Covid-19: Access to Cancer Diagnosis and Treatment

Andy Carter Excerpts

Wednesday 2nd December 2020 Westminster Hall

[Andy Carter (Warrington South) (Con)]

Thank you, Ms McVey. I will do a quick calculation.

[Esther McVey (in the Chair)]

You have quite a few minutes.

[Andy Carter]

It is a pleasure to serve under your chairmanship, and I am delighted to follow the hon. Member for Westmorland and Lonsdale (Tim Farron). I congratulate him on securing this important debate, and pay tribute to his excellent opening speech. I agree with many of the points that he made. The issue is incredibly important for families up and down the UK, and I am delighted to be able to join him in speaking in the debate.

I want to thank those who work in oncology in Warrington—the consultants, nurses, radiographers and, of course, GPs who are right at the frontline as the primary gateway into cancer services. Their work, and that of those in their sector across the UK, has continued through the pandemic.

Early on, I spoke to the chief executive of Warrington hospital, Professor Simon Constable, who outlined the steps his team were taking to try to maintain cancer care services in as near normal fashion as possible. Their ability to operate across two campuses, with a covid-free site in Halton, has meant that procedures such as breast cancer could operate very close to normal. The partnership formed with Spire hospital in Stretton, where the NHS has contracted bed space and use of operating theatres to give capacity for critical operations, has meant that referrals for urgent treatment in Warrington have continued.

I think that talking to real people is when we hear the true stories. Last Friday, I spoke to a constituent called Helen who lives in Lymm. It was one of the more pleasant conversations that I have had with her over the last few weeks. She very sadly discovered that her breast cancer had returned in April, which was the same week we hit the peak of the first wave. Understandably, she was incredibly concerned when she contacted her GP. Helen was referred back to a consultant and, after tests, was told that she needed a double mastectomy. I remember talking to her earlier in the year, when she told me the news, and she explained in detail her fears of catching covid when she went into hospital to undergo radiotherapy and tests. She was asked to isolate and follow detailed guidance, and she was superbly cared for by her son at home, who went out of his way to make sure she had everything that she needed. She went into hospital in Halton for treatment and last week, some eight weeks after the operation, told me that she was looking forward to going back to work as a supply teacher in one of our local schools. Her description of the care that she received from the NHS was incredible, and she said that they could not have done more for her. I highlight this story because I think we have not heard enough about the work that has continued over the last few months—but that does not mean we do not have a problem with cancer care services.

The local hospital in Warrington was treating 170 patients for covid at the start of November. It was one of the most under pressure hospitals in the entire country. The team has only been able to operate about 80% of normal services. I say only but I actually think that is pretty good, given that we are in a global pandemic and that is roughly in line with services across the north-west of England. I suspect though that the 80% headline masks many true and worrying statistics that we will discover over the next five years.

Last week I also spoke to executives at Macmillan Cancer about the local situation in Warrington, as well as the national picture. I pay tribute to the Macmillan nurses who have continued to work with patients in their homes through lockdown, particularly those who have supported families of loved ones who are near their end of life. Macmillan estimates that across the UK there are currently 50,000 missing diagnoses, meaning that, around 33,000 fewer people started treatment compared to a similar timeframe last year. That backlog of undiagnosed cancer could take 18 months to tackle in England alone. Most worryingly, if cancer referrals and screenings do not return to pre-pandemic levels, the backlog could grow by 4,000 missing diagnoses, reaching over 100,000 by October next year.

During much of the pandemic, the NHS has been open for business, and we should be proud of that. Anyone who needs care and treatment can continue to access it. When they need it, they can go to their GP and be seen, especially where delays could impose an immediate and long-term risk. I think the most worrying statistics are on urgent GP referrals in July and August. They were 72,000 lower than last year. In some ways, that highlights the most stark problem that the pandemic is storing up for us.

We have seen a significant reduction in people starting their cancer treatment in 2020. Between March and September, around 31,000 fewer people started their first cancer treatment, which is a drop of 17% compared to 2019. More than 650,000 people with cancer in the UK have also experienced disruption to their cancer treatment or care because of covid-19. For about 150,000 people, that included delayed or rescheduled cancer treatment.

I welcome the announcement of £3 billion of extra funding to support NHS recovery from covid-19 and to help tackle and ease some of the pressures in all our hospitals, allowing them to carry out more checks, scans, operations and procedures. That will help to ensure that cancer patients can access the care they need as quickly as possible, but we need to tackle the backlog, and we cannot afford to undo the great work and investment that has gone into cancer treatments in recent years. I am delighted to speak in a health debate today because of the news we have heard that a vaccine has been approved and is on the way. That is incredibly welcome, but we must put that alongside the challenges that exist in every single branch of medicine, and particularly in cancer care, where the patient backlog is extending.

One of the biggest challenges we face is caused not by money or pressure on NHS services but by putting things off. We all do it—mainly due to a fear of going into hospital. I mentioned Helen earlier, who talked about her greatest fear being to go into hospital. Lumps and bumps are not treated because we think it does not really matter at the moment. I am afraid that is particularly true for us men, and the pandemic has highlighted that. We really do need a public information campaign that says, “If you spot a problem, don’t leave it for a later date.”

As the hon. Member for Westmorland and Lonsdale said, since 2010, survival rates from cancer have increased year on year. We have a really good story to tell in this country—about 7,000 people are alive today who would not have been here if mortality rates had stayed the same—but to sustain that drop, the NHS and Government will have to take action like they have never done before. It is critical that the cancer workforce is ring-fenced against any further redeployment to ensure that cancer care continues and further avoidable cancer deaths are averted.

Before the pandemic, there were about 3,000 specialist cancer nurses, which Macmillan modelling indicates is around 2,500 below the level required to deliver basic cancer care—and given the backlogs, that figure is probably closer to 3,500. Patient feedback to Macmillan was that, though its nurses work incredibly hard, they are not getting the support that they need. I really welcome the 14,000 additional nurses we have recruited in the last 12 months as I do the additional £260 million fund allocated for Health Education England in the one-year spending review, which will go towards the Government’s commitment to train 50,000 more nurses. However, my hon. Friend the Minister will know that that alone will not address the significant shortfalls in specialist cancer care nurses. I am therefore really keen to hear from her how the Government can commit to further long-term funding support for the next iteration of the NHS people plan to eliminate the gap in the cancer workforce.

It is hugely important that the Government back the national cancer recovery plan and the additional resource needed to build capacity and help beat the backlog now and in the long-term, getting the right skills and resources in the right places to make sure we have the biggest impact possible and, most importantly, encourage people to get the treatment that they need. Getting all of us to feel comfortable with reaching out to our GPs early on, so that we can get treatment, must be our No. 1 priority.