Health: Cancer

Debate between Lord Clement-Jones and Baroness Verma

Thursday 11th November 2010 Lords Chamber

[Lord Clement-Jones]

My Lords, I, too, congratulate the noble Baroness, Lady Finlay, and pay tribute to her for her tireless campaigning on cancer services. At the outset, I want to recognise the great progress made in cancer treatment and survival rates under the previous Government. I welcome the coalition Government’s commitment to refresh the cancer reform strategy. I also welcome the other actions that they are taking and the additional resources being made available to cancer services, such as the cancer drugs fund announced in the comprehensive spending review and committing the funding needed to deliver 1,200 additional specialists involved in cancer services by 2012. I welcome other measures to expand access to certain therapies and the raising of cancer awareness, but as the noble Baroness, Lady Finlay, so ably put it, more needs to be done.

Given the time available, as vice-chairman of the All-Party Ovarian Cancer Group and a former trustee of Cancerbackup, whose cancer information service is now part of Macmillan Cancer Support, I want today to concentrate essentially on the implementation of information prescriptions on issues relevant to ovarian cancer diagnosis and treatment. Research by Macmillan Cancer Support shows that 93 per cent of cancer patients want to be “very or fairly involved” in decisions about their treatment and care. My late wife, Dr Vicky Clement-Jones, who founded Cancerbackup, rightly described,

“knowledge as the antidote to fear”.

Information is the key to realising the vision of a patient-centred NHS. To make informed choices, a patient must be enabled and empowered with the right information at the right time. The creation of information prescriptions was announced in 2006. These would be designed to offer cancer patients high-quality personalised information and support at key points through their treatment. The pilot schemes for information prescriptions have shown the significant improvements they can make to the delivery of information. If every cancer patient received an information prescription as standard and was supported in understanding the information given, it would also help to tackle health inequalities. So it is extremely heartening that the coalition Government have made,

“no decision about me without me”,

the central theme of their health reforms.

But despite progress on information prescriptions in general, we are still awaiting the publication of the Department of Health implementation plan for cancer information prescriptions. The implementation plan needs to be launched as quickly as possible to guarantee that every cancer patient in England has an information prescription by 2012. Information prescriptions should be routinely offered to all cancer patients so that everyone can receive high-quality personalised information at key points in their cancer treatment.

I now come to issues relating to the less common cancers such as ovarian cancer. I pay tribute to Target Ovarian Cancer, the Eve Appeal, Ovacome and Ovarian Cancer Action variously for their work, information and advocacy in this field. After breast, lung and bowel cancer, ovarian cancer is the fourth most common cause of cancer death in women. It is estimated that at least 400 women’s lives could be saved each year if the UK matched the average European survival rates for ovarian cancer. England has the lowest ovarian cancer survival rates in Europe, and the UK as a whole is very close to the bottom of the table.

I have welcomed the Government’s commitment on spending on cancer drugs, but before treatment it is important to ensure early detection. Currently, 75 per cent of women with ovarian cancer are diagnosed once the cancer has already spread and successful treatment is much more challenging to achieve. Improving early diagnosis for women with ovarian cancer is essential in order to give them the best chance of survival. It is imperative that action on symptoms awareness and access to diagnostics is taken as a matter of urgency. To do that, women in the general population must be made aware of the symptoms of ovarian cancer, and of the importance of acting on frequent and persistent symptoms. Awareness of ovarian cancer is much lower than it is for symptoms of breast, lung and bowel cancer. In 2008-09 the Department of Health accepted that there is now robust evidence on symptom patterns for ovarian cancer that distinguish it from other conditions. I understand that NICE guidance on recognition and initial management of ovarian cancer will be published in April 2011.

I welcome the signs and symptoms campaign recently announced by the Department of Health, but it will focus essentially on breast, lung and bowel cancers. There do not appear to be plans to invest in ovarian cancer. GPs must also have prompt access to the diagnostic tests that help them to decide who should be referred urgently, and they should be updated on new developments in symptoms research. In autumn 2009, it was announced that all GPs would have access to urgent diagnostic tests for bowel and ovarian cancer within a week. That commitment to one week was removed in the CSR, but it is not clear whether there is still a commitment to make sure that all GPs have access to these tests. I would very much like to hear the Minister’s response on that matter.

I turn briefly to another site-specific cancer, lung cancer. Despite improvements in service provision, the UK still has one of the worst lung cancer survival rates in Europe. The recently announced awareness campaign will cover lung cancer, and I welcome that, but there is still a need to develop screening programmes because it is the only cancer among the main common cancers which does not have such a programme. The National Lung Cancer Audit shows that only 51 per cent of lung cancer patients receive any form of active treatment. I join with the British Lung Foundation, which states that more lung cancer patients should be considered for active treatment, with all centres learning from best practice, in order to bring about better patient outcomes.

Finally, I wish to express concern about the impact on world-leading cancer research of a cap on immigration for tier 2 migrants. My noble friend Lord Ryder, as president of the Institute of Cancer Research, expressed this extremely well in the debate in October on immigration controls. His fears are well founded and I hope the Minister will reassure us that exemptions can be put in place, along with answers to the other issues I have raised. I look forward to his reply.

[Baroness Verma]

My Lords, I remind all speakers that they have six minutes.