NHS 10-Year Plan

Henry Smith Excerpts

Tuesday 19th February 2019 Commons Chamber

[Henry Smith (Crawley) (Con)]

Thank you, Madam Deputy Speaker, for calling me to speak in this debate on the NHS long-term plan. I have the privilege of being the chair of the all-party group on heart and circulatory diseases—I took over chairing it last year—and I was very pleased to set up the all-party group on blood cancer in 2016. I would like to speak about both of those in turn.

There are over 130 types of blood cancer, each with its own unique symptoms, treatments and side effects. It is the fifth most common cancer in the UK and, sadly, the third biggest cancer killer, with about 40,000 people diagnosed with each year. The rate at which it affects people is far greater than for breast and prostate cancer combined. Indeed, one in 19 people will be diagnosed with a blood cancer in their lifetimes, and about 240,000 people currently live with blood cancer in the UK.

The NHS long-term plan sets out a number of areas that affect blood cancer. On early diagnosis, the ambition to have 75% of all cancers diagnosed by stage 1 or stage 2 by 2028 is welcome, as many blood cancers are very difficult to diagnose at an early stage. A recent parliamentary answer from the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Winchester (Steve Brine), to the hon. Member for Scunthorpe (Nic Dakin) stated that there are 17 cancer sites for which no staging system exists and 67 cancer sites that are unstageable. Some blood cancers fall into these categories, and I would be grateful for clarification and assurances that these will be addressed.

I turn briefly to heart disease. Heart and circulatory disease still causes a quarter of all deaths in the UK. On average, it kills one person every three minutes or 420 people each day. The number of people living with heart and circulatory disease also remains high, at 5.9 million people across England, and there are over 42,000 premature deaths from cardiovascular disease each year in the UK.

I am delighted to see that the NHS long-term plan has a renewed focus on the prevention and early detection of the risk factors for heart and circulatory diseases. Four in 10 adults with high blood pressure remain undiagnosed, and it is estimated that one in five of those who have been diagnosed are not being optimally treated. By identifying more people who have these conditions, we can help to manage their risk and save more money and of course, crucially, lives.

I welcome the work that the voluntary sector does in supporting the NHS, and I am grateful to the Government for investing £20.5 billion more each year for the next five years in this very important service.

Exiting the European Union (Medicines)

Henry Smith Excerpts

Tuesday 19th February 2019 Commons Chamber

[Jackie Doyle-Price]

My purpose this afternoon is to ensure that we have business as usual post-exit day, and that we can maintain patient safety at that time. I would not want to encroach on any debate beyond that now.

Questions were raised regarding research funding. I should advise the House that before the Brexit vote the UK was involved in more EU-funded science projects than any other country. The UK secured 14.3% of the total share of the funding to date and is the second-highest recipient of grant funding. We are committed to remaining a world leader in science and research, and that is why, in our modern industrial strategy, we have committed to spending 2.5% of our GDP on research and development by 2027. We have invested an extra £7 billion in research and development as a first step towards that.

[Henry Smith (Crawley) (Con)]

My hon. Friend has said that just over 14% was received by this country from EU funds. Does she have the figures to hand—I would not blame her if she did not—for the percentage of funds that we gave to the EU to be distributed around the bloc?

[Jackie Doyle-Price]

I do not have a detailed knowledge of the accounts in that regard. I can only tell the House how much we have received, and how we are replacing it, which is really the crux of the matter.

Mention was also made of what the Government are doing to prevent the loss of EU nationals working in research. We have been clear that we wish the UK to continue to be an open and tolerant nation, and to continue to attract the brightest and the best. That is equally applicable here. The Prime Minister told the House of Commons on 21 January:

“Having listened to concerns”

about the settled status scheme

“I can confirm today that, when we roll out the scheme…the Government will waive the application fee”.—[Official Report, 21 January 2019; Vol. 653, c. 27.]

We want to give a clear message that we are open for business and open to the brightest and the best.

In bringing these regulations to the House, the central point is that the fundamentals of how clinical trials operate will remain the same and that, wherever possible, we have sought to maintain existing arrangements rather than creating new ones. While it is not the focus of this statutory instrument, the Government are working to ensure that the trials have continuity of supply and will continue as planned. I commend these orders to the House.

Question put and agreed to.

Resolved,

That the draft Medicines for Human Use (Clinical Trials) (Amendment) (EU Exit) Regulations 2019, which were laid before this House on 23 January, be approved.

