Community Pharmacies: Devon and the South-west
Clive Betts Excerpts(5 days, 2 hours ago)
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Adam Dance (Yeovil) (LD)
I congratulate you on securing this vital debate. In my constituency of Yeovil, pharmacies provide vital services, including more than 6,700 prescriptions per month—not quite as many as in your constituency, Rachel.
Adam Dance
Sorry, Mr Betts. Since the launch of the Pharmacy First service this year, it is estimated that pharmacies in Yeovil have saved at least 556 GP appointments. However, a lack of investment and the rise in national insurance contributions threaten the amazing work done by pharmacies in Yeovil and across the country. I understand from the response I received to a parliamentary question—
Mr Clive Betts (in the Chair)
Order. Interventions should be brief and to the point for hon. Members to respond to. They should not be another speech.
Adam Dance
Will my hon. Friend join me in urging the Minister to provide a clear timeline for the consultation to start?
Several hon. Members rose—
Mr Clive Betts (in the Chair)
Order. Given the number of Back Benchers who wish to speak, you will probably have to keep to less than five minutes each. Also, at some point we may have to suspend the sitting for 45 minutes to vote, so please do not speak unless you are prepared to come back when the debate resumes.
Several hon. Members rose—
Mr Clive Betts (in the Chair)
Order. I am going to have to squeeze speeches down to no more than four minutes.
Richard Foord
I think the hon. Gentleman has come up with an absolutely brilliant idea. Community hospitals are potentially hubs where pharmacies might sit in the future. I pay tribute to my hon. Friend the Member for Tiverton and Minehead (Rachel Gilmour) for securing this debate; she has done a great thing by doing so.
Mr Clive Betts (in the Chair)
We now move on to the Front Benchers. The two Opposition spokespeople have no more than five minutes, and then the Minister will probably have about 10 minutes left.
National Insurance Contributions: Healthcare
Clive Betts Excerpts(1 month, 1 week ago)
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Karin Smyth
As I have said, we have made a commitment to general practice and primary care by releasing extra GPs into the system. We recognise the situation in which GPs find themselves. I know this because I worked with GP practices in my previous career. We need those practices to be the foundation of our neighbourhood services, which is why we will talk in the normal process about the allocations over the next few months as part of the contract.
Mr Clive Betts (Sheffield South East) (Lab)
If we are to reform the NHS, we need to move resources over time into primary care. The reality is that GPs see at first instance 90% of patients, but receive only 8% of NHS funding. Will my hon. Friend ensure that, in the settlement that is agreed with NHS providers, particular attention is given to supporting GPs?
On the social care sector, when we help the hospices and social care providers, which are charities and small organisations in particular, can perhaps do so without subsidising some of the hedge funds that are now investing heavily in social care? We do not want to add to their profits while supporting the small charities involved.
Karin Smyth
My hon. Friend has led fantastic work in previous Parliaments on the health and social care system, which he understands very well. He makes an excellent point about ensuring that additional funding goes where we want it to, which is towards supporting our constituents, particularly with social care. We have all seen the situation over the last decade over so. Improving that is critical to the urgent and emergency care system, and to the dignity of those people who need the service. We will continue to talk to them, and to local systems, about the impact of any changes.
Cancer Strategy for England
Clive Betts Excerpts(1 month, 3 weeks ago)
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Ian Sollom (St Neots and Mid Cambridgeshire) (LD)
I thank my hon. Friend for securing this debate. The statistics he has shared are truly shocking. I want to draw attention to the five-year survival rate for pancreatic cancer, which several of my constituents have raised with me. They have heartbreaking stories of losing loved ones from a position of diagnosis at stage 4. Does my hon. Friend agree that those statistics highlight the need for a cancer strategy in the UK in order to up early diagnoses and drive forward research?
Mr Clive Betts (in the Chair)
Order. I remind Members that interventions are supposed to be brief and to the point, not a substitute for a speech.
Clive Jones
I absolutely agree with my hon. Friend. This is why we need a national cancer strategy. So many cancers do not get the resources they need. Everything is a bit too general; a lot of cancers need the focused, targeted resources that will lead to better outcomes.
Mr Clive Betts (in the Chair)
Order. I count seven Members who would like to speak, so that gives us about a six-minute maximum for contributions. I am not imposing a rigid time limit, but that is an indication of how long you should try to speak for.
Sir Roger Gale (Herne Bay and Sandwich) (Con)
I do not want to go down the road of party politics. The previous Government poured shedloads of money into the national health service, but throwing money at the problem is not the answer. I am not saying that there is not any demand for more capital expenditure—there is—but that is not the point. Unless we get the structure right, we will go on wasting more and more money. We need to be grown up about this; we must all understand that.
In the few minutes I have, I want to concentrate on an issue that the hon. Member for Wokingham (Clive Jones) touched on, but only briefly: the incidence of cancer in young people. It is many years since my eldest son used his wedding—and probably his bride too—to raise money for the Teenage Cancer Trust. In the time between then and now, sadly not a very great deal has changed. That is lamentable. The point was made that, every day, seven young people between their teenage years and their mid-20s are diagnosed with cancer. By the end of this decade, that figure is likely to have risen to 10 per day.
Most of us in the Chamber probably have family members who have had experience of cancer—or even have personal experience, as the hon. Member for Wokingham clearly has. We all know somebody who has had cancer, and sadly some of us know, only too well, people who have died of cancer. But the instances of cancer among young people are widely disregarded and neglected within the health service and beyond. It is not infrequent for a young person, subsequently diagnosed, to have to make at least three visits to a general practitioner before even being referred, because it is assumed, completely wrongly, that cancer is something that affects old people—people like me. I am expected to get cancer, but young people do not get it, do they? Well, sadly, yes they do, at a rate of seven a day, rising to 10 a day by the end of the decade.
My plea is for the Minister to take away this message: however much money is being pumped into the health service and being made available for investment in diagnostic kit, there is a real need to address one area of the population that has been neglected. That area is teenage cancer victims. It is the largest single killer of young people in this country—bar none—yet young people are overlooked when it comes to clinical trials that could be lifesaving. There is a real reason why young people as a proportion of the population should be included in clinical trials, but they are not—they are overlooked. Why? Because there is the assumption that it is not a disease that affects young people. But it does.
I make my plea on behalf of those in my family who support the Teenage Cancer Trust, and those in the Teenage Cancer Trust who have taken the trouble to brief Members of Parliament. I ram home this message to the Minister and ask him to take it away to the Secretary of State: when we set up, as I am sure we will, a national cancer strategy, the Government must make certain that the 13-to-25 age group is given the recognition it deserves, so that they get the diagnoses in time, before they die, and the treatment they need, and so they are included in clinical trials.
Noah Law (St Austell and Newquay) (Lab)
Thank you, Mr Betts, but I will not make a speech.
Tessa Munt (Wells and Mendip Hills) (LD)
I thank my colleague, my hon. Friend the Member for Wokingham (Clive Jones), for calling this timely and critical debate. It is good to see the Minister for Care in his place. I would like to mark the passing of many friends and some of my family who have lost their lives in a battle with cancer—a dreadful disease.
