Health: Pancreatic Cancer Treatment

Debate between Lord O'Shaughnessy and Baroness Redfern

Wednesday 19th December 2018 Lords Chamber

[Baroness Redfern]

To ask Her Majesty's Government what plans they have to ensure that patients with pancreatic cancer begin treatment within 20 days of diagnosis.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord O'Shaughnessy) (Con)]

My Lords, NHS England will soon introduce a faster diagnostic standard of 28 days for all cancer patients, including those with pancreatic cancer. Taken together with the 62-day referral-to-treatment standard, this will mean that all patients should expect to start their treatment within 34 days of diagnosis. This is a maximum, and trusts should continue to treat patients more quickly where there is a strong clinical need.

[Baroness Redfern (Con)]

My Lords, I thank the Minister for his comments, but the need for a paradigm shift on pancreatic cancer is now urgent. It is the deadliest cancer, with a dismal prognosis that has hardly changed in the last 45 years. It remains both the least survivable and the quickest killing cancer. It is hard to diagnose and, once it becomes clinically detectable, there is a rapid progression to an advanced stage. Therefore, for people facing a pancreatic cancer diagnosis, every day matters. For potentially curative and life-extending treatments such as surgery and chemotherapy, there is an optimum window of 20 days from diagnosis, when people with pancreatic cancer will have the option to be treated and the chance to live longer. It is ambitious to aim for 2024 but, for those people waiting, each day has deadly consequences. With a forecast of an extra £20 billion being injected into the NHS, does the Minister agree that it would be pleasing if some of that extra funding could be put towards improving those dismal survival rates?

[Lord O’Shaughnessy]

I agree with my noble friend and am grateful to her for raising this topic. The truth is that outcomes of pancreatic cancer are very poor, and have not improved, as she said. We are determined to change that through a number of routes. The Prime Minister has committed herself and the Government to improving early diagnosis of cancer, so that more cancers are caught earlier, which will be critical for those often caught at a late stage, such as pancreatic cancer. The faster diagnostic standard that I mentioned will help, as will a series of rapid diagnostic centres that have been rolled out around the country. I take the point that we need to do a lot more, and the NHS long-term plan gives us an opportunity to do that.

NHS: Specialist Services in Remote Areas

Debate between Lord O'Shaughnessy and Baroness Redfern

Tuesday 11th December 2018 Lords Chamber

[Lord O’Shaughnessy]

The noble Lord is right. Of course it is possible for us to do it in England; it is happening all over the country. Telemedicine offers fantastic opportunities, such as Skype-based GP consultations. Indeed, there is the example of Morecambe Bay’s remote clinician pilots in a variety of specialisms, such as gastroenterology and mental health care. Clearly, that is important. I point the noble Lord to the tech vision published by my relatively new Secretary of State this autumn, which points out the massive potential for digital health in reducing these kinds of inequalities.

[Baroness Redfern (Con)]

Within limits, a shifted out-patient model allows specialists to provide the same kind of consultations, investigations and procedures as in regular settings. Does the Minister not think a possible way forward would be to develop larger PCTs, as they would be more financially able and therefore have the capacity to provide that service in areas remote from the hospitals?

[Lord O'Shaughnessy]

My noble friend makes an excellent point. The number of CCGs is reducing over time, as they tend to merge. Of course, they are increasingly coming together into integrated care systems, which cover a larger geographic community. Every one of those makes sure that people have not only community care but specialist care available.

Breast Scans

Debate between Lord O'Shaughnessy and Baroness Redfern

Monday 19th November 2018 Lords Chamber

[Lord O'Shaughnessy]

Absolutely. I completely agree with the noble Baroness. Indeed, breast cancer screening saves 1,300 women’s lives every year. It is an essential part of our health system. On why women do not turn up, Professor Sir Mike Richards is reviewing all the cancer screening programmes at the moment. I will specifically put that question to him to ask him to investigate it.

[Baroness Redfern (Con)]

My Lords, we are told that pain or fear of pain is one of the main reasons why women decline screening. I ask the Minister: what initiatives have been investing to address the decline in breast screening uptake and to help ensure equality of access to screening?

[Lord O'Shaughnessy]

In addition to investigating some of the reasons through the review, a primary way in which we are encouraging women to take part in screening is through public health advertising and marketing campaigns. They have been demonstrated to have an impact. Public Health England had such a campaign on breast cancer screening this year; there will be a further campaign on cervical screening next year.

Children: Obesity

Debate between Lord O'Shaughnessy and Baroness Redfern

Thursday 19th April 2018 Lords Chamber

[Lord O'Shaughnessy]

I completely agree with the noble Lord. I believe that he chairs the National Citizen Service, which has been a massive initiative to encourage such habits in teenagers. I completely concur with him: the Government take a number of approaches to encourage youth social action, and that is something that we will continue to support.

[Baroness Redfern (Con)]

My Lords, does my noble friend agree that families need to be presented with clear information about the food they buy and how important clear labelling is? Does he agree that when the UK leaves the EU, that will give us a greater flexibility to determine what information should be presented on packaged food and how it should be displayed?

