Non-invasive Precision Cancer Therapies

Gillian Keegan Excerpts

Thursday 18th July 2019 Commons Chamber

[Gillian Keegan (Chichester) (Con)]

It is a pleasure to follow the hon. Member for Easington (Grahame Morris). Half of everyone in the UK will develop cancer at some stage in their lives and a quarter of us will receive radiotherapy treatment. Radiotherapy is highly effective, especially when compared with other therapies, given that survival rates improve by 16% compared with just 2% with other therapies such as chemotherapy. That is important because the UK has the second worst survival rates for lung cancer in Europe and we lag behind the European average in nine out of 10 cancers. We know that our population is ageing and that, more and more, our lifestyle choices are detrimental to our health. This means that over the next six years, cancer rates are expected to increase by a quarter, so ensuring that we get cancer treatment right is of fundamental importance.

The Government are making progress in this area. Since 2010, rates of cancer survival have increased year on year. It is thought that 7,000 people are alive today who would otherwise not have been. The NHS long-term plan has set out a way to ensure that future radiotherapy treatment will be faster, smarter and more effective. Although it is a welcome strategy, we in the all-party group on radiotherapy have been looking into the detail and have highlighted some pressing issues, which we look forward to publishing in due course.

As has been mentioned, there are serious workforce shortages; for example, radiotherapy clinical scientists have a current vacancy rate of 8%. We need to take swift action to address that, and specifically, to support the education and training programmes that feed the pipeline of talent. There are only 10 therapeutic radiography degree programmes in England and that will soon reduce to nine, as one very close to me in Portsmouth is due to close soon.

Since 2016, entry-level training for this industry has fallen by 23% since the loss of the bursary; last year, only 240 students undertook this training. I therefore hope that the Department for Health and Social Care and the Department for Education will review the impact of terminating the bursary programme and consider how to attract students to this profession. The Society of Radiographers recently developed an apprenticeship standard at degree level to provide another entry point to the profession. I believe that that is exactly the right approach, whereby the next generation of industry professionals can learn and earn on the job. Sadly, however, the Institute for Apprenticeships and Technical Education offered a funding band of around £19,000 for the programme’s delivery, but given the high-tech and expensive infrastructure needed to support it, the level of funding was insufficient. I urge the institute to carry out a review of the scheme and ensure that we have the right funding requirements.

During evidence sessions for the all-party group on radiotherapy, the current tariff system came up again and again, including the fact that the tariff is paid per fraction. Clearly, if we have new technology that will reduce the number of fractions, there may be a perverse incentive that would discourage the use of it. Earlier this year, the all-party group visited Elekta in West Sussex, which is pioneering the future of advanced radiotherapy technology, including the MRI LINAC—linear accelerator—machines. Ironically, West Sussex does not have a single LINAC machine—neither the MRI version nor even the standard version—so many of my constituents are travelling as far as London and Brighton for their treatment. Time and again, I have heard from them, and from charities including CancerWise, which is based in Chichester, just how gruelling these daily journeys are. Many adjacent counties have this capability, and I started this journey to make the case for having that capability for my constituents.

It is worth highlighting that £130 million was invested in 2016-17, and that upgraded and replaced machines right across England’s cancer centres. It was the largest investment for 15 years, so we thank the Department of Health and Social Care for it; it was very welcome. However, we are concerned that in the long term, the equipment may not be maintained unless there is a rolling fund. The way we budget for this seems stochastic. We know that the equipment has a life span. As it is all new, perhaps we can now plan for when it is old, and ensure that there is a rolling budget in place. We have mentioned IT. It is vital that we have the latest network, to ensure that all the constituent parts are interconnected.

Radiotherapy is the most incredible resource, and is involved in 40% of cancer cures. It is a cost-effective treatment, taking up just 5% of the cancer budget while treating 50% of cancer patients, but it needs a bigger voice, and I am grateful to my colleagues on the APPG for securing this debate and allowing us to give it that voice.

I would like to take this opportunity to thank the NHS staff across our country who deliver this phenomenal service. The changes that we are discussing could save many more lives. Britain has always embraced innovative technology, so I have no doubt that advanced radiotherapy and integrated IT networks will be the standard in the future; the question for all those suffering from cancer is merely when.

Children and Mental Health Services

Gillian Keegan Excerpts

Tuesday 16th July 2019 Westminster Hall

[Gillian Keegan (Chichester) (Con)]

It is a pleasure to serve under your chairmanship, Mr Pritchard. One in nine young people aged between five and 15 has a diagnosable mental health condition, so I thank my hon. Friend the Member for Burton (Andrew Griffiths) for securing this vital debate. The issue becomes more pressing as figures suggest that those children are twice as likely to carry mental illness into adulthood. However, the Government are taking some action and have invested £1.4 billion to improve specialist services for mental health, but we are playing catch-up.