When I arrived here in 2010, my team and I started a five-year project tracking the use of radiotherapy in England, using freedom of information requests every six months to gather data on the availability and frequency of the use of stereotactic ablative radiotherapy in England’s then 51 cancer centres. It was not a pretty picture.
It is a pleasure to return to the subject of radiotherapy, about which many of my constituents in Wells and Mendip Hills care deeply, as do I. I recall that the hon. Member for Easington (Grahame Morris) and I had common cause. He represented a constituency in the north-east and I one in the south-west of England, the two areas with the greatest incidence of cancer per head of population. I hope and trust that every one of us is persuaded that when confronted with a serious problem or challenge, the odds of successfully tackling it are immeasurably improved if one has a plan. Without a plan, there is a serious risk of misguided or confused action. Benjamin Franklin, one of America’s founding fathers, reportedly said, “If you fail to plan, you plan to fail.” That phrase is as relevant now as when he said it nearly 300 years ago.
In England we are in a battle royale against this deadly disease of cancer, which will directly affect one in two of us and indirectly affect almost every one of us through our connections to friends or family. The evidence is absolutely clear: countries with a dedicated cancer control plan show a better overall five-year cancer survival rate. That is not anecdotal; it is the clear result of an international cancer benchmarking partnership study published in The Lancet Oncology.
A report in The Lancet Oncology by 12 leading cancer experts published a blueprint for a national cancer plan. Those experts were from Imperial College London, #CatchUpWithCancer and Radiotherapy UK, the Faculty of Public Health and Policy at the London School of Hygiene and Tropical Medicine, and the Institute of Cancer Policy at King’s College London. Their blueprint consolidates four reports published separately in The Lancet Oncology over two years, clearly outlining the necessary steps—a plan—to improve cancer outcomes.
The need for a plan is urgent. We had a 10-year one, which ran out in 2022. The then Health Secretary promised a new one. There was a five-month consultation, and then the next Secretary of State binned the whole idea. We are in a dire situation on the cancer front. Cancer mortality in this country is among the highest in the OECD. The key 62-day target to start treatment has not been met in England since 2015. When we consider that international research shows that a four-week delay in cancer treatment can increase the risk of death by 10%, this failure to meet that 62-day target has potentially fatal consequences.
If the Government are in any doubt about the consensus across the cancer care community on the need to get back to having a dedicated cancer plan, they need make only a cursory scan of all the charities and other stakeholders. Almost without exception, every organisation of any standing is in favour of getting a cancer plan and getting it fast. As is widely known, there are several main cancer cure pathways: surgery, chemotherapy and radiotherapy. Any cancer plan would obviously need to include all these pathways, but I would like to say a few words about radiotherapy in the context of any such cancer plan.
For clarity, I am talking about radiotherapy, not radiography. Radiography is vital. It is the use of techniques to scan an image to detect potential issues such as cancer. Radiotherapy is the use of high-energy radiation to kill cancer cells. If anyone is perplexed by my need to clarify that, they may understand when I say that some former Secretaries of State for Health and Social Care have been heard to confuse the two. I am confident that this Minister and the current Secretary of State will not suffer a similar confusion.
Radiotherapy offers technologically-advanced, cost-effective, personalised and precise solutions to treat more patients more quickly, more accurately and better. We have about 270 radiotherapy machines in England. Of those, 70 will pass their 10-year recommended life this year, and replacing them would cost £150 million. The Minister will know that this will be money well spent, as it takes people off the waiting lists and straight into treatment and gives them a life chance that is longer, and many will return to work, just like my hon. Friend the Member for Wokingham.
Until recently, radiotherapy has been overlooked in both priority and investment, so I would like to pay testament to the impressive work of Professor Pat Price of Radiotherapy UK, the charity she founded and still leads. I also thank the Secretary of State for Health and Social Care for agreeing to meet Professor Price, representatives of Radiotherapy UK and me, so that we can all do what we can to help. I am sure that the Minister for Care will also be involved in that conversation. Professor Price’s relentless campaigning is putting radio- therapy back at the heart of the political debate. This was reflected in the recent Budget announcement of £70 million for new radiotherapy machines. That money is not enough, but it is a really positive start.
The recent Radiotherapy UK productivity report shows that smart investment in the sector could create 87,000 new cancer appointments, and the need for a new national cancer plan including measures to boost radiotherapy is clear. Only 27% of cancer patients in the UK can access the radiotherapy that they need, compared with the international recommendation of 52% to 53%. In total, 7.4 million people in the UK live in radiotherapy cancer treatment deserts. Lord Darzi’s independent review of the NHS revealed that more than 30% of patients are waiting too long for their radio- therapy cancer treatment.
Radiotherapy cannot be used on all cancers, but where it is appropriate a typical radiotherapy cancer cure can cost as little as £3,000 to £5,000, which is dramatically less than chemotherapy. The case for a national cancer plan is well made. I urge the Minister to bring the experts in and to produce such a plan.
Mr Clive Betts (in the Chair)
I thank all hon. Members for adhering to the time guidance; that is really helpful. We now move on to the Front-Bench speakers, who will have 10 minutes each—
Max Wilkinson (Cheltenham) (LD)
It is an honour to serve under your chairmanship, Mr Betts, and I will be as brief as I possibly can be. I thank my hon. Friend the Member for Wokingham (Clive Jones) for securing this important debate.
Two days ago, it would have been my father’s 64th birthday, but sadly he died of lymphoma in 2018 aged just 57. Recently my family marked 18 months since my wife was given the all-clear after ovarian cancer. It is thanks to the skill of a highly-qualified surgeon, who removed an absolutely huge lump from her body, that she is with us today and I am very grateful to them every single day.
Much has been said about the need for a national cancer strategy. I will offer the Minister one local opportunity, and it is an opportunity because the previous Government, despite taking some political credit for it in Cheltenham, failed to offer very much money to the Big Space Cancer Appeal to revamp Cheltenham general hospital’s oncology centre. As a regional cancer centre, Gloucestershire hospitals NHS foundation trust treats thousands of patients each year, but many of its buildings are now at end of life, many of the rooms have no natural light, and the outdated design is unsuitable for the number of patients in need of treatment.
We know that identifying cancer early and beginning treatment soon afterwards is key to giving people the best chance of survival. The staff at the trust work very hard but they are working under huge pressure and it is no secret that, as others have mentioned, targets are routinely missed. Our local trust is not alone in that. Many staff in the trust feel that the current space is not fit for purpose, and that certainly will not help their best efforts. That is why the trust has launched the Big Space Cancer Appeal. That situation is representative of the challenge we face in not having a strategy for dealing with cancer. The last Government gave almost no money for the project, and the £17.5 million that is being raised in Cheltenham is almost the entire capital cost of the project.
The new centre will offer patients a modern space and a better environment for treatment, healing and recovery. It will have modern consulting rooms, allowing more patients to be treated every day. That will help to cut down waiting times, so that targets can be hit and patients get better outcomes. For some people, this will mean the difference between life and death.