[Lord O'Shaughnessy]

My noble friend is absolutely right: this is one of the many opportunities which this country will enjoy after we have left the European Union. We will have the flexibility to vary food labelling to ensure that we can use the very best, and latest techniques to encourage people to eat more healthily.

NHS: Staff Pay

Debate between Lord O'Shaughnessy and Baroness Redfern

Wednesday 21st March 2018 Lords Chamber

[Lord O’Shaughnessy]

Like the noble Baroness, I think it is right to pay tribute to all the organisations involved in striking this deal. These things are never easy but it is a true partnership agreement that tries to work for everybody.

The Statement is explicit about linking pay progression with appraisals, which indeed means higher skill levels. I will write to her with the specifics of the skills and knowledge framework; I am not cognisant of that specifically, but clearly the intention is to move away from automatic progression to skill-based progression. One of the advantages of that is that it not only works for patients, but puts the onus on employers—she will see more detail of that—to make sure that there is proper professional development to help skill levels rise, so that staff can go through those gateways and progress.

[Baroness Redfern (Con)]

My Lords, in welcoming the Government’s response and the 6.5% pay rise for 1 million NHS staff, particularly in recognition of their dedication and hard work, I am pleased that the Government have recognised that the lowest full-time salaries are paid to cleaners, porters and catering staff. These groups will receive a 15% increase—£2,500—bringing their salaries up to £18,000. The fact that this is backed with new money is welcome.

[Lord O’Shaughnessy]

I thank my noble friend for making that point. It is not only about the lowest paid staff whom she has described. It is also worth dwelling on the fact that a newly qualified nurse will see a significant increase in his or her pay, which will be 12.6% higher in 2020-21. This is a package which takes account of the fact that starting salaries have been too low. We are trying to address that because it is one of the ways we can attract more people into the profession.

Prescription Drugs: Dependence

Debate between Lord O'Shaughnessy and Baroness Redfern

Monday 19th March 2018 Lords Chamber

[Lord O'Shaughnessy]

I agree with the noble Lord that it is a serious issue. A NatCen study found that there has been a doubling of the use of serious painkillers. Indeed, deaths due to opiates of all kinds have risen by about two-thirds in the past five years; of course, that is illegal as well as legally procured drugs. We agree that there is a problem. That is why the review is taking place. It is premature to say what the outcomes of that review will be, but undoubtedly we need a comprehensive approach to dealing with this problem, because it is getting worse.

[Baroness Redfern (Con)]

My Lords, I welcome this major review of prescription drug addiction. Does the Minister agree that the review must also look at the provision of alternatives to prescription drugs and the culture change needed to make that happen?

[Lord O'Shaughnessy]

My noble friend is absolutely right. It is not just about getting people off these drugs who are wrongly on them, it is about making sure that they do not go on them in the first place unless that is absolutely necessary for their treatment.

General Practitioners: Workforce

Debate between Lord O'Shaughnessy and Baroness Redfern

Monday 5th March 2018 Lords Chamber

[Lord O’Shaughnessy]

I shall have to write to the noble Baroness with the specifics on GP flexibility. However, one of the reasons that GPs take early retirement to take advantage of their pension is that it enables them to work flexibly afterwards.

[Baroness Redfern (Con)]

My Lords, regarding the workforce, having pharmacists in GP practices means that GPs can focus their skills where they are most needed: diagnosing and treating patients with more complex needs. Does the Minister agree that this not only helps GPs manage demands on their time but helps to ease their workload, while patients have the convenience of being seen by the right professional, improving quality of care and ensuring patient safety?

[Lord O’Shaughnessy]

My noble friend is absolutely right. As well as our commitment to increase the number of GPs by 5,000, we also have a commitment to increase the number of GP practice staff by 5,000, including 1,500 pharmacists, who provide exactly the kind of support she outlined.

NHS and Adult Social Care

Debate between Lord O'Shaughnessy and Baroness Redfern

Wednesday 5th April 2017 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness is quite right about the importance of public health. It is worth pointing out that it is not just an issue of money. This country was the first in Europe to act on cigarette packaging, to introduce a soft drinks industry levy and to develop a childhood obesity plan. As we have talked about previously, if you look at the risky behaviours displayed by young people, you will see good evidence that this approach is working.

[Baroness Redfern (Con)]

My Lords, as the population ages and the financial pressures on the health and care system increase, evidence tells us of the need to be better at providing proactive, preventive care to ensure that people can live independent, fulfilling lives for longer. Will the Minister do all he can in expressing these concerns and look at ways to address, as a priority, the uptake of innovation and technology, together with data sharing across the NHS, to emphasise the need to develop a credible strategy?

[Lord O'Shaughnessy]

I thank my noble friend for that and for her contribution to the work of the committee. She speaks with great experience and authority from her role in running a local authority. She is quite right that technology offers huge opportunities. The key is to make sure that the NHS and social care systems see technology as an opportunity to improve productivity rather than as providing an additional cost. That is why we are taking a variety of actions through the life sciences industrial strategy, the accelerated access review and other routes to make sure that technology is improving outcomes.