Cancer Care

Debate between Helen Whately and Peter Dowd

Tuesday 14th March 2023 Westminster Hall

[The Minister for Social Care (Helen Whately)]

It is a pleasure, Mr Paisley, to serve under your chairmanship.

I thank my hon. Friend the Member for West Bromwich East (Nicola Richards) for securing this debate on cancer care. According to Cancer Research UK, one in two people—half of us—will develop cancer at some point in their lives. There are around 290,000 new cancer diagnoses a year, or nearly 800 every day.

When we cite statistics such as these—as is the case with NHS waiting lists, for instance, across the board—I always remember that every one of the figures is about a human being. Whether it is a parent, a child or a grandparent, they are someone’s loved one. And every one of them will be worried, or even scared, about their diagnosis; their lives are disrupted and they may be living in pain.

My hon. Friend brought that to life in her speech from her own personal experience. May I express my very sincere condolences to her for the loss of her mother? Such a loss is so sad, especially as it came too soon; I believe that her mother was only in her 50s when she died last year. My thoughts are also with her staff member Bradley, who she mentioned, whose mother would have been 58 today. Also, the hon. Member for Westmorland and Lonsdale (Tim Farron) mentioned his mother, who very sadly died of cancer. So this is a moment to think about mothers, perhaps particularly with mother’s day coming up. My best friend in childhood lost her mother to cancer when we were in our teens, and I clearly remember how that was for her. And there are so many other people who have lost loved ones to cancer, too often before their time. That is why diagnosis and treatment of cancer is so important to so many of us.

My hon. Friend rightly spoke about the importance of early diagnosis and prompt treatment. They are important for everybody. However, she particularly talked about areas with higher rates of cancer and the above-average levels of cancer in her own area. As she said, health disparities are part of the problem and they must be tackled, too.

Clearly, and rightly, my hon. Friend keeps a close eye on the performance in her area. I see my job as a Minister to look across the whole country and to help our healthcare system to tackle variation in performance, and indeed to level up where there are inequalities, because everybody should have access to early diagnosis of cancer and effective treatment for it.

Right now, I have three priorities for cancer: one is to recover from the pandemic and reduce the pandemic backlog; the second is to improve early diagnosis and treatment, using the tools and technologies that we have; and the third is for there to be investment in research and innovation, and for those innovations to be developed to make a difference to people’s lives and to the diagnosis and treatment of cancer. We know that technologies such as genomics and artificial intelligence, for instance, have the potential to truly transform our ability to diagnose and treat cancer effectively as a society.

[Peter Dowd]

Yesterday, I received an email from Sarah Taylor on behalf of the #CatchUpWithCancer and Radiotherapy4Life campaign. Among other things, she indicated that in May 2022 over half the heads of radiotherapy departments wrote to the Health Secretary and warned that

“radiotherapy is at crisis point”.

However, to our knowledge, so far they have not had a reply from the Department. Will the Minister try to chase that up if I provide her with further information?

[Helen Whately]

I will come on to talk about radiotherapy, but I can say to the hon. Gentleman here and now that I will indeed look into what has happened to the response to that letter.

However, I will start by talking about the waiting times, recovery from the pandemic and reduction of the pandemic backlog. Our elective recovery plan included the ambitious target to return the number of people waiting for more than 62 days for an urgent cancer referral back to pre-pandemic levels by this month. Since the publication of that recovery plan, the NHS has seen enormously high demand for cancer checks. More than 2.8 million people were seen in the 12 months to January 2023—up by 19% compared with the same period before the pandemic. The return in demand, with people coming forward for cancer checks, is very positive after the falls we saw in the pandemic.

When giving evidence to the Health and Social Care Committee last week, Dame Cally Palmer, NHS England’s national cancer director, said that

“we are not going to meet the pre-pandemic target by the end of March, simply because of those record levels of demand.”

That is already in the public domain. However, I assure hon. Members that we are working closely with NHS England to reduce the time people are waiting to receive a diagnosis, or an all-clear, and to start treatment, and we are making progress on that. The latest published figures show that the 62-day cancer backlog for the week ending 26 February stood at just over 22,000, which is a fall of 35% since its peak in the pandemic. However, that is 22,000 people too many who have had to wait 62 days, and many of them will have had to deal with the anxiety of waiting for a diagnosis or an all-clear, which is why we are working so hard on this issue with NHS England.

