Leaving the EU: Tobacco Products and Public Health

Sharon Hodgson Excerpts

Monday 7th January 2019 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to be here on the first day back to discuss these interesting and colourfully illustrated amendment regulations on tobacco products and nicotine inhaling products, not tucked away in a Committee Room but on the Floor of the House.

As I have said previously on EU exit secondary legislation, I still strongly hope that we leave with a deal and that all these SIs will have been for naught. I understand that, as a matter of contingency planning, it is only right that we discuss these changes as a just-in-case measure. However, I have to say again that if a no-deal scenario was ruled out once and for all, none of this would be necessary, saving vital taxpayers’ money that could have been better spent elsewhere. As I understand it, these no-deal SIs run to around 900, so that be a substantial sum of money. But here we are. The Minister has already set out what these regulations mean, so I will not repeat any of that.

Smoking rates have declined. However, it is estimated that around 6.1 million adults in the UK still smoke. I hope that they were listening to your comments, Madam Deputy Speaker, and that we all show those awful images to as many people—young and old—as possible, because it is never too late to quit. Hospital admissions attributable to smoking increased by 2% in 2016-17 compared with the previous year, and last year we also saw a small increase in the number of women smoking during pregnancy.

Those figures are not surprising when coupled with the fact that £96 million has been cut from the public health budget this financial year alone, adding up to £800 million by 2021. That means cuts to vital public health services, which both the Minister and I are passionate about, including smoking cessation services. The Government must reverse these public health budget cuts if they are serious about reducing smoking rates. It is a shame that today the Secretary of State missed yet another opportunity to do that, in his statement on the NHS 10-year plan. There was no reversal or any new money that I could see for smoking cessation services or public health services. He did, however, maintain that prevention was at the forefront of the Department’s forward view, which was welcome. If that is the case, the high standards for the safety and quality of tobacco and nicotine products must be maintained or even improved if the UK leaves the EU without a deal.

With that in mind, I have a few questions about the regulations. Will they have any impact on the current advice on e-cigarettes? Will the Government be undertaking a review of e-cigarette regulations to ensure that they are fit for purpose and encourage their use by smokers to quit smoking, while also discouraging uptake by young people? More generally, will the amendments allow for regular reviews and updates of the health warnings?

That brings me to the picture warnings on cigarette packets—anyone who wants to see the new ones can find them at the back of the draft regulations. They replace a number of unappealing photographs that we currently use with new photographs, which are under copyright by either the Commonwealth of Australia or Professor Laurence J. Walsh of the University of Queensland. I am sure that this is a short-term fix, but could the Minister please elaborate, and provide some clarity, on what agreement has been reached with the Australian Government, or indeed with Professor Walsh, on using the photographs? In what form was the agreement made, what does it cover, and how and to what extent does it affect the rights of the copyright owners? What payment, if any, will the Australian Government or Professor Walsh be entitled to as a result? What conditions and constraints will there be on UK businesses using these photographs? What about current packaging that uses the old images? I hope that some contingency has been made for those to continue to be sold.

I am under the impression that these photographs are still being evaluated by the Australian Government. If they are found not to be fit for purpose in Australia, will the Minister take that to mean that they are not fit for purpose in the UK either? I know that the Government will be publishing detailed guidance on the picture warnings and the notification process this month, but it may be beneficial to businesses if the Minister could please give a better idea of when they can expect to receive the guidance?

Finally, do the Government have any plans to use UK-sourced or commissioned photographs? Surely we have some comparable images of our own, taken by doctors or researchers, that we could use? If not, are plans in place to acquire some? The legislation also introduces a fee-making power for characterising flavours and emissions on nicotine and tobacco products. Will the Government be using that power immediately, and what impact will it have on businesses?

Unfortunately, smoking is still prevalent in our country, which is why we must ensure that tobacco and nicotine products meet the highest safety and quality standards. If the worst happens and we do leave the EU without a deal, we must ensure that these standards are upheld, so the Opposition will support the regulations today, in the hope that they will not be needed.

Draft Human Fertilisation and Embryology (Amendment) (EU Exit) Regulations 2019 Draft Quality and Safety of Organs Intended for Transplantation (Amendment) (EU Exit) Regulations 2019 Draft Human Tissue (Quality and Safety for Human Application) (Amendment) (EU Exit) Regulations 2019

Sharon Hodgson Excerpts

Wednesday 19th December 2018 General Committees

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Stringer, and to be in this room to discuss these draft regulations.