You asked me to be brief, Mr Betts, so I will draw my remarks to a close by thanking Dr Sam Guglani, Dr Charles Candish and all the staff at the trust’s charity—the initiative is charity-led but backed by the trust, which does not itself have the funding to deliver it. I also thank Dr Diane Savory, who has been working extremely hard on the project.
If the Government are looking for opportunities to invest in cancer care—we have already heard about some of the consequences of not doing so in my area from my hon. Friend the Member for Thornbury and Yate (Claire Young)—I urge them to get in touch, because there is a real opportunity with this project to make a huge difference on the ground.
Mr Clive Betts (in the Chair)
We move on now to the Front Bencher. If they could just leave a minute at the end of the debate for the hon. Member for Wokingham to respond to the debate, that would be really helpful.
Mr Paul Kohler (Wimbledon) (LD)
It is a pleasure to serve under your chairmanship, Mr Betts. I thank my hon. Friend the Member for Wokingham (Clive Jones) for securing this important debate.
As so many have said, and as Lord Darzi has confirmed, our NHS is in crisis. Spiralling waiting lists, crumbling infrastructure and demotivated staff are symptoms of the mismanagement that was all too common under the previous Government. The current state of cancer diagnosis and treatment is a testament to their failure: a lack of vision and of strategic thinking has let patients and families down. Under NHS guidelines, 85% of cancer patients are expected to wait no longer than 62 days between referral and the start of treatment, but last year the figure was less than 65% and this year is shaping up to be even worse. On current trends, in excess of 100,000 patients are failing to begin treatment within that timeframe. That is simply not good enough.
The UK is a global hub for life sciences research, yet we lag behind many countries without that expertise when it comes to applying the very research that we have often pioneered. Cancer research is a top priority for the UK, but we must aim to lead the world in outcomes too. As the Health and Social Care Committee made clear earlier this year, that requires
“a long-term strategy…which has innovation at its core.”
We need a more integrated, forward-looking approach to cancer that ensures that research, policy and delivery pull in the same direction, not opposite directions. The current system is much too fragmented.
In my constituency of Wimbledon, there are concerns around breast cancer, for which early diagnosis and treatment is critical. Across Merton, the London borough within which most of my constituency lies, breast cancer screening rates are significantly below both NHS targets and the national average. In 2022, less than 57% attended a screening when invited, which is significantly lower than the 70% national standard required to make screening truly effective. Behind those statistics are lives and families. When breast cancer is diagnosed and treated at stage 1, survival rates are close to 100%, but lower uptake of screening inevitably leads to later diagnosis and a commensurate decline in survival rates. That is why my council colleagues and I have been campaigning for NHS England to provide a breast cancer screening site in Wimbledon, which lacks the screening infrastructure necessary to meet national screening targets.
At a recent Radiotherapy4Life session in Parliament, I heard similar concerns about the lack of investment across England in radiotherapy. Only half of those who could benefit from radiotherapy are accessing it, because—in the words of the medics I spoke to—this country lacks a cancer strategy. The entire set-up is far too fragmented. To take one depressing example, even though integrated care boards are responsible for radio- therapy, some 30% of them, when subjected to a freedom of information inquiry, did not even know that.
In contrast, when the cancer referral system works well, the approach is transformational. Two weeks ago, in the wake of an elevated prostate-specific antigen level, I was put on a two-week cancer pathway; two days ago, I had an MRI and received a clean bill of health. It took just 10 days to give me peace of mind. Not everyone will be so fortunate, but everyone deserves that alacrity. A more integrated approach to cancer will speed up diagnosis and treatment and improve cancer outcomes. Consequently, I echo my colleagues’ calls for the Government to introduce a cancer strategy.
Dr Ben Spencer (Runnymede and Weybridge) (Con)
It is a pleasure to serve under your chairmanship, Mr Betts. I thank the hon. Member for Wokingham (Clive Jones) for securing this important debate on what is clearly a difficult subject, given how much cancer affects people: as several hon. Members have said, it affects all of us, not just those who are directly affected. I listened carefully to the powerful speeches that he and the hon. Member for Cheltenham (Max Wilkinson) made about the direct impact that they have experienced.
I pay tribute to all the people who work in our NHS, the charity sector, the research sector and all parts of our community that are active in prevention and in supporting, treating and helping people through the journey with cancer. My speech cannot cover every cancer in the limited time I have, but I will focus on the major cancers, so to speak, in terms of prevalence and mortality rates. That is not to diminish the importance of the range of cancers: it is critical that we focus on rare cancers as well as the major ones.
I thank the hon. Member for Wokingham again for his speech and for sharing his personal experience. He did not mention the fact that he has raised more than £800,000 for cancer charities in his work following his diagnosis. It is important that we pay tribute to him for bringing forward this debate.
I was deeply concerned by the story told by the hon. Member for Thornbury and Yate (Claire Young) about the impact on her constituent of the cessation of their treatment as a result of financial measures. I hope that the Minister can meet her or take up the case; I would be interested to hear how that decision was taken. I hope that the family and the individual affected are doing okay with their treatment. My right hon. Friend the Member for Herne Bay and Sandwich (Sir Roger Gale) made important points, to which I will return later, about childhood and teenage cancer.
I was pleased that the hon. Member for Woking (Mr Forster), my constituency neighbour, raised the impact on his constituents in terms of seeking direct cancer care. As he knows, both of our constituencies are served by Ashford for broader cancer support. I would welcome the chance to meet him to discuss how we can help our constituents, particularly with journey times to access cancer care locally.
It is important to focus on data, so I will refer to data from the NHS and from Cancer Research UK. I have a series of questions for the Minister; I know that a lot may not be in his portfolio, but if he cannot answer today I will be grateful for a written response.
Fundamentally, the things that the state can do about cancer strategies break down into prevention, diagnosis, care and treatment, and research. All the major cancers have modifiable risk factors. Of the 44,000 bowel cancer cases a year, 54% are deemed to be preventable, with 11% linked to obesity, 28% linked to diet and fibre, 13% linked to processed meat and 5% linked to physical activity. Breast cancer is the most common cancer in the UK: of the 56,800 cases a year, about 8% are believed to be linked to or caused by obesity. Lung cancer is the third most common cancer: of the approximately 50,000 cases a year, about 80% are preventable and 72% are linked directly to smoking.
Overall, tobacco is the largest preventable cause of cancer. Some 50,000 cancer cases per year are attributable to smoking. In the last Parliament, we introduced the Tobacco and Vapes Bill because we recognised the importance of reducing smoking. Can the Minister tell me when his Government plan to reintroduce that Bill, so that we can start to see its health benefits? Obesity is the UK’s second biggest cause of cancer, after smoking. It is believed to cause about one in 20 cases: 20,000 cases of cancer per year are attributable to obesity. We brought forward an obesity strategy. Will the Minister review it and bring forward an obesity strategy in this Parliament?