As I said, it is good that more people have come forward for cancer checks but, in response, we must increase our capacity to diagnose and treat cancer. That is one reason why we have been investing in community diagnostic centres, and we have more than 93 centres open and operational. That is why the NHS is rolling out what we call fit tests to speed up diagnosis for people who may have, for instance, bowel cancer. That is why the NHS is rolling out teledermatology to speed up diagnosis for people who may have skin cancer, and speeding up access to MRI scans for people who might have prostate cancer. Those are the three types of cancer with the most people waiting for a diagnosis or an all-clear or, if they have a diagnosis, to start treatment, and I am determined to reduce those waits.

When I meet charities and clinicians, the one message I consistently hear is how important early diagnosis is for improving patient outcomes and care, and that was something my hon. Friend the Member for West Bromwich East referred to. She talked about the ambition in our long-term plan to be diagnosing 75% of cancers at stages 1 or 2 by 2028. As part of achieving that, we are extending targeted lung health checks, with more than double the number of community lung truck sites. The targeted lung health checks programme had diagnosed 1,625 lung cancers by the end of December 2022, with 76% of those diagnosed at an earlier stage.

To help people get a cancer diagnosis or an all-clear more quickly, since November GPs have been able to directly order diagnostic tests such as CT scans, ultrasounds or brain MRIs for patients with concerning symptoms who fall outside the National Institute for Health and Care Excellence’s guideline threshold for urgent referral. Alongside that, community pharmacists in pilot areas are helping to spot signs of cancer in people who might not have noticed symptoms or realised their significance, and we continue to see non-specific symptom pathways rolled out. As of December 2022, more than 100 are live across the 21 cancer alliances.

To encourage people to contact their GP if they notice, or are worried about, symptoms that could be cancer, NHS England has run the “Help Us, Help You” campaign, which seeks to address the barriers deterring patients from accessing the NHS if they are concerned they might have cancer. In March and June 2022, we saw a 1,600% increase in the number of visits to the NHS website’s cancer symptoms landing page, so the campaign had a huge impact on the number of people looking to see whether they might have cancer symptoms. NHS England is in the process of planning “Help Us, Help You” activity for 2023-24, to make sure we continue the momentum and continue to encourage people to come forward if they have worrying symptoms of something that might be cancer.

However, we all know that diagnosis is just the first step on a patient’s journey, so we are also taking steps to improve cancer outcomes by rolling out innovative new treatments, such as the potentially life-saving drug pembrolizumab for one of the most aggressive forms of breast cancer, and mobocertinib to treat a specific form of lung cancer. The National Institute for Health and Care Excellence has made positive recommendations in all 18 of its appraisals of breast cancer medicines since March 2018, and those medicines are now available to NHS patients. NICE is also able to make recommendations to the cancer drugs fund, which has benefited more than 88,000 patients, with 102 medicines receiving funding for treating 241 different cancers.

My hon. Friend the Member for West Bromwich East mentioned radiotherapy equipment, as did the hon. Members for Westmorland and Lonsdale and for Bootle (Peter Dowd). Since 2016, more than £160 million has been invested in radiotherapy equipment so that every radiotherapy provider has access to modern, cutting-edge radiotherapy equipment. That investment enabled the replacement or upgrade of around 100 radiotherapy treatment machines and in some cases the roll-out of new techniques, such as stereotactic ablative radiotherapy. On top of that, £260 million has been invested in establishing two services to deliver proton beam therapy in London and Manchester.

On the workforce, from 2016 to 2021, the number of therapeutic radiotherapy staff grew by more than 17%, and the number of clinical oncologists by more than 24%. From 2021, there has also been an uplift in the number of entry-level places available, with 108 in clinical oncology, up from an average of around 60 per year in previous years.

I want to pick up on the claim that only 27% of cancer patients are treated with radiotherapy. That claim is outdated and incorrect, as it includes radiotherapy only as part of a patient’s primary treatment for cancer and does not capture a substantial proportion of patients who receive radiotherapy as a subsequent treatment. Also, I am told that the data is from 2013-14, so that is also out of date. NHS England has assured me—I have looked into this—that those who need radiotherapy treatment can access it.

Finance (No. 2) Bill

Debate between Helen Whately and Peter Dowd

2nd reading: House of Commons
Monday 11th December 2017 Commons Chamber

[Peter Dowd]

My hon. Friend makes an excellent point. The Government have reached the stage where they blame anyone they can. The gaffe-prone Chancellor has blamed disabled people for bringing down the productivity rate. He is so out of touch that such comments are water off a duck’s back to him.

As the Minister said, this is the third Finance Bill of the year. All three of them have failed to address the challenge that our economy faces.

