Children’s Cancer Care: South-East

Debate between Christopher Chope and Ed Davey

Wednesday 13th March 2024 Westminster Hall

[Ed Davey (Kingston and Surbiton) (LD)]

I congratulate my hon. Friend the Member for Twickenham (Munira Wilson) on securing the debate. I should declare an interest of sorts, because my disabled son, John, has been treated at both these hospitals. A few years ago, he had a very successful operation at St George’s, and for most of the last two years he has been attending a weekly clinic at the Evelina. My wife and I are grateful to both hospitals; they are both excellent hospitals, and we regard them very highly. So the fact that I strongly believe that NHS England should choose St George’s is no reflection on the Evelina—not in the slightest.

I have approached this issue from the start by looking at the facts, talking to clinical experts and listening to both sides. I have also looked at the risks of each of the options, because that is what we really look at when we take big decisions: which is the least risky option to make sure we have the quality of services? I have looked at the facts and the evidence, and talked to clinical experts, and they suggest to me that St George’s is easily the less risky option for locating these specialist children’s cancer services—for my constituents and for people across south London, Surrey, Sussex and beyond.

I want to take everyone through some individual cancers and how risks lay for those. I will start with neurosurgery. Twenty-five per cent of children with cancer have a brain or spinal tumour, and many of those will need neurosurgery. St George’s currently delivers that; the Evelina does not. The Children’s Cancer and Leukaemia Group, which is the UK’s professional association for those involved in the treatment of children with cancers, said in response to the public consultation that if the Evelina was the option chosen, it

“would be the only Principal Treatment Centre in the UK where neurosurgery is not carried out on site”—

the only one—and that there is

“evidence that suggests that Principal Treatment Centres for childhood cancers should be co-located with neurosurgery.”

In other words, with respect to neurosurgery, the Evelina option is the most risky. The Evelina’s solution to that—to use King’s—defeats the purpose of uniting children’s cancer services.

Let us move to oncology surgery. Another 15% of children with cancer will have a neuroblastoma, renal tumour or germ cell tumour. Those children often require major surgery by a paediatric oncology surgeon to remove or reduce the tumour. That expertise is rare. There are around 20 such surgeons in the country, three of whom are at St George’s. The Evelina does not have that expertise at all and will need either to rely on surgeons from St George’s going to work at the Evelina or to build a new surgical team from scratch.

If St George’s surgeons were to travel to the Evelina to operate on children with cancer, there would remain the question of the wider, non-surgical expertise required to manage those children, including the specific anaesthetic skills. Furthermore, it would be much more challenging to manage post-operative complications. In other words, for oncology surgery, as for neurosurgery, the Evelina option is the most risky.

Let us go on to bone marrow transplants. Another 42% of children with cancer will have leukaemias, other blood cancers or lymphoma. For those children, bone marrow transplants and, increasingly, chimeric antigen receptor T-cell treatment, where a patient’s cells are modified to help fight cancer, are key treatments for any new primary treatment centres to be able to deliver. Those treatments are complex, high risk, heavily regulated and difficult to set up without experience. Indeed, the process to do that probably takes years, not months. St George’s has a bone marrow transplant programme for adults and is accredited to provide CAR-T for adults, so it is well placed to extend that offer to children. The Evelina partnership, including Guy’s and St Thomas’ Hospitals, does not currently have a bone marrow transplant programme and is not accredited to deliver CAR-T. Developing such a programme there and delivering it with the required quality, without the adult service, will cost much, much more and be much, much more challenging.

I could go on with other examples of specific cancer treatments for children, but I will end by focusing on some wider issues where, once again, it is clear that the Evelina option is just more risky. Which of the hospitals has the most experience with paediatric cancer? As my hon. Friend the Member for Twickenham said, St George’s has 25 years’ experience of caring for children with cancer. The Evelina does not have the experience of caring for children with cancer—nothing like the experience of St George’s.

On staff, where are the specialist cancer staff currently working, and what would they do if there was a change? There are 432 staff at St George’s who are involved in caring for children with cancer. They are from a wide range of specialities and professions. The vast majority of those staff and the expertise they have built up in caring for children with cancer over the years will not move to the Evelina if the primary treatment centre is moved there. Why? Because most spend only a proportion of their time caring for children with cancer and the majority of their time caring for children with other conditions. St George’s estimates that only four whole-time equivalents, out of 432 staff, would be likely to transfer under TUPE regulations. Not only would the skills be lost, therefore, but they would need to be redeveloped in another group of staff. At a time when the NHS is facing one of its most substantial staffing and skill shortages ever, is that really a risk that NHS England wants to run? That type of basic medical risk analysis points clearly to St George’s being the solution.

