Pancreatic Cancer

Debate between Lord Jackson of Peterborough and John Baron

Monday 8th September 2014 Westminster Hall

[Mr Jackson]

Or frequently, in my case, as my hon. Friend says.

A good friend of mine—a non-political friend in my constituency—was utterly shocked at the premature death of the husband of a very good friend of hers. He was, I think, 48, and the father of two young children. He had visited his general practitioner several times and was told over again that he was suffering from a very bad case of back pain. By the time he had his scan it was too late; the tumour was inoperable and was wrapped round other vital organs. It was not possible to operate and the poor gentleman died, leaving a young family, a matter of weeks later. That account prompted me to think and research more. Of course, I read the moving article that my hon. Friend the Member for Lancaster and Fleetwood wrote for The Daily Telegraph about his experience and the tragic death of his partner such a short time after diagnosis, and that, too, prompted my interest.

Figures have already been given about the comparative spending on different cancers. The current figure of 1% of research spending, representing £5.2 million, is pitiful for a cancer that is so prevalent. If 8,800 people were being knocked down on the roads every year or killed on level crossings or through any other possibly preventable cause, we would demand immediate action; but it seems we are prepared to countenance little if anything being done by central Government on pancreatic cancer. That is not a party political view, obviously. The comparative data show that the USA has a 6% survival rate after five years and Australia has a rate of 5%; but in the UK it is only 3.3%. We must address that. My hon. Friend the Member for Stevenage (Stephen McPartland) made the point that it is shocking that people attend accident and emergency jaundiced and clearly seriously ill before it dawns on anyone that they are in the advanced stages of pancreatic cancer. I just feel that something more can be done, not least because, according to the briefing we have received, one in six people attend a general practitioner or other health care facility more than seven times, yet they do not receive the treatment they need.

[Mr John Baron (Basildon and Billericay) (Con)]

I congratulate my hon. Friend on his powerful speech. I think we all accept that earlier diagnosis is cancer’s magic key. The problem is that one in four cancers are first diagnosed late in A and E and the figure for pancreatic cancer is double that—nearly half of all pancreatic cancer patients are diagnosed there. In fairness to the Government, and I will speak about this when I make my speech, does my hon. Friend agree that the focus on survival rates as a means of driving forward initiatives for earlier diagnosis at local level, whether better awareness, better screening, better diagnostics or better care pathways, is the secret to unlocking this dreadful disease?

[Mr Jackson]

I thank my hon. Friend for his excellent work as chairman of the all-party group on cancer in raising the issue of cancer generally. He is right in saying that there is no magic bullet and that a multi-faceted strategy is needed to deal with the issue. I will elucidate on that in a few moments without taking up too much further time.

The hon. Member for Worsley and Eccles South is right about public perception. We must remember that 25% of men and women who are diagnosed with this condition are not old, but younger men and women. The public should understand and embrace that fact, and I know from my experience of a much younger man who was diagnosed with the disease and died very quickly. It affects everyone throughout the country irrespective of gender, age, ethnicity, region and so on.

Over and above academic research, we should focus on GP education. This is not an opportunity to have a go at general practitioners, who do a fantastic job and work hard, but reference has been made in the nicest possible way to the ping-pong effect, as was mentioned in the all-party group’s report. We must stop that and make a decision to have clear strategies with a clinical pathway that people can get on to if they exhibit certain symptoms.

There are several reasons for the poor rate of diagnosis, which are not strictly speaking the “fault” of the general practitioner. As I have already said, there are no definitive biomarkers or tests and there is no way to get round that. It may be ameliorated or overcome following future research, but at the moment GPs are unable to decide definitively that someone is suffering from pancreatic cancer. That is clearly linked to more funding over and above the current 1%, to which I will refer later.

Low awareness of symptoms among the general public needs a multi-media approach to try to persuade people that they are not wasting a general practitioner’s time by alerting them to their symptoms, even if they are under 65. There is a lack of obvious referral pathways into secondary care for patients without obvious symptoms. The hon. Member for Worsley and Eccles South gave an excellent anecdote about the way people are pushed around between different clinicians. That is completely different from the treatment of breast cancer where there are prescribed and definitive treatment pathways.

What are the priorities? It is vital to develop local screening tests. People should not have to travel 40 or 50 miles, and there should be such a testing facility locally in an acute district hospital or in primary care facilities. There should be collaboration between clinical commissioning groups, for example, as well as GP training, referral guidelines and diagnostic support.

