The Parliamentary Under-Secretary of State for Health (Jane Ellison)
I congratulate my hon. Friend the Member for Hove (Mike Weatherley) on both securing this debate and moving it in such a personal way and giving us an account of his own experience of this dreadful disease. I am sure his words will resonate with all of us who have listened tonight, and in particular the way he took us on that journey from the first difficult moments of diagnosis through to treatment. It was a vivid and thought-provoking, but also a heartening, account.
My hon. Friend is absolutely right to draw attention to the dedicated and inspirational NHS staff, who work so passionately up and down the country for their patients. How nice it was of him to take the opportunity to put that on record this evening; that was tremendous. Never is the debt of gratitude we owe the NHS staff felt more keenly than when we personally benefit from the care they provide, often at our most vulnerable and weak moments. They are, as he says, not just care-givers, but life-savers in those situations.
My hon. Friend rightly challenged us to do better in this area. Improving cancer outcomes is a major priority for this Government and, as the annual report on our cancer outcomes strategy last December showed, we are on track to save an extra 12,000 lives a year by 2015. That is the projection based on the figures to date. We all want to see the best possible results for all cancer patients, but he was right to highlight the fact that outcomes are particularly poor for patients with oesophageal cancer. I am aware, from all our debates, that this is an area in which we have not seen the sort of movement that we have seen with other cancers. Each year in England, about 7,000 people are diagnosed with oesophageal cancer and 6,000 people are diagnosed with stomach cancer. Those diseases cause around 10,200 deaths in England each year.
We had some exciting news recently: the NHS England cancer taskforce was announced on 11 January. NHS England announced that this new independent cancer taskforce would develop a five-year action plan for cancer services with the aim of improving survival rates and saving thousands of lives in England. The cancer taskforce has been set up to produce a new cross-system national cancer strategy to take us through the next five years to 2020, building on NHS England’s vision for improving cancer outcomes that was set out in the NHS’s “Five Year Forward View”. It was formed in partnership with lots of different cancer charities and other parts of the cancer community, along with other health system leaders, and it is chaired by Dr Harpal Kumar, the chief executive of Cancer Research UK.
The taskforce will cover the whole cancer pathway through prevention, diagnosis and treatment to provide support for those living with and beyond cancer and end-of-life care, as well as covering how all those services will need to develop and innovate. My hon. Friend was right to challenge us to look creatively at different ways of doing things, and that is exactly what the taskforce has been charged with doing. NHS England is assessing the opportunity for improved cancer care and will produce initial views by March—next month—with the new five-year cancer strategy to be published in the summer.
As my hon. Friend emphasised, early diagnosis is absolutely key. Tackling late diagnosis will be an important element if we are to achieve our ambition to improve cancer outcomes, which is why our cancer strategy invested £450 million during this Parliament in improving earlier diagnosis. As his own experience has attested, it can be difficult to diagnose oesophageal cancer, especially in its early stages. I congratulate him again on securing this debate and I hope that there is someone out there tuning into the debate who has heard his words. I am sure that they will help to publicise the message about taking notice of symptoms.
When symptoms do manifest themselves, it is often an indication that the cancer has developed. That is why early diagnosis is crucial. Just under 70% of people diagnosed with oesophago-gastric cancers at the earliest stage survive for at least five years. My hon. Friend has highlighted what it means in human terms for those who are diagnosed at a very late stage. It has been estimated that around 950 lives could be saved in England each year if our survival rates for oesophageal and stomach cancers matched the best in Europe, and that clearly has to be our aim: we have to do better.
NHS England has launched a major early diagnosis programme, working together with Cancer Research UK and Macmillan Cancer Support to test new approaches to identifying cancer more quickly. I hope that that programme will give my hon. Friend some encouragement, because it touches on some of the issues that he has mentioned. It will include offering patients the option to self-refer for diagnostic tests; lowering the threshold for GP referrals; creating a pathway for vague symptoms; and setting up multi-disciplinary diagnostic centres so that patients can have several tests done at the same place on the same day.
Steve Brine
Southampton has been mentioned, as has my constituent Tim Underwood, who leads the team there. What the Minister is saying is absolutely right. Does she agree that regional centres such as Southampton—which do things that, quite rightly, not everyone does—are the key to providing regional areas of specialism to help us to do even better on the diagnosis and treatment of oesophageal cancer?
Jane Ellison
In a recent Back-Bench debate on cancer, mention was made of the tension that we all feel as constituency Members between the desire to have services nearby and the recognition that the expertise resulting from seeing lots of cancers, particularly the rarer ones, is really important to developing clinical excellence. We have to be clear that there are areas where concentrating excellence and clinical experience will save lives, and my hon. Friend perhaps highlights one such area. We often underestimate just how few cancers of any kind the average GP sees, and that is especially true of rarer cancers.
