Improving Cancer Outcomes

Andrew Gwynne Excerpts

Thursday 5th February 2015 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

I congratulate the hon. Member for Basildon and Billericay (Mr Baron) on securing this incredibly important debate and on the considered way in which he set out the issues in his opening speech.

I thank my hon. Friends the Members for Washington and Sunderland West (Mrs Hodgson) and for Easington (Grahame M. Morris), the hon. Member for Castle Point (Rebecca Harris), the right hon. Member for Sutton and Cheam (Paul Burstow) and the hon. Member for Salisbury (John Glen). I have not left out the hon. Member for Filton and Bradley Stoke (Jack Lopresti), but have left him to the end. I pay special tribute to him for the moving way in which he shared his personal experience. His message will have offered hope and inspiration to people who are listening to this debate. I thank him especially for that.

I extend my thanks to the Backbench Business Committee for ensuring that this debate could go ahead. It is crucial that when we mark important events such as world cancer day, the message goes out from this House of Commons that, whatever our political differences on whole areas of public policy, including the national health service, when it comes to matters such as our commitment to tackling cancer, we speak with one voice.

It is a particular privilege to take part in this debate on behalf of Her Majesty’s Opposition. From the outset, I want to echo the proposer of the motion in paying my own tribute to the various cancer all-party parliamentary groups, which do such good work to highlight these issues in Parliament. Cancer care and prevention is one of the most important policy areas for politicians to consider.

When I was a teenager, my mother was diagnosed with ovarian cancer. I would like to say a personal thank you to my hon. Friend the Member for Washington and Sunderland West for the work that she does on ovarian cancer. Despite my mother paying numerous visits to her GP in the months before she was diagnosed, the cancer was not picked up until a later stage. As my hon. Friend described, although the symptoms were there, they were put down to other factors such as heavy lifting at work. By the time the cancer was diagnosed, it was too late for treatment to be effective and my mother passed away in hospital when I was 19. Not a day goes by that I do not miss her. Not only was I robbed of my mother; my three children missed out on a pretty fantastic grandmother. I therefore understand the very personal hurt that a loss from cancer can cause.

I do not blame the GP for not spotting my mother’s cancer. As my hon. Friend the Member for Washington and Sunderland West set out, patients with ovarian cancer often present with symptoms that are not easily recognisable. However, it did make me question what more could have been done. That was in 1994. In the 20 years since, we have made huge progress in improving cancer services. In the last decade, five-year survival rates improved for nearly all types of cancer. However, as we heard in the opening contribution of the hon. Member for Basildon and Billericay and in the speeches of other hon. Members, we still lag behind other countries.

There is worrying evidence from the past five years that the progress that we have made on cancer care has stalled to some extent. People are waiting longer for vital tests and the national cancer target has been missed in the past three quarters. Over the past four years, cancer spending has been reduced by £800 million in real terms. It is worth saying that in government, Labour created 28 cancer networks to drive change and improvement in cancer services. Those networks brought together the providers and commissioners of cancer care to plan and deliver high-quality cancer services in their areas. They helped to oversee and drive up the quality of services that were delivered to cancer patients. By significantly changing their structure and reducing their budgets by millions, as well as by scrapping the highly regarded national cancer action team, I would argue that the Government have disrupted those networks.

Cancer Research UK published an analysis late last year that suggests that cancer services have been weakened by the shake-up of the NHS. It also suggested they lack the money to cope with the fast growing number of people getting the disease. The charity found that real-terms spending on cancer reached a record high of £5.9 billion in 2009-10, but since then it has declined to £5.7 billion in 2012-13. So not only has the money been reduced, but the delivery mechanisms, which helped share expertise and best practice, have been dismantled.

Our hard-working clinicians and staff are trying their best within the system, and despite the challenges, continue to deliver quality care, and we should all recognise and pay tribute to the work that they do across the NHS. Let me come on to what we would do were we in government. We have made a commitment that within the first six months of the election, the next Labour Government will publish a cancer strategy with the goal of being the best in Europe on cancer survival. That would include increasing the rate of cancers diagnosed early, which—as we have heard in this debate—drastically increases the chances of survival. At the moment, just over half of cancers are diagnosed at an early stage, but over the next 10 years, we want to see that increase to at least two in every three cancers. If the benchmark of today’s best performing areas—60% of all cancers being detected early—were met across the country, it would mean 33,000 more cancers diagnosed early each year by 2020.

We also plan to make leaps forward on screening and diagnostic tests. We have announced that we will put an extra £750 million of investment into testing over the next Parliament. That will enable us to guarantee a maximum one-week wait for tests and a one-week wait for results by 2020. That will be the first step towards achieving one-week access to key tests for all urgent diagnostics by 2025. That will be made possible by new investment, paid for through a levy on the tobacco industry, because it is only right that those who make soaring profits on the back of ill health should be forced to make a greater contribution in that area.

We will also ensure that the new bowel scope screening programme is rolled out by 2016, which I know will please the hon. Member for Basildon and Billericay. Research has found that patients who are able to see their GPs within 48 hours are less likely to have their initial cancer diagnosis via an emergency hospital admission.

[Mr Baron]

The whole cancer community has been behind the all-party group on cancer and the cancer-specific all-party groups in pushing for the one-year survival rates to be broken down by CCG and put on the delivery dashboard. The shadow Secretary of State welcomed that development when he spoke at the Britain against cancer conference in December. I do not intend to make predictions about who will win the general election during this debate, but may I press the hon. Gentleman—I am pressing my own side—to ensure that if Labour wins it will attach as much importance to the one-year figures and pursue those CCGs that are underperforming, in order to drive forward initiatives at a local level that encourage earlier diagnosis, as I know my party will do, once returned.

