Health: Cancer

Baroness Pitkeathley Excerpts

Thursday 11th November 2010 Lords Chamber

[Baroness Pitkeathley]

My Lords, I thank the noble Baroness, Lady Finlay, for securing the debate. No one is more fitted to lead such a debate, and it is a privilege to take part. It is a privilege, too, to speak in your Lordships’ House from personal experience. It is even more of a privilege that, thanks to the expertise and dedication of NHS staff at many levels, I am alive to participate, as I have twice recovered from cancer—although on the second occasion it was a very close run thing.

As well as to that expertise and dedication, my recoveries—in the plural—can be put down to two things: early diagnosis and proper follow-up care. On early diagnosis, I am delighted that I share the view of the noble Baroness and of Professor Mike Richards, the cancer tsar. He was recently quoted as saying:

“if you wanted to sufficiently change outcomes from cancer I would not spend £200 million on expensive cancer drugs; I would spend it on earlier diagnosis and involving GPs”.

That was certainly my experience.

The first time that I was found to have cancer was due to the vigilance of my GP, as I had virtually no presenting symptoms; he just had an uneasy feeling that something was wrong so he sent me to see a consultant. The second diagnosis was made no less than 14 years later as a result of the screening that I was still having, although, admittedly, only occasionally. On that occasion, another primary cancer was detected in another part of my colon. I was considerably more ill the second time and spent a long time in hospital, but the important thing was that all the cancer was removed. Although I was constantly back and forth between intensive care and the ward, there was excellent liaison among all parts of the system.

In this context, I want particularly to mention the work of patient emergency response teams, which are now often referred to as critical intensive care outreach. My team was based at the Middlesex Hospital—it now operates at UCH—and ensured the liaison between teams that is so important to patients. The period of transfer between intensive care and the ward is often difficult for patients. I commend those teams.

I have mentioned the elements that I believe led to my recovery and to the excellent health that I now enjoy because, like the noble Baroness, I fear that they may at this moment be under threat because of the spending programme that is being implemented. We keep hearing that the money for the NHS is ring fenced but, as a 0.1 per cent real-terms increase is nowhere near enough to keep pace with demand, I wonder how these services will continue. As the coalition has abandoned the one-week target for cancer test results, literally more people will die as a result of late diagnosis. That figure is currently estimated at 10,000 per year.

Much late diagnosis is due to patients not seeking treatment until it is too late, so I hope that the Minister can assure the House that the Government have no plans to scrap screening programmes or those promotional activities designed to ensure that people seek consultation. As a result of there being a possible hereditary element to the cancer that I had, my son and daughter also have regular colonoscopies. Will such services fall victim to the “must do more with less” mantra? Sadly, there are still too many people who find a possible diagnosis of cancer so frightening that they put off consulting a doctor until it is too late. I am sure that every one of your Lordships could name a friend who has ignored obvious symptoms such as weight loss, unexplained bleeding, coughs and so on. That is one reason why those of us who are fortunate enough to have recovered have an urgent responsibility to say so and to help remove the fear that gets in the way of seeking help.

I do not see how, in these hard financial times, we can possibly be thinking of spending £3 billion on an NHS reorganisation, which few seem to want, without it further affecting the services that are so vital to early diagnosis. Moreover, I fear that giving the bulk of the resources to GP consortia will run counter to the liaison between hospital and locally based services, which proved so helpful to me. GPs will have to decide whether treatments are necessary, affordable and the cheapest option, but the care will be in the hands of the hospital consultant. How is that likely to benefit the patient? At the very least, it seems to provide much opportunity for delay and little encouragement for the integrated services that cancer patients often need. We must be wary, too, about GP consortia becoming so overloaded with their commissioning functions that they cease to have as much interest as they should in promoting lifestyle changes, such as smoking clinics and exercise clubs, which are so important in the prevention of cancer.

I finish with a plea to remember the families and carers of those with cancer. They, too, need to be involved in the process and fully informed, as they will often provide the bulk of the care. I know that confidentiality of information is an issue, but that can usually be resolved. If families do not know, they cannot help. Cancer affects the whole family and we need to remember that.