It concerns me that we have to have contingency plans in place in the event of a no-deal Brexit. I certainly hope that all of us in this room would prefer us to leave with a deal, so that we can have an element of certainty. However, in lieu of any certainty, I understand and acknowledge that the draft regulations are very much needed and are the next option. I am sure that the public will also be concerned. What assurances can the Minister give patients, who will inevitably be concerned about these contingency plans? Will she give assurances that the draft regulations will retain—and in some cases even improve—patient safety?

I understand that the draft regulations will come into effect on 30 March 2019 in the event of a no-deal Brexit. However, these changes must be effectively communicated to the affected agencies in a timely manner. Do the Government have a deadline for doing that? The draft Human Tissue (Quality and Safety for Human Application) regulations include a six-month transition period, with provisions to ensure that imports may continue while licences and agreements are put in place. Can the Minister please elaborate on what those provisions will consist of?

The draft regulations must not affect the safety, quality or supply of organs, tissue or cells. We know how the healthcare system depends on there being a constant supply of those, so it is crucial that there is no interruption in that. Hopefully, the draft regulations will not be needed—but if they are, I hope that all these issues will have been considered by the Government.

Draft Blood Safety and Quality (Amendment) (EU Exit) Regulations 2019

Sharon Hodgson Excerpts

Wednesday 19th December 2018 General Committees

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Sharma, and to be in Committee on another SI. We were at it this morning and yesterday, if not with this Minister, with his colleague. A few in the room, such as his Parliamentary Private Secretary and our team’s PPS, are seemingly doing both, or all, stints. We were at it yesterday as well. I understand that a few SIs are going on across the Committee Rooms at the moment.

As I said this morning, I would prefer that we did not have to do any SIs because we are leaving with a deal and do not have to worry about no deal. As a matter of contingency planning, however, it is only right to be in Committee to discuss the changes as a just-in-case measure.

Having said that, people will be rightly concerned that we are even having to make contingency plans in the event that we have a no-deal Brexit, so what assurances will the Minister give patients, in particular those with rare diseases who receive important blood and blood components? Will the Minister give assurances that the changes will not affect the safety, quality or supply of blood and blood components in the UK, and that the standards we enjoy now will be maintained? The UK has set the regulatory benchmark for the EU, so it is important that that is not impaired post Brexit.

I understand that regulation 8 means that a UK establishment, rather than an EU establishment, will be responsible for labelling, recording and storing blood from the EU. Will the Minister confirm that the UK has the capacity to label, record and store blood, and which UK establishment will be responsible?

I hope the amendments will not be needed in the end, but I appreciate that the Government have to make them and are keen to get it right. I therefore hope the Minister will consider everything that has been mentioned and will give us assurances.

Draft Human Fertilisation and Emryology Act 2008 (Remedial) Order 2018 Draft Human Fertilisation and Emryology (Parental Orders) Regulations 2018

Sharon Hodgson Excerpts

Tuesday 18th December 2018 General Committees

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is indeed a pleasure to serve under your chairmanship, Mr Evans. The Minister and I shared a phone conversation about this issue earlier this year; I believe it was sometime in the summer. I told her then that I would support the Government in this change and I remain committed to that today. I know that the Government have been keen to get this right. It is a shame that it has taken so long for the measure to be brought forward. Sadly, Brexit seems to get in the way of everything at the moment.

In May 2016, as we have heard, the High Court ruled that the inability of a single person to obtain a parental order was incompatible with the European convention on human rights. The Government rightly confirmed in December 2016 that they would lay a remedial order before Parliament, but with the referendum and then a general election and Brexit business in-between, we are now only just getting to debate the revised draft of the remedial order.

I understand that a draft remedial order was tabled in November 2017, but that the Joint Committee on Human Rights said that a blanket ban on a person

“who is in a couple getting a single parental order is clumsy and inflexible, as well as discriminatory”,

and, in relation to the requirement for a single person still married or in a civil partnership to prove that a separation from a partner was permanent, that that would be

“difficult or impossible to prove to the Courts”.

The Government’s revised remedial order has addressed the JCHR’s concerns, and it has advised that there are now no reasons why this order should not be agreed by both Houses of Parliament. However, I would like to place a couple of questions on the record, which I hope the Minister will be able to address when she concludes the debate.

First, when will single people be able to apply for a parental order? As the Minister will be aware, many people have already been waiting years for the legislation to come forward and so will be very eager to start a family of their own. Can she provide an update on what this will mean for surrogacy and adoption legislation? I know that the Law Commission is looking into the matter as part of a three-year review, but I am sure that if the Minister could please update us on it as soon as possible, that would be helpful to families and campaigners.