I am realistic and I understand that not every GP will be an expert on pancreatic cancer, but there should be a general practitioner in the local area who can offer expert advice, training and assistance. GPs should also have direct access to CT scans. The all-party group on pancreatic cancer made all those recommendations. There should be one-stop shops where patients with vague symptoms can have a battery of different diagnostic tests. That would not remove the risk that someone has pancreatic cancer, but it would reduce the risk that they remain undiagnosed. There should be a rapid access clinic for jaundiced patients. It may be too late for some people, but some may be saved.

We need research into the biology of tumours and we must look again at the cancer drugs fund, as my hon. Friend the Member for Lancaster and Fleetwood said. We must move to a personalised-medicine approach. It is wrong that pancreatic cancer is struggling to receive even £10 million a year for research. The Department should aspire to higher funding than the current £700,000. It should aspire to £25 million by 2022. We need a new strategy along the lines of the Recalcitrant Cancer Research Act passed by the US House of Representatives for cancers of unmet need. We must ring-fence grants for such recalcitrant cancers by means of clinical trials.

This has been an excellent debate. I am convinced that the issue will rise up the political agenda and I thank everyone who has made that possible. I have had dealings with the Minister and I know that she is compassionate and diligent. I believe that she and her Department are listening and that we are well on the way to beating pancreatic cancer.

Iran

Debate between Lord Jackson of Peterborough and John Baron

Monday 20th February 2012 Commons Chamber

[Mr Baron]

The hon. Gentleman makes a fair point. In certain quarters in the middle east, it is felt that double standards are being applied in that Israel has developed nuclear weapons and the west does not seem to worry about them. [Interruption.] My right hon. and learned Friend the Member for Kensington (Sir Malcolm Rifkind) suggests that the evidence is circumstantial, and I am willing to grant him that point.

[Mr Stewart Jackson (Peterborough) (Con)]

Can my hon. Friend name any experts in the field who would explain how enrichment to a 20% threshold, currently being undertaken by the Iranian regime, could plausibly be for civilian and not military use?

[Mr Baron]

My hon. Friend makes a fair point, which I will address later in my speech, but I say to him now that there is a world of difference between nuclear capability and actually having nuclear weapons. I am sure that the House would accept that difference.

A second inconvenient truth relates to the usual depiction of Iran as intransigent and for ever chauvinistic in her foreign policy. Western Governments, I suggest, too easily forget that Iran is not totally at fault here. There have been opportunities to better relations between Iran and the west, but the west has spurned those opportunities. We forget, for example, that following 9/11, Iran—unlike many in the middle east street—expressed solidarity with the US. We forget also that attempts were made to develop contacts during the early stages of the Afghan war. What was Iran’s reward? It was to be labelled or declared part of the “axis of evil” by President Bush, which led directly to the removal of the reformist and moderate President Khatami. Despite that, there were further attempts at co-operation in the run-up to the Iraq war, but those efforts were similarly rebuffed.

Again, I ask the Foreign Secretary whether he is prepared to deny that the west has made mistakes in its dealings with Iran and has missed opportunities to better relations. I would genuinely like to hear his views on that and would welcome an intervention.

Eurozone Crisis

Debate between Lord Jackson of Peterborough and John Baron

Tuesday 15th November 2011 Westminster Hall

[Mr Baron]

My right hon. Friend makes a good point. By raising such issues in Parliament and in collaboration with other like-minded individuals, we can hope that we can force the Government to think again and to look at the various mechanisms at our disposal in the House. If we do not raise these points in our Chambers, the Government will not answer the questions that need to be put to them. My right hon. Friend is right; we will not change anything today. The hope is that together we can force the Government to think again.

Let me go back to why the IMF is getting involved at all. What makes the situation even worse is that the eurozone has resources that could do much more to help. For example, the Bundesbank has reserves of £180 billion, £130 billion of which is in gold, and gold is going up in price. That is in stark contrast to our country and the action of the previous Government, who sold gold at near the bottom of the market.

