who have suffered serious physical damage following post-operative radiotherapy to treat breast cancer; and if he will make a statement. [4836]

§Ms Jowell

The Government have every sympathy with women who have suffered adverse side-effects as a consequence of radiotherapy treatment. However, it is a longstanding principle that compensation should be paid by the National Health Service only when there is evidence that negligence has been involved.

The following action has been taken to help women with damage as a result of radiotherapy for breast cancer: In May 1994 the Department issued guidance entitled "Quality Assurance in Radiotherapy—A Quality Management System for Radiotherapy".The Royal College of Radiologists at the Department's request, convened a small group of professionals and lay people in autumn 1994 to consider guidelines for care of women who have suffered tissue damage following radiotherapy for breast cancer. This report was issued to the NHS by the Department in October 1995.The Royal College of Radiologists carried out a confidential clinical review of 126 women who had suffered injury following radiotherapy treatment for breast cancer at 15 centres in the period 1980–1993. The report makes recommendations on the management of breast cancer, particularly on radiotherapy, and for further research.

With regard to those suffering adverse effects following pelvic radiotherapy for gynaecological cancers, in 1996, a Working Group, which includes representatives from a number of Royal Colleges, voluntary organisations and the Department, was set up to consider the preparation of patient information leaflets concerning possible adverse effects following pelvic radiotherapy and to raise awareness generally. A sub-group is also considering issuing guidelines for health professionals on the care of women suffering adverse effects as a result of pelvic radiotherapy.

House of Commons Debate - Cervical Cancer (Radiation Injuries)

http://hansard.millbanksystems.com/commons/1995/nov/21/cervical-cancer-radiation-injuries#S6CV0267P0_19951121_HOC_428

House of Commons Debate - 21 November 1995 vol 267 cc562-70562 10.18 pm

§Ms Janet Anderson(Rossendale and Darwen)

I am grateful for the opportunity this evening to highlight the plight of a number of women who have suffered the most severe injuries resulting from radiation treatment for cervical cancer. Approximately one year ago, I was invited to meet a group of women in the Manchester area who had, during a period from the late 1970s to the early 1980s, received radiation treatment for cervical cancer at the Christie hospital in Manchester.

It transpired, as revealed by a BBC Radio 4 "File on Four" programme in 1991, that hundreds of patients had been damaged by the experimental selectron treatment. It was shortly after that that Vicky and others founded the action group RAGE—Radiotherapy Action Group Exposure…..

File on 4 - Trial and Error, Christie Hospitals & RAGE Bowel Patients – 15/10/1991
https://www.youtube.com/watch?v=IKzYhHRSNKk

It is hard to believe that in this country, and in this day and age, cancer patients were completely unaware that they were part of a clinical trial in which they had absolutely no say.

In October 1991, 20 RAGE victims started individual legal actions against the Christie hospital. The cases are so complicated, dealing not only with legal aspects but medical rules and ethical questions, that they are still going on. However, nothing could ever compensate the victims and their families for what has happened.

RAGE now has 3,000 members. Not all its members have had injuries through a pelvic or abdominal cancer: some have been victims of radiotherapy for breast 564 cancer, and they have their own group, RAGE Breast. It is now apparent that it is not only women who have been abused in this way. RAGE now has a small number of men among its members who have radiotherapy injuries from treatment for prostate, bladder, testes and colon cancers.

The women are now seeking an independent investigation into radiotherapy damage and compensation. The Government have decided to audit injuries on two breast cancer cases. Surely the Minister must now agree to a simultaneous audit for all radiotherapy injuries.

Mr. Andrew Miller(Ellesmere Port and Neston)

……….. Does my hon. Friend agree that the issue of consent, a form for which appears to have been introduced by the Christie hospital only in 1991, is critical? Many of the women were clearly experimental guinea pigs prior to that time. It was only after the damage had been identified that people were asked to sign that form.

Ms Anderson

………. He [AM] is quite right. The whole case turns around whether the women knew they were part of an experiment. As he pointed out, the Christie did not introduce the consent form until 1991. The women that I am talking about received treatment in the late 1970s and early 1980s. I thank my hon. Friend for that well-timed intervention.

Surely the Minister must agree to a simultaneous audit for all radiotherapy injuries, and most particularly those sustained during the period of experimental treatment for cervical cancer on the selectron machine.