On screening and treatment, while cancer outcomes continue to improve in comparison with the OECD, it is worth looking at the data in the Darzi report. One of the most interesting slides shows that over the past 14 years, we have improved relative to the gradient of cancer outcomes, but we started at a very low point. There are lots of questions to be asked about why we started at such a low point back in 2004. The NHS is still recovering from the disruption to cancer care caused by the covid pandemic, but thanks to the hard work of NHS staff, waits of more than 62 days declined between September 2022 and August 2024. Obviously there is still more work to be done.
Community diagnostic centres and surgical hubs made a difference. They were backed by a £2.3 billion investment, the largest cash investment in MRI and CT scanning in the history of the NHS; those scans, tests and checks are now being delivered in 170 CDC sites. As the independent Health Foundation recently pointed out, surgical hubs have helped to build capacity and reduce waiting lists over the past few years. Although it was not mentioned in Lord Darzi’s report on NHS performance, I welcome the Government’s intention to expand surgical hubs. Will the Minister provide more details on how many new surgical hubs will be established? What plans have the Government to expand the CDC network further?
There is clearly more work to be done to improve cancer waiting times and outcomes. The major conditions strategy developed under the last Government was designed to provide more impetus for improving cancer outcomes, alongside those for other major conditions. Developing the strategy involved significant consultation and engagement with cancer charities and professional bodies. Since the election, the Government have decided to scrap the strategy. Can the Minister explain why he made that decision?
Given the time that cancer charities and organisations have put in, can the Minister explain how their contributions will be used to develop the 10-year plan for the NHS? Can he explain why, in the NHS consultation that is now being run, there are no cancer-specific questions? We heard earlier that eight people in 10 want a cancer strategy. Will he respond if similar results emerge from the consultation?
The Government scrapped the children and young people cancer taskforce, and we have yet to hear an alternative approach to improve of outcomes in that area. Will the Minister provide clarity on the Government’s plans on children’s cancers and the reasons why they discontinued the children and young people cancer taskforce?
Research is most relevant to some of the rarer cancers that are often not talked about. We very much welcome the protection of Government investment in R&D, with £20 billion allocated to 2025-26 and core research spending protected. That includes a £2 billion uplift for the National Institute for Health and Care Research. I should mention that my doctoral research fellowship was funded by the NIHR, although it was mental health research rather than cancer research. It is great that we support that fantastic institution.
I am pleased that the Government have kept the current rate of research and development tax relief. However, the Minister will know that a lot of support and research is provided by or directly commissioned from charities, which are a critical part of the cancer care and treatment infrastructure. My understanding is that in yesterday’s Budget, public services were protected from the rise in employers’ national insurance contributions. Can the Minister explain what the impact of national insurance employer contributions will be on charities that provide care and treatment in this area? What conversations has he had with those charities, and what concerns have they raised with him?
In the Darzi report and elsewhere, there is rightly a focus on the diagnostic pathway and on the time it takes to diagnose and treat someone following a query as to whether someone has cancer. When does the Minister expect the huge £22 billion injection in the NHS to produce outcomes? Or does he agree with the comments in Lord Darzi’s report that the NHS does not necessarily need more money for outcomes? It has had a lot of money from the former Conservative Government over the past few years. Does the Minister think that reform is the best way to ensure improvement?
Mr Clive Betts (in the Chair)
I call the Minister. It would be helpful if he could finish by 4.28 pm to allow the mover of the motion a couple of minutes to respond.
Stem Cell Transplant Patients
Clive Betts Excerpts(1 year, 6 months ago)
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Mark Tami
My hon. Friend must have read my speech, because I will develop precisely that theme, as it is very important. When we went through that very difficult time, we were fortunate financially in that I had a well-paid job, being a Member of this House. I also had a very flexible and understanding employer; I was allowed the time off to be at the hospital. We had a car. We could afford to stay in a hotel if necessary and to eat out. Saying that, we still managed to build up debts, but we were in the hospital off and on for about two years and we saw many people who were not in that fortunate position—single mothers, people without a car who had to rely on public transport, people without a family network to support them, and people without that financial back-up to get through what is not only a traumatic process but a costly process for the family of the person being treated.
Mr Clive Betts (Sheffield South East) (Lab)
First, let me declare my interest: I am vice chair of the all-party group, and also a recipient of a transplant six years ago. My right hon. Friend is absolutely right on this point. When I was having my chemo, the hospital kindly arranged it so that for several weeks I could go in on a Monday morning, then come down here by train, and go back on a Thursday and have my second dose. Also, throughout the whole process I was able to do my job on email. The nurses used to laugh at me when I had my stem cells harvested—my right hon. Friend will know about that; it took me three goes, four hours at a time—because during that process I would carry on doing my emails. They used to laugh at me, but they understood the process. That is very different from the situation facing someone who has to go to work, perhaps in a manual job on a low income, who loses out right through the process. We must reflect on how we can better help people in those circumstances.
Oral Answers to Questions
Clive Betts Excerpts(1 year, 6 months ago)
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Kate Hollern (Blackburn) (Lab)
Mr Clive Betts (Sheffield South East) (Lab)
Holly Mumby-Croft (Scunthorpe) (Con)
Steve Barclay
The whole House will be hugely saddened to learn of the passing of Elliott, especially at such a tender age.
The hon. Lady is right to highlight the importance of speedy diagnosis, and I was pleased that we met the faster diagnosis standard in February for the first time and again in March, with three in four patients receiving their diagnosis within two weeks and nine in 10 starting treatment within a month. She is also right to point out that there is still variation between trusts, and we are focusing on that in particular, but it is good that nationally we are hitting the faster diagnosis standard.
Mr Betts
When I was diagnosed with multiple myeloma six years ago, my GP gave me two pieces of advice: keep positive and keep active. The other day, I visited the wellbeing centre in my constituency, which is run by Sheffield Hallam University, the Sheffield Teaching Hospitals NHS Foundation Trust and Yorkshire Cancer Research. It is putting on a programme called Active Together to which people who are diagnosed with cancer can be referred by their consultant and have a bespoke programme of treatment involving physical activity, nutrition and psychological support to prepare them for surgery, and a programme after surgery to help them recover. Would the Secretary of State like to come to my constituency to visit this novel and innovative programme to see how it could be rolled out across the country and treat more cancers well in this way?
Steve Barclay
The hon. Gentleman raises an interesting and important point. How we better equip patients pre-surgery and post-surgery, how we look at their wellbeing—the keep positive bit and the social prescribing—and how we think about being active are all are hugely important. I would be keen to learn more about the programme that he highlights and for either me or one of the ministerial team to follow up on his offer.
Recovering Access to Primary Care
Clive Betts Excerpts(1 year, 7 months ago)
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Steve Barclay
First, I commend my hon. Friend because this is an issue that she has championed and she has been right to do so. These are degree-qualified clinical roles, so it is sensible that we make far better use of the skills that they offer. We saw during covid just how much value they offer to their communities. I confirm that they will be paid for these roles; that is what the additional funding is all about. She has been right over the years to highlight the importance of pharmacies and what they can offer, and that is what this announcement is all about.
