(9 years, 10 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I hate to disagree with the hon. Gentleman. I agreed with a great deal of what he said in his speech, but the absurdity of the previous economic strategy—the regional development agencies—was that London, which is the richest part of the country, had its own agency. I know something about that, having been a member of it. What the hon. Gentleman says was not the message I got from Lancaster university, Lancaster council or Lancashire county council when I was elected in 2010. As I said, the regional development agency for the north-west concentrated wholly and utterly on Merseyside and Greater Manchester, and we got precious little.
The point raised earlier about regional development agencies is one of the big myths still perpetuated by some. The reality is that, during the period they existed, and for all the work they may have done, the north became relatively less well off and relatively poorer compared with the south.
(11 years ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I would like to think that I take the message, Mr Owen. It is a pleasure to serve under you.
It is also a pleasure to congratulate the new Minister, my hon. Friend the Member for Battersea (Jane Ellison), on her appointment. She has a reputation as a listening Minister and I am sure that, when she makes her closing remarks, she will prove to have listened to all of us here today.
I start off in a very partisan situation. As the hon. Member for Strangford (Jim Shannon) said, we are getting to the “cancer world”, as I call it; it is like a separate world that involves different people, often through personal experience. My experience of it is personal, but also through being secretary of the all-party group on pancreatic cancer. If I may, Mr Owen, I will give a little plug here—the all-party group is producing a report, which the Secretary of State for Health has agreed to take at a meeting on 25 November. All hon. Members will be invited to that meeting.
The report is about improving outcomes. I congratulate my hon. Friend the Member for Hertsmere (Mr Clappison) on securing this debate at this timely moment. What we in the all-party group are trying to see is a further improvement in outcomes, at a time when outcomes for cancer patients are improving. When I was growing up in the 1950s and 1960s, if somebody mentioned the word “cancer” it was almost as if a life sentence had been passed. We are in a different situation now.
Pancreatic cancer is seen as perhaps the most difficult cancer, and there are issues connected with that. I will cite some statistics to demonstrate the situation that pancreatic cancer patients often find themselves in. My hon. Friend the Member for Basildon and Billericay (Mr Baron) is far more experienced in this area than I am, and he put his finger on the issue by stressing the importance of early diagnosis.
I will give the figures from the national cancer patient experience survey: 40% of pancreatic cancer patients visited their GP three or more times before diagnosis; and 25% visited their GP five or more times before diagnosis. Those figures compare with 75% of all other cancer patients who are referred to hospital after one or two GP visits.
From the investigation that the all-party group made, I can cite the specific example of someone who came to us to give their own personal experience. They said:
“With regard to early diagnosis, the most important aspect for us was the fact that Gemma went to her GP on a total of 10 separate occasions between the middle of April 2009 and the end of August, when she was finally referred to a specialist”.
That is the experience of most people with pancreatic cancer. In my own case, I think that my partner went to the GP six or seven times before somebody then said, “Better go to a hospital.”
Then, when a patient gets to the hospital situation, quite often there is no access to a specialist in pancreatic cancer. If a clinical nurse specialist is not available, the patient is even more lost. I underline the importance that the all-party group attaches to the clinical nurse specialist in almost holding the hand of somebody with cancer as they go through the system.
I want to tell my hon. Friend about a meeting that I had with a radiotherapist in my constituency just a week or two ago. They told me that, all too often, patients who appear for treatment tell him that they visited their GP on numerous occasions and, sadly, often they were sent home. I know that it is incredibly difficult for GPs. We are expecting a lot of them, but there is still a lot more to be done in ensuring that GPs across the country are consistent in their approach to people who present with certain symptoms.
My hon. Friend is absolutely right and I totally agree with him. That is the kind of information that we, as an all-party group, have been receiving from right across the country.
As I said, there is a lack of specialism, even in a hospital situation sometimes. The issue with pancreatic cancer is that there is a repetition of non-specific symptoms. Again, I cite my own personal experience from the case of my partner—he just had a stomach ache that went on and on, without a particular issue. Other hon. Members have referred to what males tend to do, and they are absolutely right; we often put these things to one side and say, “It is a stomach upset”, despite the repetition of symptoms. What we are trying to get GPs to look at is this: if they are seeing somebody who has never been to them before, somebody who never really goes to a GP but keeps turning up, an alarm bell should be sounding.
