The Parliamentary Under-Secretary of State for Health (Ben Gummer)
It is a great pleasure to respond to the excellent speeches that have formed this interesting and remarkably well-informed debate. I echo the thanks given by the shadow Minister and others to my hon. Friends the Members for Basildon and Billericay (Mr Baron), for Bury St Edmunds (Jo Churchill) and for Bosworth (David Tredinnick) for securing the debate in such a timely manner. I do not think that even they would have anticipated it coinciding with today’s launch of the consultation.
The debate touches on the lives not only of everyone in this House but of everyone in the country. The frustrating regularity of cancer diagnosis—in the past week, two of my friends have had a cancer diagnosis confirmed—is shared by Members and by people watching this debate across the country. That is why this is such an important and salient issue for all our constituents. I am therefore very grateful to hon. Members for both speaking on this matter and for bringing it to the attention of the House.
At the start of my speech, it is worth reflecting that we are able to speak about this issue from a position of celebrating the success of the past few years. There have been quantum leaps in the treatment, diagnosis and survival rates of cancer. More than half of people receiving a cancer diagnosis now live 10 years or more, a remarkable statistic that would scarcely have been believed 20 or 30 years ago. The fact that we are able to speak frankly about this at all, with the very personal speeches hon. Members have given today, marks the end of the dangerous taboo surrounding talking about cancer. Happily, we are now able to replicate that fight in relation to mental health and end-of-life care. The work done by cancer charities over many years, to talk about cancer and to make it a live issue in the public imagination, is now reflected in other important areas of care.
Mr Baron
The Minister is absolutely right to say that we have made great strides, and the Government are to be congratulated on playing their full part in that, but may I gently remind him that as we have made great strides, other countries have also made great strides? The debate is largely about the fact that we are still well behind European averages on survival rates. The first year survival rate in this country is 69%, whereas in Sweden it is 81%. That apparently small difference accounts for about 10,000 lives a year in this country being needlessly lost because we diagnose too late. I am sure the Minister will agree that there is still a lot to improve on.
Ben Gummer
I could not agree more with my hon. Friend. I was not trying to offer mere bromides. Indeed, I was about to say that although we perform well in many clinical areas, we perform badly on cancer compared with other countries. We have made significant progress over the past few years, but we are still not where we should be: at the top of the pack. There are many reasons for that, some of which we understand and some of which we do not, but it behoves us all to do something about it, which is why the taskforce was set up. In that regard, I add my thanks to Harpal Kumar and the many people who contributed to the taskforce’s conclusions.
I am speaking to an expert audience here—I am conscious that almost everyone who has spoken has considerably greater expertise in this area than I do—so I will not rehearse the history of the taskforce or its recommendations. Importantly, there is now a consensus about what needs to happen. Various things have to happen if we are to deliver on the aims of the taskforce.
Ben Gummer
We should indeed. I found the hon. Gentleman’s remarks extremely interesting; I learned a lot from them.
I want to answer hon. Members’ questions as well as I can, although I am conscious that I am answering them on behalf of the public health Minister, who has responsibility for cancer and has considerable expertise in this area. She is sorry she cannot be here. My hon. Friend the Member for Basildon and Billericay (Mr Baron) asked some salient questions. The first was: when will the taskforce conclusions be implemented? He will know that the new national director for cancer has just been appointed, and I met her yesterday. As he knows, she is an immensely impressive women, having run one of the foremost cancer institutes in the world, and she is aware that one of her initial tasks is rapidly to set out an implementation plan. In doing that, I know she will want to speak to the all-party group on cancer as soon as she develops her plans in order to keep its members abreast of developments and to hear their views about the pace of implementation. I will ensure that officials write to Members with any further details about implementation.
My hon. Friend asked about the CCG scorecards. I understand the nervousness—I detected it in his voice—about the complex measurements and the dashboard being translated into apparently simple measurements in the scorecard. I want to give him some reassurance. The scorecards used for hospitals are immensely complex and have behind them a huge amount of data that are then distilled into simple scorings, the point of which is to provide clear accountability and transparency to patients and people living in CCG areas, who, at the moment, have no grip, because we do not give them any, on how well a CCG is performing. The expert panel looking at the operation of the scorecards will be out for consultation next month and will report back before the scorecards are put in place in April. I know it will listen carefully to his comments about one-year survival rates and the detail of how the scorecards are put together, but I am clear that the oncological experts on the panel will not want to undermine the work done on the various metrics and the dashboard.
My hon. Friend spoke with eloquence about genomics. It is of course true that the reason we are able to make increasingly rapid progress is that cancer is a genetic disease, and genetics and genomics are the great new frontier in medical innovation. In a sense, therefore, dealing with cancer and drugs for cancer will be the tip of the spear when it comes to developing all new drugs in the decades ahead. It is very exciting, but presents massive challenges to funded healthcare systems around the world. It is in trying to find a way of affording the new drugs that are coming online, but also releasing the unique possibilities that the NHS offers, that we think we are in such a strong position to offer opportunities both to those wanting to research cancer from an academic point of view and to those businesses and companies doing so in order to develop drugs.