Mr Clive Betts (Sheffield South East) (Lab)
First, I thank the GPs in my constituency and their staff for the job that they are doing for my constituents under the most enormous pressure. I want to include in particular GPs’ receptionists in that for the up-front service they give; there is particular pressure on them. GPs—often in their 50s—are saying to me that they want to leave and give up not because of pensions but because of the overbearing workload they have, and the incredible centralisation and red tape coming from NHS England at national level. They look for new GPs coming through and see so many trainees and qualified doctors now going off to Canada, New Zealand and Australia because the terms and conditions of work are better there. When will we see from the Secretary of State the workforce plan that has been promised over and over again—it was supported by the Chancellor when he was Chair of the Health and Social Care Committee—to deliver the amount of training we need and the efforts to retain the GPs we already have?
Steve Barclay
I agree and thank the hon. Member, who is absolutely right to recognise the huge amount of work done by GPs and their staff, including receptionists. That is why the recovery plan is very much targeted at recognising the workload. I flagged in my statement the additional volume of patients that a typical GP surgery is seeing and that reflects the huge amount of work that is done. I think pensions were a factor, certainly in the feedback from the profession. The issue was raised. The changes the Chancellor announced take 9,000 GPs out of the tax changes, but the hon. Gentleman is right—that was not the only factor; the workload was another. The recovery plan looks to cut bureaucracy and, as I say, reduces the targets to five. It also looks at areas where there are appointments that we do not feel are necessary—so it looks at how secondary care can do fit notes, for example, rather than someone needing to go to the GP to get one. There are areas where we can streamline GPs’ workload and that is what the recovery plan does. On the workforce plan, we have said on a number of occasions that, post purdah, we would set that out very shortly. We will have more to say on that in due course.
Liver Disease and Liver Cancer: Diagnosis
Clive Betts Excerpts(2 years, 2 months ago)
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Margaret Ferrier (Rutherglen and Hamilton West) (Ind)
I beg to move,
That this House has considered the diagnosis of liver disease and liver cancer.
It is a pleasure to serve under your chairmanship, Mr Betts. I am proud to sit as a vice-chair on the all-party parliamentary group on liver disease and liver cancer. I am delighted to have succeeded in securing today’s debate.
While health policy may be devolved in Scotland, I believe that work in this area across our four nations is vital. We can support each other in cutting mortality rates and improving outcomes across the UK. The liver is a remarkable organ. Like something from science fiction, it can regenerate. It is one of the more forgiving pieces of our anatomy. We can make lifestyle changes and treat it a bit better, and it has the capability to heal itself and undo some of the damage we may have caused in the past.
Considering that the liver is one of our most important organs in terms of its function, we probably do not give it the attention it deserves. Some 49% of liver cancer cases in the UK are preventable, and 20% of liver cancer cases in the UK are caused by smoking, according to Cancer Research. There are around 6,200 new liver cancer cases in the UK every year and 5,800 deaths. That is roughly 17 diagnoses a day and 16 deaths. There are five types of liver-affecting cancer, with hepatocellular carcinoma, or HCC, being the most common, accounting for more than three quarters of liver cancer cases globally.
While mortality rates for other cancers have improved over the decades, liver cancer mortality has more than doubled since the ’70s, with only 13% of patients surviving more than five years from diagnosis. Right now, the United Kingdom is facing a liver disease crisis. The number of deaths from the disease have doubled in the last two decades, while other disease outcomes, for example from diabetes or respiratory diseases, have stabilised or even improved. Around 10,000 people die from liver disease and liver cancer each year in the UK. It is the second leading cause of premature mortality in England and Wales after suicide. These statistics come in spite of the fact that 90% of liver disease is preventable.
As a Scottish MP representing a Scottish constituency, this hits even closer to home. Scotland has the highest mortality rate for liver disease in the whole United Kingdom. We also have one of the highest mortality rates for chronic liver disease across central, northern and southern Europe. This health crisis is affecting my constituents, and the statistics are sobering. In 2020, Scotland saw an 11% rise in chronic liver disease deaths on the previous year. It is one of the leading causes of premature deaths, above breast cancer and suicide. Approximately seven in 10 people who died of liver disease were of working age, so under 65. In a country with an average life expectancy at birth of 76.6 years for males and 80.8 years for females, these are premature deaths.
I want to look at why liver disease and cancer outcomes are so poor in Scotland and across the UK and at what work needs doing to address that. Let me start with the why. One of the biggest barriers to effective diagnosis and treatment is the social stigma that continues to cloud how we view patients with liver disease and cancers. It is crucial to acknowledge and understand the part that poverty has to play in the demographic of patients with these conditions. As the UK grapples with the cost of living crisis and a drastic drop in living standards, this is not a contributing factor that can be overlooked or ignored—it will be a huge risk to public health and the lives of those living in our most vulnerable communities—and it would be a catastrophic mistake to do so.
There are over 100 causes of liver disease, but the ones that contribute to the most cases are also factors much more likely to be present in poorer communities: alcohol misuse and obesity. In Scotland, 58% of liver disease deaths are alcohol related. Across the UK, alcohol-related liver disease accounts for 60% of diagnoses. Like most addictions, alcohol abuse is statistically higher in poorer communities and carries a heavy stigma: the resulting harm is seen as self-inflicted. To improve outcomes for alcohol-related liver disease, we need to look at alcohol dependency and the reasons for its prevalence. Most importantly, we need to support patients in making positive lifestyle changes. Access to the right care is paramount, and increasing the availability and quality of support available at a primary care level is essential.
On the impact of obesity, which is also higher in Scotland than the rest of the UK, non-alcohol related fatty liver disease, or NAFLD, is expected to become the leading variation of the disease in the UK within the next decade. Nearly one third of Scottish adults are obese and two thirds are overweight, but the statistics across the UK are similar. Again, obesity is more prevalent in deprived communities; it is seen as a choice. Obese people are seen as greedy or lazy, and societal conditioning teaches us that we do not need to look much closer at the reasons why.
There are many reasons why obesity is on the rise in those communities, including underlying health conditions, eating disorders and a lack of access to high-quality healthy foods. Like alcohol abuse, this challenge needs to be met with increased access to the right support, such as weight management programmes, but by far the most important tool on the road to prevention is early detection. That goes for alcohol-related liver disease, NAFLD or viral hepatitis, autoimmune or genetic-related.
Liver disease is largely asymptomatic in the early stages. Three quarters of patients with cirrhosis are diagnosed only when it has progressed too far for intervention or treatment. Without early detection pathways and investment in treatment, we will continue to see mortality rates rise. The British Liver Trust’s 2021 survey showed massive disparities in access to patient care pathways for early diagnosis in primary care settings region to region. It revealed that just 26% of local health bodies in the UK have effective pathways in place. It is calling for every integrated care system or health board to ensure that there is a named person responsible for liver disease and the identification of high-risk patients, and for all GPs to have the means to assess fibrosis.
