Childhood Cancers

Brian Binley Excerpts

Wednesday 25th February 2015 Commons Chamber

[Nicola Blackwood]

The hon. Gentleman is absolutely right to say that this is about not just Government funding but the way in which funds are given, and charities in particular play an important part. The fundraising that they do through individuals is vital.

As I was saying, 700 children and young people are diagnosed with a brain tumour every year, and that makes it the most common form of cancer affecting children and young people. It is also the most lethal. Brain tumours kill more children and young people than any other cancer—around 160 children a year—but despite being responsible for more than a third of childhood cancer deaths, brain tumours receive only 6% of childhood cancer funding. That funding matters because children’s cancers are biologically very different from adult cancers and treating them effectively requires specifically tailored research and targeted treatment regimes. At the moment, only about 50% of childhood cancers are part of a clinical trial; the remainder are treated using standard treatment guidelines. As Sally and Andrew Hall discovered, that can have serious consequences.

Cancer treatment is harsh at the best of times, and recent studies show that while many survivors of children’s cancers go on to live healthy lives, others face long-term disability and reduced immunity. Radiotherapy, the gold standard in terms of its efficacy in treating cancer, can also have damaging long-term consequences for the developing child. This is particularly true of childhood brain tumour survivors, 60% of whom are left with a life-altering disability. In a few cases, the side effects can be so severe as to be fatal. That is what happened in Skye’s case.

The Milan protocol, under which Skye was treated, was a standard treatment guideline, because as with about 50% of other childhood cancers there is no clinical trial available. It has become clear that there is currently no formal infrastructure in place to collect, record and share data, particularly on adverse effects of treatment, about standard treatment guidelines. I understand that before 2008 the responsibility for collecting and sharing data for clinical trials and for standard treatments fell under the remit of the Children’s Cancer and Leukaemia Group. Subsequently, clinical trials monitoring was tightened, and the CCLG’s “Guide to Clinical Trials” states:

“Clinical trials are very closely monitored by a number of different individuals and organisations. This will include the Chief Investigator…the working group…and relevant staff within the clinical trials unit. An Independent Data Monitoring Committee may also be established to oversee the conduct of the trial. At a national level, there will be an ethics committee and the national regulatory body. If there are any concerns about the conduct of the trial or the results, a trial may be stopped early.”

By contrast, in a letter responding to my concerns about the issue, the National Cancer Intelligence Network, told me that

“all of us in the field accept that (adverse effects in Standard Treatments) is something that should, under ideal circumstances, be a part of the data that we routinely collect. Such data are, however very much more difficult to collect than might be imagined and adverse effects were never part of what the CCRG (Childhood Cancer Research Group) or the CCLG themselves collected outside of a clinical trial. There are no nationally agreed datasets relating to adverse effects and few clinicians systematically collect and collate data of this sort...but it is clearly something that we in the NCIN should be considering.”

I am grateful that the NCIN has recognised that these data should be collected and collated, but I do not think that considering doing it is a sufficiently robust or urgent response to the problem, given the gravity of the consequences if a standard treatment goes wrong.

Clearly, in an ideal world all childhood cancers would be the subject of a full clinical trial and new targeted therapies being developed to reduce the long-term risks, but all of us know the challenges associated with research into childhood cancers, where cohorts of rarer cancers can be incredibly small and the ethical issues are more complex, making recruiting participants more difficult. Obviously, I am going to urge the Government to do whatever they can to fund and encourage more research into childhood cancers. I am going to ask the Minister to consider whether having only 6% of childhood cancer funding going to the biggest killer in childhood cancer represents getting the balance right, and I am going to ask her to maintain investment in the Health Research Authority programme to streamline the regulation and governance processes for clinical research in the NHS.

[Mr Brian Binley (Northampton South) (Con)]

May I say that, as a cancer sufferer, I welcome my hon. Friend’s courage in bringing this debate? May I pay tribute and offer my sorrow to these parents? May I also say that our Front-Bench team need to take on board the problems? I have seen parents, week in, week out in Northampton general hospital, and I know the case she is making is a real and heartfelt one. I hope that we will get good words from the Minister.

Mid Staffordshire NHS Foundation Trust

Brian Binley Excerpts

Tuesday 19th November 2013 Commons Chamber

[Mr Hunt]

The hon. Gentleman is right that reporting back about complaints to board level is a fundamental thing that should happen at every trust. We also need to make sure that all trusts are putting patients first; they will not be able to get a good inspection result from the chief inspector of hospitals unless they do so. The hon. Gentleman will know that the new structure of foundation trusts is designed to make sure that FTs are run for the benefit of their patients by the large number of members who are effectively the governing body of FTs. The hon. Gentleman is also right to say that this is not happening everywhere, and that is why today’s changes will, I hope, make a big difference.