Has the Department made any assessment of unintended consequences to the way parental orders operate as a result of these measures? Applications for parental orders can be made six weeks after the birth of a child and are made to the Children and Family Court Advisory and Support Service—CAFCASS—for a court fee of £215. Has the Government made any recent assessment of the cost of the court fee and any accessibility issues that it may cause?

The Minister recently said:

“The order will allow a six-month period where an existing sole applicant can retrospectively apply for a parental order for a child born through surrogacy.”—[Official Report, 19 July 2018; Vol. 645, c. 38WS.]

Currently, applications can be made six weeks after birth. Why has a six-month period been chosen for retrospective applications, and has any assessment been made of the impact that that could have on the surrogate mother, parents and child?

As I have said, I support the Government in making these changes, so I am happy to end my remarks there.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 27th November 2018 Commons Chamber

[Steve Brine]

The hon. Gentleman will remember, of course, that £1 billion extra was put into mental health in the Budget last month, but I would absolutely be interested to hear from him. There are very good things going on up and down the country in local authorities with the ring-fenced £16 billion that we have given them. We are very interested to hear about where there are good examples of things going on, and the long-term future discussions around them will take in the spending review, as I have said.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

The Secretary of State claims that prevention is one of his top three priorities, yet this year alone the Government have slashed public health budgets by £96 million. That includes cuts to smoking cessation services, sexual health services, obesity and addiction services and many more. This affects the most vulnerable in our society, so will the Minister do the right thing today and cut the rhetoric, commit to reversing these damaging cuts to public health, and put funding in the long-term plan?

[Steve Brine]

The hon. Lady—my shadow Minister—knows that I have a great deal of respect for her. She mentioned smoking; smoking rates in England are at their lowest ever levels. We hear spending commitment after spending commitment from the Labour Government; it is like the arsonist turning up at the scene of a fire. I will take very seriously, as I am sure will the Treasury, her bid towards the spending review discussions, but yes, prevention is better than cure and it will be at the heart of the long-term plan.

Ovarian Cancer: Diagnosis and Treatment

Sharon Hodgson Excerpts

Tuesday 30th October 2018 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Bone. I thank the hon. Member for North East Derbyshire (Lee Rowley) for securing this very important debate and for his vice- chairmanship of the all-party parliamentary group on ovarian cancer, which I am extremely proud to chair. We work very well together. Indeed, earlier this year he and I shared the chairing responsibilities for two oral evidence sessions as part of the preparation for publication of our report entitled “Diagnosing ovarian cancer sooner: what more can be done?” to mark World Ovarian Cancer Day 2018. I thank him for that also.

The hon. Gentleman made an excellent and extremely moving opening speech. He shared many examples of women’s lived experiences of this awful disease, including his own experience with his mum Linda. I have no doubt she will be proudly watching him lead this debate. We are all MPs—that’s for sure—but we are also real people with lived experiences and families. Sharing those personal experiences can improve the debate, as it has done today. I thank the hon. Members for Strangford (Jim Shannon), for Berwickshire, Roxburgh and Selkirk (John Lamont) and for Lanark and Hamilton East (Angela Crawley) for their contributions to this important debate. We have also had some excellent interventions.

Many of the key statistics around this awful disease have been covered so far in this excellent debate, but if something is worth saying once, it is worth saying twice. Over 7,000 women are diagnosed with ovarian cancer every year in the UK, but sadly survival rates are among the lowest in Europe. Less than half of women diagnosed with ovarian cancer survive five years or more. Tragically, 4,000 women in the UK die each year because of this awful disease. Although progress has been made in diagnosing and treating ovarian cancer, there is still much more to be done and I want to highlight some ways the Government can do that.

I was extremely grateful to the Minister for meeting with me recently to discuss the key recommendations from the APPG’s report, which I just mentioned, and I will raise some of them now. Diagnosis is one of the key ways that women with ovarian cancer are often let down. Many women report experiencing delays in diagnosis. An astonishingly high proportion, 45%, say that it took three months or even longer to receive a diagnosis after first approaching their GP with symptoms. As we have heard, symptom awareness is one of the key things we must address. This is most concerning because we know the significant impact early diagnosis can have on chances of survival. Nine in 10 women who receive an early diagnosis of ovarian cancer can survive for five years or more, compared with less than five in 100 women who are diagnosed at a very late stage.

