National Cancer Plan

Derek Twigg Excerpts

Tuesday 4th February 2025 Commons Chamber

[Andrew Gwynne]

One reason we think a national cancer plan is so important is precisely to get the investment in the areas we need so that we can tackle those health inequalities. There are very real inequalities when it comes to the diagnosis of cancer and, more importantly, the treatment and therefore the outcomes. I am really keen that we focus on that in the plan, to ensure that all parts of the country achieve the best outcomes for people who have been diagnosed with cancer.

Part of the plan is the roll-out of community diagnostic centres so that we can get diagnosis much earlier. That then puts greater pressure on getting people through the front door for treatment, so that is why, as part of the recovery plan that the Prime Minister and the Health Secretary announced, we are seeking to get more people treated more quickly on those treatment pathways. Hopefully, that will get the desired outcomes we want. It is a commitment that we will seek to restore the national health service to its constitutional standards. That is a priority of this Government.

On radiotherapy machines, the £70 million investment will fund about 25 or so machines. The criteria for evaluating bids are the age of the machine, the proportion of machines aged over seven years, and the performance against the 31-day standard for radiotherapy, with poorer performers prioritised. On future rounds of funding, the cancer plan will feed into spending reviews and future Budgets. It is our priority to ensure that we reach the cancer targets, so hopefully we can make the case to the Treasury for future investment in further years.

[Derek Twigg (Widnes and Halewood) (Lab)]

As someone who lost his wife to cancer, I know the dire circumstances that a cancer diagnosis can bring. It is right that cancer plans should focus on the best outcomes: improving the amount of time that people live for, or having a cure. I would like to raise with the Minister the specific issue of pain relief management. As part of the plan, will he ensure that there is an investigation into how pain relief management can be improved for cancer patients, and that it is given not just during the week but at weekends too?

[Andrew Gwynne]

Absolutely. My hon. Friend raises a really important point about how people receive pain relief and how that is managed. There are some really good examples out there of how it is done really well and, shockingly, there are some that are less good. We want to learn from the best. As my right hon. Friend the Secretary of State says, it is about taking the best of the NHS to the rest of the NHS. Absolutely, that should form part of the plan.

Health and Adult Social Care Reform

Derek Twigg Excerpts

Monday 6th January 2025 Commons Chamber

[Wes Streeting]

We had a referendum and two subsequent general elections on the issue of Brexit, and I can tell the hon. Gentleman that none of those three democratic events went the way that I wanted. As we said to people at the time, the country chose a path that would have consequences and implications. However, we have a constructive working relationship with our friends and allies in the European Union, and while we cannot change the past, we can build a new partnership and a brighter future for our country.

[Derek Twigg (Widnes and Halewood) (Lab)]

As my right hon. Friend will know, a large number of elderly people are admitted to hospital, through A&E, with respiratory conditions. What plans does he have to strengthen the community respiratory teams, who do a great deal of good work but could do more work, if they had the resources, to prevent admission, and certainly readmission?

[Wes Streeting]

My hon. Friend is right, and that is why the vaccination campaign has been so important this winter. He is also right about the importance of community-based teams. One of the Darzi conclusions was that since 2019, we have significantly increased staffing in our hospitals, but because we had the wrong people in the wrong place, we ended up with falling productivity in hospitals. We need a shift out of hospital into the community, which is what our 10-year plan will deliver.

Children’s Hospices: Funding

Derek Twigg Excerpts

Wednesday 30th October 2024 Westminster Hall

[Ian Byrne]

I thank my hon. Friend for that excellent intervention, with which I wholeheartedly agree. Former football stars from Liverpool joined the efforts, donating more than £150,000. The local paper, the Liverpool Echo, and its staff led by Liam Thorp, have thrown their weight behind the campaign, doing everything they could to save the hospice. On Monday, we had the incredible news that Liverpool-based company Home Bargains was pledging £2.5 million to the campaign, bringing us within touching distance of the total.