[Andrew Gwynne]

I absolutely agree with the hon. Gentleman. In fact, my right hon. Friend the Member for Leigh (Andy Burnham) has given that commitment as shadow Secretary of State. We need to make sure that if CCGs are not performing as well as they could be in this area, Ministers and NHS England take every action they can so that we bring standards up and everyone can expect the same level of treatment, irrespective of which part of England they live in.

The right hon. Member for Sutton and Cheam is not able to be here for the winding-up speeches but, as a courtesy, he let both Front Benchers and the proposer of the debate know that he would not be able to be here. He was right to raise the issue of long-term funding for the NHS. I do not think it is appropriate to talk in a knockabout fashion in this debate about who is going to raise what or when, but Labour has committed to the new time to care fund, which will enable us to have 8,000 more GPs by 2020. That, undoubtedly, will help to improve access and ensure that doctors get more time with their patients.

At the moment, fragmented primary care makes it more difficult for patients, particularly the elderly, to see one doctor who can develop a long-term view of long-term complex conditions. That is why, alongside our commitment to guaranteed GP appointments within 48 hours, we have made an equally important pledge to ensure that patients can book ahead with a GP of their choice.

Hon. Members may also have heard that Labour wants to work with the Teenage Cancer Trust to expand its cancer awareness programmes across all schools in England. Too many young people leave school without knowing the warning signs of cancer. Every young person should have the opportunity to learn more and know where to go if they are worried about their health. We in this place, on both sides of the House, owe it to our young people to teach them the signs of cancer and it is just as important to build their confidence so they can seek help. Early diagnosis, as we have heard, is critical to improving cancer survival, because treatment is more likely to be successful at an earlier stage. I commend the hon. Member for Castle Point for her powerful contribution today, and for the work she is doing in her constituency along these lines to make sure, working with those charities, that young people are more aware of the symptoms of cancer and where they should go if they exhibit signs of ill health.

When doctors catch bowel cancer at the earliest stage, more than nine in 10 people survive for at least five years. At the moment, however, fewer than one in 10 people with bowel cancer are diagnosed at the earliest stage. Many Members will be aware of the appalling statistic that a quarter of cancer cases in England are currently diagnosed through an emergency route. Naturally, far too many of these cases are in the advanced stages, meaning the prognosis is poor compared with cancer diagnosed through other routes.

Late diagnosis is not just worse for health outcomes; as we have heard, it can cost more too. The average cost of treating stage 1 colon cancer is about £3,400, compared to £12,500 at stage 4. Analysis by Incisive Health found that if all CCGs were able to achieve the level of early diagnosis of the best CCGs—our long-term target—then across all cancers we would be making annual savings in treatment costs of about £210 million. That touches on the points made by the hon. Member for Basildon and Billericay, as well as by the hon. Member for Salisbury and the right hon. Member for Sutton and Cheam.

The hon. Member for Salisbury also touched on the postcode lottery for diagnostics and treatments. He is absolutely right. With the leave of the House, I would like to talk about a case from my early time as a Member of Parliament, back in 2005. I have the privilege of representing a cross-borough constituency, so I have two of everything. I have two local authorities and two police divisions and so on. Back then, there were two primary care trusts. My constituent came to my surgery having been diagnosed with breast cancer. Her doctor had decided that the best treatment for her was Herceptin. If she had lived in the other part of my constituency, the primary care trust responsible would have provided Herceptin treatment for her, but because she lived on the other side of a road, with an invisible line down the middle, she was not able to access that treatment. It was one of those moments where it was appropriate for the MP to throw all his toys out the pram, and thankfully the PCT changed its decision. One of my nicest moments as an MP was about two years ago when the lady, whom I did not recognise, came back to my surgery with a completely different case. At the end, she said, “Mr Gwynne, you don’t recognise me, do you?” I looked blank, and panic-stricken, because we deal with so many constituents, and she said, “I’m that lady you got Herceptin for. I’m still here.” It was one of the proudest moments of my time so far as an MP.

That brings me to our plans for treatment. We have pledged that a Labour Government would continue to work with the cancer drugs fund, but we also recognise that the fund unreasonably excludes other advanced treatments. This takes up the point made by the hon. Member for Castle Point and the firmly and long-held views of my hon. Friend the Member for Easington. For that reason, we would expand the cancer drugs fund to include other treatment options, such as radiotherapy and surgery—the two treatments that together are responsible for nine in 10 cases where cancer is cured. That point has been powerfully made by my hon. Friend on so many occasions—it is still ringing in my ears.

The nature of cancer is changing. Just as with AIDS, rapid advances in technology mean that cancer is no longer the death sentence it once was, and this welcome change means that cancer is increasingly considered a long-term condition, which brings its own requirements, in terms of long-term care and support. A report from the King’s Fund suggested that as cancer survival rates improved, health care services needed to improve the quality of life of the growing number of people with cancer. The needs of cancer patients often span every tier of care in our system, yet it often proves incredibly difficult to navigate the various systems. We therefore plan to give everyone with the greatest need a single point of contact. This person will be their co-ordinator and advocate in the system, identifying their needs and ensuring they are met. No cancer patient should end up lost in our vast health system, unable to find the treatment they are entitled to.

Cancer survivors have to be properly supported once their treatment stops to help their recovery and minimise the impact of their illness on their overall health. The current formulaic approaches are not meeting the needs of cancer patients, and the current hospital-based follow-up service will not cope with the growing cancer population. We owe it to families battling cancer to continue to have high ambitions. In that spirit, Labour has set out its plans for improving early diagnosis and expanding access to new innovative cancer treatments. I thank all Members for their contributions. Despite our many political differences, we have the same ambition for cancer—to bring forward the day when this terrible disease is beaten.