I agree with the point made by my hon. Friend the Member for Clacton about why we supported Christine Lagarde, the former French Finance Minister, being put in charge of the IMF. It is like putting the debtor in charge of the debtors’ prison. Christine Lagarde has admitted on record that the bail-out arrangements broke the rules, but she said that that could be justified because we all had to rally round to save the euro, which itself is a political objective. That is complete nonsense and it does not augur well for the future, and the Government taking confidence in the fact that the IMF has signed off the packages does not augur well either. The IMF signed off the initial Greek package and look at what happened then: the situation went from bad to worse. I suggest that it will get worse still. Having some sort of blind confidence in the IMF signing off the packages is basically abdicating one’s responsibilities of Government to question what is going on. I do not see that detailed questioning happening at the moment.

I suggest that the Government’s line on this issue—their approach to the eurozone crisis—is symptomatic of their flawed approach generally to the euro. The Government seem to have fallen in behind the French and Germans in this cry that somehow we must save the euro. I suggest to the Minister that that is economic clap-trap. Binding divergent economies into a single currency without full fiscal union was, and remains, a massive mistake. Similar thinking warned us of the perils of exiting the exchange rate mechanism, yet look what happened then: almost to the day that we exited the ERM, our recovery started and it was a very strong recovery.

I suggest to the Minister that the sky will not fall in if the euro breaks up. We will still have, by and large, a free market, although I think that it could be improved, and we will still have consumers demanding goods. If anything, by not trying to save the euro, we could help to stimulate demand, because by trying to save the euro we are cutting off one of the key ways to improve competitiveness—devaluation. By cutting off that option, we are making the austerity packages worse; we have to add to the austerity packages because the countries in need do not have the option of devaluation.

Saving the euro is making matters worse, yet the Government are silent on this issue. They have shown no leadership. They have fallen behind the line that saving the euro is everything—it is not. I suggest that the Minister and the Government look at the experiences of Norway and Switzerland, which have their own currencies and free trade agreements with the EU. Those countries are doing very well. Saving the euro should not be the ultimate goal, because it is making the austerity packages worse.

[Mr Stewart Jackson (Peterborough) (Con)]

My hon. Friend is making a powerful and convincing speech, but is the situation not even worse than he suggests, in that the Government are effectively adopting a de facto policy of support for a tighter fiscal union, which in the long term will inevitably militate against this country’s strategic political and economic interests as a sovereign state?

[Mr Baron]

My hon. Friend makes a good point. By joining in the chorus that we must save the euro, we are implicitly supporting fiscal union within the eurozone, which is the wrong approach to take, certainly for this country’s interests. But, no doubt, the Minister will be able to clarify the Government’s position on that issue.

The same flawed approach by the Government has denied the people of this country a referendum on the EU and our future relationship with it, while allowing massive budget transfers to Brussels. Our budget increase totals about £21 billion or £22 billion. It will increase from £19 billion for the last seven years to about £41 billion in the next seven years. What could we get for that additional £21 billion or £22 billion? We could get 100,000 police officers on the streets for each of those seven years, 100,000 nurses in our hospitals or 100,000 teachers in our schools. How could we stimulate growth with that money? We could cut basic rate income tax by 1p in the pound for each of the seven years. We could cut small business corporation tax by 6p in the pound. My goodness me—would that not be a concrete measure to stimulate growth and encourage competitiveness in this country?

I am afraid that the Government’s thinking on this issue is intellectually incoherent, economically flawed and, perhaps worst of all, flies in the face of what the majority of people in this country want. What we want is leadership—strong leadership. We hear noises such as, “Oh, regulation from the EU hurts growth.” There is nothing new in that; saying it is just making noise for the sake of making noise. We have known that about EU regulation for years. What we want is strong leadership that repatriates powers to this country, stops the salami-slicing of our political sovereignty, encourages the establishment of a genuine free market in Europe and guards against our liabilities to the eurozone crisis. But I do not see that strong leadership in front of me today, which worries me and a number of my colleagues and right hon. and hon. Friends greatly. Meanwhile, we stumble on.

I suggest to the Minister that this country will wake up about this issue one day and that we will renegotiate with the EU. My hope is that we will renegotiate a free trade arrangement, similar to the arrangements that Norway and Switzerland have, and that we have a constructive businesslike arrangement with the EU, without sacrificing political sovereignty and without going down the road of political union. My concern is about the damage that will be caused to this country between now and then and the cost that we and our children will have to bear.

I hope that the Minister, as he has refused my invitation to intervene on the questions that I have put to him, will come up with some answers when he winds up this debate. I hope that he answers the questions that I have put, because they are the questions that people in this country are asking.