Pressures on the younger generation are at a new high with the advent of social media. There is a constant pressure to keep up on platforms such as Instagram, Snapchat and Facebook, which is compounded when we look at their exposure to image and celebrity culture. Although social media can be a power for good, it is clear that such platforms can have a detrimental impact on children’s mental health. We have already had some truly devastating cases, such as that of Molly Russell, whose suicide sparked this important conversation nationally. I welcome the current review by the chief medical officer, Dame Sally Davies, who is assessing the impacts that social media has on a child’s mental health.

Another mental health condition on the rise, especially in young people, is eating disorders. I recently met a constituent, Lizzie Speller, here in Parliament, with the charity Beat UK, which supports people with eating disorders. Lizzie spent several years fighting anorexia. She overcame her long battle and got the help that she needed. It is fantastic that four fifths of young people with eating disorders now receive treatment within one week. Lizzie is doing a lot to help others. She has set up Mental Health Mates walks, a Chichester community group that has a monthly city walk. My husband and I joined them earlier this year. It is an opportunity to meet and talk about things that concern people. The role of Beat is important in spreading the network across the country.

Another Beat ambassador is my goddaughter’s sister, Isabella Tee, who worked hard to overcome anorexia as a teenager and now works to support others at York University. Schools have a vital role in offering support and spotting the signs when people need help. Many schools in my constituency—Chichester High School and Bourne Community College, to name just two—have done a lot to support mental health in schools and have trained mental health first aiders and pupil mental health ambassadors. On the ground, visible services are exactly what we need, and I look forward to seeing the impact of the new mental health support team pilot in my area, as the Coastal West Sussex CCG is taking part in the first wave.

Getting to grips with mental health is important, as the consequences of not doing so are unimaginable. On 17 July 2017, one of my constituents, Jo Marsden, had her life turned upside down when her 20-year-old son, Ned, took his life at Witley station. Ned had been excluded from school earlier in his life, and over the years had withdrawn from his family and friends. His mental health issues were well masked and not identified at school or later when his doctor tried to identify signs. I have met Jo several times now, and she is an inspiring woman. She has created Ned’s Fund, which offers vocational courses to young people who drop out of school. She said:

“My dream is to help as many children as I can by funding vocational training. I’m not a fairy godmother but nothing would bring me greater happiness.”

The impact of suicide on a young person is truly devastating, as my family knows from personal experience because my young cousin, Sallie Gibson, took her life some years ago.

People across Chichester continually come together to improve each other’s lives. Tackling mental health issues needs a comprehensive approach where, in every part of a young person’s life, someone is available to give a much needed helping hand.

Living with Dementia

Gillian Keegan Excerpts

Tuesday 25th June 2019 Westminster Hall

[Gillian Keegan (Chichester) (Con)]

It is a pleasure to serve under your chairmanship, Mr Paisley. I thank the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) for securing this important debate, and the Backbench Business Committee for granting it.

Both my grandmothers suffered with dementia, so like many here today I have seen at first hand how people slowly become a shadow of their former selves. We are all living longer than before, but with the gift of more time comes complex illness and disease. It is expected that, by 2020, more than 1 million people across the UK will have dementia, with one in five people aged over 90 suffering from it. Chichester has a significant elderly population, and we therefore have more sufferers than the national average.

We know that this area of health will only become more of an issue in the coming years, so policy around it needs to be robust, for both patients and their families. In 2015, the Challenge on Dementia 2020 was launched, setting out the vision for how dementia care support, awareness and research will be transformed by 2020. A big part of this is awareness raising, so people can spot the signs in loved ones. I and my team are registered to take part in Age UK’s dementia awareness training, and I am sure that many people across the country are doing the same. More people are receiving a dementia diagnosis than ever before, helped by the fact that more than 660,000 NHS staff have received dementia training. That is important, because the earlier the diagnosis, the more time patients and their families have to prepare for what is to come.

From my own experience, I know that dementia is a very changeable disease, with good days and bad. Sometimes I would sit with my nan and she would be as sharp as a pin. Sadly, on others, she would barely recognise me. However, there are some things that can beat dementia, and in her case it was politics. I will never forget visiting my nan, Joan Roberts, after she moved out of her council house and into a local care home in Huyton. I had just finished my first election campaign, contesting St Helens South and Whiston in 2015—as a Conservative—and wanted to show her my election leaflets. At the time, she was in the advanced stages of dementia. She looked at the photos and admired the different outfits I was wearing, but all of a sudden her face went as black as thunder when she realised I was standing as a Conservative. “That is not my party,” she exclaimed. I said, “Goodness, nan; you can’t remember what you had for breakfast but you still remember that you’re Labour.” I went on to reassure her that we had never agreed on politics, and she seemed happy enough with that reply.