NHS Long-term Plan

Henry Smith Excerpts

Monday 7th January 2019 Commons Chamber

[Matt Hancock]

I will raise the hon. Lady’s point with NHS Improvement, which considers these things. Local provision of services should, rightly, be decided by local clinical priorities, but she makes a cogent point that I will raise with NHSI, and I will ask its chief executive, Ian Dalton, to write to her.

[Henry Smith (Crawley) (Con)]

I declare an interest, as chair of the all-party parliamentary group on blood cancer and the APPG on heart and circulatory diseases. I very much welcome this plan’s focus on those areas. In tribute to my caseworker, Susan Lester, who sadly passed away last week from pancreatic cancer, can I have an assurance from the Secretary of State that he will continue to work with voluntary sector organisations such as Bloodwise, the British Heart Foundation and Pancreatic Cancer UK?

Blood Cancer

Henry Smith Excerpts

Friday 23rd November 2018 Commons Chamber

[Henry Smith (Crawley) (Con)]

I am grateful for the opportunity to raise the important issue of the NHS long-term plan and blood cancer. In doing so, I congratulate my hon. Friend the Member for Wimbledon (Stephen Hammond) on his appointment to his ministerial position.

We are already nearing December. It is often said that the months seem to fly by, and this is very much the case in terms of the work of the all-party group on blood cancer throughout 2018. As chair of the all-party group, it certainly does not seem like almost a year ago that we launched our first report, which coincided with a Westminster Hall debate on blood cancer care and the NHS. As we come towards the end of the year, we are also approaching the publication of the Government’s long-term plan for the NHS. It is vital that the needs of blood cancer patients are considered and implemented if we are to build on the progress undertaken in recent times for people with blood cancer.

Our all-party group has continued to take evidence from a host of experts and to raise further awareness with health officials and policy makers. Our pursuit of this cause in Parliament is ongoing. September saw Blood Cancer Awareness Month. To mark that occasion it was my pleasure to host Bloodwise, as it invited MPs to meet members of their successful and ever growing patient ambassador programme. Speaking with people such as patient ambassadors really helps to put cancer into a human context. It is important to highlight the fact that some 40,000 people are diagnosed with blood cancer in the UK each year, but listening to just one or perhaps a handful of people who are either living with or have been treated successfully for blood cancer is a powerful reminder that behind every statistic are individual patients, with their own story to tell.

[Mark Tami (Alyn and Deeside) (Lab)]

I add my praise for the work that the hon. Gentleman has been doing with the all-party group. When it comes to patients who need a transplant, around 60% of patients who are white will get the best possible match, but if someone comes from a black, Asian and minority ethnic background, that drops to 20%. Does he agree that we need to do much more work to improve this dreadful situation?

[Henry Smith]

I am grateful for the hon. Gentleman’s intervention, and I pay tribute to him for his contribution to this debate and for raising this matter in this place just yesterday. I absolutely endorse what he says about the importance of transplantation.

Last week, the APPG held its latest meeting on the timely topic of ensuring that patients have access to the best drugs and treatments, ahead of the publication of the NHS plan. In recent months, there have been some significant decisions regarding treatments for blood cancer on the NHS. In September, CAR—chimeric antigen receptor—T-cell therapy was approved for entry into the cancer drugs fund by the National Institute for Health and Care Excellence and NHS England to treat children and young people with relapsed acute lymphoblastic leukaemia. CAR-T therapy is a new type of therapy that modifies a person’s infection-fighting T cells to better spot and kill cancer cells. It could offer people with certain hard-to-treat blood cancers the chance for long-term survival, or even a cure.

I was pleased to question my right hon. Friend the Prime Minister at Prime Minister’s questions about CAR-T therapy following the NHS England announcement. I continue the call I made that day for the Government to ensure that a focus on blood cancer awareness, diagnosis and prevention will continue into the future. With that in mind, will the Minister update the House on when people with blood cancer are likely to benefit from CAR-T treatment and on whether the health system is ready for this type of personalised medicine?

Additionally, NHS England changed its mind recently and allowed ibrutinib to be used for patients with chronic lymphocytic leukaemia after three years’ remission. The development of new drugs is ongoing. Bloodwise estimates that over one third of all indications for which drugs are funded on the cancer drugs fund are for blood cancer, which highlights not only the challenges we face, but the potential to help.