I want to share a story, as a few hon. Members have. My constituent Gail wrote to me ahead of this debate telling me the experience of her younger sister, who has stage 3 ovarian cancer that has spread to her stomach lining. Although she is currently responding to treatment, it took a long time to get the diagnosis in the first place. At one point, she was being incorrectly treated for rheumatoid arthritis. That changed only when she developed blood clots in her legs, which led the hospital to look for cancer. We can only imagine the added distress that this kind of delay can cause in an already extremely difficult experience.

As a result of her sister’s diagnosis, Gail underwent genetic testing and discovered that she had the BRCA2 gene, which, as we know, gives her a high predisposition to ovarian and breast cancer. My constituent underwent elective surgery at the start of the year to remove her ovaries and fallopian tubes, and is awaiting the next step with regard to the breast cancer risk. This case shows how important it is that patients are diagnosed as soon as possible, not only for themselves, but for their family members who may have to undergo further testing.

On early diagnosis, will the Minister support a review of the referral pathway for ovarian cancer, particularly in relation to the introduction of the shortened pathway that we have seen in Scotland, so that, as the hon. Member for North East Derbyshire also requested, the CA125 blood tests and ultrasound tests can be done at the same time, rather than sequentially, as they are now? What steps has the Department taken to ensure that NICE guidelines, which say that women should be offered BRCA testing at diagnosis, are adhered to? Ovarian Cancer Action found that 30% of women are not being offered this testing. I know that the new multidisciplinary diagnostic centres will also help with early diagnosis, but they are in the pilot stage and limited to 10 sites. Will the Minister confirm whether there are plans for more centres, so that everyone can have access to those services regardless of where they live?

As we know, the four key symptoms of ovarian cancer are a bloated tummy, needing to urinate more often or urgently, experiencing tummy pain and always feeling full. Anyone newly experiencing those symptoms 12 times a month or more is advised to see their GP. However, awareness of these symptoms is worryingly low. According to Target Ovarian Cancer, just 20% of women can name bloating as a symptom and only 3% can name feeling full or loss of appetite. Awareness campaigns run by Public Health England have been shown to be highly effective. The one currently running focuses on blood in urine. Considering that we know how important it is that those with ovarian cancer are diagnosed quickly, it would be helpful to know whether Public Health England has any plans to run a Be Clear on Cancer campaign that focuses on either ovarian cancer or a cluster of symptoms for a range of cancers, including ovarian.

I recently attended Ovarian Cancer Action’s research grant award ceremony, where I heard about some of the incredible work being funded across the UK. The innovation and determination of some of the projects is truly astonishing. One project—it is hard to describe, but I will give it a go anyway—had a huge number of examples of DNA that needed going through on an individual basis and labelling. Due to the sheer quantity of data that needed sifting, those in charge of the programme invented a Tinder-style app—I know it sounds unusual—that enabled people to quickly categorise the different examples of DNA by swiping left or right. That information was then fed back into the research team’s data, to build up a comprehensive body of data.

Another project that received funding was that of Dr Jonathan Krell and Dr James Flanagan of the Ovarian Cancer Action Research Centre. They are investigating how changes to our genes can play a big part in the risk of developing cancer, including assessing how feasible it would be to implement a new genetic testing model that identifies and supports families at risk of ovarian cancer because of an inherited BRCA1 or BRCA2 gene mutation. With that in mind, does the Minister’s Department have any plans to increase Government funding into medical research for the early detection, diagnosis and prevention of ovarian cancer?

Finally, I want to cover the issue of surgery. As the Minister knows, surgery for ovarian cancer is widely considered one of the biggest factors in survival rates. Surgery for ovarian cancer is extremely difficult. Someone I know well who had the surgery once described it to me as being like trying to remove a bunch of grapes, and if any of the grapes was punctured or broke that would cause huge internal damage by spreading the cancer. Although there are a number of surgical centres of excellence across the UK, there are many women who do not have access to them and are being operated on by general surgeons—no generalist will ever be as good as a specialist. Through no fault of their own, those women will have a lower chance of survival than those who receive the specialist surgery. What assurances can the Minister give that steps are being taken to ensure that all women with ovarian cancer have access to a specialist surgeon and that the regional variation can be brought to an end?

Before I conclude I want to pay tribute to some of the incredible organisations and campaigners that I have had the pleasure of working with on this issue over the years. They work tirelessly not only to combat the disease, but to provide support and comfort to those who have it. They include Ovarian Cancer Action, the Eve Appeal and Target Ovarian Cancer, which also does much to support the work of the APPG on ovarian cancer in its role as the secretariat to the group. I look forward to hearing from the Minister about the ways in which the Government can support the work of those great charities and campaigners, and support the thousands of women across the country who sadly suffer from this disease.