Having seen how this disease impacted my family, I think it is crucial that we bolster support for family carers. My constituent, Wendy, cares for her husband Richard and has had her life turned upside down. Her husband was her main support through life, and they used to talk about everything, but now they cannot. In contrast to much of their marriage, she now cares for him. Wendy, like many others, receives support from Sage House, our local dementia hub. The services it offers sufferers and their carers are a vital lifeline.

My family were very lucky in that regard. Coming from a large Liverpudlian family, we have a home-made support network, but not everyone is so lucky or lives close enough to each other. When my other grandmother, Jessie Gibson, was diagnosed with Alzheimer’s, her 11 surviving children, including my dad, drew up a 24-hour rota so that someone was always there to care for her in her home in Huyton. However, having 11 children who live within a few miles of each other is quite an unusual care option, and not one that I guess many of us have.

Sage House is an amazing local service. It is there from the earliest stages of dementia to end-of-life care. It has group sessions, which are important to people with dementia because loneliness often becomes more of an issue. Similarly, Chichester Lunch Club offers a fantastic support service that helps people to build and maintain relationships. Anyone who has loved ones with dementia will know how important it is for their wider mental health that they keep up social interaction.

Like most issues of the 21st century, there is always a technological advancement that can help. Chichester Careline is the only monitoring service in West Sussex providing telecare equipment to the most vulnerable in our society. Its services are becoming ever more invaluable, because they are often used by people in the earlier stages of dementia. People with dementia often get confused, and on occasion get lost; they sometimes wander out of their house. My nan used to go out looking for her two daughters, who she thought had not come home for the evening, even though they were in their 60s and 70s. Careline operates a “Mindme” service. That means that if a person becomes lost or disorientated, they can be located through a website, which is monitored by their family, friends and carers as well as Chichester Careline. That service is available 24/7, 365 days a year. The technology can now go further for people who are prone to wandering off. An imaginary ring fence can be installed around a location, and that sets off an alert if a user crosses it.

Dementia is an illness that has touched my family and will affect more and more families up and down the country. A key concern of mine is social care—for those with dementia and for the elderly more generally. I believe that we need a transformative adjustment in policy that genuinely offers a sustainable, integrated model of care. At this point, I urge hon. Members here today who have not already done so to join the all-party parliamentary group on social care, which I set up with the hon. Member for Sheffield, Heeley (Louise Haigh) and in which we are working to be a voice for the industry and its professionals to improve the status of that vital work, on which many people up and down the country rely. It is our great responsibility to care for those who cared for us. We need to get this right. One day, and sooner than we think, we will be the ones in need of that care.

Cystic Fibrosis Drugs: Orkambi

Gillian Keegan Excerpts

Monday 10th June 2019 Westminster Hall

[Paul Scully]

My hon. Friend is absolutely right. The young son of the lady who had her Orkambi withdrawn at the end of the trial asked her, “Mum, what was the worst day of your life?” She said, “It was when that drug was taken from me.” Her son—from memory, I think he was seven—said, “You know what? That was the worst day in my life as well.” This is about the extended family and the people around the patient. A number of hon. Members have talked about the cost per patient, but it is not just about the patient; it is also about their friends, family and loved ones.

[Gillian Keegan (Chichester) (Con)]

I thank my hon. Friend for securing this debate. I met my constituent Jack when I went to visit our local hospital. It is not surprising that I met him, because he spends six months in the hospital every year. He is now running out of treatment; he has tried everything. He is on 30 tablets a day, and he is on nebulisers. He is trying treatment after treatment, and the treatments are running out. Patients like Jack need this drug urgently, because there is almost nothing left.

[Paul Scully]

My hon. Friend is absolutely right. People are desperate; this has been dangled in front of them and it is about time that we acted.

I welcome my hon. Friend the Minister to her place—it is fantastic to see her serve as well as she does. I know that Vertex and NICE will be listening to the debate, and I hope that they act. It is so important that that we get this right and get it done now, for the sake of the thousands of people across the country who look to politicians to do things. I talked about the independence of the system, but we need none the less to do everything we can to bring the parties together to ensure that they deal with the matter. As I keep saying, this is about human beings, their life expectancy and their quality of life. I look forward to the Minister’s response.

