The Secretary of State for Health and Social Care (Matt Hancock)
I would like to update the House on the progress we have made in tackling brain cancer, including on a new innovation that is now available across England.
For far too long, tackling brain cancer has been put in the “too difficult” box, and we are determined to change that. I want to pay tribute to the Petitions Committee, which did so much work on this; my hon. Friend the Member for Mid Norfolk (George Freeman), who picked up the subject in Government as Life Sciences Minister; my hon. Friend the Member for Castle Point (Rebecca Harris), the former chair of the all-party parliamentary group on brain tumours, which brought parliamentarians together; my hon. Friend the Member for St Ives (Derek Thomas), the current chair of the APPG; and, of course, Baroness Tessa Jowell, who campaigned passionately and tirelessly while battling the illness herself, and who, sadly, passed away a year ago.
Brain cancer is the most common cause of cancer-related deaths in children and young people under 19. Baroness Jowell called for all patients to benefit from 5-aminolevulinic acid, or “pink drink” as it is otherwise known: a dye that makes cancerous cells glow under ultraviolet light, thereby making it easier for surgeons to target the right areas. Trials have shown that, when the dye is used, surgeons can successfully remove a whole tumour in 70% of cases, compared to 30% of those without.
I am pleased to inform the House that we have now rolled out this ground-breaking treatment aid across England, with the potential to save the lives of 2,000 patients every year. That is part of the £33.9 billion extra that we are putting into the NHS and the NHS long-term plan. This procedure will now be expanded to every neurological centre in England. That is a fitting testament to Tessa Jowell’s memory.
It is worth pausing for a moment to remember the courageous words that Tessa Jowell used to urge us to rise above our differences. She said that this
“is not about politics but about patients and the community of carers who love and support them. It is…about the NHS but it is not just about money. It is about the power of kindness”.—[Official Report, House of Lords, 25 January 2018; Vol. 788, c. 1169.]
That represents the very best of our democracy and of our Parliament. On behalf of all those who have died of brain cancer, all those—children and adults alike—who have campaigned, and all those seeking to do research, of which there is more to come in future, we are acting.
I want to mention three further areas in detail. The first is research. In the past, not enough research was done into the causes of and treatments for brain cancer. In the last year, the Government have made an unprecedented £40 million available to fund cutting-edge research of new treatments and drugs through the National Institute for Health Research. That will build on our outstanding reputation for neuroscience and oncology research, and increase the quality, quantity and diversity of brain cancer research. That funding was further enhanced by Cancer Research UK committing an additional £25 million to support brain tumour research. The size of those pledges will cement the UK’s position as a leading global centre.
Secondly, on our NHS cancer workforce, the number of specialist cancer staff in the NHS is set to grow as we put the £33.9 billion into the NHS over the next five years. Health Education England’s cancer workforce plan, and our upcoming NHS people plan, will set out in detail the steps we are taking to recruit a world-class cancer workforce. We made available an additional £8.6 million in the cancer workforce last year, and we aim to have 300 more radiographers start training by 2021.
Finally, on empowering patients, we have worked closely with the Tessa Jowell Brain Cancer Mission, Jess Mills and others to ensure patients are at the heart of all these efforts. The mission brings together Government, the NHS, researchers, pharmaceutical companies and patients to ensure that data is shared and disseminated properly so that more patients in the UK and around the world can benefit from what is learned. Due to the complexity of brain cancer, we must provide joined-up care that meets each patient’s unique needs. The NHS is focused on improving care for brain cancer patients to ensure they have access to dedicated out-patient clinics and consultations, wherever they live.
I hope the whole House will recognise the important progress made over the past year in rising to the challenge set by Baroness Jowell and the families of those who have lost loved ones to brain cancer. That progress has been possible only through the collective effort of patients, the NHS, charities and industry. That work is and will continue to be collaborative.
In her final speech in the other place last January, Tessa Jowell said:
“I am not afraid. I am fearful that this new and important approach may be put into the ‘too difficult’ box, but I also have such great hope.”—[Official Report, House of Lords, 25 January 2018; Vol. 788, c. 1170.]