But let us look at the financial risk too. NHS England itself has assessed the St George’s proposal as involving lower capital costs—£13.5 million lower—representing better value for money and having a better revenue impact. By 2030-31, the St George’s option would be breaking even, whereas the Evelina option would be running a £2 million-a-year deficit. Even taking into account the charity funding envisaged for the Evelina option, it would cost the NHS £3.5 million more in capital funding than the St George’s option, and the charity funding could presumably be used elsewhere. If the PTC were moved to the Evelina, St George’s would lose the income but would not be able to lose the associated staff. The trust estimates that that would leave a £2.5 million financial gap to close in the first year. Given that NHS finances are under real strain, why take the capital and revenue risk of opting for the most expensive option?

I have listened to the counter-arguments brought forward by the Evelina, some experts and NHS England. A big focus of those arguments is on research into developing new treatments into the future, so let us look at that. Cellular treatments such as CAR-T are likely to be central to the future treatment of children’s cancer. St George’s is accredited and commissioned to provide CAR-T, whereas the Evelina is not. Research into using vaccines to treat cancer is at an early stage, but St George’s, University of London, co-located with St George’s, is an international leader in research into vaccines, infection studies and clinical trials, with the long-term potential for vaccine technology to be developed to support the treatment of cancer. The hon. Member for Carshalton and Wallington (Elliot Colburn) was right to point to the Institute of Cancer Research and the Royal Marsden being in close proximity to St George’s. Again, they are part of the research offer that only St George’s can provide.

To conclude, I think this is a no-brainer. I am staggered that anyone has any doubt about which is the right option. I listened to the hon. Member for Mole Valley (Sir Paul Beresford), and I take him very seriously. He is a great professional in dentistry—he offered my wife some treatment in a previous debate, and I was grateful for that. He is right that we are all looking in expectation to see what happens with tomorrow’s decision. However, having listened to the experts and spent a lot of time looking at the issue, I just do not think there is any doubt: yes, the Evelina is a fantastic children’s hospital, and my son goes there every week, but it is not an expert in cancer services or in children’s cancer services, which is the point of this decision. St George’s can offer those specialities and the expertise, and it can do it more cheaply and in a more accessible way. It is by far the less risky option. I am grateful to the Prime Minister for saying that I can meet the Health Secretary to discuss this issue, and I look forward to that. I hope that tomorrow, given the arguments set out in this debate and elsewhere, NHS England will decide for St George’s.

[Sir Christopher Chope (in the Chair)]

I let the right hon. Gentleman finish his speech, but I am told that there are now going to be two Divisions, which means the sitting is suspended for 25 minutes.

Oral Answers to Questions

Debate between Christopher Chope and Ed Davey

Thursday 18th December 2014 Commons Chamber

[Mr Davey]

I have to say that we have a very good record on energy-efficiency, as today’s announcement of 1 million energy-efficiency measures from the green deal and the ECO demonstrates. I do not know about the particular example in the hon. Gentleman’s constituency. I can tell him that because of some of the changes we made to the ECO this time last year, some energy- efficiency schemes have not gone ahead, but what has gone ahead is a £50 cut, on average, in people’s energy bills.

[Mr Christopher Chope (Christchurch) (Con)]

Does the Secretary of State think it is fair that at the public inquiry into the Navitus Bay offshore wind park, the applicants have in the middle of the inquiry put forward a separate and different application? It is now being considered alongside the original application, which has not been withdrawn. Is that not oppressive and a breach of the principles of the rule of law?

[Mr Davey]

I am surprised that my hon. Friend, who has great experience in the House, should ask a Minister to comment on a live planning inquiry.

Energy Bills

Debate between Christopher Chope and Ed Davey

Monday 2nd December 2013 Commons Chamber

[Mr Davey]

It was the last Labour Government’s Energy and Climate Change Secretary who said that

“alarming people about energy issues is not a mature way to conduct politics”—[Official Report, 13 January 2010; Vol. 503, c. 773.]

If only he had kept to his word. This coalition Government have taken energy bills seriously, unlike the previous Government. They killed competition, whereas we are increasing it. They did not take the measures that we are taking, and they should be ashamed of their appalling record.

