Health: Cancer

Baroness Hussein-Ece Excerpts

Thursday 11th November 2010 Lords Chamber

[Baroness Hussein-Ece]

My Lords, I, too, congratulate the noble Lord, Lord Howard, on his excellent maiden speech and on his new important role in leading the hospice movement. I also thank the noble Baroness, Lady Finlay, for securing this debate and for the leadership that she shows in this subject.

All people who have cancer want high quality services and want to be involved as equal and active partners in decisions about their treatment and care. I welcome measures to improve cancer services in the UK over the years. Attitudes towards cancer care and quality of life have changed, and many want to ensure, as has been mentioned, that cancer care and early diagnosis are given the same priority as research into treatments and cures. Improving quality of life matters as much as improving quantity of life.

Dealing with a cancer diagnosis is difficult for both the patient and their family and friends. Being given the right information and support, whether that is someone to talk to, information about specific cancers or advice on benefits, can make a difference and make living with cancer a little easier.

More than 109,000 people of working age are diagnosed with cancer each year. The impact of this usually means people making changes to their working lives or leaving work. The effects of cancer and treatment can impact on people’s lives in many different ways and can affect them for weeks, months or even years after treatment has ended. Fatigue—extreme tiredness—is a very common and frustrating problem, with 65 per cent of cancer survivors saying that they have to deal with fatigue following treatment. Then there are the practical problems when people who are diagnosed with cancer need to take time off from work for treatments or check-ups. Practical problems such as these can make a person’s working life difficult, especially if employers are not supportive or understanding of their needs.

I was interested in what support is currently given to people with cancer to help them remain in work or return to work. The truth seems to be that too many people do not receive enough help or support. There is a lack of information available for people who want to remain in work, and there seems to be a lack of knowledge of legal responsibilities. A supportive employer can be vital in helping someone with cancer return to work. However, new research shows that the majority of employers do not know about their legal responsibilities towards people with cancer—for example, fewer than half of employers know that cancer is covered under the Disability Discrimination Act. Equally, employees also lack knowledge of their employers’ legal obligations to them, and so will often not request the support they are entitled to.

Fewer than 40 per cent of people with cancer know that cancer is covered by the DDA. From 1 October this year, all disability discrimination legislation falls under the Equality Act, as we know. Under the Equality Act, employers must consider requests such as flexible working hours or physical adjustments to the workplace from someone who has cancer. If they meet these obligations, they can avoid potential discrimination charges along with damage to their reputation, legal fees and lost time. Employers who support an employee with cancer will generally foster a greater sense of loyalty from them and improve engagement and morale. Seeing a colleague supported in this way can also reinforce other employees’ sense of fairness and trust and fosters a positive image of that particular employer. Sometimes it will take a minor adjustment to help that employee to remain in work. I ask my noble friend the Minister what can be done to address the lack of information to patients on this matter.

I turn to an issue that, sadly, is not consistent across the UK. Overall, England spends 5.6 per cent of its healthcare budget on cancer, compared with 7.7 per cent in France and 9.6 per cent in Germany. Spending on cancer services has increased by an estimated 36 per cent over the past five financial years, but survival rates have not improved at the rate they should have done, given the increased investment. In January this year, research found that patients from deprived areas in England were more likely to have a late cancer diagnosis and be admitted to hospital as an emergency, as a study suggests. Women and older people also fare worse in getting a prompt diagnosis, as a study team from University College London found. Patients from deprived areas were also less likely to undergo key procedures for rectal, breast and lung cancer, despite the good news that there was a downward trend in the proportion of patients with breast cancer admitted as emergencies. In all, though, patients from deprived areas, older people and women are more likely to be admitted as emergencies.

We know, as has been mentioned, that good-quality palliative care, which helps the most seriously ill and terminally ill to make the most of the time they have left, can provide a period of quality of life for terminal cancer patients. A recent study found that patients who started, soon after their diagnosis, on palliative care along with usual cancer care lived nearly three months longer than people given only standard cancer care, even though this second group had more chemotherapy. I touched on my own experience in a recent debate in your Lordships’ House when my own late father had a very late diagnosis followed by an extremely poor standard of care. This seems to vary from hospital to hospital. Older people are also less likely to receive appropriate pain control than their younger counterparts. This is especially so for patients with dementia.

We need to focus not on the question of additional resources but on ensuring consistency across the country. Older people in particular should be given the same treatment as a young person.