The tireless and wonderful work of so many has been invaluable over the past few weeks. There are so many to thank, if I had the time, but I must pay tribute to the wonderful comic, Adam Rowe and fellow funnyman, Willie Miller, who have done so much to raise this issue both publicly and behind the scenes, and John Gibbons from “The Anfield Wrap” for his tireless efforts over the past few weeks.

There are still 10 days to go, and we are not over the line yet, but we are proving that if any city can do it, Liverpool can. The community, the solidarity, the togetherness—I have never been prouder to be a Scouser. Today, the plans for the future are coming together. Last week, we announced what the new Zoe’s Place Liverpool would be like, operated and run in Liverpool, putting it on a footing to care for kids from across Liverpool and beyond for generations to come. I am really optimistic that we will do it.

But the truth is this: talk to the families who rely on Zoe’s Place and Claire House, see the support that those hospices give to seriously ill children, babies and families, and you will know that that support is not a luxury—it is essential in a modern, functioning society. They provide a vital service that should not require charity to keep it going. Everyone who needs it should have access to high-quality palliative and end of life care, but that is not happening at the moment. Not just Zoe’s Place, but children’s hospices across the country are in crisis, with many more fearing for their future.

That is why today’s debate is important to families up and down Britain. Despite children’s hospices providing an essential service, they are overwhelmingly funded by charity. Less than a third of their income—around 30% —is public money, with the remaining 70% coming from charitable donations. That is a broken model. Let me be clear that I have the utmost respect for people who give up their time and money to support our hospices, but as one constituent said to me recently:

“We shouldn’t have to sell charity cupcakes to make sure kids are cared for”.

But that is what is happening at the moment.

The public funding element of children’s hospices is both inadequate and messy. Most of it comes from the children’s hospice grant. Introduced by the previous Labour Government, it was designed to provide direct funding to children’s hospices. Today, it stands as a £25 million grant, but it has an uncertain future. It was renewed by the previous Government for 2024-25, but the new Government have not yet said whether the funding will continue. According to the charity Together for Short Lives, if the grant is not renewed, there will be a profoundly negative impact on lifeline care and support. Eighty-two per cent of children’s hospices told the charity that they would have to cut or stop providing respite care or short breaks; 70% said they would have to cut or stop providing emotional and psychological support; and 45% said they would have to cut end of life care.

Will the Government commit to maintaining the £25 million children’s hospice grant as a ringfenced fund in 2025-26 and for the long term? Will they commit to making it centrally distributed once again? Many care homes have said to me that they are opposed to the integrated care board model that NHS England is using, as it has led to delays in children’s hospices receiving money.

The next biggest pot of public money for children’s hospices comes from integrated care boards, which have a legal duty to commission palliative care, but the funding is patchy and falling. Research shows that the funding per child with a life-limiting or life-threatening condition varies wildly across the country. It is just £30 per child in Northamptonshire but £397 in Bristol, north Somerset and south Gloucestershire. In my area, Cheshire and Merseyside, it is slightly above average at £206, but there should be no postcode lottery in funding care for kids. And the funding is falling—last financial year, children’s hospices on average received almost 10% less funding than the year before, and almost a third less than the year before that. What are the Government doing to make sure that every seriously ill child and their family, regardless of where they live, have fair and equal access to palliative care?

Local authorities have a duty

“to provide services designed to assist”

family carers of

“disabled children to continue to”

provide care

“or to do so more effectively, by giving them breaks from caring.”

Local authorities, which are under immense pressure, account for just a small fraction of children’s hospice public funding—about 2.5% of the total. The funding fell by 26% from last year to this year, and more than half of children’s hospices received no funding at all from their local authorities. What conversations is the Minister having with colleagues in the Ministry of Housing, Communities and Local Government to ensure that local authorities meet their legal duty to provide short breaks for disabled children who have life-limiting or life-threatening conditions?