In January, the APPG launched its inaugural report, “The ‘Hidden’ Cancer—The need to improve blood cancer care.” Key to this is the word “hidden”. Blood cancer is known as the hidden cancer because although patients may indeed be receiving or waiting to start treatment, they may not be displaying any obvious or visible signs of ill health.

I am careful to try to refer to patients and their support networks, especially in this context, as the impact of diagnosis on a patient’s family must also be considered, especially when children are involved. This is particularly the case for patients on so-called watch and wait. That is typically an option only for people with few or no worrying symptoms, whose quality of life and prognosis will not be affected by delaying treatment, and it is recommended for those with blood cancers or related conditions that are stable or slow-growing. However, if someone has been told that they have cancer and, at the same time, they know that they will literally watch and wait to see when they are in a position to begin treatment, it is understandably disconcerting, to say the least. Patients on watch and wait told the APPG inquiry that specific emotional support was required to help them to come to terms with what was happening. Approximately 27,000 people with blood cancer are currently on watch and wait in the UK. To put this in context, that is 13% of those living with blood cancer.

Turning to mental health, anyone with experience of living with cancer or supporting a friend or family member who has done so will know of the dedication of NHS staff and health workers in seeking to do all that they can to provide support. However, it is vital that these staff are given the tools to ensure that patients are fully equipped mentally through the psychological support that they receive. Our APPG report recommended:

“Patients should have access to the full range of emotional and psychological support services throughout their treatment, for themselves and their families”.

The Government have put mental health on a par with physical health. As such, I would be grateful for the Minister’s assurances that blood cancer patients will receive the psychological support that they need after diagnosis, during treatment and after it has been completed.

I congratulate the hon. Member for Alyn and Deeside (Mark Tami) again on his Adjournment debate yesterday on psychological support after cancer treatment. By working together on a cross-party basis, it has become powerfully apparent to me that we can make a significant difference. Indeed, I have mentioned that only last week, the blood cancer APPG held its latest meeting on access to drugs and treatments for patients. We were fortunate to be joined by MPs, charity representatives and, of course, patients, one of whom said something that has remained in my mind. She said that patients

“don’t know if they’re living or dying”.

That highlights succinctly and powerfully the importance of this work and the importance of patients, politicians, cancer charities, the Department of Health and Social Care and the wider national health service in ensuring that patients are supported as well as treated.

One of the most striking passages of our APPG report referred to the long-term nature of blood cancer, and how it is different from solid tumour cancers. Respondents to our inquiry found that the term “living beyond” blood cancer was irrelevant. They will probably never live without blood cancer—it will remain part of their life—and very few of those patients have access to the recovery package. Indeed, one respondent even said that they did not know what the recovery package was, which is a point of concern. The recovery package assists patients after their cancer treatment has ended so that they can seek to return to their normal life.

I welcome the fact that the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Winchester (Steve Brine) recently reiterated that

“the recovery package is being commissioned and delivered in full or in part by many Clinical Commissioning Groups and providers across England”.

He continued:

“NHS England’s aim is to accelerate the process to ensure full implementation by 2020 so the package will be available to all cancer patients across the country regardless of location.”

He also stated that NHS England was

“building up a picture of current provision to help target future work to support rollout.”

I should be grateful for clarification from the Minister for Health on how support for blood cancer patients is included in this analysis.

Turning to data collection, the inclusion of blood cancer in a range of data collection initiatives will help policy makers to gain a greater understanding of the condition and how patients can be supported. For example, clinical commissioning groups and cancer alliances do not group blood cancer into a single disease area, unlike the national cancer patient experience survey, which means that blood cancer currently receives less attention and therefore fewer resources. The inclusion of blood cancer in the cancer dashboard, which only covers breast, colorectal, lung and prostate cancers, would be a step forward for patients.

Earlier this year, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Winchester, said in a written answer:

“A second iteration of the dashboard is being considered by the National Cancer Transformation Board with a wider ambition to include rarer cancers and cancers with a lower incidence, such as blood cancers, as the dashboard develops.”

May I ask when we may expect such a development to come into effect?

