Children’s Cancer Care: South-East

Andrea Leadsom Excerpts

Wednesday 13th March 2024 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

Thank you, Sir Christopher. It is a pleasure to serve under your chairmanship in what has been quite a drawn-out debate on such an important topic. The hon. Member for Twickenham (Munira Wilson) has raised an incredibly important issue. I hope she and all hon. Members accept that clinical assessment and knowledge are crucial to making vital decisions that affect children’s health at such a difficult time for them and their families.

I am responding to this debate on behalf of my right hon. Friend the Member for Pendle (Andrew Stephenson), but I will endeavour to respond to each colleague and commit to writing where necessary. The debate has understandably stirred some strong emotions, because every colleague has had direct or indirect exposure to some of the questions it has raised. I am therefore grateful to all hon. Members for their contributions, which demonstrate the huge importance to us all of getting the right outcome.

Each of us has helped a parent who has called our constituency offices seeking help at an incredibly difficult time. I want to assure everyone that each person in the Government, from the Prime Minister down, knows the importance of getting this right. That is why cancer services for children are an absolute priority. From my own work in the Start for Life programme, and in the few months I have been in my current role, I have seen a collective determination to ensure that children right across the country receive the highest possible standards of care. Children with cancer are the key priority.

The Royal Marsden Hospital and St George’s Hospital currently care for most of the children with cancer in south London and the south-east. I pay tribute to the work of those dedicated doctors and nurses who do everything they can to look after the children entrusted to their care, and I want to be clear that NHS England’s proposed changes do not reflect on the stellar service that those staff members have given and continue to give. Rather, the proposals follow advice from Professor Sir Mike Richards’ review, which made it a clinical requirement for cancer services to be placed in the same location as an intensive care unit in order to give critical life support to the most unwell children.

Sir Mike’s reasoning was simple. First, we need to end transfers between hospitals for very sick children, which add risks and stress for them, not to mention their families, during what is already an unimaginably difficult time. Secondly, while we will not compromise on safety, we need to ensure quality of care. As every Member will agree, children deserve to benefit from the very latest technology available. Thirdly, we need to ensure a seamless, joined-up approach.

NHS England has listened to patients, parents and clinical experts to hear how we might best improve their care. The NHS England process has been rigorous, and it has been immensely important for all those patients, parents and specialists to put forward their own significant insights. Last year, NHS England carried out a 12-week public consultation on two options for the future location of the principal treatment centre for south London and much of the south-east: Evelina London Children’s Hospital and St George’s Hospital. Under both options, all radiotherapy for children with cancer would be at University College Hospital.

Both Evelina London and St George’s deliver outstanding-rated children’s healthcare. They also provide outstanding-rated education in their hospital schools. Both are capable of delivering a future principal treatment centre that meets our high standards. They are also both adept at listening to children, young people and their families to improve on the care they deliver.

The experience and expertise of specialists working side-by-side with intensive care and surgical teams will make a real difference: enabling children to get care where they need it, when they need it, on a specialist cancer ward; bringing down the number of children admitted to intensive care; making it easier for different specialist teams treating the same child to work closely together; improving care for children; upskilling the workforce and supporting new kinds of research. Importantly, it will also mean that the future cancer centre will be capable of offering the most innovative and cutting-edge treatments, which may bring precious new hope for children and their families.

The centre will build on the strengths of the existing service, including high-quality care by expert staff and access to clinical trials. It will be a family-friendly centre for children and young people, at the forefront of groundbreaking research and continuing the close relationship with the Institute of Cancer Research.

[Munira Wilson]

The Minister said a moment ago that the new centre will build on the service and the experience. The point that I and many Members have made is that St George’s has that experience. While the Evelina is brilliant in many paediatric specialisms, it does not have children’s cancer experience, so what will it build on? On the point about process, it was already predetermined, as I pointed out. It has been made clear in meetings we have had that a lot of the responses will not be taken into account unless there is new evidence. The views of children, their parents and clinicians are not being listened to in the consultation.

[Dame Andrea Leadsom]

I am afraid I fundamentally disagree with the hon. Lady on that point. The consultation has been open, with an open mind and following the best principles of open consultation. I think she is taking quite a liberty to suggest it is a foregone conclusion. I do not think she is correct in her belief. It is essential that clinicians can take all the inputs from those consultations to come to the right decision.

[Several hon. Members rose—]

[Dame Andrea Leadsom]

I will give way first to my hon. Friend the Member for Mole Valley (Sir Paul Beresford).

[Sir Paul Beresford]

Knowing quite a number of consultants at St George’s, if they heard that they were at a standstill position and not building on what they have now, they would be insulted.

[Dame Andrea Leadsom]

I will also take the intervention from my hon. Friend the Member for Woking (Mr Lord).

[Mr Jonathan Lord (Woking) (Con)]

Like several colleagues, I thank the existing hospitals for the amazing care that they have given over the years, but I agree with my hon. Friend the Member for Mole Valley: I do not think this decision is necessarily a no-brainer. We need to look at the final decision and report, and weigh up what is good and what is bad. Who knows what the final decision and its reasoning will be? I agree with the Minister that it has been a proper process. We should allow it to come to its conclusion very shortly, look at the evidence, and look at the decision in that light and with an open mind.

[Dame Andrea Leadsom]

I absolutely agree with my hon. Friends that the consultation is critical, that it has been an open consultation and that all views are being taken into account. I am grateful to them for supporting the process. As Members of Parliament and constituency representatives, we all want the best for our constituents, but in the case of clinical care, it is vital that those with specialist knowledge and understanding should be able to make such important decisions that will affect life and death outcomes for children.

The new centre will be a family-friendly centre forusb children and young people at the forefront of groundbreaking research, continuing a close relationship with the Institute of Cancer Research. The centre will lead joined-up working between different children’s cancer services so that children get proper access to care, wherever they live. Importantly, it will have many more services on site, reducing the need for some families to travel, which will be particularly helpful for children with complex needs and families that struggle to speak English.

I assure colleagues, and anyone who might be watching at home, that once the decision has been taken, there will be no sudden changes to how patients receive care. Of course, some families will naturally be worried about what the change might mean for their children. That is entirely normal, and NHS England will carefully involve every clinical team currently providing care, keeping parents and families closely updated at every stage. NHS England will encourage experienced staff to move to the future centre so that they can continue to provide a friendly and familiar face to the children they serve. No one from among the clinical staff will be made redundant in any future changes resulting directly from this decision. NHS England has met staff to listen to their views, and they assure me that that will continue.

The consultation heard from children, their carers, and families who have received the worst news. They have talked about their own experiences selflessly to try to help others. The consultation closed in December last year, and an independent research organisation published its findings in January. NHS England has taken into account every word of feedback and every inch of evidence to inform the decision-making process. NHS England leaders are meeting tomorrow to decide the future location of the centre. The meeting will be livestreamed so that everyone who is interested can hear the discussion and the decision.

In conclusion, wherever the future centre is placed, I am confident that tomorrow’s decision will offer the right outcome for our children and take all views into account.

[Munira Wilson]

Before the Minister sits down, will she give way?

[Dame Andrea Leadsom]

No, the hon. Lady will have her chance in a moment. Throughout this process, the guiding principle has always been safety, quality of care and the best outcomes for children with cancer, now and for the long term. The children and their families deserve nothing less.