Cancer Priorities

David Heyes Excerpts

Thursday 13th February 2014 Commons Chamber

[David Heyes (Ashton-under-Lyne) (Lab)]

I am unaccustomed to being called to speak so early in a debate, and I shall do my best to make the most of the opportunity. I rather wish that I had prepared a much longer speech.

I start by thanking the Backbench Business Committee for scheduling the debate. I particularly commend the excellent work of the hon. Member for Basildon and Billericay (Mr Baron) and the rest of the all-party group on cancer in producing its recommendations. I am especially pleased to speak in this debate as it gives me a chance to make a brief contribution based to some extent on my own skirmish with cancer, which has kept me away from this Chamber for much too long in the past couple of years.

My experience and treatment as a patient, at the Pennine Acute Hospitals NHS Trust, the Salford Royal NHS Foundation Trust and the Christie NHS Foundation Trust in Manchester, has been excellent. I owe enormous thanks to the remarkable surgical skills of Mr Senapati and his upper gastrointestinal team, and to the care of the Macmillan clinical nurse specialists and many other NHS professionals whom I have encountered in the course of my treatment.

My comments will be based on the experience of seeing the delivery of cancer services from the patient’s viewpoint; and that experience places me among the 80% of cancer patients who rate their care as good or excellent. We have yet to see the full consequences of the major structural changes taking place in the NHS. Hopefully, we can expect an improvement in cancer services—and an improvement is needed if we are to save the extra 5,000 lives a year that we must achieve if we are to match average European survival rates. Goodness knows we ought to set our sights on being the best, not just the average.

Given the scale and extent of the upheaval in the NHS, there is a real danger that cancer services will end up being damaged and made worse. That is why the all-party group on cancer’s report is so timely and important. It sets out with admirable clarity what the Department of Health and, through it, NHS England need to do if we want to improve standards and deal successfully with the predicted increase in cancer diagnoses in the period ahead.

The report’s recommendations do not depend on the injection of large sums of money. Much of what is recommended is about doing things in a better way—shaping sensible policies and working practices, from GP and community care group level upwards. The recommendations are particularly aimed at promoting early diagnosis, which, as the hon. Gentleman says, is above all else the key to turning back the cancer tide.

I do not want to go through all the report’s recommendations; I just want to comment on a few points based on my own recent experience. One of the main reasons why I consider my patient experience to have been so positive was the close involvement of cancer nurse specialists at every stage of my treatment. The easy one-to-one contact with a named individual, a clinical expert in the field, meant that there was a way to raise concerns and get reassurance when it was needed and—this was very important for me—to give me the confidence to be an active player in mapping out my own care pathway.

The report is clear that access to clinical nurse specialists is patchy across the country and decreasing in some areas and specialisms. NHS England needs to be clear on how it will ensure the continuation and enhancement of access to clinical nurse specialisms to maintain their vital role in ensuring quality cancer care.

As has been said, early diagnosis is obviously the critical factor in improving cancer survival. My GP picked up reasonably quickly on my symptoms and I soon entered a pathway of diagnosis and treatment. In that respect, I was fortunate in having the right GP, but sadly more than a quarter of people diagnosed with cancer see their GPs three times or more before being referred to a specialist. Too many people are still being diagnosed in the advanced stages of cancer. Again, the report is clear on the need to improve GPs’ awareness of cancer symptoms as a vital factor in helping to identify cancer earlier and improving survival rates.

The starting point is for NHS England to make it clear to GPs, through its community care groups, that they will be held to account on the basis of their outcomes indicator set. Personally, I am encouraged that NHS England accepts the need to incorporate measures to encourage earlier diagnosis by recording the stage of cancer at diagnosis and whether the cancer is detected in an emergency. However, I agree with the hon. Gentleman that that can be effective only if it is recoupled with the survival rate measures to serve best as an important factor in pressing clinical commissioning groups to promote earlier diagnosis.

Under the previous Government, there was huge progress in improving cancer care. The national cancer plan and the cancer networks made a real impact on lifting NHS care for cancer patients towards the standards being achieved in other countries. However, the move from 27 cancer networks to 12 strategic clinical networks, each covering a larger area and with fewer dedicated cancer staff, is a backward step. The report reveals that the funding of cancer networks will be slashed by a quarter, and that 20% of their staff will go. Those worries are exacerbated by the uncertainty over what the strategic clinical networks will be able to deliver in comparison with cancer networks. We face a real risk that the lack of clarity surrounding these structural changes will damage outcomes for cancer patients. NHS England needs to recognise that concern, and to act to remove the uncertainty over the functions of the strategic clinical networks.

Being in a cancer treatment programme can cause big problems and great worry for patients of working age. I know from talking to fellow patients that holding on to their job and continuing or returning to work were major concerns for many. This is not just about keeping the money coming in. The world of work represents a sense of normality for many, and a target to aim for, to help them to get through what can be a debilitating treatment pathway. Again, I speak from experience. My treatment kept me away from this place for a long time, but my ability to continue with a good proportion of my constituency work gave me a sense of normality and helped to counter the negativity and uncertainty that can be a feature of living with cancer.

There are good economic reasons for supporting cancer patients to get back to work. The report refers to the findings by the Policy Exchange in 2008 that estimated lost productivity at £5.3 billion in that year alone as a result of cancer survivors not returning to work. It is for all those reasons that the report calls for NHS England to publish plans detailing how it will support people with long-term health conditions to stay in or return to work. That makes sense not only for the individual cancer patient but for the economy.

I am glad to have had this opportunity to make those few points, and I urge those on the Government Front Bench to respond positively to the report’s recommendations and to work with NHS England on implementing them as a matter of urgency.