Organ Donation (Deemed Consent) Bill

Sharon Hodgson Excerpts

3rd reading: House of Commons & Report stage: House of Commons
Friday 26th October 2018 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I thank and congratulate my hon. Friend the Member for Coventry North West (Mr Robinson) on introducing the Bill and on the constant campaigning that has led to the Bill reaching its final stages. As we heard from my hon. Friend the Member for Barnsley Central (Dan Jarvis), my hon. Friend the Member for Coventry North West is unable to be with us today, so I wish him well and I am sure that the whole House will want to wish him a good recovery. I thank my hon. Friend the Member for Barnsley Central for so ably standing in for today’s final stages and for his many years of campaigning, and I thank the hon. Member for Boston and Skegness (Matt Warman) for his thoughtful contribution.

Many hon. Members have brought this issue to the House over the years, and I want to pay tribute to my hon. Friends the Members for Mitcham and Morden (Siobhain McDonagh), for Newport West (Paul Flynn) and for Sunderland Central (Julie Elliott) and, again, to my hon. Friend the Member for Barnsley Central. I also commend the Daily Mirror on its sterling work, its awareness-raising campaigns and especially for supporting the case of Max Johnson, then a nine-year-old boy badly in need of a new heart. Thankfully, Max got a new heart due to the bravery of the family of Keira Ball, his donor, and it was great to hear from my hon. Friend that Max is doing so well.

There is no doubt that we need more organ donors in England. As of 19 October 2018, a total of 6,198 people were registered on the active waiting list for a transplant, with 285 of them needing a new heart. That is why I am proud to support this Bill, which will hopefully help to deliver an increase in the organs available for donation and shift social norms towards donation.

The gap between the number of organ donors and patients requiring organ transplantation is higher in black and minority ethnic communities than in the general population. Earlier this year, I sat on a panel with my hon. Friend the Member for Wolverhampton South West (Eleanor Smith)—I am pleased she is here today—and my right hon. Friend the Member for Tynemouth (Mr Campbell) to review BAME blood, stem cell and organ donation and to hear real-life stories of why more organ donors are needed for these communities.

It is important to recognise that the campaign to increase organ donors will not end with this Bill. We need a comprehensive communications strategy that can reach everyone, but especially those who may not already be convinced by the call to be an organ donor. Will the Minister commit to working with Public Health England to establish a national media campaign to raise awareness and enable people to make an informed decision on organ donation? Any media campaign should be followed up regularly, to ensure that the message is spread far and wide. We will also require investment in health structures, including the workforce, to maximise the potential of a soft opt-out system. Will the Minister consider increasing the number of organ donation specialist nurses, so that families can be supported in their decision?

In closing, this Bill is so very important, but what happens next is crucial. Just one donor can save up to nine people and give them a future with their loved ones. That is why we need any future system to be supported by a national media campaign and increased resources for our healthcare structures, so that everyone has the information they need to make an informed and important choice.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 23rd October 2018 Commons Chamber

[Nigel Adams]

I know that the hon. Gentleman takes a keen interest in this subject and that he campaigns assiduously on behalf of his constituents in this regard. He is right to suggest that Ministers are keeping a very close eye on these negotiations, and we urge Vertex to consider NHS England’s fair and final offer. However, it is absolutely right that we have a system—introduced by the Labour party—in which experts, not politicians, determine the fair price for a drug, based on robust evidence.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I almost thought you had forgotten about me, Mr Speaker.

Last month, speaking on this very subject, the Secretary of State said that he would not let pharmaceutical companies hold the NHS to ransom, but the 5,200 patients who could benefit from Orkambi are left suffering while this war of words continues. What does the Secretary of State have to say, through his Minister, to those patients who are awaiting a resolution to this stalemate?

[Nigel Adams]

The hon. Lady makes a correct point, and we are very keen that patients receive this drug. I understand her ire, but perhaps it should be directed at Vertex, the manufacturer. The offer of £500 million over five years for the size of the eligible population is the largest-ever commitment of its kind in the 70-year history of the NHS, and it would guarantee immediate and expanded access to Orkambi and to other drugs.

Breast Cancer

Sharon Hodgson Excerpts

Thursday 18th October 2018 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Mr McCabe. I thank my hon. Friend the Member for Crewe and Nantwich (Laura Smith) for leading this timely debate during Breast Cancer Awareness Month and for her excellent speech. It is timely because it is on the same day as Baroness Jowell’s moving memorial service, which I attended prior to this debate. I will say more about why that is relevant later.