GP surgeries are a vital part of the NHS. Like all MPs, I receive correspondence from my constituents on the subject of access to GPs. Indeed, in the NHS plan, we need enhanced support for doctors and their capacity to see patients every day, both in Crawley and up and down the country. While the A&E in Crawley Hospital was closed under the previous Government, Crawley Hospital urgent care centre is now open 24 hours a day, seven days a week. I urge the Minister to ensure that hospital services continue to come back to sites such as Crawley Hospital, while at the same time ensuring that the resources are in place to enable our constituents to access their GP, not on the other side of the town or county, but in their own local area.

GPs need more assistance to detect and flag up blood cancer. A GP will see, on average, eight cases of cancer per year, only one of which will be blood cancer. The number of GP visits needed before a cancer diagnosis is significantly higher for blood cancer patients than for people with other forms of cancer. Someone with cancer will of course want to be diagnosed the first time they see their GP with symptoms, but one in six blood cancer patients needed to visit their GP three, four or even more times before diagnosis. Only one in 42 breast cancer patients required such regular visits to be diagnosed with their condition.

In the wider debate, the numbers and the statistics are important. Not far shy of a quarter of a million people are living with blood cancer in the UK, and one in 19 people will develop blood cancer at some point in their lives. In Crawley there were fewer incidents of blood cancer than either breast or prostate cancer, but there were more blood cancer deaths than from either of those other forms of cancer. The challenges are immense. Blood cancer is the UK’s fifth most common cancer, and the third biggest cancer killer. However, there are reasons to be positive. Over a period of almost four decades, from 1971-72 to 2010-11, 10-year survival rates for leukaemia, one of the most common groups of blood cancer, increased from 7% to 46%. Among children, the figure has trebled to 81%.

In all those figures are the individuals who live with blood cancer, who care for family members who are patients, or who are advocates on behalf of those affected by the condition. My constituent Bill Bedford was diagnosed with myeloma in September 2016. He has undergone a stem cell transplant operation and is now fortunately in remission. Bill is one of many patients who are seeking to give something back. He has undertaken a 310-mile cycle ride, from London to Paris, to raise funds for Myeloma UK. Seven-year-old Ebonie Musselwhite, also from Crawley, was diagnosed with acute lymphoblastic leukaemia two years ago. About 650 people are diagnosed with ALL each year in this country, half of them children. Crawley Fire Station and Crawley Lawn Tennis Club are just two of the local organisations that have held fundraising events to help contribute to the cost of support for Ebonie. Angus Rowland, a young man living just outside Crawley, was diagnosed with acute myeloid leukaemia in 2010. Sadly, he died in May 2011, just 14 and a half years old. The Angus Rowland Forget-Me-Not Walk and Run took place in October, just outside Crawley, to raise funds for Bloodwise in Angus’s name.

I said at the APPG report launch that we could not just stand there and be pleased with what we had published in our first report. Rather, it must form the basis of a continued programme of work to effect lasting change. To people living with blood cancer right now, who may be on watch and wait, who may be undergoing treatment, or who may have only just been diagnosed, 1 say this: there are people in Parliament who are on your side, and we will stand up for you. We want to help, and we will keep the pressure on the Government and the NHS. To those who may have undergone treatment, who may be having treatment now, or who simply want to ensure greater support for blood cancer patients, my message is simple: contact your local MP and ask him or her to contact the Department for Health and Social Care, NHS England and local clinical commissioning groups. Let us continue to raise awareness, so that blood cancer is no longer the hidden cancer.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I am delighted to welcome back to the Dispatch Box the Minister, Mr Stephen Hammond.

Healthcare (International Arrangements) Bill

Henry Smith Excerpts

Wednesday 14th November 2018 Commons Chamber

[The Minister for Health (Stephen Barclay)]

I beg to move, That the Bill be now read a Second time.

This is a short Bill, with six clauses, to enable continuity of healthcare for British nationals and EU citizens after Britain leaves the European Union. It is clearly in the interests of the British public to ensure reciprocal healthcare arrangements continue when we leave the EU, whether that happens through an agreement with the EU itself or through individual agreements with EU member states. By enabling us to implement those arrangements, the Bill will help us to help nearly 200,000 British pensioners living in EU countries to continue to access the medical treatment that they need, and it will mean that the hundreds of thousands of British citizens who require medical treatment each year during holidays in Europe can still be covered for medical assistance when they need it.

The Bill will help to ensure that UK nationals who live and work in EU countries can continue to access healthcare on the same basis as local people. It will mean that EU citizens can be covered for reciprocal healthcare here, so that the UK continues to be a place tourists want to visit and vital workers, such as our NHS workforce, want to live in. The Bill will also mean that we can continue to recover healthcare costs from Europe as we do now.