Health

Gillian Keegan Excerpts

Tuesday 14th May 2019 Commons Chamber

[Gillian Keegan (Chichester) (Con)]

The NHS is without a doubt a much-loved and vital service. Established almost 71 years ago, it has been under the stewardship of a Conservative Government for 44 of those years, almost two thirds of its existence. The NHS treats 1.4 million patients every 24 hours. It is literally where we start our life, and a constant support and safety blanket throughout our lives. We simply could not live without it.

That is why the NHS is this Government’s No. 1 spending priority. It is beyond question that this Government have provided the biggest investment ever into our NHS in the post-war period. The scale of the commitment is mind-blowing, at £33.9 billion extra in cash terms by 2023-24. If any other Government had done it they would have been celebrating it and would have spoken of little else. By 2023, we will be spending £157 billion a year—many billions of pounds more than the Opposition proposed.

My mother-in-law, who was a frequent user of the NHS in her later years, used to say to me “You have to be able to cope to be able to care.” I find her words very poignant when talking about our magnificent NHS, because it is vital that we maintain a strong economy to fund the NHS at these record-breaking levels. The biggest danger to the NHS in my view is a dangerous experiment with socialism coupled with a £1,000 billion spending commitment. The NHS will literally be competing with railways and utility companies and goodness knows what else for a pot of money which will be much smaller due to economic failure.

As someone who has worked in the private sector for most of her life, my approach is somewhat different. The private sector has to work well if the NHS is to have the funding that it needs. There are other lessons that are relevant in my experience. It is reasonable to assume that we can increase efficiency. There are many examples across the NHS and many new ways of working: multidisciplinary teams, primary care networks, integrated services, urgent care centres, Pharmacy First, online GP services, and much more innovation to come as part of the long-term plan.

Nowhere have I see that endeavour for excellence combined with efficiency more than in St Richard’s Hospital in Chichester. I pay tribute to our wonderful staff and the phenomenal record of the whole Western Sussex Hospitals NHS Foundation Trust, led brilliantly by Dame Marianne Griffiths. We are extremely proud that our hospital trust is rated outstanding, and was described as effective, caring and well led during its Care Quality Commission evaluation. It is not surprising that the trust has won awards. Over the past four years it has won best organisation in the health service, best education and training in patient safety, and the top hospital award. Marianne has won best chief executive two years running. We need that excellence in all our hospitals across the country.

Before I was elected to Parliament I was lucky to serve on the hospital trust board of governors, where I learned a great deal. Most importantly, I saw its can-do attitude and search for continuous improvement combined with sensible and inclusive leadership that ensured that it delivered great results. For those who doubt that the NHS can make efficiency savings year on year while maintaining top-quality services, Western Sussex Hospitals has managed a surplus every year but one since its creation in 2009, wiping out £20.5 million-worth of legacy debts.

West Sussex County Council has stepped up to the public health challenge, and only last month launched a new joint health and wellbeing strategy, “Start well, Live well, Age well”. Prevention through education is a key component of our health and wellbeing. In West Sussex, we have introduced a winter falls prevention programme, a tobacco control strategy and alcohol reduction initiatives, as well as programmes to counter loneliness, suicide and self-harm. Listening to Opposition speakers in this debate, people could believe that the system is broken. It is not, and that is certainly not the story in my constituency, where I am lucky to work with great people: doctors, nurses, porters and all the other NHS staff.

None of this is to the credit of politicians, who often use the NHS as a political football, spreading nonsense and rumours with threats of privatisation. It is down to the committed people in the NHS doing a great job with strong leadership on the ground. That is now underpinned by the right funding model for the future—the biggest cash injection in NHS history, which is something that we should all celebrate.

Healthcare (International Arrangements) Bill

Gillian Keegan Excerpts

Wednesday 14th November 2018 Commons Chamber

[Gillian Keegan (Chichester) (Con)]

It is a real pleasure to follow my hon. Friend the Member for Walsall North (Eddie Hughes). Like him, I am optimistic about securing a Brexit deal and continuing our international healthcare arrangements. Since the 1950s, the UK and its European neighbours have had reciprocal healthcare and social security arrangements, and I have personally made use of many of them, having spent years living and working in European countries. Good reciprocal healthcare arrangements give peace of mind to all of us, and they will be important as we continue. Current arrangements give all UK nationals a sense of security and the knowledge that they can access the healthcare they need when they live, study, work or travel across Europe. The same applies to EU citizens when they are in the UK. Healthcare co-operation is therefore actively supporting business and tourism by removing a barrier to people’s life choices. Arguably the greatest beneficiaries of these arrangements are our citizens who live on the continent, many of whom are enjoying their golden years in the sun.