[Mr Christopher Chope (Christchurch) (Con)]

Why has the Secretary of State not taken the simple and straightforward option of abolishing VAT on household energy bills? That would deliver greater benefits to householders and be far less complex.

[Mr Davey]

I think my hon. Friend knows that that would be illegal.

Annual Energy Statement

Debate between Christopher Chope and Ed Davey

Thursday 31st October 2013 Commons Chamber

[Mr Davey]

I agree with the right hon. Gentleman on transparency. That is what I announced in my statement and it is why Ofgem is publishing a consultation on greater financial transparency—so that the accounts of these big energy companies can be properly exposed and we can see from where the profits are made.

[Mr Christopher Chope (Christchurch) (Con)]

VAT on household energy bills is now yielding the Government about £500 million a year. Why do the Government not abolish VAT on household bills? If they say that they cannot because the European Union will not allow it, is that not another good reason for leaving the EU?

[Mr Davey]

I congratulate the hon. Gentleman on trying to bring Europe into this debate. I have to tell him that the European Union can help us bring down our energy bills. A proper single energy market in Europe, with better connections, would see prices go down.

Daylight Saving Bill

Debate between Christopher Chope and Ed Davey

Friday 20th January 2012 Commons Chamber

[Mr Chope]

If that is so, and I am sure it is, we are in danger of embarking on a course that will waste an enormous amount of public money and Government time. The Under-Secretary of State for Business, Innovation and Skills, the hon. Member for Kingston and Surbiton (Mr Davey), said in Committee that a trial involving advancing all the clocks in the UK by one hour would not proceed

“if there was clear opposition from any part of the country.”––[Official Report, Daylight Saving Public Bill Committee, 7 December 2011; c. 4.]

[The Parliamentary Under-Secretary of State for Business, Innovation and Skills (Mr Edward Davey)]

indicated assent.

[Mr Chope]

I see the Minister nodding in agreement.

--- Later in debate ---

[Mr Davey]

Thank you, Mr Deputy Speaker.

I should like to speak to the lead amendment in this group, amendment 59, which seeks to turn the Bill into a summer time extension Bill by changing the dates on which summer time ends. I think that the hon. Member for Christchurch realises that that would not be compatible with the EU directive on summer time arrangements, which has been in force for many years. The House might wish to reflect—

[Mr Chope]

Will the Minister give way?

[Mr Davey]

No.

The House might wish to reflect—

[Mr Chope]

On a point of order, Mr Deputy Speaker. Can you advise me whether it is in accordance with the traditions and courtesies of the House for the Minister to refuse to give way to the proposer of the amendment under discussion?

--- Later in debate ---

[Mr Davey]

The position that I have set out is the policy of the Government, irrespective of whether I am the Minister responsible. I said that time is a devolved matter in Northern Ireland but not in Scotland and Wales, which is why we have adopted this formula.

[Mr Chope]

Will the Minister give way?

[Mr Davey]

No.

The Bill also provides for the devolved Executives to be consulted about any proposals to increase the trial period, and their views will be fully taken into account. The power to lengthen the trial will be available from the date of the report, and if the report indicated that a longer trial was necessary, that power could be exercised to lengthen the trial before the devolved Executives gave their view on whether to have a trial. That means that they would know then about the trial’s expected length, so the amendment that suggests otherwise misses the point.

Asking for reports from the First Ministers, as proposed in amendment 38, is neither necessary nor appropriate. The Secretary of State will monitor the effects of the order for the whole country, and is the person best placed to do so, but the First Ministers would, of course, be welcome to submit anything that they might wish for the Secretary of State to consider. It would not be appropriate for the House, through this Bill, to require any report from the First Ministers or to impose any costs on them. After all, they are devolved Administrations.

Canterbury City Council Bill

Debate between Christopher Chope and Ed Davey

Monday 5th July 2010 Commons Chamber

[Mr Chope]

My hon. Friend will recall that there was quite a lively debate in the previous Parliament about the interaction of the services directive and the provisions of the Bills. In the end, it was resolved by the then Minister saying that, as far as he was concerned, the legislation would not make any difference and that pedlars would still be able to carry on their pedlary irrespective of the interaction with the services directive. However, my hon. Friend is right to suggest that the matter might not be quite so clear cut.