I also thank other hon. Members for their excellent contributions—the hon. Members for Bexhill and Battle (Huw Merriman), for Strangford (Jim Shannon) and for Central Ayrshire (Dr Whitford), and my hon. Friend the Member for Lincoln (Karen Lee). I also thank the amazing campaigners, ambassadors and charities, especially Breast Cancer Now and Breast Cancer Care, for their unswerving support to us as politicians campaigning on the issue, but more importantly to the women, men and families who are living with breast cancer, before, during and after treatment.

As we have heard so movingly today, so many of us, especially those here today, have had our lives touched by breast cancer. I lost my mother-in-law to breast cancer 21 years ago—I have spoken about this before—and that is what inspired me to join the all-party parliamentary group on breast cancer when I became an MP. As the hon. Member for Bexhill and Battle so astutely spotted, I served as co-chair of the group, with the Minister and the hon. Member for Central Ayrshire, and I still serve as the vice-chair. That shows how close breast cancer is to the heart of the health spokespersons of each party and how important it is to work in a cross-party, collaborative way on such an important issue.

More women are surviving breast cancer than ever before. Around 95% of women will survive for one year and more than 80% survive for five years or more. However, the UK still lags behind countries such as Sweden, Portugal, Malta, Germany and France. It is clear that more must be done. Many different issues have been mentioned, but I will specifically talk about breast screening, the workforce and prevention, which others have touched on.

We all know how important early diagnosis is to improving the chances of survival. Breast cancer screening has a huge part to play in this, yet uptake is the lowest it has been in ten years, with stark variations across the country. According to Breast Cancer Now, increasing breast screening uptake from the current decade low of 71.1% to the 80% standard set for breast screening units could prevent over 1,200 breast cancer deaths per annual cohort of eligible women. Will the Government be taking steps to increase breast cancer screening, so that over 1,200 breast cancers deaths can be prevented each year?

The Prime Minister’s commitment as part of the NHS long-term plan to see three out of four cancers detected at an early stage by 2028 included a plan to make screening programmes more accessible and easier to use. Can the Minister elaborate on those plans? Will they include outreach services to groups who are less likely to attend screenings, such as those from certain demographic groups or those with learning disabilities?

Earlier this year it was announced that there had been a serious breast screening invitation error, which meant that over 10 years more than 174,000 women did not receive an invitation to their final breast screening appointment. A review into this error is expected to be published next month. Can the Minister provide an update on that review and is it expected to report on time?

Every year over 55,000 people in the UK are diagnosed with breast cancer, but the failure to address those increasing numbers means that, according to Breast Cancer Now, the number of breast cancer deaths is set to rise within four years. That is why pressure on the workforce needs to be addressed as a matter of urgency. Demand on the breast imaging and diagnostic workforce is set to increase over the next 10 years. We already have a workforce crisis with growing demand, but the problem is only going to get worse if it is left unaddressed. For every three breast radiologists who retire over the next five years, only two are expected to replace them. What plans do the Government have to deal with the growing pressure on an overstretched workforce?

Leaving the EU could also have an impact on our NHS workforce: 5.6% of the NHS workforce in England are from the EU. Changes to immigration rules may exacerbate existing workforce problems for breast cancer patients, particularly among the nursing workforce. Can the Minister provide any clear guarantees to EU citizens working in our NHS? What steps is his Department taking to ensure that the UK continues to attract nurses from the EU?

The current cancer strategy for England includes a recommendation that all patients diagnosed with cancer are supported by a clinical nurse specialist, but this support is not widely available. We heard from my hon. Friend the Member for Lincoln how devastating that is and what it means in reality, when she talked about her experience with her daughter. That support is not available to the majority of the 35,000 people in the UK living with secondary breast cancer. Nearly 72% of hospital organisations in England, Scotland and Wales do not have a dedicated secondary breast cancer clinical nurse specialist. I share Breast Cancer Care’s belief that incurable should not mean unsupported. Does the Minister share that belief and what steps will he take to close the stark disparities and support between primary and secondary breast cancer patients?

[Dr Whitford]

The hon. Lady has recognised the comment I made earlier, that our patients all have the support of a cancer nurse specialist, but they do not have a title of secondary nurse specialist. That is something that requires looking into in more detail, so that we can identify places where there really is no support versus places where support is linear, and the decision has been made to follow patients through their whole journey rather than make a decision on a title.

[Mrs Hodgson]

That is an important point and the model that is used in Scotland should perhaps be looked at. I took on board the hon. Lady’s point, when she said that patients who are assigned a secondary breast cancer nurse know what that might mean, whereas if it were someone who had been with the patient on their whole journey, that would be a different experience.