The framework put in place by the Bill will ensure that the Secretary of State has the necessary power to maintain or negotiate arrangements in any Brexit eventuality. One of my constituents recently emphasised the importance of having these arrangements. His grandmother, who is now over 80, lives alone in France. A few years ago, she had a car accident that left her seriously injured. She required an operation and spent over a month in hospital. That was followed up by time in a convalescent home. All that care would have cost a small fortune but, luckily for her, she enjoys healthcare under the European health insurance card S1 route. Access to that is fundamental to her and to the other 190,000 pensioners like her, particularly as their health needs may increase over time. The Bill should calm the anxieties of our citizens abroad. It will also save the taxpayer money. The Nuffield Trust has calculated that, if those pensioners had to return home for their treatment, it would cost the NHS between £500 million and £1 billion a year.

Similarly, continuing the European health insurance card scheme is crucial as it safeguards the 50 million UK nationals who travel throughout the European economic area every year. It is worth mentioning that this is not about the number of people who carry EHICs; it is about the stories behind them, because 250,000 medical incidents affecting UK tourists are resolved via the EHIC scheme and they include one of my constituents, who experienced at first hand the value of the cards when on a family holiday in Germany. Her husband was left seriously injured after being flung from a toboggan, leaving his shoulder quite literally in pieces. To her amazement, and despite the severity of the injuries, her husband was allowed on to the ambulance only once she had presented his EHIC. These sorts of accidents are quite common with many Brits choosing to travel to Europe to ski, which often leaves people—myself included, twice in recent years—in need of medical attention.

I welcome the Bill, as we have a long history of reciprocal healthcare arrangements in our country. UK and Irish citizens have been able to access healthcare in each other’s countries for the past 100 years—a long time before the European Union was established. The UK also has reciprocal healthcare arrangements with other parts of the world, including Greenland, the Faroes, the Balkans, Australia, New Zealand and many of our overseas territories. The Bill will allow the Secretary of State to continue to grow this network, and I hope that it will eventually lead to the global availability of free healthcare for British citizens, and to removing barriers to people looking to travel, work, study and live around the world.

Gosport Independent Panel: Publication of Report

Gillian Keegan Excerpts

Wednesday 20th June 2018 Commons Chamber

[Mr Hunt]

I thank the shadow Health Secretary for the considered tone of his comments. I agree with everything he says. Members across the House will understand that we are all constrained in what we can say about the individual doctor concerned—because that is now a matter for the police and the CPS to take forward—but we are not constrained in debating what system lessons can be learned, and we should debate them fully, not just today but in the future. The big question for us is not so much, “How could this have happened once?”—because in a huge healthcare system we are, unfortunately, always occasionally going to get things that go wrong, however horrific that sometimes is—but, “How could it have been allowed to go on for so long without being stopped?”

Reflecting the hon. Gentleman’s comments, the poor treatment of whistleblowers, the ignoring of families and the closing of ranks is wrong, and we must stop it. We must go further than we have gone to date. In a way, though, it is straightforward, because we know exactly what the problem is and we just have to make sure that the culture changes. The more difficult bit is where there were process issues that happened in good faith but had a terrible outcome.

In particular, this report is a salutary lesson about the importance of transparency. Obviously I had only a couple of hours to read it—so not very long—but it looks as though the Baker report was left to gather dust for 10 years, for the perfectly straightforward and understandable reason that people said that it could not be published in the course of a police investigation or while an inquest was going on. I am speculating here, but I am pretty certain that had it been published, transparency would have prompted much more rapid action, and some of the things that we may now decide to do we would have done much, much earlier. That is an incredibly powerful argument for the transparency that has sadly been lacking.

How confident can I be that this would not happen again? I do think that the culture is changing in the NHS, that the NHS is more transparent and more open, and that interactions with families are much better than they were. However, I do not, by any means, think that we are there yet. I think that we will uncover from this a number of things that we are still not getting right.

As the hon. Gentleman will understand, it is not a decision for the Government as to which police force conducts these investigations. We have separation of powers and that has to be a matter for the police. One of the things that we have to ask about police investigations is whether forces have access to the expertise they need to decide whether they should prioritise an investigation. When the medical establishment closes ranks, it can be difficult for the police to know whether they should challenge that, and it does appear that that happened in this case.

In terms of wider lessons on the oversight of medicines and the Health Service Safety Investigations Bill, we will certainly take on board whether any changes need to be made there.

[Gillian Keegan (Chichester) (Con)]

The culture of closing ranks and ignoring whistleblowers in the NHS is gravely worrying. Even as a new MP, I have had constituency cases where people have alerted me to this, and I feel that it could still happen today. What implications will the report have for the wider health service, particularly for elderly care and people who have family members in these situations?