That hope was an inspiration to us all. We will rise to the challenge that she left us. We must not waiver in that task. I commend this statement to the House.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
I thank the Secretary of State for an advance copy of his statement. We warmly welcome today’s announcement. His tribute to our much-missed friend and colleague was moving and powerful. It is an extraordinary testament to Tessa’s bravery that in the final harrowing months of her life, faced with a highly aggressive and very-difficult-to-treat cancer, and in full knowledge of the life expectancy associated with such a devastating cancer, Tessa led from the front to campaign for better brain cancer treatment for others. She spoke with extraordinary courage in the Lords, she brought the then Secretary of State and me together, and she convinced Ministers to shift policy, not by garnering sympathy, understandable though that approach would have been, but by persuasion based on facts and policy argument. It was typical Tessa.
Tessa would have been delighted by the Government’s announcement—some 2,000 brain cancer patients a year will now benefit from the “pink drink” solution—but she would be keen to go further still. Almost 11,000 people are diagnosed each year with a primary brain tumour, including 500 children and young people, which is 30 people every day, and more than 5,000 people lose their lives to a brain tumour each year. Brain tumours reduce life expectancy by around 20 years, which is the highest of any cancer, and are the largest cause of preventable blindness in children.
We live in hope of dramatic improvements, but further research is needed, given that less than 2% of the £500 million spent on cancer research is dedicated to brain tumours. I welcome the Secretary of State’s commitments on research, but does he agree that we also desperately need more involvement in clinical trials? The number of brain cancer patients taking part in clinical trials is less than half the average across all cancers. How will the Government encourage more trials and data sharing?
Finally, we know that the NHS remains under considerable strain generally. The 93% target for a two-week wait from GP urgent referral to first consultant appointment was not met once last year. Neurosurgery is no exception. In March 2019, the 18-week completion target for referral to treatment pathways stood at 81.3% for neurosurgery— 5% lower than the average for all specialties—which made neurosurgery the worst performing specialty. This is a question of both resourcing and staffing. I know the Secretary of State has his answer on revenue resourcing—we disagree, but we will leave our political arguments for another day—but on workforce there are vacancies for more than 400 specialist cancer nurses, chemotherapy nurses and palliative care nurses, and there are diagnostic workforce vacancies too.
Meanwhile, the staff who are there are reliant on outdated equipment, and we have among the lowest numbers of MRI and CT scanners in the world. Failing to diagnose early is worse for the patient and more costly for the NHS, so will the Secretary of State update us on when we can expect Dido Harding’s workforce plan? Can he reassure us that the cancer workforce will be a key part of that plan? On equipment and MRI scanners, can he guarantee that the NHS will see increased capital investment budgets in the spending review so that it can upgrade existing equipment and increase the number of MRI and CT scanners?
Overall, however, we welcome today’s announcement. It is a fitting tribute to our friend Tessa Jowell, and like Tessa herself will touch the lives of so many.
Matt Hancock
The cross-party tone of this discussion demonstrates what we can achieve when we work together. This is not just about Baroness Jowell, who did so much and was so brave in how she made her case—in the last few months in particular, but before that as well. It is about the many others who have worked together, including the many who were inspired by her words to work harder on brain cancer.
In truth, the amount of research money going into brain cancer—and therefore the number of clinical trials, which the hon. Member for Leicester South (Jonathan Ashworth) mentioned—was too low. There were so few clinical trials because research overall was too low. That is partly because brain cancer is a very difficult disease to treat. Just because it is difficult, however, does not mean we should not try, so we have increased the amount of research money, and I am determined to see an increase in the number of clinical trials and to make sure that the data from them is properly used and openly disseminated.
The hon. Gentleman asked about the cancer workforce. As I mentioned, of course we will need more people to treat cancer. That is partly what the £33.9 billion extra is all about.
The hon. Gentleman is also right to say that we need more early diagnosis. The truth is that, while the NHS is very good at treating cancer once it has been spotted—indeed, it is one of the best in the world—our cancer survival rates in this country need to improve through early diagnosis. That means giving more support to community services, strengthening primary care and ensuring that we have the diagnostic tools that he mentioned. We have more MRI scanners and more Linux machines for treatment purposes, but of course there is always more that we can do.