CT and MRI scans are a critical tool for diagnosis and informing treatment plans, but this is an area that has been overlooked. The key problems are access to the right equipment and the quality of the equipment available. Some 41% of clinical radiologists state that they do not have the equipment they need to deliver a safe and effective service for patients. Industry surveys show that one in 10 CT scanners and almost a third of MRI scanners are more than a decade old—the age at which the equipment is considered obsolete. That is shocking.
This area of the NHS, like so many others, it is struggling with workforce numbers. The British Liver Trust welcomed the Government’s 15-year workforce strategy earlier this year, and I back its calls for gastroenterology and hepatology to be given due recognition through that process.
In May, I visited the Royal Free Hospital in Hampstead with the hon. Member for Caerphilly (Wayne David), as part of the APPG’s work, and we saw the Sheila Sherlock Liver Centre, a leading centre for liver disease treatment. It is well equipped with excellent, highly skilled staff. I would like every area of the UK to have something similar in place for patients. I met the chief executive, John Connolly, and Dr Thorburn, a consultant hepatologist, along with some of the patients. My conversations with Lucy and Hannah, two young women undergoing treatment at the centre, really brought home the human aspect of the disease. I am grateful to them for taking the time to speak to me about their experiences.
This morning, I received some very disappointing statistics from my local health board, NHS Lanarkshire, which is categorised as “red”, with no effective pathways in place for early detection and disease management. I have reached out to NHS Lanarkshire to request an urgent meeting so I can discuss this and seek assurances on its plans for improvement. The stats for my local board have cemented just how fundamental it is to properly fund detection and treatment of liver disease and liver cancer, and to give the NHS the tools it needs to support our communities.
While NHS Lanarkshire falls under the remit of the Scottish Government, I want to make some requests to the Minister here, too. The all-party parliamentary group on liver disease and liver cancer, along with the British Liver Trust, is calling for a full review of adult liver services by NHS England. I urge the Minister to make that a priority. I hope that I have set out enough reasons to illustrate why that is so essential, and I am sure that other Members will have more to add.
As part of the plans to improve early detection rates, the NHS health check must routinely include assessment for non-alcoholic fatty liver disease, as it looks to become the leading cause of liver disease over the next 10 years. Pathology is also vital, providing the study of disease and informing the development of treatment. I back calls for a new, nationally endorsed pathology pathway. That is another area that desperately needs support with its workforce supply and funding. I hope that the Minister will be able to address her Department’s plan for that support. Overarching all of this is the need for Government commitment and direction to address the disparities in access to care through policymaking and implementation.
Before I finish, I thank several organisations for supplying briefings to inform so much of this speech, and for their ongoing work in this area. I thank The British Liver Trust—particularly Paul, Richard and its chief executive officer, Pam—as well as Cancer Research, the Royal College of Pathologists and the Royal College of Radiologists. I look forward to the Minister’s response; I hope that, through collaboration, we can accelerate progress across the four nations to improve outcomes for patients and for our constituents.
Mr Clive Betts (in the Chair)
The wind-ups have to start at about quarter past, so that is six Back Benchers in about an hour. I think you can probably work out the time limits for yourselves in that respect. First of all, from the Government Benches, I call Peter Gibson.
Peter Gibson (Darlington) (Con)
It is a pleasure to serve under your chairmanship, Mr Betts. I congratulate the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) on securing this debate. I also welcome the Minister, my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), to her place. I wish her every success in her new role. I have known her for over 30 years, and I have every confidence that she will be a thoughtful, listening Minister in a Department where she has professional experience and expertise.
Last month, my father should have celebrated his 80th birthday. Instead, his life was cut short by liver and pancreatic cancer. He died at 47—the age I am now—exactly six weeks to the day from being diagnosed. Looking back on the events of his passing in 1990, I would have assumed that things had improved. Advances in screening, treatment and diagnosis surely must have led to a very changed picture. However, in preparing for today’s debate, I have sadly learned that things do not look better. The British Liver Trust reports that there were around 200,000 deaths from liver disease in 1990, and in 2018 that figure had risen to almost 400,000.
In the north, the picture is quite bleak. It has the highest levels of liver disease, the highest admissions and the highest deaths. Liver disease is the second biggest cause of premature mortality and lost working years of life. We have seen a 400% increase in deaths from liver disease over just the last two generations. Liver cancer has seen the second fastest increase in incidence of any cancer in the UK, and the fastest increase in mortality rates over the past decade of any cancer for both men and women. Liver cancer mortality rates have more than doubled since the 1970s. I am reliably informed by the British Liver Trust that, sadly, the mortality rate in Darlington is the worst in the north-east, at 46 deaths per 100,000. Those are the worst results of any constituency in the north-east, which in itself is the worst in the country.
Those figures are not worrying or troubling; they are shocking. That is why I am pleased that we are having this debate. It is essential that the Government focus on tackling the causes of liver disease and cancer, so that we can prevent further families from losing a loved one prematurely.
As we know, liver disease is largely preventable, however symptoms often do not present until the damage is irreversible, making early diagnosis difficult but key to tackling disease. We know that liver disease deaths are higher in more deprived areas and are increased by higher levels of alcohol harm and obesity. When we talk about levelling up—improving our roads and railways, improving our homes and hospitals—we must not forget, and indeed must have a keen focus on, the health mission element of our levelling-up goals: to narrow the gap in healthy life expectancy and increase healthy life expectancy by five years.
The British Liver Trust’s “Make early diagnosis of liver disease routine” campaign in Parliament earlier this year was welcome, as are the Government’s efforts to improve diagnosis times and make testing more readily available. The evidence from this debate, however, is clear: we need to go much further and much faster to have a real impact on the dreadful mortality figures.
As I said at the beginning, I know that the Minister is someone who listens and who will have listened closely to the debate. I know too that, as someone who was born in the north-east, she will share my concerns about those families robbed of their fathers or mothers too early. She will want to do all that she can to reduce those losses in the future. I look forward to her response to the debate.
Mr Clive Betts (in the Chair)
Those Members who were listening intently to what I said earlier will have noticed that I tried to extend the debate by a further half hour, although we do have to start the wind-ups at about quarter past. For guidance, that gives about five minutes for each speech.
Several hon. Members rose—
Mr Clive Betts (in the Chair)
I remind hon. Members to try to keep to five minutes. The next Member indicated that he has to leave before the end of the debate, and I accept his reasons, so I call Anthony Mangnall.
Rachael Maskell (York Central) (Lab/Co-op)
It is a pleasure to serve under your chairmanship, Mr Betts. I congratulate the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) on securing this important debate, as well as on the important work that she and my hon. Friend the Member for Caerphilly (Wayne David) do with the APPG.
While there are multiple causes of liver disease, such as from viral hepatitis, obesity and alcohol, I particularly want to focus on alcohol. Successive Health Ministers will know that, over a period of time, I have consistently raised concerns about the absence of a comprehensive alcohol strategy. This afternoon we have heard only too clearly why that is so important. For too long, alcohol has been promoted as a social norm, and not to imbibe as an anomaly, yet the scale of alcohol harm, psychologically and physically, is off the radar. It is something that is causing me significant concern, whether it is used for pleasure or to address pain. It must become a priority of this Government.
