Improving Cancer Outcomes — House of Commons, 2015-02-05
Topic: Health
Paul Kenneth Burstow (Liberal Democrats, Centre to centre-left): Thank you, Madam Deputy Speaker. I wish to echo that very point. Some of the best debates that we have in this House, and certainly some of the best Back-Bench business debates, are ones in which people bring their own personal experience and their own stories. My hon. Friend the Member for Filton and Bradley Stoke (Jack Lopresti) talked about the stories that gave him inspiration and hope. I hope that people listening to this debate will gain inspiration and hope from what he has said today. I hope, too, that those who are responsible for planning and commissioning our services and for training our medical professions gain insight from it We talk a lot about the concept of shared decision making, and my hon. Friend has demonstrated where that can work well and where it can fall apart. When it falls apart, the impact on the person concerned is immeasurable. I am really grateful to my hon. Friend for his unique and important contribution I also thank my hon. Friend the Member for Basildon and Billericay (Mr Baron) for tenaciously pursuing not just the opportunity to have this debate but this whole issue. It is undoubtedly the case that, when it comes to cancer, he has been there championing the cause. When I was a Minister, I had plenty of occasions to feel the effects of his championing. I always appreciated the way in which he pursued the matter, and I am sure that the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), has experienced that as well. He is always civil, always polite, but relentless in pursuing what he wants to achieve In this particular week, when we have marked world cancer day and had the news from Cancer Research UK that one in two of us are likely to experience cancer in our lifetime, it is absolutely right that we should be debating what more we need to do to go beyond the ambition of this coalition Government to save lives and to achieve the ambition that we set for the NHS in the next Parliament Part of the news that sits behind that one in two figure is the fact that we are living longer. I want to caution against the notion that, in some way, living longer is some sort of curse—all too often it is portrayed in that way—and that we should be worried about it. The other thing behind that research is that those cancers that may occur in later life are not inevitable. There are things that we all can do if we make choices about the lifestyles that we lead—whether that is quitting smoking or losing weight. When one considers that there are still 100,000 deaths a year due to smoking and that two thirds of people who are addicted to smoking become addicted before the age of 18, it is clear that we need to focus quite rightly and relentlessly on issues around prevention as well. That is why we should celebrate the news that, just yesterday, the Minister successfully took the regulations through this House that will result in a ban on smoking in cars where children are present, which will make a difference. We have an assurance from the Minister and the Government that, before the end of this Parliament, there will be a vote to have standardised packaging, which will be a real step forward in dealing with the impact of smoking We must do more to tackle smoking, especially in the context of mental health and mental health services, where the prevalence of smoking is so much higher. There are examples of good mental health services that have found ways to reduce smoking. None the less, there is a significant difference in life expectancy between people with severe and enduring mental health problems and people who do not have such problems Some reference has already been made to the health inequalities with regard to ageing, and I will come back to that. We need to recognise that there is a broader issue around the social gradient. If someone is poorer, they are more likely to be at risk from cancer, especially when lifestyle is a factor. The strategy that is being drawn up by the taskforce needs to address the whole range of health inequalities to deliver on the challenge that was rightly set and the duty that was imposed on the NHS to tackle health inequalities under the Health and Social Care Act 2012 Sean Duffy, the national clinical director for cancer, has said that our cancer survival rates are at an all-time high, and my hon. Friend the Member for Basildon and Billericay set out the statistics that show why we should celebrate the progress that has been made over a number of years. Clearly, if half of us will get cancer during our lifetimes, we must keep looking afresh at what more we can do. That is why the announcement of the taskforce in January to look at what the next five years should hold for cancer work is absolutely right. We cannot rest on our laurels Again, I pay tribute to the hon. Member for Easington (Grahame M. Morris) for tenaciously pursuing the case for radiography, just as my hon. Friend the Member for Wells (Tessa Munt) has done, and I give him due respect for doing so. The strategy that is being developed must answer the concerns that he and other hon. Members have been raising for a number of years. The ability to combine different innovations—whether pharmacological or technological—is absolutely key to how we catch up and then stay ahead in terms of cancer survival rates, and it is why we need this ambition of going beyond just achieving the average cancer survival rates in Europe to strive to become the best in Europe. Better prevention, swifter diagnosis, better treatment and aftercare are all part of that On early diagnosis, we have heard that a quarter of diagnoses or thereabouts take place at an emergency stage—far too late—and the outcomes are bad as a result. Therefore, we need a clear commitment to fund the Be Clear on Cancer campaign throughout the life of the next Government, because awareness raising and the identification of signs and symptoms make a difference. For example, in the areas where the lung cancer signs and symptoms campaign was tried initially, 700 extra patients were diagnosed—700 people had an opportunity to live their lives longer as a consequence The hon. Member for Washington and Sunderland West (Mrs Hodgson), who, again, is a tenacious pursuer of ovarian cancer issues, is absolutely right to ask why, on the basis of the pilot evidence from 2013, we are not pursuing ovarian cancer in the Be Clear on Cancer campaign. I hope that the Minister will answer that and perhaps give us the prospect of good news. The hon. Lady certainly persuaded me when we took the decision to hold the pilots, and I would want to know why we should not pursue it. Certainly, the pilots that she referred to suggest that there is good cause to do just that I was struck in preparing for the debate by the research published by Cancer Research UK looking at what could be achieved with earlier diagnosis if we strove to eliminate inexplicable variations in England. In other words, if we had diagnosis rates at the best level just in England everywhere—for colon, rectal, ovarian and lung cancer—it would benefit 11,000 patients and save the NHS £44 million. If we could do that for all 200 cancers, it would help 52,000 people. It is within our grasp to do massively more if we learn just from the best in our own country, let alone striving to be the best in Europe, which we would become if we did that. I very much welcome the work that CRUK and Macmillan are doing with NHS England to deliver that My hon. Friend the Member for Basildon and Billericay talked about the unacceptable cancer death toll among older people and the over-reliance on chronological rather than biological age in making judgments. As the then Minister who took the decision that there should be no exemptions from the equality duty with regard to age discrimination for the NHS, I think that that is not acceptable. Chronological age should not be used; the person and their individual circumstances should be considered in judging which treatments should be available It is therefore also vital that we recognise that in later life, because of complex comorbidity and frailty, there are additional needs, sometimes social needs, that are not properly taken into account. While I was the Minister with responsibility for cancer, I was pleased to help launch the work that Age UK and Macmillan were doing to pilot new ways of ensuring that more older people would gain access to cancer treatments. It would be useful if the Minister could say where that has gone and whether it will be continued. I hope the work will be looked at when the taskforce draws up its strategy.