[Mr Hunt]

There is one very important point that the shadow Health Secretary mentioned that it is important to understand from this report. We very often have a problem where people in an end of life situation are not treated in the way that we would want for our own relatives or parents. To put it very bluntly, the worry is that someone’s end may be hastened more quickly than it should be. We have made a number of changes, including scrapping the Liverpool care pathway, which happened under the coalition Government. But in this case, these patients were not in an end of life situation. They were actually going to the hospital for rehabilitation and expecting to recover—but they were old. One of the things that we will have to try to understand—all of us—is how this could have been allowed to happen and how this culture developed. I am afraid that the report is very clear that, inasmuch as the doctor was responsible—I have to be careful with my words here—lots of other people knew what was going on.

Privatisation of NHS Services

Gillian Keegan Excerpts

Monday 23rd April 2018 Westminster Hall

[Gillian Keegan (Chichester) (Con)]

It is a pleasure to serve under your chairmanship, Sir Graham. I thank the hon. Member for Hartlepool (Mike Hill) for introducing the debate. It is important to get the facts out in the open and to ensure that erroneous arguments about the use of third-party companies in the NHS are put in context and understood. It is also important that the 1.3 million people who work in our NHS are assured that they will continue to do so and that they are not about to work for a private company.

We have all turned to the NHS for help at one time or another, and I think it is safe to say that we are all proud of our doctors, nurses and community carers. However, our healthcare system, which is regularly rated the best in the world, will have to adapt as we all demand more from its services. This change may include the use of third-party companies—they are already used to build our hospitals and sometimes to transport patients, or in key services such as dentistry and GP practices—all of which are private.

The NHS faces significant challenges. In tackling them, we must adopt a collaborative approach among all sectors to ensure that patient outcomes remain the driving force and that the health service remains a patient-first system. My right hon. Friend the Health Secretary recognises that better integration of health, social care and community care services is a big part of improving our health system. If we achieve more integration, we will improve services, save money and reduce some of the fragmentation that was referred to, which is a function not of who runs the service but of how the system is designed.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

Does the hon. Lady not recognise that if parts of the service are in competition with one another for their financial survival, it is very difficult to integrate them and that that causes fragmentation?

[Gillian Keegan]

I recognise that as a challenge. It is not just competition but organisational ownership—organisations sometimes want to control things themselves. We certainly saw that in West Sussex when we tried to put together two public sector pieces under an accountable care organisation. At the moment, we are going to have to find a different model to do that. That is not to do with finances or competition, although that can occur; it is to do with the will of the leadership to work in a more collaborative way. I accept that we face many challenges in the future that we must go towards.

Integration has a worthwhile prize: improved services that are delivered more effectively. When I served as a governor at my local hospital, St Richard’s, I saw at first hand acute beds being occupied by patients who, in medical terms, were perfectly fit for discharge but who still needed care. There were not sufficient community care services for patients to be discharged to. That situation would be exacerbated if private community bed options were removed as a result of petitions such as the one we are debating.

It has been the ambition of all major political parties to implement a modern health model that is fit for purpose and fully integrates community and acute care, but I think we can all agree that, despite our best intentions, that is easier said than done, for some of the reasons we have discussed. It is like someone trying to change the tyres on a car while they are driving—it is difficult because the system is operating.

In my constituency, we have capitalised on the support offered by this Government, such as the public health grant and the better care fund. West Sussex County Council is working on preventive action. Chichester is home to one of seven wellbeing hubs across the county. That hub, which is run by the district council, supports people one to one to reduce their risk of developing diseases such as heart disease, cancer and type 2 diabetes through sustained lifestyle changes. It helps people to lose weight, to be more active and to develop techniques to reduce their risk of falling, to name but a few things. Those services are provided in conjunction with local community and voluntary organisations, and with third-party companies, which provide a wealth of different expertise.

More than one quarter of my constituents are over 65, so adequate social care integration is vital. West Sussex County Council, in partnership with Coastal West Sussex CCG, has connected local authorities, GPs, voluntary and community sector partners, third-party companies, primary care services and our community foundation trust to form two local community networks. That list spells out some of the complexity there is even today, with many services delivered through the public sector. Those networks divide the more populated south, where there is a city, and the more rural areas in the north, recognising that needs are different in each locality. A social prescribing project has been formed as part of that work: a team of community referrers will be co-located in GP practices across the district to find community-based solutions to non-clinical issues.