The point of saying that is that the cancer drugs fund, which many Members referred to in their speeches, will necessarily have to change in response to the significant changes of the last few years. To the shadow Minister’s point about the cancer drugs fund, I would gently say that it was an innovation personally promoted by the Prime Minister in 2010. He has made a personal commitment to it, so all Members should take solace from the fact that he will be watching carefully how the fund develops. It has risen from a few hundred million pounds to over £1.2 billion. That demonstrates a commitment that was not present before the cancer drugs fund was invented. Its size is such that it now makes up a considerable part of the overall drugs spending of the NHS.
I hope hon. Members will take comfort from the fact that the consultation announced today by NHS England aims to build on the success of the cancer drugs fund, to incorporate the new structures that need to come about as a result of the significant changes in genomic research over the last five years and to align the general research, licensing and funding of drugs through NICE with the principles of the cancer drugs fund, so that we have a far more integrated system in future. I would encourage all hon. Members present to contribute to the consultation on the cancer drugs fund and thereby help to inform the second stage of its existence, when that comes about—I imagine at some point next year.
David Tredinnick
I may be pre-empting what my hon. Friend is about to say, but on the point about widening the scope of drugs, which he has alluded to, will he take note of the remarks about broadening the scope of patient choice and the range of therapies available, and perhaps using Professional Standards Authority-regulated professionals rather more?
Ben Gummer
I will, and I was about to move on to my hon. Friend’s remarks. He made a similar point—that great progress had been made but there was still much to be done. He spoke with eloquence and detail about complementary treatments, in which I have absolutely no expertise—I shall have to disappoint him on that. I know that he has written to me about the regulation of herbal medicines. I have today spoken to the Minister for Life Sciences, and I know that my hon. Friend will be receiving a full response about the various issues he has raised.
In response to my hon. Friend’s points about complementary treatments, I would say that it is very important when spending taxpayers’ money on cancer treatments that there is a solid evidence base for what we do. However, his point is well made—that the entire person needs to be taken into account when considering treatment. That can also involve people living with cancer, not just the treatment of it.
It was very nice to hear the hon. Member for Alyn and Deeside (Mark Tami) speak. It was also good to hear him speak from a personal point of view—it was good of him to share his sorrow regarding his son. On the stem cell transplantation issue that he raised, I can tell him that the recovery package as part of the taskforce’s recommendations that the Government have already moved on will apply to blood cancer patients who have undergone stem cell transplantation. The Government are very supportive of the work by the Anthony Nolan trust and other charities, but I will make sure that the hon. Gentleman gets a fuller response on the specific issues that he raised, so he can be satisfied that we have taken into account the particular difficulties and challenges facing those who have undergone stem cell transplantation.
It was a great pleasure to hear from the hon. Member for Scunthorpe (Nic Dakin). I have a particular affection for him, not only because he helped me on the way through King’s Cross the other day, but because he spoke just before me in my maiden speech—we made ours at the same time. This is a good point at which to reflect that the Member who spoke after me was the former right hon. Member for Oldham West and Royton, who is much missed in this place.
The hon. Member for Scunthorpe brought to our attention the issue of rare cancers—specifically pancreatic and blood cancers. I would like to reassure him about research. He will know that Cancer Research UK has looked specifically at the rare cancers and has prioritised work in the areas where it feels additional research funding and effort need to go, which include blood and pancreatic cancers—and, indeed, brain cancers, which my hon. Friend the Member for Castle Point (Rebecca Harris) mentioned. The hon. Member for Scunthorpe also raised the issue of GP imaging capacity, and I would like to reassure him that, as part of the ACE programme—Accelerate, Co-ordinate, Evaluate—by NHS England, imaging will be expanded within primary care. I hope that I will be able to write to him with further details.
I thank my hon. Friend the Member for Castle Point for her fascinating speech and for bringing to our attention the very sad story of her constituent Danny Green. Her point about a national register for off-label drugs was well made, and I know it is an issue that the Under-Secretary of State for Life Sciences, my hon. Friend the Member for Mid Norfolk (George Freeman), is looking at actively. My hon. Friend the Member for Castle Point made a point about research,. She will be aware that it is always difficult to try to divvy up research funding, but I will make sure that her point is reflected back to my hon. Friend the Under-Secretary.
My hon. Friend the Member for Bury St Edmunds (Jo Churchill) made some very good points about joined-up care. It is certainly the case that we need to see such care across the NHS.
The hon. Member for Foyle (Mark Durkan) spoke about the cancer drugs fund, and made an interesting point about a UK-wide set of arrangements. I shall certainly pass on his comments to the Minister responsible for cancer. He also spoke about molecular diagnostics, and I would like to reassure him that, in England at least, we will significantly roll out molecular diagnostics as a result of our acceptance of the principles of the taskforce recommendations.
Finally, the hon. Member for Ellesmere Port and Neston (Justin Madders), the shadow Minister, rightly made some points about public health strategy. It is, of course, difficult to make sure that we balance the books, while keeping to our manifesto pledges. His points about tobacco and obesity were well made, and I know that the Government will be coming forward with obesity plans in short order.
With no more time available to me, I would like to thank Members for their full, excellent and expert contributions to this fascinating debate. I hope that the Government have shown the kind of progress and commitment to this important area that they are so keen to see.
Madam Deputy Speaker (Natascha Engel)
That leaves one minute for John Baron to conclude the debate.