[Henry Smith (Crawley) (Con)]

A few years ago, I presented a private Member’s Bill on the recovery of costs under the European health insurance card scheme. More than half of NHS trusts did not record the treating of foreign nationals at all so that they could claim back on those reciprocal arrangements. Can I get an assurance that, under the new arrangements, the NHS will be properly refunded for the care it provides to those from other countries?

[Stephen Barclay]

My hon. Friend makes an important point. Perhaps I should declare that, when I was a Back Bencher, I tabled a number of parliamentary questions on that very issue, relating to my hospitals and to claiming. We pay out around tenfold what we recover. I will come on to that point, but part of the Bill relates to the NHS’s increased focus on the issue, which he is correct to raise.

Reciprocal healthcare agreements benefit people in all regions and nations of the United Kingdom. The Department of Health and Social Care currently funds and arranges EU reciprocal healthcare for people from England, Scotland, Wales and Northern Ireland. The Bill will allow us to continue doing that, if agreed with the EU. We have been working for some time now with the devolved Administrations and will of course continue to do so to ensure that we legislate for reciprocal healthcare in a way that fully respects the devolution settlements.

We can all agree that access to healthcare is essential both for British nationals living in European countries and for EU citizens living in the UK. The Bill will also allow us to strengthen existing reciprocal healthcare agreements with non-EU countries and explore new arrangements. As the Prime Minister said last night, the negotiations for our departure are now in the endgame and we are working to reach an agreement. As Members would expect, we are continuing to make the necessary preparations for all scenarios. It is in everyone’s interests to secure a good deal, but it is the job of a responsible Government to prepare for all scenarios, including in the event that we reach March 2019 without agreeing a deal.

In the event of no deal, the powers in the Bill will help to implement deals with EU countries that will seek to provide continuity of care for UK nationals and avoid a cliff edge. The powers will enable the UK to act swiftly to protect existing healthcare cover for British nationals in the EU, the European economic area and Switzerland, whether deals are made with the EU or individual member states. That is in the interests of everyone and, most importantly, will benefit millions of UK nationals who live, study, work or travel in mainland Europe.

British people who have paid their taxes in the UK their whole working lives and have retired to Spain, France or other EU countries should not have to worry about healthcare and how much it is going to cost them. Similarly, the millions of British people who travel to mainland Europe each year should be able to do so with the peace of mind that the European health insurance card scheme brings. These schemes are popular across the UK. There are currently 27 million EHIC cards in circulation in the UK, with 5 million issued each year. Reciprocal healthcare arrangements enable UK nationals to access healthcare whether they live in, work in or visit EU countries.

The current arrangements involve EU member states reimbursing one another for healthcare costs. We support UK nationals in the EU by spending approximately £630 million a year on healthcare for British expats and tourists. At present, we recover £66 million each year from EU member states under the same rules, but that amount is increasing as the NHS gets better at identifying EU visitors and ensuring that the UK is reimbursed for care provided, which speaks to the point that my hon. Friend raised. It is a net spend because many more British pensioners and tourists go to Europe than the other way around.

It is clearly in the interests of the British public to ensure that reciprocal healthcare arrangements similar to those currently in place continue when we leave the EU. The Bill does not affect the UK’s ability to negotiate or enter into international agreements, and the details of any new reciprocal healthcare arrangements will remain subject to negotiation and parliamentary scrutiny.

Until now, the majority of UK-EU reciprocal healthcare has been enabled by EU regulations. Once we leave the European Union, the EU reciprocal healthcare arrangements will no longer apply in the UK in their current form and we will need new legislation to provide for future arrangements. With a deal, the withdrawal agreement will enable the continuation of existing reciprocal healthcare rules during the implementation period, and afterwards for people covered by that withdrawal agreement, but it is not a long-term arrangement for the British public as a whole, does not provide for the event of the withdrawal agreement not being concluded and does not cover healthcare arrangements with countries worldwide.

The UK already has important agreements in place with Australia, New Zealand and many of our Crown dependencies and overseas territories and the Bill will help us to strengthen those, should we wish to, or seek new arrangements with other countries. The Bill underscores the Government’s commitment to reaching a robust reciprocal healthcare agreement with the EU.