The charitable sector is heavily involved in the delivery of many of our healthcare services. I recently visited the Sussex Snowdrop Trust, which works with children who have life-threatening illnesses and is funded in part by the NHS and in part by charitable donations. Its nurses give specialised care at home and teach parents how to care for their seriously ill children. The impact of its work is clear, and we should not underestimate the importance of working with such specialist community partners. The corporate structure of those partners is less relevant than the importance of the work they do. The Government have set out not only to better integrate the entire healthcare system but to allow local commissioners to dictate health provision to suit their populations. In cases such as the Sussex Snowdrop Trust, which provides specialist local services to a very small and specific portion of the population, the outsourcing funding model is effective and provides an invaluable service to families.

I fully support the work that is being done by local authorities in Chichester. They have already put plans in place to tailor services to different parts of the population—rural and urban—with different needs, and to focus on prevention and adult social care, in line with the Government’s five year forward view. Those changes are long overdue and will take time to bear fruit, but they are key to achieving a truly integrated health service. Being overly prescriptive about who can be involved in delivering services would limit options as we move towards integrating health and social care, using technology more widely and placing a bigger emphasis on preventive treatment, much of which will be new. It is important that the right level of patient care is delivered quickly and efficiently, and that it is free to all citizens who need to rely on our wonderful health service.

--- Later in debate ---

[Rachael Maskell]

That is exactly how we should move forward, whether with consensus across all parties, which of course I would like to see, or just by putting forward what is logical.

[Gillian Keegan]

rose—

[Rachael Maskell]

NHS staff are calling for it, managers are calling for it, and I trust that the Minister has heard the call in today’s debate.

Cancer Treatment: Patient Travel Times

Gillian Keegan Excerpts

Wednesday 10th January 2018 Westminster Hall

[Tim Farron]

Yes, I fully agree. That is why the NHS England consultation is the right time to set criteria. If we all say, “We’d rather like it if these issues are addressed,” nothing will happen, but if they are set as firm criteria and priorities as a consequence of the consultation, something should happen. The hon. Gentleman was right to raise that point.

Requiring NHS trusts to make it a priority for investment to ensure that radiotherapy is available more locally—such as by bringing a satellite unit to our local hospital in Kendal—would significantly improve outcomes for patients. That has been the focus of our long-running community campaign. I want to say a massive thank you to the many thousands of people who have been involved in that campaign so far. Just before Christmas, on behalf of our community, I presented a private Member’s Bill that would specify 45 minutes as the maximum time that patients have to travel to access radiotherapy treatment. I urge the Minister to support that Bill and ensure that the Government accept it.

I was asked on the radio this morning why, after nine years of fighting this campaign, I had not just accepted defeat and walked away. The answer is that every week in Westmorland, more families learn that they must fight cancer, and we have no right to turn our backs on them. Sadly, the challenge of cancer renews itself week after week, and so our zeal in fighting for those families must also be renewed week after week.

[Gillian Keegan (Chichester) (Con)]

Some 840,000 people live in West Sussex and yet we are the only county in the whole of England that has no radiotherapy facilities within its boundary. I can also confirm the point made by my hon. Friend the Member for Filton and Bradley Stoke (Jack Lopresti). I recently visited the Sussex Snowdrop Trust, which looks after desperately ill children. The stories of them traveling up to London or Southampton and having to stop several times along the way were heartbreaking; it is the worst thing to happen when they are facing that kind of trauma. I agree with the hon. Member for Westmorland and Lonsdale (Tim Farron) completely that patient travel times need to be taken into account during the consultation. I hope that they are, and that St Richard’s Hospital in Chichester is considered as a worthwhile investment for LINAC—linear accelerator—machines to help local people in West Sussex.

[Tim Farron]

All the points that the hon. Lady makes are absolutely right and relevant to those of us who are here today—especially so, given the nature of her county.

Our community in south Cumbria remains proud that we won part one of our fight for a cancer centre. When we launched our campaign in 2009, it was for chemotherapy and radiotherapy. In 2011, we cut the ribbon on the Grizedale ward—the chemotherapy unit—and we are determined to win our fight for radiotherapy too. We have had an overwhelming response to the petition we launched again last September, adding to the 10,000 people who signed the original petition. Thousands more have written in and shared their stories with me locally and nationally. They include stories of the pain they went through in travelling hours every day to get the treatment that they desperately needed; stories of families who suffered watching relatives deteriorate as the long days of arduous travel visibly took their toll; and stories of choosing not to proceed with treatment because of the unbearable rigours of travelling huge distances. All those people have told me how a centre at Kendal could have helped them and their loved ones.