[Helen Whately (Faversham and Mid Kent) (Con)]

The hon. Gentleman referred to low wages, but he knows that the Finance Bill contains measures to raise the national minimum wage, so we are addressing that. He seems to be reluctant to answer people’s questions, so I want to bring him back to some that he was asked a few moments ago. My hon. Friend the Member for Aldershot (Leo Docherty) asked him a simple question about the shadow Chancellor of the Exchequer, and the hon. Member for Dover (Charlie Elphicke) asked him a clear question about the cost of Labour’s proposals. The answer is not written down anywhere, so may I ask—this is the 24th time—about the amount and cost of borrowing that would result from Labour’s tax proposals?

[Peter Dowd]

The hon. Member for Aldershot (Leo Docherty) might not like the answer that I gave to his question, but I have referred him to the documentation. If the hon. Lady is incapable of going to the internet and looking up the facts and figures, it is not for me to do that for her. The bottom line is that there is nothing in the Bill for public sector workers, who head into the new year with their wages continuing to fall and the cap sticking.

Benefit Claimants Sanctions (Required Assessment) Bill

Debate between Helen Whately and Peter Dowd

2nd reading: House of Commons
Friday 2nd December 2016 Commons Chamber

[Helen Whately]

I agree with the hon. Lady that it would be good to have a consistently high standard of support in jobcentres across the country. I do not agree, however, that a Bill is the right way to achieve that. There are other ways of achieving improvement across all the sectors of our public services. I have done an enormous amount of healthcare work, as she might know, and I do not believe that legislating from the top is necessarily the right way to reduce variation and bring everyone up to the level of the best. There are many ways of doing that that do not involve legislation.

[Peter Dowd]

I want to ask a specific question about the Bill. Clause 1 states:

“Before sanctions or reductions (“sanctions”) may be imposed on a person in receipt of social security benefits which will have the effect of reducing or restricting those benefits—

(a) an assessment of the relevant circumstances of the person must be carried out, and

(b) conditions in this Act found to be satisfied.”

What is the problem with that principle?

[Helen Whately]

I am going to deal with that point later in my remarks. As I was saying a moment ago to the hon. Member for Paisley and Renfrewshire South, legislation is not always the right way to achieve improvement. Personally, I believe that, where possible, it is better to give those who work in the public sector greater autonomy to do a really good job. That gives people an enormous amount of motivation, because they usually go into those jobs because they want to make a difference.

--- Later in debate ---

[Helen Whately]

My hon. Friend is right that those circumstances are considered already, so much of what is in the Bill duplicates what is already done, and is included in extensive guidance to work coaches.

[Peter Dowd]

Will the hon. Lady give way?

[Helen Whately]

I wish to move on now to speak about mental health.

--- Later in debate ---

[Peter Dowd]

Just briefly, please.

[Helen Whately]

I will give way briefly.

[Peter Dowd]

The hon. Lady says that legislation should not be introduced when it is not necessary, but the Government are poking their noses in all sorts of places where they should not be, so why not here? [Interruption.] She does not like legislation, but what about a code of conduct setting out the procedures, tests and standards to be followed and applied in carrying out assessments? What is wrong with a code of conduct laid down via regulation?

[Helen Whately]

As I literally just mentioned, there are already extensive guidelines, so why add to them with another code of conduct? It is simply duplication.

I wish to move on now to mental health. I am chair of the all-party group for mental health, and I recognise that there have been particular problems with sanctions being imposed on people with poor mental health. We know that people with mental health problems have been disproportionately affected by sanctions, partly because of the complex and fluctuating nature of those conditions, and that sanctions have caused them a great deal of stress and anxiety.

Mind, the mental health charity, has made the point about the great number of people with mental health conditions who have been receiving sanctions. In its evidence to the Work and Pensions Committee in 2014, it talked about the problems with the way that people with mental health problems were being supported in the benefits system, and those problems persist. We know that an individual’s mental health problems are not always well understood by the people in the jobcentres, and that some of the activities required of them as conditions for receiving benefits can be inappropriate and are sometimes thought to move them further away from work. That can be the case despite the fact that people with mental health conditions frequently very badly want to work.

Efforts are already being made to support people with mental health problems into work. Work coaches already receive guidance specifically on how they can best support people with mental health conditions. For instance, the definition of people regarded as “at risk” now includes those with mental health conditions, so hardship payments can be expedited. In recognising the challenge for people with mental health problems getting into work, the Government have recently published a Green Paper, “Improving Lives”, which is a joint effort between the Department of Health and the Department for Work and Pensions. I very much welcome it, as it recognises that there is a large employment gap between those in good health and those with long-term illnesses—physical and mental—and it sets out a series of proposals to try to improve that situation. One proposal seeks to improve the support for people with mental health conditions, including developing the employment offer alongside talking therapies, enhanced training for work coaches to support people with mental health conditions, more disability employment advisers, and personal support packages offering better tailored employment support for people with health conditions. That set of proposals must be a reminder to everyone here how committed the Government are to helping people with health conditions into work, particularly those with mental health conditions. The Government are doing an enormous amount to help people in these situations. The Green Paper is very much part of a common theme of the Government listening, responding to the situation and trying to make the system better.