[Dr Whitford]

It varies in Scotland. We are a huge and rural country, so we will have some areas where there is a cancer nurse specialist and, for example, islands where there is someone who has the training to act in that role. In Glasgow and Edinburgh there may well be nurses who are different. It was a decision that we took as a team, as we felt it would be hard on the patients to suddenly move to someone new. It is also hard to sustain the nurse, if they are only ever involved in that part of the journey and do not have other days when they see patients get discharged, be well or be diagnosed.

[Mrs Hodgson]

The challenge to the Minister is whether improvements to the breast cancer workforce will include recruiting and training additional secondary breast cancer nurses, clinical nurse specialists—whatever we may decide to call them—so that patients have the vital support they need and no one has to witness their loved ones suffering in agony, with only over-the-counter painkillers to ease the pain, as my hon. Friend the Member for Lincoln so bravely testified to earlier.

[Karen Lee]

Does my hon. Friend agree that the withdrawal of nursing bursaries cannot fail to have impacted on the numbers of nurses training? There are figures out today—I have been on the radio this morning. I think there has been more than a 30% drop in the number of people training to be nurses since the nursing bursary was withdrawn. That cannot fail to have had an impact. It impacts on radiographers as well, because they train for three years, then for another year after that to do mammograms. Does she agree that those bursaries absolutely must be reinstated?

[Mrs Hodgson]

Yes, I agree. Obviously, that is why it is in our manifesto that we would reinstate those nursing bursaries. I would urge the Government to look at this closely, especially in light of Brexit, and what might happen post Brexit, with regard to the EU workforce, as I already mentioned.

Finally, I will move on to prevention. It is a challenge to us all to live healthier lives. I do not stand here saying I am doing a very good job, but we know that regularly drinking alcohol, as the hon. Member for Central Ayrshire mentioned earlier, and being overweight or obese, can increase the risk of developing breast cancer—and most cancers—as can smoking and lack of exercise. Regular physical exercise and reducing all the above can reduce the risk. Researchers estimated that 23% of breast cancers are preventable through lifestyle changes. That means there were approximately 10,600 preventable cases in 2016. Turning that into money, approximately £102 million in treatment costs could have been saved in 2016 if all those cases had been prevented. I know that may not be completely achievable, but since 2015, public health budgets have been cut by 3.9% a year until 2020-21. Has the Minister made any assessment of the effect that cuts to public health budgets have had on the incidence of breast cancer, and will he commit, as much as he can, to an increase in public health funding to help to prevent more cases of breast cancer? I know that might be above his pay grade; he is not the Chancellor—yet.

In closing, I will touch on secondary breast cancer. More than half of women are given no information about the signs and symptoms of breast cancer returning. Will the Minister look into ensuring that all patients are advised at the end of their primary breast cancer treatment about lifestyle and symptoms, so that where possible all cases of incurable secondary breast cancer can be prevented? I know that, like me, the Minister is incredibly passionate about breast cancer and that he will take much if not all of what he has heard today back to his Department to work on, so that he can achieve the best future for breast cancer.

On the day of Dame Tessa Jowell’s memorial, I will end by quoting from her magnificent last speech in the House of Lords in January this year, when she said:

“In the end, what gives a life meaning is not only how it is lived, but how it draws to a close.”

She said that she hoped the debate would give hope to other cancer patients,

“so that we can live well together with cancer—not just dying of it”.—[Official Report, House of Lords, 25 January 2018; Vol. 788, c. 1170.]

Perhaps her most precious legacy will be not only Sure Start and the Olympics, as wonderful as they are, but a better future for everyone with any form of cancer.

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

Thank you for chairing our session today, Mr McCabe. I add my congratulations to the hon. Member for Lincoln (Karen Lee) on securing the debate and the hon. Member for Crewe and Nantwich (Laura Smith) on leading us off today. Breast cancer sadly affects so many of us so personally. It is always a privilege to respond to any debate in this House, especially on cancer and more especially on breast cancer, and this has been a constructive, small and perfectly formed debate.

It is always a pleasure to follow my shadow Minister and friend, the hon. Member for Washington and Sunderland West (Mrs Hodgson); I think this is the first time that a debate has been led by all three chairs of the same all-party parliamentary group, speaking for their respective parties. It was important to us when we chaired the group that we had the three main parties in the chair. The third chair was then held by the Liberal Democrats—remember them?—[Laughter.] Stop it. When the hon. Member for Central Ayrshire (Dr Whitford) joined the House, it was a real pleasure that she came on board and took that seat.