Steve Brine (Winchester) (Con)
During my time as the cancer Minister, I had the pleasure of meeting Tessa. You will recall, Mr Speaker, a very special debate that we had in the Chamber last April, when Tessa was back in the House of Commons, sitting in the Under-Gallery with her lovely family and listening to the debate.
Obviously I welcome the roll-out of 5-aminolevulinic acid—5-ALA—which allows surgeons to tackle some of the most difficult cases while ensuring that the healthy cells remain untouched. Does the Secretary of State agree that the exciting new frontier in cancer treatment is not only allowing people to survive it—more people are doing that for longer than ever before—but enabling them to live really well after treatment? It is no good surviving cancer if it is a rubbish time afterwards. Is that not the real promise of this?
Matt Hancock
My hon. Friend is a former colleague and dependable Minister, and I regret not having mentioned the work that he did in my opening remarks. The hon. Member for Leicester South said that he and my predecessor as Secretary of State had worked together on this issue, but the person who did the hard yards was my hon. Friend, and I pay tribute to him.
My hon. Friend is completely right: it is not just about surviving cancer, but about living well both with and after it. We must make sure that we learn that lesson and put the needs of patients at the heart of the process—not only their medical needs, but their non-medical and social needs. One of the humorous and amusing things that Tessa would talk about was the importance of the shape of the wig and the colour of the headscarf to a person who is going through chemotherapy, and that should be at the heart of treatment.
Neil Gray (Airdrie and Shotts) (SNP)
I welcome the statement, and thank the Secretary of State for giving me advance sight of it. I join Members on both sides of the House in remembering Dame Tessa Jowell, her lifetime of public service and, of course, her brave campaigning during the final months of her life.
This research funding is very welcome, and it was good to see Edinburgh University’s Dr Steven Pollard involved with the Tessa Jowell mission. Will the Secretary of State expand on what he said about research spending being UK-wide, and on the implications of that? Will he also say something about how his Department has worked with the Scottish Government in this important area?
I am sure that the Secretary of State is aware of the statement made this morning by Medac, which manufactures the “pink drink”, and its concerns about medical supplies post Brexit. Will he update the House on the work that he is doing to ensure the smooth continuing supply of that very important medicine?
Matt Hancock
It shows the power of bringing people together that we can agree with the Scottish National party’s Front Bencher on the importance of this agenda. I am delighted that the research spans the whole UK. The National Institute for Health Care Reform is reserved, and health research takes place throughout the country, and indeed internationally—throughout Europe and the world as a whole. Much of the best research is global, and that must continue. I shall be happy to work with colleagues in the SNP Government to further this mission and this end. Innovations of this kind are of course available to the NHS in Scotland, but the decision on whether to roll them out there will be a matter for Scottish Ministers, as that element is devolved.
As for the question of Brexit, I have absolutely no doubt that whatever form Brexit takes, we will do everything we can to ensure the continued and unhindered flow of medicines. We did an enormous amount of work to ensure that was the case ahead of 29 March. I have seen the comments the hon. Gentleman mentions from the company that supplies this drug. I see absolutely no reason to think that Brexit should have any impact at all on the ability to use this cutting-edge drug to save people’s lives.
Rebecca Pow (Taunton Deane) (Con)
First, may I thank everyone in Taunton Deane who was involved in raising money for the new MRI scanner? It was a huge local team effort. May I also welcome today’s announcement and the use of this dye, which will potentially save 2,000 patient lives and which is to be rolled out into all those neurological centres? That is wonderful news and demonstrates that where there is a will in this place there usually is a way.
I also want to highlight the following. Does the Secretary of State agree that when we are talking about this issue, we should also remember cancers that spread from other parts of the body to the brain—it is called metastasis? This is a very complex area and it needs more input in just the way that we have looked at this issue. Does the Secretary of State agree that we ought to look at that in more detail? Unfortunately, I speak about this from experience, with a close family member being involved.