I will cite some other figures, although I am aware of the time factor. Some 33% of pancreatic cancer patients feel that they have been given conflicting information, compared with 29% of all other cancer patients. Some 13% of pancreatic cancer patients did not get answers to important questions all or most of the time, compared with 9% of all other cancer patients. Some 36% of pancreatic cancer patients felt less likely to feel that their views were being taken into account by doctors and nurses when discussing treatment, compared with 30% of all other cancer patients.
As I said, I am being totally partisan. The all-party group’s experience and my experience personally is that, for some reason, this country is way down the line on pancreatic cancer—despite it being the fifth biggest cancer, in terms of the number of people who die from it—when it comes to international comparisons for improved outcomes. There are treatments, but far too often they are far too late, because of people’s constant appearances at GPs.
Other Members have talked about dignity and humiliation. I will be utterly personal about the issue, because, in one sense, that is what has driven me to get so involved. I remember my partner’s situation. It was a case of finally going to hospital, being told that people there would do some tests and then that they would carry out an operation because they thought it was cancer. “What does that mean?” We did not know.
I can remember being sat in the hospital and my partner coming back, straight from surgery, with things wrapped round. We said, “What is it?” The doctor turned round and said, “Oh, it’s terminal.” That is the kind of situation that happens. Where is the understanding? Where are the few minutes where they say, “Let’s just go through this. Let’s look at the options”?
I understand that people working in hospitals are under pressure, but there were repeated examples of such experiences at the all-party group. As other hon. Members, particularly those from Northern Ireland, have said, a person should not have to be brain of Britain or have gone on a training course to have a little more time and to treat people with a little more dignity.
I finish with two particular demands, or requests, for the Minister. The all-party group wants consideration to be given to an awareness campaign, particularly about pancreatic cancer. I add my praise for the involvement of Macmillan and Pancreatic Cancer UK, which is the charity that backs up the all-party group and continues to support us, in terms of the campaign on awareness.
Macmillan has been piloting decision tools to help GPs assess the risk of cancer, including pancreatic cancer, and make decisions about further referrals. We would like to see those properly evaluated with consideration given to a full roll-out of the pilots that Macmillan has been spearheading so fantastically.
We have also been trying to raise awareness that pancreatic cancer is not an old man’s disease, in crude terms. The risk increases with age, but 35% of all diagnoses of pancreatic cancer occur in people under the age of 65—that is about 3,000 of the 8,500 diagnosed each year. The split among men and women is reasonably even, with slightly more cases in women than in men. I am not sure that that is clear, so that would be part of what we would request in a campaign. It would lead to greater awareness and, hopefully, earlier referrals and better outcomes.
My final request relates to the national cancer patient experience data. Pancreatic Cancer UK paid for a separation of data for pancreatic cancer patients—in fact, the Department of Health paid for that to be done once. We would like pancreatic cancer patients to be routinely separated out from all upper-gastrointestinal cancer patients as part of the system of getting such statistics. I do not see why a charity or the Department should try to do that as an extra thing. It should be part and parcel of the routine, given the nature and impact of this dreadful, increasingly misunderstood cancer.
(13 years, 10 months ago)
Commons ChamberI join other hon. Members in congratulating my hon. Friend the Member for East Hampshire (Damian Hinds) on securing this debate, and I hope that they will pay attention to what he says later, because he has more ideas on how to progress this matter, which is key to many of us across the House. I shall try to keep to his principle of seeing this as a cross-party effort. As an ex-teacher, I have learned lessons today from legal experts and about early intervention.
I want to talk about an aspect of disadvantage that has not been mentioned yet. I am glad to see the hon. Member for Hackney North and Stoke Newington (Ms Abbott) in her place, because she has fought for this for a number of years. We talk about poverty, but there is also disadvantage in regard to race and culture. Year in, year out, she has gone on about the underperformance of black boys in particular, but, after all this time, there is still underperformance among children of Pakistani, Bengali and Kurdish origin. I do not know how many reports on that subject have come through the system.
As I said, I am an ex-history teacher, and it might seem that I am giving the House a history lesson, although I hope that things can be learned from history. My speech might bring back reminiscences of an old history teacher. I want to say something about my experience. I do not think there is anyone here who cannot think back to either a teacher or a school that made a difference to them. I support the Secretary of State when he said that
“our schools should be engines of social mobility”.
After 27 years in teaching, I passionately believe that to be the case. I went to a grammar school, and before Members raise their eyes to the ceiling, let me assure them that I am not going to give them a lecture about bringing back grammar schools across the country. My constituency does, however, have the advantage of having the very successful Lancaster royal grammar school for boys and Lancaster girls’ grammar school, which I shall say more about later.