The funding streams are insufficient for children’s hospices at the best of times, but we really are at crisis point. That is why we are all here today. With public funding falling, charitable donations squeezed as the cost of living crisis bites—the cost of living crisis, again, is affecting us all— and increased energy prices, children’s hospices have seen their income fall. That is having grave consequences. More than half of children’s hospices in England ended the last financial year with a net deficit, and it gets worse: next year, more than two thirds of children’s hospices forecast a deficit. Unless more public money is found, more and more children’s hospices will have to cut back, more services will be reduced, more kids will miss out, more families will have nowhere to turn and more children’s hospices will be put at risk, just like Zoe’s Place in Liverpool. Extra funding is needed just to stay still, let alone to build the world-class care system that our constituents deserve.

According to research from Together for Short Lives, the NHS needs almost £300 million extra to meet the standards for children’s palliative care set by the National Institute for Health and Care Excellence. That is the inheritance of 14 years of Conservative chaos, with deeply damaging NHS reforms and chronic underfunding of our public services. Our new Labour Government promised change, and that must be delivered. Will they use the opportunity of the NHS 10-year plan to fill the almost £300 million gap in funding for children’s palliative care?

Let me remind everyone that there is money in this country to fund children’s palliative care. Our problem is not a lack of wealth, but its extremely unequal distribution. In the run-up to today’s Budget, I was one of the MPs who called on the Chancellor to raise taxes on the richest, with policies such as a 2% wealth tax on assets over £10 million, which would raise £24 billion a year—enough to meet the palliative care funding gap 80 times over. That is why I introduced a private Member’s Bill yesterday that would launch a review of the funding for children’s hospices and guarantee high-quality care for all seriously ill children and their families. I really hope that the Minister will take up that call.

In Liverpool, the people have risen to the challenge, and we are on the cusp of saving Zoe’s Place. Now this place has to rise to the challenge as well, and we have to give children’s hospices the funding they need to survive. The children and families who rely on these incredible institutions do not have time to waste.

[Derek Twigg (in the Chair)]

I remind Members to bob if they wish to speak—I am pleased to see that they are doing so.

--- Later in debate ---

[Several hon. Members rose—]

[Derek Twigg (in the Chair)]

Order. If hon. Members can keep speeches to not more than four minutes—that precedent has been set well so far—I will not have to impose a time limit at this stage. Interventions will obviously extend the limit.

--- Later in debate ---

[Derek Twigg (in the Chair)]

I thank Members for their co-operation in terms of the time they are taking for their speeches. I say to the Front-Bench speakers that I am keen that the hon. Member for Liverpool West Derby (Ian Byrne) should get a chance at the end of the debate to wind up for a minute or so.

Oral Answers to Questions

Derek Twigg Excerpts

Tuesday 23rd January 2024 Commons Chamber

[Victoria Atkins]

I thank my hon. Friend sincerely for her question. The good news is that community diagnostic centres have now delivered over 6 million additional tests and scans since July 2021 thanks to the hard work of NHS staff, but I will of course be delighted to meet her to discuss her plans for her local constituency.

[Derek Twigg (Halton) (Lab)]

T3. New British Heart Foundation analysis shows that the number of people dying before the age of 75 in England from heart and circulatory diseases has risen to its highest level in over a decade. The rate of premature deaths from cardiovascular disease has now increased in England for three years back to back. Why are the Government taking such a long time to get to grips with this crisis?

[Andrew Stephenson]

The NHS long-term plan commits to a number of key ambitions to improve care and outcomes for individuals suffering from cardiovascular disease, including enhanced diagnostic support in the community, better personalised planning, and increasing access to cardiac rehabilitation. Those ambitions will support the delivery of the aim to prevent 150,000 heart attacks, strokes and dementia cases by 2029.

Oral Answers to Questions

Derek Twigg Excerpts

Tuesday 17th October 2023 Commons Chamber

[Steve Barclay]

My hon. Friend raises an important point, and I know she has secured a debate in the House this week to further explore these issues. She will be aware that there has been a 13% increase in the number of midwifery programme place starters since two years ago. That is alongside the £165 million added to the maternity budget since 2021 and the key increase in midwifery places in the long-term workforce plan.