Matt Hancock
I know about my hon. Friend’s, sadly, personal experience with this horrible disease and pay tribute to her for speaking up because it is not easy. She is right to raise another frontier that we must cross, and I am fully open to research bids in this area to work not just on brain cancer but on brain cancer that is a secondary cancer, because that is a very important area to get right, too.
Helen Hayes (Dulwich and West Norwood) (Lab)
I welcome the announcement today and the progress made over the past year since Tessa so sadly passed away. I also welcome the announcement as someone who lost both my paternal grandparents to brain cancer. I want to pay tribute in particular to Tessa’s daughter, Jess Mills, who has worked with unswerving determination and energy to drive forward progress in Tessa’s name over the past year. May I say on behalf of my constituents in Dulwich and West Norwood, who Tessa represented for 23 years, how proud we are of her powerful legacy on brain cancer and the difference her work will make for thousands of people for generations to come? Throughout the whole of Tessa’s 23 years in Parliament, she was a tireless champion of King’s College hospital, which is currently in a very challenged financial position. May I encourage the Secretary of State in continuing his commitment to £33.9 billion of additional funding to look at how this national support may also be marshalled to secure Tessa’s legacy at local level?
Matt Hancock
Baroness Jowell’s successor in her parliamentary seat speaks very powerfully and the hon. Lady is right to highlight the role of King’s in this research. King’s has been developing this treatment for years, and as a result of its work, it can now be rolled out nationally. It is a hospital that, as the hon. Lady says, needs to address some of its local challenges, but we should not take away from some of the globally cutting-edge work that it does and the positive impact it has: potentially 2,000 people alive each year who would otherwise die. That is testament to the importance of this research.
Sir Peter Bottomley (Worthing West) (Con)
The first person I know who had a brain tumour and cancer and died was John Davies, who had been the MP for Knutsford shortly after I was first elected.
The NHS website is very good about the possible symptoms of brain tumours. May I strongly recommend that everyone who thinks they may have a worry consult their medical practitioners so that either they can be cleared or they can get early treatment, and is it not right that early diagnosis is the best way forward for those who may have the condition?
Matt Hancock
My hon. Friend is absolutely right about that: early diagnosis is critical to improving the proportion of people who survive cancers, because of course it is easier to treat people if diagnosis is early. We are reviewing all cancer screening programmes because they are not working well enough; the National Audit Office set that out in some detail recently, and we accept those findings. We want to get early diagnosis and screening right, and it is a top priority for the new Public Health Minister, my hon. Friend the Member for South Ribble (Seema Kennedy), to make sure we do so that more people can survive.
Sarah Jones (Croydon Central) (Lab)
As the Secretary of State said, last weekend marked a year since the death of Tessa Jowell. We all heard the moving interview that Jess did at the weekend, which showed the commitment that she still has for taking on this issue and fighting for her mother’s legacy. On 19 April last year, we were in this place for a Back-Bench debate, with Tessa sitting in the Under-Gallery. I had sponsored the debate, alongside the right hon. Member for Old Bexley and Sidcup (James Brokenshire), and I should also like to thank you, Mr Speaker, for helping us at that time. We heard many moving speeches, and we were all glad to be there to pay our tributes to Tessa.
I am privileged to sit on the board of the Tessa Jowell Brain Cancer Mission, and I want to thank the Department of Health and Social Care for its support and for the roll-out of the pink drink that we have all been talking about. That is one of the many important initiatives that the mission has prioritised. Will the Secretary of State give us his assurance that the Department will provide the same amount of support and commitment to the other initiatives that we have identified? He has talked about some of them. They include the national roll-out of the integrated multidisciplinary care model, support for the first adaptive trial for brain cancer and the Tessa Jowell fellowship programme for oncologists. The NHS is one of the few care systems in the developed world that does not train or employ experts in brain tumour treatment. Rather, brain tumour patients are typically cared for by colleges and radiologists who predominantly treat other cancers. This strategic programme is really important, as it will revolutionise the skills in the health service to tackle this difficult problem.
Finally, I worked for Tessa Jowell, and I also worked for Mo Mowlam. They were two of the most powerful, wonderful women in this House, and they both had brain tumours. We need to find a faster cure, to ensure that people with brain tumours live well for longer so that women like those two amazing parliamentarians can continue to contribute for much longer. I thank the Secretary of State for the work that he has done, and I ask him to carry on doing it.