I have 27 years’ experience of teaching in comprehensives, 25 of them in social priority schools. The lessons that I have learned apply to Governments of all persuasions, because they are all tempted to take certain actions. Comprehensives were supposed to be the vehicle for raising social mobility. When I started teaching in them, I was told that they would be the grammar schools for everyone. Then, certain schemes were introduced, including mixed-ability classes and special needs. Then we had special needs teaching in the classroom, and special needs teaching outside it. Then came integrated studies, environmental studies and humanities.
Often, more than 50% of the children whom professionals in those schools were dealing with were entitled to free school meals. Often, for more than 50% of them English was a second language. That is still the case in some of those schools today, although that has not yet been mentioned. Those factors existed alongside all the other problems that hon. Members have pointed out. Every few years, a Government scheme would be introduced in which the teacher was taken out of the classroom and trained to do something new. Any teacher dealing with circumstances of disadvantage will say that the key thing is how much stability, security and aspiration can be given to those children. Why is it that the most way-out education experiments are always done for the lowest achievers and the most disadvantaged?
It is precisely this issue of having initiative after initiative after initiative that we must end. One particularly damaging example from recent years, given the important role teachers can play in young people’s lives, was hiving off the pastoral role of teachers to other people working in schools. That left teachers simply to deliver the curriculum, never to nurture the children. This provides another example of the constant “initiativitis” from which we must move.
My hon. Friend makes an important point. It is always the schools undergoing initiatives that need the greatest stability. That is why I welcome the Secretary of State’s reform of the national curriculum, which will put real history and geography back into it. When those schools attained the achievement and stability they wanted and lifted their pupils A to C grades, they faced another problem. When the students left the school or entered university, the subjects they had studied were not counted as equal to other subjects learned in the more advantaged schools. This happened for the best of intentions, but it amounted to underselling. In my experience, however, with security, good teaching and, particularly, a good head teacher, there is nothing those children cannot achieve. They can match anybody and should be given the right to do so. That means having the right to learn the same subjects that are taught in the best schools. That would provide a level playing field and support could be continued through the system.
I want to give Ministers a case study from Lancaster. In 2003, with the best intentions, the previous Government set up an excellent cluster in Lancashire that linked the primary schools—Bowerham, Dallas Road, Willow Lane, Ridge and Moorside—with the following secondary schools: the Central Lancaster High school, Lancaster Royal Boys’ grammar, Lancaster Girls’ grammar and nine other schools in Morecambe. Teachers had to apply to participate in the initiative, which was conducted under a programme called “Excellence in Cities”, combined with another called the behaviour improvement programme. Civil servants draw up these initiatives, but teachers have to deal with the applications. What this achieved for those schools was, I think, roughly £1 million extra a year, which went to providing learning mentors.
The scheme was abolished in 2008—after just five years. After a few years, the Government no longer even measured the success of the scheme, but it can be measured. Performance at key stage 2 consistently went up year on year above the county average, while exclusions went down far below the county average—and there were some tough primary schools in this cohort. Attendance was also above the county average. Despite the achievements, it was stopped. We were told that the money was being moved to the school development grant. The poor heads were told that they had to reapply to go through the new system, which they did successfully. If we move to the present, we find that the school development grant has been amalgamated into the general schools grant. A successful system, therefore, which stopped being measured—except by the schools—has been moved, moved and moved again by all Governments.
I believe that this case study provides an example of what the pupil premium can achieve. In my view, the schools can get money through the pupil premium, but it is a year away. There are now 12 months in between, during which the whole system might well collapse. There is a gap in the process of one policy following another policy, which has happened before. It provides a warning to the coalition parties. If we want seriously to achieve things, it is not good enough just to agree to great schemes. What is important is what the schemes do on the ground and their impact on the teachers. That brings me back to my point about the teachers who are trying to create stability for what we call the most disadvantaged pupils—the very children who need that stability. I hope that we can continue monitoring these aspects, which will be key to any and every Government.
I acknowledge what the previous Government did with, for instance, academies and Sure Start, but we will have a job to do in tying up the pupil premium and what is left of the education maintenance allowance with the national scholarship for students. We need to tie up that golden thread to maintain support for disadvantaged children in every sector of education, and I hope the Government will pick that up and drive with it.
The lessons that I learn from history are that not only must this issue be dealt with—and it can be dealt with through the provision of good schools and good teachers—but we should pursue it beyond the next month and the next scheme.