[Derek Twigg (Halton) (Lab)]

It is obviously welcome to train and recruit as many staff as possible, but part of the problem is actually retaining the staff. We are increasingly seeing among the reasons given for leaving, particularly by nurses, their work-life balance. What is the Secretary of State doing to address that?

[Steve Barclay]

Just yesterday, I met leaders of the NHS Staff Council, who represent trade unions under Agenda for Change, as part of our ongoing discussions on the agreement we will reach with them, which includes working together on retention and how we address some of the challenges the workforce face.

Oral Answers to Questions

Derek Twigg Excerpts

Tuesday 11th July 2023 Commons Chamber

[Helen Whately]

I congratulate my hon. Friend on his commitment to ensuring that we are focused on cancer outcomes and on his successful campaign for that to be included in the NHS mandate, which it has been, as I just mentioned. The best way to improve outcomes for cancers is by catching cancer early. That is one reason why we have a range of metrics, including process metrics, which measure early diagnosis and therefore help us to achieve our ambitions on outcomes. Other metrics such as patient experience are important as well.

[Derek Twigg (Halton) (Lab)]

I agree with the hon. Member for Basildon and Billericay (Mr Baron). One of the problems is the time it takes from the GP’s referral to the consultant at the hospital and the treatment then starting; there are still concerns about delays in that. What is the Minister doing to speed up the process from not just the GP’s referral to the consultant but from the consultant to treatment starting?

[Helen Whately]

The hon. Member is right that the duration is very important. One reason why we are focused so much on increasing early diagnosis is because we know that the sooner we diagnose people, the more likely they are to have a successful outcome from cancer treatment. We are seeing improvements in cancer survival. For instance, in 2010, two thirds of people would survive for one year after a cancer diagnosis; now the figure is three quarters. The NHS is working very hard on further improving cancer diagnosis, and we have reduced the number of people waiting more than 62 days since the pandemic by over a third.

Lung Cancer Screening

Derek Twigg Excerpts

Monday 26th June 2023 Commons Chamber

[Steve Barclay]

My hon. Friend, an experienced parliamentarian, opens two different issues there. As he well knows, one is a question of tax, which, rightly, I say as a former Treasury Minister, is a matter for the Treasury. As for the roll-out of the programme, the additional cost of the programme will be £1 billion over the seven years. That is the additional cost of that expansion, but how it is funded will be an issue for the Treasury.

[Derek Twigg (Halton) (Lab)]

Anybody who has lost a loved one through lung cancer will know what a horrible and cruel disease it is. Obviously, we welcome any move to improve screening and get more people screened. But I would be interested to know two things from the Secretary of State. First, in one of my local hospitals—recently, I asked a parliamentary question about this—only 77.8% of patients got an urgent referral within 62 days, so quite a lot of people did not. Secondly, how much of the £1 billion will be used to bring in the extra clinicians and staff who will be needed to do the screening?

[Steve Barclay]

I am sorry, but I missed the second part of the question. On the speed of treatment, that is why significant work is going into the faster diagnosis standard, which was hit for the first time in February. Part of the additional capacity going in—the extra 108 diagnostic centres—is to boost that capacity and speed up that treatment. There has been a surge in demand; a significant uptick in the nature of demand. That is the backlog we have been working through as a consequence of the pandemic, but the additional capacity is to address that exact point.

Oral Answers

Derek Twigg Excerpts

Tuesday 25th April 2023 Commons Chamber

[Steve Barclay]

As a result of the fantastic work of Sir Jim Mackey and Professor Tim Briggs through the Getting It Right First Time programme, we have been making significant progress in respect of elective procedures. When it comes to urgent and emergency care, there are lessons coming out of the various strikes which we are keen to adopt, but this situation is also clearly having an impact on patients and the number of cancellations. As my hon. Friend well knows, we publish the figures.