In a city where I see more and more licensing of premises, I am aware of the impact and harm that that is having on livers. We see it in the statistics. My discussions with the British Liver Trust over the summer highlighted the fact that more and more people with liver harm were younger and sicker. Our excellent public health team in York says that it is their No. 1 concern. When we match that against the fact that 90% of liver harm is preventable, we realise that there must be a more comprehensive strategy. As the profile of those with liver disease changes, so must investment in prevention, diagnostics and disease management.
Astoundingly, since 2010 hospital admissions for liver disease have risen by a staggering 45%. NHS Humber and North Yorkshire ICS currently has no clinical pathway for the early detection of liver disease. I have written to express my concern, and the ICS tells me it will respond on 4 November.
There are many causes of liver disease and cancer, but prevention and early detection can make a significant difference to outcomes. In Yorkshire and the Humber, our pressurised NHS is seeing a 13% increase on the national average for admission rates due to liver disease, and rates are 38% higher for alcohol-related liver disease. In York, alcohol is a major factor in A&E attendance. For women in York, admissions due to liver disease are 30% higher than the national average. As we focus on York being a drinking capital, we have to look at those correlations.
Over the covid period, many people turned to alcohol as a means of addressing other needs. When so many people are dying from alcohol-related disease, the Government must turn their attention to that matter—not least because we know the impact it has on the most deprived communities, as we have heard. In York, the mortality differential is 10 years between the most deprived communities and the wealthiest. One in four with alcohol-related liver disease will die in hospital within 60 days of detection.
I know from working on a ward specialising in hepatology how important this subject is, but also how tragic it is for families. That is why I urge the Government to focus attention on this public health matter in a way akin to Dame Carol Black’s work on drug-abuse harms. There were 4,859 drug deaths in 2021. I am not belittling that statistic at all, but the fact that there are 10,000 liver deaths—over double—really demands the Government’s attention and a strategy. However, there is none in place.
That is why the Minister has a unique opportunity—one that she must take hold of. Ministers can turn their attention to so many things, but getting on top of this issue, driving a strategy that makes that difference and ensuring that every community has a diagnostic centre, as York longs to, could make a serious difference to our communities and our nation. I trust that she will embark on an alcohol strategy and ensure that there are community diagnostic centres, that alcohol harm is properly addressed and focused on, and that we also understand and focus on non-alcohol related fatty liver disease. We have an opportunity to double down on tackling liver disease, and I trust that this Government will not let this moment pass.
Mr Clive Betts (in the Chair)
To co-operate with the timing, we head to the Front Benches, with five minutes for the Opposition, 10 minutes for the Minister and a couple of minutes at the end for the mover to wind up.
The Parliamentary Under-Secretary of State for Health and Social Care (Dr Caroline Johnson)
I thank the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) for securing a debate on this important issue. She has been a great advocate on this topic, and I share her commitment to tackling this serious disease. I also thank my hon. Friend the Member for Darlington (Peter Gibson) for his kind words and for sharing his family story and speaking about some of the personal, family impact of these terrible conditions.
It is a year ago this month that our colleague, Sir David Amess, was tragically taken from us. He had a huge interest in liver disease. He was the co-chair of the APPG for hepatology and did so much to raise awareness of this disease in Parliament. One of the many ways we can take forward his legacy is to improve the lives of those with liver disease. That is why, although the Minister responsible for this topic was unable to attend, I wanted to ensure that I took forward this important debate and updated hon. Members on the work we are doing.
Many have talked about the scale of the problem, so I will not go further into that, but I want to talk about what we will do to address it. First, the NHS plan will help us to do that. It recognises the importance of preventing avoidable liver disease through targeted policies to address alcohol consumption and obesity. Unfortunately, most people are diagnosed with liver disease at a late stage, when it is less treatable, and they are often diagnosed during an emergency hospital admission. It is for that reason that liver disease is often called the silent killer.
To help detect early signs of liver disease, NHS England has a number of trials in train. One is evaluating intelligent liver function tests. That is when patients get a normal liver function test, and the laboratory has a process in place, based on those results, to test the same sample further, not necessitating a further appointment, so we can work out which patients need further investigation and treatment.
The NHS health check for 40 to 74-year-olds also identifies people particularly at risk of alcoholic liver disease and refers them in for further treatment and investigation. On top of that, we have the fibroscans, which have been rolled out through community diagnostic centres. They help to identify fibrosis in the liver at a time when we can try to treat it and before it becomes worse. Last year’s spending review allocated £2.3 billion for diagnostics to increase the number of community diagnostic centres to at least 100 by March 2025. That will boost diagnostic capacity to diagnose liver disease and improve earlier diagnosis and health outcomes.
The hon. Member for Strangford (Jim Shannon) talked about education for children about alcohol. Education on alcohol is now a statutory component of relationships, sex and health education in England.
My hon. Friend the Member for Totnes (Anthony Mangnall) talked about a review of liver disease and liver care. That is taking place in 2022-23, and there should be a report after that. He and my hon. Friend the Member for Warrington South (Andy Carter) raised transplant care. I will ask the responsible Minister to write to them with further details about what is being done in that area.
The hon. Members for York Central (Rachael Maskell) and for Strangford said that many liver diseases can be prevented and are preventable, particularly in relation to alcohol, obesity and hepatitis, and I want to talk a little about what we are doing in those areas. Alcohol is the leading risk factor for liver disease, and identifying disease early in those at risk and supporting them to stop drinking is critical. If they stop drinking, that can halt or even reverse damage to the liver. People at risk of alcoholic liver disease are being identified and given early access to tests, to detect emerging liver disease through the health check and other means.
The NHS has also invested in the treatment of alcoholism: £27 million has been used to establish specialist alcohol care teams in hospitals with the highest rates of admissions related to alcohol dependence. Those specialist teams will help identify alcohol-dependent patients, start them on specialist alcohol treatment in hospital and support their transfer to community alcohol services.
Since April 2022, NHS England has introduced a measure known as commissioning for quality and innovation, which incentivises providers to improve earlier detection of liver disease for alcohol-dependent in-patients in acute and mental health services. We are also committed to increasing liver health investigations in community treatment settings. Through the drugs strategy, we are making the largest ever single increase in drug and alcohol treatment and recovery funding, with £780 million of additional investment over the next three years.
As hon. Members said, another major risk factor is obesity. Tackling obesity is a major priority for the Government. We have seen some important successes since 2016. The average sugar content of drinks subject to the soft drinks industry levy decreased by about 43% between 2015 and 2019. This month, regulations have been brought in about store placement of products that are high in fat, salt and sugar, so that they cannot be displayed in areas of the store that are attractive and available to children. There have also been the provisions set out in the Calorie Labelling (Out of Home Sector) (England) Regulations 2021 and an investment in further weight management services for people living with obesity.
I would like to turn to hepatitis B and C, which are also important risk factors for liver disease and primary liver cancer. Through the NHS hepatitis C virus elimination programme, we have reduced the number of people living with chronic hepatitis C virus infection in England by 37% since 2015. New treatment with direct-acting antivirals has massively improved the success of the treatment, with mortality from hepatitis infections falling by 35% since 2015. So that has already reaped rewards.