[Mr Brian Binley (Northampton South) (Con)]

My A and E department has seen a massive 30% increase in patient throughput in recent years and a concerning 16% in recent months. Furthermore, 100 people who do not need medical care are taking up beds. I have recently organised meetings between local government leaders and the chief executive officers of our hospitals to explore other ways of dealing with these problems. Will the Secretary of State accept that more can be done in this respect, and will he tell us what he can do to further that approach?

[Mr Hunt]

My hon. Friend is absolutely right to focus on those pressures. We have been thinking about this very hard. Over the summer we announced £250 million to be distributed to the 53 A and E economies where the most difficulty is being experienced in meeting high standards for the public, and we are doing more. We are talking to the College of Emergency Medicine. Anything that my hon. Friend can do at a local level will be greatly appreciated. This is going to be a difficult winter and we need to stand full square behind our front-line staff.

Changes to Health Services in London

Brian Binley Excerpts

Wednesday 30th October 2013 Commons Chamber

[Mr Hunt]

I think the best reassurance I can give the hon. Gentleman is that, unlike when the Labour party was in power, the Secretary of State does not sit behind his desk planning reconfigurations in every part of the country. This is a locally driven process. We have put in place safeguards to ensure that, where there is a reconfiguration proposal from a local NHS, it meets certain criteria. It has to be supported by local GPs and there has to be proper engagement with the public. If his constituents are worried, I hope they will take heart from the thoroughness of the process that has happened today. It is the right process and a good process, and it will lead to better outcomes for the people involved.

[Mr Brian Binley (Northampton South) (Con)]

My own general hospital, in keeping with many throughout the country, has come in for unfair criticism owing to the increasing pressures exerted on its A and E department. What does the Secretary of State think has caused those pressures, and will he reassure my constituents by telling us what he is doing to help relieve A and E departments?

[Mr Hunt]

My hon. Friend is right to draw attention to the pressures. I am sure that most A and E departments, including his own one in Northampton, would say that the biggest single cause has been the increase in the frail elderly population and the inadequacy of the care those people receive outside hospital. We are trying to put that right by having named, accountable GPs responsible for out-of-hospital care, reversing the historic mistake made in 2004, when that personal link between GP and patient was abolished.

Managing Risk in the NHS

Brian Binley Excerpts

Wednesday 17th July 2013 Commons Chamber

[Andy Burnham]

I am glad that the Secretary of State nods. Does that not make the case, however, for a duty of candour on individuals, which would have allowed staff to say to management, “No, I’m going to speak to the Keogh review and I won’t face action afterwards because it is my duty to do so”?

[Mr Brian Binley (Northampton South) (Con)]

It is generally accepted that there were some serious management breakdowns. The Secretary of State at the time was the chief executive of the organisation. In my business, I would want to know what was happening. Does the right hon. Gentleman accept that he should have known what was happening?

[Andy Burnham]

I always took action when anything was brought to me. When mortality data on Basildon hospital were published, I immediately ordered an in-depth review of all hospitals in England, which led to warnings on five of the trusts on the Keogh list. Those warnings were inherited by the hon. Gentleman’s Government, but Ministers allowed those trusts to carry on cutting staff, and the same was true for the hospital in the constituency of my hon. Friend the Member for Denton and Reddish (Andrew Gwynne), even though it was subject to a warning about patient care. I think that Government Members have to look at themselves before making claims.

On the duty of candour, the final recommendation that we need to see progress on relates to the regulation of health care assistants, which is long overdue. If the Secretary of State took these three sensible measures, he would provide support to staff and reassurance to the public, but they are not in themselves the answer to the structural challenge the NHS faces. That brings me to my final point on the longer-term solution. I have thought long and hard about what happened at Stafford hospital and why we hear recurrent echoes of the same elsewhere in the NHS, with older people lost on acute hospital wards, disorientated and dehydrated. I believe that the problem goes far deeper than any regulatory solution. Governments of all colours have underinvested in social care over many years, and in the end we get what we pay for: a malnourished, minimum wage system that dishes out care in 15-minute slots, which is barely time to make a cup of tea, let alone exchange a meaningful word.

Looking after someone else’s parents should be the highest calling that any young person can answer. However, if we are honest with ourselves, the effect of decisions taken here in this House over many years means that the signal we are currently sending is that it is the lowest calling that a young person can answer. Some 307,000 care staff in England—20% of the work force—are on zero-hours contracts. That is an appalling figure. This situation cannot carry on. Good care cannot be provided on a zero-hours, here-today-gone-tomorrow basis.

The collapse of decent social care in England means that too many elderly people are drifting unnecessarily towards hospital. Our hospitals are becoming increasingly full of very frail, very elderly people, and that is not sustainable in either human or financial terms. That is why I have proposed—