We have been working constructively with the NHS Staff Council. Unison voted by a majority of 74% to support the deal, there will be further votes this week from other key trade unions, and there will be a decision from the staff council on 2 May. Obviously, that will be extremely important when it comes to addressing the concern highlighted by my hon. Friend.

[Derek Twigg (Halton) (Lab)]

According to figures that I obtained recently from the House of Commons Library, in January 2023 54.4% of patients who were treated after an urgent referral received their first treatment within 62 days of that referral. The target is 85%. The figure for performance in January 2020, before covid, was 73.6%. Why has there been such a deterioration?

[Steve Barclay]

To be honest, I think the position is mixed. In certain areas we have seen significant improvements in performance: the faster diagnosis standard, for example, was hit for the first time this month. Purdah prevents me from going into the details of the 78-week wait, but I expect to be able to update the House very soon on the progress that has been made. As the hon. Gentleman says, there are still challenges as a consequence of the pandemic, but we are seeing much more progress than the NHS in Wales, and it is also worth reminding the House that, through Barnett consequentials, the Welsh NHS receives more funding that the NHS in England.

Covid Pandemic: Testing of Care Home Residents

Derek Twigg Excerpts

Wednesday 1st March 2023 Commons Chamber

[Helen Whately]

My hon. Friend is absolutely right about how we ramped up incredibly fast from a capacity of just 3,000 tests a day in March 2020, to more than 38,000 in mid-April, and more than 100,000 by May. We were then able to test many millions per week during the course of the pandemic. That was the most extraordinary increase in the capacity to produce, carry out and analyse tests, and he is absolutely right to draw attention to it.

[Derek Twigg (Halton) (Lab)]

The Minister said that what my hon. Friend the Member for Leicester West (Liz Kendall) said was shocking. What is shocking is the number of people who died but who might have been saved in the first place. Is the Minister really saying that, at the beginning of the pandemic, there was no rush to get people out of hospital and back into the community without being tested?

[Helen Whately]

The questions about the discharge policy have been interrogated on a number of occasions, including by Select Committees. The hon. Gentleman will well know that in general, and in the work that we are doing now on discharge, it is rarely good for somebody who is medically fit for discharge to continue to be in hospital beyond that time. So of course it is right that when people are medically fit, they should be discharged home. The guidance of how that was done was set out on a number of occasions during the pandemic, and that guidance was updated both as we learned more about the virus and as greater testing capacity became available.

Urgent and Emergency Care Recovery Plan

Derek Twigg Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

My right hon. Friend makes an important point. Again, within that is patient choice and how we empower more patient choice—providing services that are free at the point of use—to use what capacity there is within the system, including in the independent sector. I absolutely agree that we should be maximising capacity. At Downing Street with the Prime Minister, we had a very useful roundtable with the independent sector about how we can make more use of its capacity. That is certainly an area that we are exploring.

[Derek Twigg (Halton) (Lab)]

I saw for myself only a few weeks ago the real crisis in our hospitals when I accompanied a close relative to Whiston Hospital, where I saw every single space in the corridors taken up by a bed, a trolley or a chair. Quite frankly, what the staff—doctors, nurses and support staff—were doing was amazing, and they deserve all our praise for the hard work that they are putting in. The Secretary of State’s lauding of the fact that two-year waits have virtually been eliminated is bizarre: when Labour left office, waits were somewhat less, with an 18-week target and many people being seen within weeks, not months. The Secretary of State said that the Government are on track to recruit 15,000 new nurses, but how many have left the NHS in the last two years?

[Steve Barclay]

First, the hon. Gentleman is right to recognise the work that the staff have been doing. He mentioned a family member; when I made a statement earlier in January, I recognised that there has been huge pressure on the system. We saw the flu numbers and the spike in cases. On the two-year waits, the point is simply that there has been pressure on services—the pandemic impacts—across the United Kingdom, but the two-year wait is far worse in Wales, whereas we have cleared it in England. On recruitment and retention, we are bringing forward the workforce plan. The fact is that we are recruiting more nurses, but it is about meeting demand pressure as well.