Finally, will the Minister tonight give us an assurance that he will agree to that, and that he will now take steps to set up a national register of victims? There are hundreds of women such as Vicky Parker and her colleagues who deserve to have their voices heard and their condition recognised. It is the responsibility of the Government to assess the scale of the problem, to give recognition to those women, and to make sure that nothing like this ever happens again.

The Parliamentary Under-Secretary of State for Health (Mr. Tom Sackville)

I am grateful to the hon. Member for Rossendale and Darwen (Ms Anderson) for bringing this matter to the attention of the House. I start by expressing my deepest sympathy for the women who have suffered severe adverse effects as a result of radiotherapy treatment for cervical cancer, many of whom were treated using the selectron, as the hon. Lady said, at the Christie hospital in Manchester in the 1980s.

Let me first say something about the selectron treatment. Internal radiotherapy has been available for decades. The difference with the selectron is that, in old-style therapy, the radiation sources were inserted manually. The selectron is a way of inserting the source and removing it automatically by remote control. Such a system has the advantage of reducing staff exposure to radiation, because the radioactive sources could be withdrawn along pipes into a lead-lined safe at the foot of the bed.

565 In 198, the low dose rate selectron system devised by the Christie hospital was introduced. It is now in use at other United Kingdom centres, including Edinburgh, Glasgow, Leeds, Liverpool and the Marsden.

In its early days, the correct dose on the selectron had to be calculated because stronger sources were used than in the former manual—that is, non-retractable—treatment system. It must be remembered that, although it was a higher dose of radiation than before, it was still a relatively low dose.

The treatment of women using the selectron during the 1980s was part of a randomised, controlled trial, designed to try to establish the optimum dose for patients with an early stage cancer. As I said, the selectron is still used in the treatment of cervical cancer, and the system developed at Manchester is used worldwide.

§Mr. Miller

Can the Minister advise the House how the calculations were undertaken in those early clinical trials and what the dose rates were? Furthermore, does he agree that it is unacceptable that the letter from the Christie to my hon. Friend dated 26 July stated that those patients had experienced difficulties and distress? It is far more than that. Those women have had their lives destroyed; the Christie ought to admit it, and so should the Department of Health.

§Mr. Sackville

The hon. Gentleman will perhaps not be surprised to learn that I do not have the information on his first, technical question. I will try to supply him with it in writing. On his second question, that was a highly regrettable series of events. As I said, we all have the deepest sympathy. Later, I will explain how I very much hope that ways will be found to avoid that situation recurring.

The selectron is still in use, and we now have the benefit of experience of doses that have been found to have acceptable levels of adverse effect. I am aware that the women who received significant adverse effects, which they believed were caused by their treatment with the selectron, are taking legal action against the Christie hospital, on the grounds that they were given insufficient information as to the nature of the treatment.

It is now clear Government policy that all patients have a right to consent to or reject treatment, and are entitled to a clear explanation of any treatment proposed, including any risks and alternatives. All treatments carry some level of risk, and patients must be allowed to decide whether they wish to continue with the treatment proposed. That is a principle that has been highlighted in the patients charter.

Some of those suing the Christie are part of a support group, RAGE National, which, with its sister group RAGE Breast, is pressing central Government for recognition and compensation for radiotherapy-related injuries. Representatives from RAGE met my noble Friend Lady Cumberlege and the chief medical officer last year to discuss its members' concerns. Following that meeting, and at the Department's behest, the Royal College of Radiologists agreed to undertake a confidential clinical review of 126 RAGE Breast members to discover what —

Full Hansard Report:

http://hansard.millbanksystems.com/commons/1995/nov/21/cervical-cancer-radiation-injuries#S6CV0267P0_19951121_HOC_428

Radiotherapy Damage

To ask Secretary of State for Health if he will award ex gratia payments to women suffering permanent, progressive, disabling injuries after radiotherapy treatment for breast cancer;

HC Deb 17 February 1998 vol 306 c553W553W

http://hansard.millbanksystems.com/written_answers/1998/feb/17/radiotherapy-damage#S6CV0306P0_19980217_CWA_198

§Mr. Sanders

To ask the Secretary of State for Health if he will award ex gratia payments to women suffering permanent, progressive, disabling injuries after radiotherapy treatment for breast cancer; and if he will make a statement. [29867]

§Mr. Boateng

We are aware of the often severe problems experienced by women who have been injured following radiotherapy treatment for breast cancer. Unfortunately, there are risks associated with most medical interventions and radiotherapy treatment for breast cancer is not the only area where patients may suffer health and other problems as a result of treatment they have received.