I will start by saying, “Happy BCAM!” There is much to celebrate, as hon. Members have said, and it is Breast Cancer Awareness Month, or BCAM for short. I pay tribute to all the people who are here, the survivors—survivorship is very important—and to all the people who have gone. Macmillan Cancer Support ran a heartfelt campaign earlier this year on the idea that “A mum with cancer is still a mum”, which was one of the best pieces of advertising I have seen in the health space for a long time. The reason I say, “Happy BCAM!” is that the people who have gone were still mums, daughters and sisters, even while they were going through their challenges. That is very important. Even children who lose their battle with cancer after being on this earth for a matter of days leave an indelible mark, because they were here for a few days. It is important to me that we always remember that, and I always do.

The title of today’s debate on the Order Paper is “Future of breast cancer”. The hon. Member for Washington and Sunderland West said to me once in one of our group meetings, “You will be cancer Minister one day.” If she could predict something else great for me, that would be excellent.

[Mrs Hodgson]

Chancellor.

[Steve Brine]

Oh yes; the hon. Lady has already said Chancellor today. I am not sure about that one.

As the cancer Minister, I want a future where there is no breast cancer. The hon. Member for Strangford (Jim Shannon) mentioned that, and I think all hon. Members who have contributed this afternoon would like to see a future where there was no breast cancer. One day, perhaps—but the statistics show that we are making good progress. That is why I said that there are things to celebrate. We are ensuring that more people than ever survive breast cancer. As has been said, 10-year survival rates have almost doubled, from around 40% to nearly 80%, in the last 40 years.

I hope I do not need to say it, but cancer is a huge priority—the priority—for me. The Prime Minister chose to make it a central point of her party conference speech this month, and there was a reason for that; it is a huge priority for her and for her Government. Survival rates have never been higher, and they have been increasing year on year. Of course the Prime Minister celebrates that, but it is also why she announced a very ambitious package of measures for cancer care and treatment, showing that cancer will be absolutely central to the long-term plan for the NHS, which she has challenged NHS England to write before the end of this year and of which I will say more later. We are committed to investing an extra £20 billion a year in our NHS. The investment will build on the success we have already achieved through the implementation of the cancer strategy for England. I pay tribute to Harpal Kumar and those at Cancer Research UK who put that strategy together. We will build on that legacy and take it forward into the long-term plan.

In opening the debate, the hon. Member for Crewe and Nantwich raised a number of good points. She talked about secondary breast cancer data collection—a number of people did so, but she raised it first. She is right that the robust and timely collection and sharing of data is vital for improvements in breast cancer services. If we do not measure it, we do not know, and if we do not know, we cannot act. The National Cancer Regulation and Analysis Service, or NCRAS, collects data on all cancers diagnosed in England, with the data collection specified by the cancer outcomes and services dataset. That data collection of secondary breast cancers was mandated as part of the COSD for diagnoses from April 2013 onwards.

I remember, with my shadow Minister, taking a delegation to see Prime Minister David Cameron in No. 10 to talk about that exact issue just before Christmas; I remember our photo by the tree. It is good that that happened, but it is evident, comparing the collected data with sources in academic literature, that a large proportion of cases are still not being reported in the COSD. That is of great frustration to me. NCRAS continues to work with NHS trusts to improve the completion of the data, and we have redesigned aspects of the COSD to allow more relevant information on occurrence to be captured, but I do not for one minute shirk the fact that there is more to do in this area, and I assure the House and colleagues that I will constantly redouble my efforts in that regard.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 24th July 2018 Commons Chamber

[Steve Brine]

Yes, he will. I am pleased to say that prevention is one of the Secretary of State’s three key priorities. The HPV vaccine is a key prevention measure, while one of the drivers behind the child obesity plan was Cancer Research UK’s very clear advice that being overweight was one of the big risk factors, alongside diabetes, in cancer. Yes, prevention is always better than cure.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I welcome the Government’s acceptance of the JCVI’s recommendation to extend the vaccination programme to adolescent boys, but the Minister will know that there are huge regional differences in the take-up of the vaccination among girls. What steps will he take to tackle these regional differences before and during the roll-out to boys?

[Steve Brine]

The shadow Minister is absolutely right to raise this issue, which she also raised with me in the Westminster Hall debate on the same subject introduced by my hon. Friend the Member for North Thanet (Sir Roger Gale), who has done a lot in this area. I have already spoken to Public Health England about this in respect of the girls’ programme, and I will be speaking to it again now that we have announced the boys’ programme, because the equality of doing the dual programme must be matched by the equality of its taking place in her constituency as much as in mine in Hampshire.