There is a new opt-out pilot programme of testing for HIV, hepatitis B and hepatitis C in emergency departments in areas of the country where HIV is most prevalent, which is a proven way of identifying new cases. During the first 100 days of the pilots in London, Blackpool, Brighton and Manchester, 328 people with hepatitis B were newly diagnosed, with 30 found to be lost to care. Each of them is an individual who will now be able to be treated effectively for the condition, which will reduce the risk of passing it on. Similarly, 137 people were newly diagnosed with hepatitis C, of whom 23 were found to be lost to care. Those are promising early results in just the first 100 days, and we now looking at what we can do to perhaps roll this programme out to other centres.
Many hon. Members talked about primary liver cancer, which has a tragic impact. As my hon. Friend the Member for Darlington said, the number of recorded deaths has more than doubled in the last two decades. Cancer Research UK statistics show that there are around 6,200 new cases diagnosed each year and, tragically, 5,800 deaths. Unfortunately, the five-year survival rate for people with liver cancer is poor, at only 13%, and that could be markedly improved by earlier diagnosis, as I mentioned.
To contribute to achieving a long-term plan ambition to diagnose 75% of cancers at an earlier stage by 2028, the NHS cancer programme has launched the early diagnosis liver programme. The programme aims to detect more liver cancers at an earlier stage, so that more patients can benefit from treatment. More people at a high risk of liver cancer are referred to six-monthly liver surveillance. The national cancer programme is working in partnership with the hepatitis C virus elimination programme to deliver 11 community liver health check pilots.
The pilots aim to support early detection and diagnosis of liver cancer by identifying and referring people with cirrhosis or advanced fibrosis into a liver surveillance pathway, and providing them with a peer supporter who can help and guide them through future appointments. The pilots will target people experiencing significant inequalities and those who disengage from the healthcare service, including homeless people, those with alcohol and substance addiction, sex workers, people in the justice system, disabled people and others. The hon. Member for Enfield North (Feryal Clark) mentioned the workforce; she will be interested to know that over the last five years there has been a 20% expansion in the number of consultant hepatologists.
This is an important debate on a very important issue. We have heard some heartfelt contributions about the pain that liver disease and liver cancer bring to so many people and their loved ones across the United Kingdom. This Government are determined to take action and to make the changes that are needed to tackle this deadly disease.
Health and Social Care Leadership Review
Clive Betts Excerpts(2 years, 6 months ago)
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Mr Clive Betts (Sheffield South East) (Lab)
I hope the Secretary of State will agree that it is key that managers in the NHS and local authorities can work together effectively. I give great credit to the leaders in the clinical commissioning group, the hospital trust, the director of public health, the social care directors and the city council, who worked really well together in Sheffield during the pandemic to deliver a joined-up service and have kept us as MPs thoroughly involved.
As we move on to the slightly wider integrated care system and integrated care board, will he give a commitment that the place-based working that has been so effective in the past will be allowed to continue at local authority level?
Draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2022
Clive Betts Excerpts(2 years, 10 months ago)
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Mr Clive Betts (Sheffield South East) (Lab)
It is a pleasure to serve under your chairmanship, Mrs Murray. I shall not detain the Committee long; I just want to put on the record that the Levelling Up, Housing and Communities Committee is currently conducting an inquiry into social care and its funding. I will not go into the details of that as I would be straying from my remit this afternoon.
I want to draw attention to two or three issues that are directly relevant and came up, on which we will be reporting as a Committee in due course. We talked to care users and carers the other day and heard some heart-rending stories: “Please when you reform and review, will you do it with us and not to us?”
Mr Betts
I did mean the Minister; I am sure you would do it only too well, Mrs Murray, without having to be directed in that way. I was explaining what the carers and the people receiving care were saying. I hope the Minister reflects on that message in future.
There are two direct issues to do with Care Quality Commission inspections that came out from our conversations as well; the Minister may at some point wish to think about discussing these with the CQC. One is: “Why does it always announce inspections before they happen? They change the arrangements in our home before the inspectors come, so what’s the point of the inspection? If you’re really going to find out what is happening, go in and inspect without giving the warning.” That is a matter directly to do with the regulations—how they are implemented in future.
The other issue is something that the local government and social care ombudsman said to us at a different hearing. He is really concerned that so many care homes do not clearly demonstrate to the residents, and their friends and relatives who visit, that if things are wrong they can access not merely a complaints procedure themselves but that procedure can lead on to a report to the ombudsman. We are all too well aware of that, but residents often are not.
The CQC could draw attention to that in their inspections and relationship with the sector. The ombudsman is asking for specific parliamentary powers, but this could be done through encouragement from the CQC when it is inspecting, saying, “Have you got your complaints procedure up there? Is there a clear indication to people that they can go to the ombudsman if they are not satisfied?” That is something positive that inspectors could do as part of the regime and regulations that we are discussing today.
Vaccination Strategy
Clive Betts Excerpts(2 years, 11 months ago)
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Maggie Throup
My hon. Friend is quite right that we do bear responsibility. I do not take these decisions lightly at all and neither does my right hon. Friend the Secretary of State. That is why the JCVI and the CMO continually review not just the UK data but the national data for every age range, every vaccine and every eventuality. The CMO will have heard my hon. Friend’s request and I am sure he will be completely focused on making sure that the JCVI continues to monitor the situation in the specific way my hon. Friend asks for.
Mr Clive Betts (Sheffield South East) (Lab)
First, I congratulate everyone in Sheffield—including GPs, the hospitals and the city council—who worked brilliantly together to deliver thousands of vaccines in the run-up to Christmas.
I want to ask about people with compromised immune systems, and I declare my own interest in that. Having the third dose, followed by a booster, is absolutely right, but to begin with there was a lot of confusion about whether the consultant or the GP should be responsible for contacting people. I think it has just about been sorted out, but I have received an email today from my constituent Jeanette, who says that although everyone in her situation should have received a letter offering the availability of new treatments, she got a letter but her husband did not; that although everyone should have been sent a PCR test in the post, she did not get one; and that although she was told to ring 119, when she did so she could not find the option to complain that she had not received a PCR test. Will the Minister have a look at who is responsible for the availability of new treatments and the sending of PCR tests, and at what happens when things do not happen properly?
Maggie Throup
I thank the hon. Gentleman for raising this important part of our strategy to make sure we can react quickly in respect of those with certain conditions. Giving them ready access to the antivirals is the third part of our strategy to combat coronavirus. GPs and hospital consultants should link up to make sure that the right conditions are considered. I advise the hon. Gentleman’s constituent initially to contact her GP to make sure that she fits the category. If she has received the letter but no PCR test, she should contact 119—Test and Trace—
Maggie Throup
Or she should go online to find out whether there has been a mismatch in the data. If she has received the letter saying that she should receive the PCR so that she can do one if she has symptoms, we just need to make sure that she gets one delivered to her home.