Following careful consideration of the issues we have no plans to introduce a general scheme of ex gratia payments for specific groups such as those who have suffered injury as a result of radiotherapy treatment for breast cancer.

National Health Service bodies already have the authority exceptionally to make ex gratia payments in individual cases. Decisions to do so for those suffering adverse side effects from medical treatment are a matter for the individual NHS trust, after careful appraisal of the facts.

The Breast Radiation Injury Litigation

*Robb v. East London and City Health Authority and Unitt v. Bristol and District Health Authority.

In 1998 RAGE, after discussions with the Department of Health, entered into litigation to establish claims for injury as a result of radiotherapy treatment for Breast Cancer.

This became known as: The Breast Radiation Injury Litigation
Otherwise known as: Robb v. East London and City Health Authority and Unitt v. Bristol and District Health Authority.

From Hansard Reports:
Breast Cancer: Actions for Damages - Hansard Reports
http://www.publications.parliament.uk/pa/ld199899/ldhansrd/vo990524/text/90524w01.htm

Lord Ironside asked Her Majesty's Government: Whether all the High Court proceedings involving plaintiffs in the Legal Board's multi-party action seeking compensation for injuries caused by radiotherapy treatment for breast cancer have now been completed; and

(a) Which cases were withdrawn;
(b) Which cases were settled either in court or out of it and what sums were settled; and
(c) What judgments were handed down.[HL2423]

The Lord Chancellor: On 17 November 1997, the group plaintiffs (then 109 in number) submitted to judgment against them on the principal issues.
Two cases (Robb v. East London and City Health Authority and Unitt v. Bristol and District Health Authority) were tried as separate actions. Judgment was given for the defendants on 8 May 1998.

Eighty of the underlying cases were then discontinued as a result of the judge's findings.

Ten cases were settled. These were:

  1. Smallwood v. East London and City Health Authority,

  2. Eels v. Barking, Havering and Brentwood Health Authority;

  3. Wainman v. Barking, Havering and Brentwood Health Authority;

  4. Ford v. Barking, Havering and Brentwood Health Authority;

  5. Virdi v. Barking, Havering and Brentwood Health Authority;

  6. McClure v. East Kent HA;

  7. Crawford v. Dalley;

  8. Bushby v. Cambridge HA;

  9. Elliott v. Dr. Xaavier;

  10. Haxton v. North East Essex HA.

The sums awarded were confidential between the parties and were, for that reason, not disclosed in open court.

Further medical examinations and negotiations took place in the remaining cases: this resulted in discontinuance or withdrawal of the remaining cases. Four cases are currently outstanding for trial. It is anticipated that they will be tried in the Autumn term of 1999.

Lord Ironside asked Her Majesty's Government: What are the total costs incurred to date by the firm of solicitors acting for the plaintiffs, under contract to the Legal Aid Board, seeking compensation for injuries caused by radiotherapy treatment for breast cancer; and whether these are the final costs.[HL2424]

24 May 1999 : Column WA67
The Lord Chancellor: The total paid on account to date, to all solicitors including the firm acting for the claimants under a contract to the Legal Aid Board, is £2.9 million.

I am not in a position at present to give details of the costs paid specifically to the firm of solicitors acting under contract with the Legal Aid Board as their claims have yet to be assessed by the court. A final detailed assessment was adjourned by the court until June 1999, in order to allow the costs of private clients to be assessed at the same time.
http://www.publications.parliament.uk/pa/ld199899/ldhansrd/vo990524/text/90524w01.htm

Lord Ironside: My Lords, is my noble friend aware that the Legal Aid Board has funded a multi-party action for alleged victims of radiotherapy treatment for breast cancer, which is unlikely to reach the High Court until at least the middle of next year? Can she now say what is the total current expenditure on the aid which has been provided for those, I believe, 120 cases?

Baroness Cumberlege: My Lords, I am aware of that court case. I imagine that it is sub judice and therefore it would be inappropriate for me to go into the detail of it. As to the expenditure granted by the Legal Aid Board, that is a matter for the board.