Most of us know, and all can imagine, the shock of being diagnosed with cancer. It is a life-shattering blow. Imagine then being faced with weeks of daily, grindingly long and tiring journeys to receive care. The travel can become the biggest part of the problem. One of my constituents, Philip from Grange-over-Sands, gave me this story, and his words speak more powerfully than any I could use. He said:

“At the age of 81 I had to attend 37 visits for treatment between the May and July 2013. The round trip from Grange to Preston Hospital was in excess of 100 miles per day whether by road or by train and then bus to the hospital. The times of my treatment varied day by day from 8am to 6pm. The treatment machine was not always available at the specified time which meant further time added on to the days travelling. All the above resulted in a very stressful time for myself and my wife on top of suffering from prostate cancer.”

Thankfully, Philip has now been discharged following three years of follow-up visits. He added:

“I trust that future patients may get their treatment at Kendal so good luck with your efforts.”

I was also contacted by the parents of Josie from Oxenholme. They told me:

“After a truly horrific chemo-therapy regime, which nearly killed her, Josie was left shattered and we faced the prospect of having to make daily trips for 4 weeks to Preston for Radiotherapy. The round trip typically takes 4-5 hours. She is left tired and with little time in the day to do much else. A unit in Kendal would have transformed this experience and left her with more energy and time to take more care of herself.”

Lastly, the words of Magda from Windermere sum up the problem perfectly:

“The whole idea of ever having to do any of this again would make me think twice about undergoing the treatments I was offered”.

Thousands of residents joined me back in 2009 when we launched a similar campaign to bring chemotherapy treatment to the south Lakes. Back then, patients had to travel many miles for any kind of cancer treatment. Thanks to local support, the chemotherapy ward at Westmorland General Hospital opened in 2011, and since then hundreds of local people have benefited from treatment there. We showed that when a community gets behind a campaign and the Government recognises that there is a real issue, changes can be made, funding can be allocated and problems can be solved.

It is true that the problem of outrageous travel times thankfully affects a relatively small proportion of the population throughout the UK—evidenced by the fact that although this is a massively important issue, only a few of us are here today—but in the places where access is a problem, it is a dreadful problem. NHS England must address it directly and explicitly in its current consultation on radiotherapy. I ask the Minister to ensure that NHS England does just that.

Solving the problem for south Cumbria would not create an expensive precedent—there are relatively few sizeable communities in this position—but for the people who are affected, living in rural areas makes accessing treatment unbearably difficult and arduous. That was highlighted recently by Age UK’s Painful Journeys campaign. It would cost the Government a relatively small amount to fund a satellite radiotherapy unit in Kendal: a capital cost of about £12 million—a sum that had been earmarked during the coalition Government in early 2015. That investment would lead to important changes. Above all, it would stop local people opting not to take up lifesaving treatment because of the need to travel those distances. In south Lakeland, the number of people aged over 60 is 10% above the national average, so older people and people with disabilities in our area are disproportionately negatively affected by distant access to radiotherapy treatment. That makes it all the more important for us to take advantage of this consultation to tackle the problem.

The Equality Act 2010 was passed by the House to ensure that services are offered to people in such a way as not to discriminate against older and disabled people, among other characteristics. Through those unbearably long travel times, those groups are disproportionately disadvantaged and indirectly discriminated against in breach of that Act.

My request is simple. I want travel times and equality of access, particularly for people who are older or who have disabilities, to be key criteria when allocating cancer services. This NHS England consultation on radiotherapy is the opportunity to ensure that those criteria are set so that access is prioritised. I want the Minister to agree to do that today. An expectation should then be placed on hospital trusts to ensure that satellite units of existing established centres are provided in rural communities such as the south Lakes to meet those criteria. Only then will our community be able to access cancer treatment fairly, equally and safely.

NHS Winter Crisis

Gillian Keegan Excerpts

Monday 8th January 2018 Commons Chamber

[Mr Dunne]

I indicated in my opening remarks that this Government have taken action. We have freed up the number of beds available through the DToC procedure, with an increase of 1,100 in the run-up to winter. We have also, as a result of the extra money we have been given, including the several million pounds given to the hon. Lady’s area, provided an additional 2,700 winter beds. The procedure for future bed closures has been made very clear by NHS England: it will not happen unless acceptable alternative community provision is available in the area.

[Gillian Keegan (Chichester) (Con)]

Western Sussex Hospitals NHS Foundation Trust, which runs St Richard’s Hospital in Chichester, provided excellent care over the Christmas period, despite a 9% increase in the number of patients since last Christmas. Does my hon. Friend agree that that is a tribute to excellent leadership, brilliant staff and innovative planning with other local community services to improve processes and anticipate this annual need?

[Mr Dunne]

My hon. Friend highlights articulately the fact that proper co-ordination between local authorities and NHS trusts in some areas means that they can cope with the pressures better than others. I commend the example that she has given.