Let me go back to the different ways of looking at earlier diagnosis. NHS England’s aim is to evaluate these innovative initiatives across more than 60 centres around England to collect evidence on approaches that could be implemented from 2016-17. In 2013, Macmillan Cancer Support, partly funded by the Department, piloted an electronic cancer decision support—CDS—tool for GPs to use in their routine practice. It covers lung, colorectal, pancreatic, oesophagus and stomach, and ovarian cancers. Following the pilot, the CDS tool has been refined and is currently installed in more than 1,000 GP practices across the UK. It is designed exactly to deal with the point about helping people who do not see certain things very often with those diagnostics. Macmillan is working with software companies to adapt the CDS for different IT systems and make it available to GPs as part of their standard software offer.
I just wish to mention the Be Clear on Cancer campaign, which I am glad my hon. Friend the Member for Hove mentioned.
Steve Baker (Wycombe) (Con)
The Minister has said many things that give me the impression that there is potential for a huge additional demand on consultants. One of the most striking things that my hon. Friend the Member for Hove (Mike Weatherley) said was that a consultant will get only six minutes with a patient. Will the Minister explain what the Government are going to do to make sure that consultants have enough capacity to deal with the extra demand that is likely as a result of these laudable new methods?
Jane Ellison
The cancer taskforce is charged with looking at all those challenges and resolving those tensions, but the NHS’s own “Five Year Forward View” considers some of the ways in which it can be innovative about the use of consultants and the interaction between primary and secondary care, and whether we can do more by looking at that differently. If my hon. Friend is interested in that, it is definitely worth looking at. That is very much the sense of direction and we are now looking to the cancer taskforce to examine all those issues. Parliamentary all-party groups have been asked by the cancer taskforce to contribute to its review, and we ascertained that before the Back-Bench debate. He highlights a fair point; all these things bring their challenges, and that is one reason why we put so much effort into testing the Be Clear on Cancer campaign.
I was delighted that the recent pilot of the Be Clear on Cancer campaign for oesophageal and stomach cancer in the north-east and north Cumbria was so successful. We carry out the pilots in order to understand what additional demand they create in the system, so we can model that and cope with it if the campaigns are rolled out. Following the pilot, a national four-week campaign ran from 26 January until yesterday, and was supported with national TV, radio, digital and out-of-home advertising and a public relations campaign. A variety of face-to-face events were held across the country in venues such as shopping centres.
The campaign aimed to raise awareness of the symptoms of oesophageal and stomach cancers and to encourage those with symptoms such as persistent heartburn to visit their GP. The campaign was targeted at men and women aged 50 and over. Of the nearly 13,000 people who are diagnosed with oesophageal or stomach cancer each year in England, more than nine out of 10 are aged 50 and over. The campaign was also aimed at friends and family, who can encourage those with symptoms to make an appointment with their doctor if they are concerned. We are all aware of those times when despite knowing what is good for us, we need a loved one to say, “It is time to go to the doctor.” The campaign takes that into account.
Let me deal with the clear and good points made about endoscopy, including by my hon. Friend the Member for Winchester (Steve Brine). We accept that there are issues to address on endoscopy capacity, which is why we have been working with NHS England and Health Education England to prioritise this area. A joint endoscopy working group, set up by the NHS England’s national clinical director on diagnostics and imaging, has been analysing the latest data, and an action plan has been developed to ensure sufficient capacity in the short and long term.
Let me briefly mention treatment. NHS England’s oesophageal and gastric cancer service specification clearly defines what it expects to be in place for providers to offer evidence-based, safe and effective oesophageal cancer services, in line with the National Institute for Health and Care Excellence’s clinical guideline, “Improving Outcomes in Upper Gastro-intestinal Cancers”.
I want to touch on research, because people should understand what we are doing to invest in understanding more about these specialist areas. The National Institute for Health Research has awarded £2 million for a research professorship with a focus on improving outcomes for oesophageal cancer through innovative screening and surveillance tests. It is also funding a £2 million trial of palliative radiotherapy in addition to self-expanding metal stents for improving outcomes of dysphagia and survival from advanced oesophageal cancer. The NIHR clinical research network is currently recruiting for 24 clinical trials and studies in oesophageal cancer.
In conclusion, I thank my hon. Friend the Member for Hove for securing this debate and congratulate him on the way he moved and delivered it. I do not underestimate the challenge of improving outcomes for people with oesophageal cancer. However, I hope that what I have briefly set out here shows that we are committed to improving cancer care through building greater awareness among the public; targeted and high-profile awareness campaigns, such as the Be Clear on Cancer; using technology and innovation to support GPs to better identify symptoms and improve the referral process; and taking action to ensure sufficient capacity in areas such as endoscopy. Things are improving, but there is much work still to be done. We are committed to improving cancer survival rates and building on the improvements we have made so far so that we have the best cancer outcomes in Europe. My hon. Friend’s speech tonight illustrated far more eloquently than I can, with all my facts, figures and statistics, why that is important to our fellow countrymen and women and why it is so important that we continue to make progress, and I thank him for highlighting that this evening.
Question put and agreed to.