I turn now to the issue of radiotherapy, as raised by the noble Lord, Lord Ironside, arising from a group of patients who suffered very traumatic injuries in the course of their treatment.

The START trial, to which he referred, began recruiting on 4th January this year and has recruited so far 21 patients.
All the participating centres will be scrutinised by a quality assurance team before patients may enter the study and any radiotherapy centre may volunteer to participate.
The trial hopes to recruit 4,000 patients in four years, so completing recruitment in 2003.
Follow up of patients will continue for 10 years or more after radiotherapy.

Radiotherapy Quality Assurance

http://www.publications.parliament.uk/pa/ld199596/ldhansrd/vo960425/text/60425w01.htm#60425w01_sbhd7

Lord Ironside asked Her Majesty's Government: Whether the Quality Assurance Review Technique (QART) standard has now been adopted as a national quality assurance standard for all the 53 radiotherapy treatment centres in the United Kingdom.

Baroness Cumberlege: Quality Assurance in Radiotherapy--A Quality Management System for Radiotherapy (QART) resulted from pilot studies in two clinical centres in Bristol and Manchester, funded by the Department of Health, on how best to implement a radiotherapy quality standard. The guidance was issued to all radiotherapy centres in 1994 and now serves as a model for other radiotherapy centres to follow.

Lord Ironside asked Her Majesty's Government: Whether the staff at the Bristol Oncology Centre and the Christie Hospital, Manchester, are authorised to carry out quality assurance assessments to the Quality Assurance Review Technique (QART) standard at other Untied Kingdom centres, and whether they have done so.

Baroness Cumberlege: This is a matter for the hospitals concerned.

Radiotherapy Quality Assurance

http://www.publications.parliament.uk/pa/ld199596/ldhansrd/vo960425/text/60425w01.htm#60425w01_sbhd7

Lord Ironside asked Her Majesty's Government: Which radiotherapy treatment centres have certificated approval to the ISO 9002 Quality Assurance standard and which of the 53 centres in the United Kingdom have not yet put a quality assurance system in place in accordance with the Quality Assurance Review Technique (QART) standard issued in May 1991; and

Which of the 53 radiotherapy treatment centres in the United Kingdom have used contractors to assess their ability to meet the requirements of the Quality Assurance Review Technique (QART) standard and obtain certification to ISO 9002; and

Which contractors and assessment bodies have accreditation from the Department of Trade and Industry and Department of Health to carry out the quality assurance assessments to meet the

25 Apr 1996 : Column WA107 requirements of the Quality Assurance Review Technique (QART) standards for radiotherapy treatment centres in the United Kingdom and elsewhere.

Baroness Cumberlege: The information requested is not available centrally.

X-Ray Mammography

http://www.publications.parliament.uk/pa/ld199798/ldhansrd/vo971112/text/71112w02.htm#71112w02_sbhd7

Lord Ironside asked Her Majesty's Government: How many X-ray mammography facilities are operated by the National Health Service; and where each of them is sited.

Baroness Jay of Paddington: This information is not held centrally. It is a matter for health authorities in partnership with trusts to decide how many X-ray mammography facilities to operate and where to site them, based on clinical need among the local population.

Lord Ironside asked Her Majesty's Government: Whether they will introduce legislation to require National Health Service X-ray mammography screening facilities to obtain a certificate of approval, to be prominently displayed and renewed at yearly intervals, covering equipment, procedures, methodology, film processing, operator and consultant qualifications, keeping of records and monitoring of screening plans for women in eligible age brackets and susceptible categories.

Baroness Jay of Paddington: There are no plans at present to introduce legislation to require National Health Service X-ray mammography screening facilities to obtain a certificate of approval.

12 Nov 1997 : Column WA34

Lord Ironside asked Her Majesty's Government: How many X-ray mammography facilities used in the National Health Service are certified as having ISO 9002 Quality Assurance Standard approval.

Baroness Jay of Paddington: This information is not held centrally. It is not a requirement of the National Health Service that X-ray mammography facilities are certified as having ISO 9002 Quality Assurance Standard approval.

Lord Ironside asked Her Majesty's Government: How many different types of X-ray mammography equipment are used by the National Health Service and whether the National Health Service has now selected a preferred type of equipment which will improve image definition and reduce the radiation dose.