[The Parliamentary Under-Secretary of State for Business, Innovation and Skills (Mr Edward Davey)]

There might well be an issue relating to the services directive that we need to take into account, and I will say a little more about that in my speech. European legislation is actually ahead of the game in this regard, in that it encourages this House to protect ancient rights and ensures that we legislate properly and thoughtfully.

[Mr Chope]

I am most grateful to the Minister for that intervention. I shall not refer back to exactly what was said in that previous debate, but what he says is a revelation. He is obviously in charge of what is happening in his Department in relation to European legislation, and I look forward to hearing more from him later about the interaction between the Bills and the services directive.

Mr Deputy Speaker, you above all others will know that the issue before us is quite a narrow one. It is a question of whether these two Bills should be revived.

--- Later in debate ---

[Mr Davey]

In a former life, you would have enjoyed such an intervention, Mr Speaker, as you were renowned for your erudition. I represent the royal and ancient borough of Kingston-upon-Thames. In a revived marketplace, we enjoy not just farmers markets but a German market; Italian and Spanish traders also come. One of the many advantages of such activity is that it can create a vibrancy in our marketplaces. It is important that local authorities consider my next point, which I wish to emphasise. The fact that additional traders come to sell their goods and services can help the traders already there. If those additional traders improve the vibrancy and vitality of a town centre, it becomes more attractive to shoppers and visitors. It is not at all a zero-sum game.

[Mr Chope]

Will the Minister sum up the interaction of clause 4 in the two Bills—provisions on street trading and services—and the services directive? Are the clauses made redundant by the directive?

[Mr Davey]

We will give some detail on that when we publish our consultation. I do not wish to prejudge the final analysis, but I say simply that we know that we need carefully to consider the services directive, and I believe we can respond without undermining the centuries-long tradition of pedlary. I hope that that gives the hon. Gentleman the reassurance he needs.

City of Westminster Bill [Lords]

Debate between Christopher Chope and Ed Davey

Monday 5th July 2010 Commons Chamber

[Mr Davey]

I think my hon. Friend is trying to tempt me to pre-judge the response to the consultation. Tempting though that is, I am afraid that I am not going to accede to the request for an absolutely straight answer—save to say that if the rights of genuine pedlars were embedded in a future national framework, whatever form it took, local authority legislation could well be superseded. When we respond to the consultation and look at future legislation, we will consult local authorities and try to ensure that any legislation is flexible enough to take account of the special concerns of any particular local authorities.

Given the real spirit of coalition behind our exchanges, I would like to answer a particular point raised by my hon. Friend the Member for Wellingborough (Mr Bone). He made an important point about examples of false pedlars being involved in the trafficking of children. I am sure that the whole House will be alarmed to read those reports and will want to know that action can be taken. I am sure that my hon. Friend is well aware that it is not for this legislation or any legislation that might come from it—whether it be a national framework or future private Bills—to tackle that issue. It is a matter for the Home Office, but I can give my hon. Friend an assurance that I will write to Home Office Ministers to bring their attention to this very important matter. At this point, it is right to pay tribute to the former Member for Totnes, Anthony Steen, who I believe retired at the last election, as he campaigned so brilliantly for the rights of women who had been trafficked to this country. It is right for this House and this Government to ensure that we take action on trafficked women. It is not an issue for my Department, but I hope and believe that this Government will want to look at the problem.

[Mr Chope]

May I say how much I appreciate the fact that the Minister is going to respond to this consultation within two or three months? When we last debated one of these Bills, I think he said that waiting for the framework might be like waiting for Godot. What he has said tonight suggests that he has taken it on himself to push this matter forward, on which I congratulate him.

[Mr Davey]

I am obviously grateful for any congratulations. I hope that I will not be too Beckett-like in my approach to this matter. I do want to make it clear, however, that we are not promising early legislation in this area, as I would need to speak to my right hon. Friend the Leader of the House about that. If I gave an unduly certain commitment, I am sure I would be called to order, but that is not to say that we do not think there is room to progress action in this area—I shall return to this in my later remarks—as there are other reasons for us to look at this with the degree of gravity that it requires.

The debate has shown the cross-party consensus on the legislation and what the Government need to do in due course to relieve the burdens on local authorities in tackling the issue, to ensure that the rights of pedlars are respected, and to ensure that we crack down on those who are trading illegally on our streets and genuinely causing problems. That is promising for debates to come, and I hope that we make progress with the Bill tonight.