On the other actions the Government are taking, we have heard that they accepted the recommendations of the Oakley review. The Work and Pensions Committee, in its recent follow-up review, said:

“We welcome DWP’s acceptance of the Oakley Review’s findings, and the steps that it has taken towards implementation of the Review’s recommendations.”

The Government have accepted many of the recommendations in the Select Committee’s follow-up report, including trialling the yellow card system, so claimants will have 14 days’ warning before they are sanctioned, and we will soon hear how that has gone. The Government have been issuing comprehensive guidance to staff to improve awareness of how JSA conditions can be varied to take account of the claimant’s physical or mental health condition and caring responsibilities. The Government have also provided for claimants to agree with their work coach any restrictions in their pattern of availability and/or in the type and hours of work they are capable of doing, as long as the restrictions are reasonable in light of their condition. Therefore, all JSA claimants should have conditionality requirements that are tailored to their specific circumstances. As more people move on to universal credit, more will benefit from its even more tailored approach.

To conclude, given all that is being done to improve the system we have—a system that is rightly designed with a level of flexibility to allow for improvement—the Bill is unnecessary and unhelpful. It is unnecessary because it seeks to legislate for things the Government are already doing. For instance, there is guidance that requires an assessment to be carried out of whether hardship payments are appropriate. There is also a whole set of guidance about things that would count as good reasons for a claimant not to attend an appointment or make their Work programme commitments. Those good reasons include things such as homelessness, travel time, domestic violence, bullying, harassment, mental health conditions and learning difficulties.

I could go on, but, as has been said, that list is not intended to be exhaustive, and it gives scope for judgment on the part of the decision maker. Critically, the system we have is intended to support and enable work coaches to give flexible support to the individuals they are helping into work. It is intended to give some autonomy and responsibility to jobcentres in supporting people into work.

What we should not try to do where a system does not work perfectly is always to centralise and always to legislate. It is better to persist with an approach that is about improving the way the service works on the ground. My experience of work coaches is that they are thoughtful and doing their absolute best for the individuals they are trying to help into work, and I absolutely support them. What they have told me they need more than anything is time to spend with the individuals they are supporting. What they do not need is more complexity, more legislation and more rules that might get them into legal knots. Let us give them the support and the time to do the best possible job by the individuals they are helping into work.

Welfare Reform and Work Bill

Debate between Helen Whately and Peter Dowd

Tuesday 27th October 2015 Commons Chamber

[Helen Whately]

Public sector workers are getting a 1% pay rise. Over the past few years, private sector pay has, in the main, been frozen while public sector pay has continued to go up.

I will move on to the Opposition amendments on the benefits cap. The Government intend to reduce the cap to £20,000, or £23,000 in London. We should be clear that that is the net figure, so it would amount to a salary of about £25,000 before tax. We have heard some rather mixed messages from Labour Members. Their leader has said that he wants to cap benefits overall but not for individuals. I am sure that it will become clear today exactly where they stand on the amendments tabled by SNP Members, who I understand do not want any reductions in the benefits cap. Benefits should be a safety net. We need a benefits system that is sustainable and therefore affordable and fair. It cannot allow people to do better on benefits than in work. That creates the wrong incentives. It is also deeply unpopular and therefore unsustainable in its own right. Surely Opposition Members have had conversations with people who are just above the threshold that would allow them to receive most benefits. They must understand their legitimate anger when they see their taxes funding a lifestyle they cannot afford.

[Peter Dowd]

Is the hon. Lady aware that 70% of the money that the Treasury will save as a result of cuts to tax credits will come from working mums?

[Helen Whately]

It was pointed out in Committee that people who receive benefits also pay tax. I do not think we should try to parcel people up in different tribes or groups. This is about getting the right thing for the country, trying to help everybody make the most of their opportunities and making work pay.

I have certainly had difficult conversations on the doorsteps in my constituency, because the majority of employees in Faversham and Mid Kent are paid less than £20,000 per annum. At its current level the benefits cap has been working. More than 16,000 capped households have moved into work, and households subject to the cap are 41% more likely to get into work. We know that work is the best way out of poverty and I believe that everyone in this House wants to see people move out of poverty. We should make the benefits cap work harder. That is what this is about.