Baroness Jay of Paddington: This information is not held centrally. It is a matter for individual health authorities to decide what mammography equipment to use, taking account of the Department of Health's Revised Guidance for Health Authorities on Mammographic Equipment (STD 90/46). Further guidance on mammographic equipment is included in the Breast Screening Programme's Guidance notes on mammographic X-ray equipment: Selection, maintenance, suspension from use, and replacement. There is no preferred type of equipment so long as STD 90/46 is complied with, and the equipment is maintained and checked to standards set out in the above guidance.

Copies of the documents are available in the Library.

Breast Cancer Radiotherapy: Legal Aid Board Action

http://www.publications.parliament.uk/pa/ld199798/ldhansrd/vo981027/text/81027w01.htm#81027w01_sbhd2

Lord Ironside asked Her Majesty's Government: In respect of the Legal Aid Board's multi-party action in which plaintiffs are seeking compensation for injuries caused by radiotherapy treatment for breast cancer, whether the experts' meeting ordered to take place before the end of September to consider the continuation of legal aid in 41 of the remaining cases has reached a conclusion; and, if so, with what results.[HL3422]

The Lord Chancellor (Lord Irvine of Lairg): The experts' meeting ordered for the end of September has not taken place as the defence experts were not ready. A rearranged date has yet to be fixed.

Lord Ironside asked Her Majesty's Government: In respect of the Legal Aid Board's multi-party action in which plaintiffs are seeking compensation for injuries caused by radiotherapy treatment for breast cancer, on what grounds the 10 lead cases out of the total pleading in May 1998 were chosen, given that five of them were formally discontinued before trial as the alleged facts and evidence did not appear to be sustainable.[HL3423]

The Lord Chancellor: In group actions it is usual practice for lead cases to be chosen which best illustrate the issues raised by the group as a whole. As with any litigation there is always a risk that a particular case will fail on its own facts. However, I am determined in reforming legal aid to ensure that taxpayers' money should only be expended on any case that has so strong a prospect of success and clear benefit to the individual

27 Oct 1998 : Column WA205

concerned, that, if the individual was able to fund the case out of own resources, he or she would do so and accept the risk of litigation.

Lord Ironside asked Her Majesty's Government: Whether they consider that the net expenditure by the Legal Aid Board amounting to £2.3 million up to August 1998 in their multi-party action involving 105 plaintiffs claiming compensation for injuries caused by radiotherapy treatment for breast cancer is proportionate to the amounts recovered by the three successful litigants out of the 10 lead cases.[HL3425]

The Lord Chancellor: I cannot comment on the merits of individual cases. I am determined in reforming legal aid, however, to ensure that taxpayers' money should only be expended on any case that has so strong a prospect of success and clear benefit to the individual concerned that, if the individual was able to fund it out of own resources, he or she would do so and would accept the risk of litigation.

Lord Ironside asked Her Majesty's Government: Whether they consider the total net sum of £2.3 million stated as being spent by the Legal Aid Board up to August 1998 on cases in which plaintiffs are seeking compensation for injuries caused by the use of radiotherapy treatment for breast cancer has been an appropriate use of public money.[HL3424]

The Lord Chancellor: I cannot comment on the merits of individual cases. I am determined in reforming legal aid, however, to ensure that taxpayers' money should only be expended on any case that has so strong a prospect of success and clear benefit to the individual concerned that, if the individual was able to fund it out of own resources, he or she would do so and accept the risk of litigation.

Effects of radiation on normal tissue: consequences and mechanisms - Lancet

http://www.researchgate.net/publication/10575447_Effects_of_radiation_on_normal_tissue_consequences_and_mechanisms

The use of radiation therapy to treat cancer inevitably involves exposure of normal tissues. As a result, patients may experience symptoms associated with damage to normal tissue during the course of radiotherapy for a few weeks after radiotherapy or months or years later.

Symptoms may be due to cell death (in normal healthy tissues) or wound healing initiated within irradiated tissue………

  1. Acute (early) effects are those that are observed during the course of treatment or within a few weeks after treatment.

  2. Consequential effects (sometimes called consequential late effects) appear later, and are caused by persistent acute damage.

  3. Late effects emerge months to years after radiation exposure.