Matt Hancock
The hon. Lady expresses the thoughts of the whole House. She, too, has done an awful lot. I should of course have mentioned my right hon. Friend the Member for Old Bexley and Sidcup (James Brokenshire), who used his enforced sabbatical from the Cabinet due to cancer to push this agenda. I add his name to the tributes. It is absolutely true that campaigners on this subject who have had personal experience of brain cancer either themselves or in their loved ones and friends, as I have, feel very strongly about it, and this is absolutely not the end of the drive. I wanted to update the House on what we have done in a year, but there is still plenty more to do.
Chris Bryant (Rhondda) (Lab)
Melanoma is one of the cancers that can metastasise into the brain, because it can travel either through the blood or through the lymphatic system. We also know that, although it can kill, especially in the circumstances we are talking about, it is very preventable. I just wonder whether there is not considerably more that the Government could do to ensure that every child covers up in the sun and that more people use sunscreen, perhaps by taking VAT off sunscreen that is higher than SPF30 or SPF50. We must also ensure that we have enough dermatologists in this country to check moles and other growths that people might have on their bodies.
Matt Hancock
Yes, I agree with all that. Of course, protection from too much exposure to the sun is part of the prevention agenda in healthcare, as well as being an absolutely sensible thing to do.
Wes Streeting (Ilford North) (Lab)
Like others, I want to congratulate the Government and everyone involved in the Tessa Jowell Brain Cancer Mission on making a painful anniversary for Tessa’s friends and family a bit more bearable for knowing that her vigour and energy are still very much alive and kicking through the mission. This is also a painful time of year for my constituents, Scott and Yang Lau, who lost their young daughter Kaleigh to a diffuse intrinsic pontine glioma, a particularly pernicious brain tumour that largely affects children. They are working with Jess Mills on fighting that particular form of brain tumour. What more can the Department do, generally and specifically through the Tessa Jowell Brain Cancer Mission, to focus on childhood brain tumours, particularly rare tumours such as DIPG, so that other families do not have to suffer what my constituents and others have had to go through?
Matt Hancock
The hon. Gentleman is right to say that, and I send my condolences to his constituents. The truth is that brain cancer is one of the most, if not the most, predominant cancers among children. Although it is relatively rare among all cancers, that is not true among children. Thousands of people still die from brain cancer, which is why it was right that Parliament and Tessa Jowell came together to highlight the lack of research in the area—something that we are determined to put right.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
May I too thank the Government for today’s statement? I was heartened by the answer given to the hon. Member for Worthing West (Sir Peter Bottomley), because early diagnosis is incredibly important. There are certain things that people can recognise, such as the effect on vision. Ironing a pinstripe shirt, for example, can lead to an odd effect, which is an early sign. Early screening in built-up areas and cities is quite easy, but it is harder in rural areas, so I make a plea for the Government to consider sparsely populated regions such as mine.
Matt Hancock
The hon. Gentleman is right that screening is vital. One of the reasons why we are looking at the whole screening programme is that the use of technology has not been nearly good enough. For many people, but not all, that can be valuable, especially in rural areas. Technology is not only used for the screening itself, but for notification and for ensuring that we get to everybody who needs to be reached. Professor Sir Mike Richards is undertaking the review of all screening, and I would be happy to put Sir Mike in contact with the hon. Gentleman to ensure that the review properly considers the impact of rurality on the need to get screening to everybody who needs it.
Mr Speaker
I thank the Secretary of State, the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth), and all colleagues for both the content and the spirit of the exchanges that have just taken place. Let us hope that Tessa’s husband David and children Jess, who has rightly been referred to, and Matthew will derive some succour from knowledge of the continuing interest in Tessa’s passionate crusade that exists in the House. We know in our heart of hearts that that continued interest will endure for as long as is necessary, both because of the supreme importance of the cause and because we are united across the House in this. We have huge respect for the courage, stoicism and unrelenting determination to make progress on this subject that Tessa Jowell, in extreme adversity, exhibited at all times.