This is important and necessary legislation, introduced so that the British public can look to the future with confidence that they will get the healthcare they need, when they need it. I commend the Bill to the House.

NHS Long-Term Plan

Henry Smith Excerpts

Monday 18th June 2018 Commons Chamber

[Mr Hunt]

Any funding commitment made by the UK Government will be appropriated to Wales in accordance with the Barnett formula. That is the procedure that we have followed. The choice for the Welsh Government is whether they put all that money into the NHS or, as they have done in the past, choose to prioritise it elsewhere.

[Henry Smith (Crawley) (Con)]

I very much welcome my right hon. Friend’s announcement that some of the subscriptions that we will no longer be paying to the European Union will be redeployed for the national health service. Under the last Labour Government, Crawley Hospital lost its A&E department and its maternity department. Over the last eight years, services have been returning. Can I have an assurance that this additional spending on the NHS will follow through with the return of further local services?

[Mr Hunt]

It absolutely needs to boost local services. If there is one lesson that we have learnt from the last few years, it is that we will not, in the long run, crack the funding pressures in our health system unless we find a way of properly investing in local services, which I know my hon. Friend has campaigned for so hard.

Breast Cancer Screening

Henry Smith Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

That is a good point. I can assure my hon. Friend that the Department will be leading a big consultation exercise so that everyone is informed about how their individual organisations will be affected.

[Henry Smith (Crawley) (Con)]

As chair of the all-party parliamentary group on blood cancer, I am pleased that the Secretary of State talked about the lessons that will be learned from this breast screening error. Will he assure me that what is picked up will inform future diagnostic programmes?

[Mr Hunt]

Absolutely. That will be one of the most important things that the review does.

Oral Answers to Questions

Henry Smith Excerpts

Tuesday 20th March 2018 Commons Chamber

[Mr Speaker]

Order. In Question Time, as in the health service under all Governments, demand tends invariably to exceed supply. We have time only for two more—we do not really have time, but I am creating it.

[Henry Smith (Crawley) (Con)]

I would like to thank the Under-Secretary of State for Health, the hon. Member for Winchester (Steve Brine), for his response to the all-party parliamentary group on blood cancer report. Will he continue to ensure that cancer alliances and GPs are diagnosing early?

[Steve Brine]

That is an easy one—absolutely, yes.

Mental Health Services: Children and Young People

Henry Smith Excerpts

Thursday 8th March 2018 Commons Chamber

[Steve Brine]

I do not know about the issue in St Helens. I will look into it, or ask my colleague, the Under-Secretary of State for Health, to do so, and get her to write to the hon. Gentleman.

[Henry Smith (Crawley) (Con)]

I very much welcome the Government’s commitment to mental health workers throughout England’s schools. Will my hon. Friend update the House on its timely roll-out?

[Steve Brine]

As I have said, we will be considering the four-week pilot as part of the Green Paper. We want to see these mental health first-aiders in schools, and as soon as we can give my hon. Friend an exact timetable on the situation Crawley, as well as elsewhere, I am sure that my colleague the Under-Secretary will do so.

NHS Blood Cancer Care

Henry Smith Excerpts

Wednesday 17th January 2018 Westminster Hall

[Henry Smith (Crawley) (Con)]

I beg to move,

That this House has considered blood cancer care in the NHS.

Mr Wilson, it is a pleasure to serve under your chairmanship.

Like many people in this room today, I have lost a family member to blood cancer. Five and a half years ago, my mother died from acute myeloid leukaemia, also known as AML, an extremely short time after diagnosis. I have been touched by the many stories of families in Crawley and nationwide who have contacted me to share their own experiences of losing a family member to blood cancer. With conditions such as AML, there is an incredibly short time—sometimes just a matter of days—between being diagnosed and this form of blood cancer taking a life.

It was with those stories in mind that in 2016 I was pleased to set up the all-party parliamentary group on blood cancer. I place on the record my thanks to all colleagues, including those who left Parliament last year, for their work in getting the group up and running and in starting our inaugural inquiry on NHS blood cancer care. While the inquiry, held last year, and the report, to be launched in the Palace of Westminster right after the debate, focus on the implementation of the cancer strategy for England, we are keen to learn from examples of good practice in Scotland, Wales and Northern Ireland and have made approaches to the devolved Administrations accordingly.

[Nick Thomas-Symonds (Torfaen) (Lab)]

I would like to talk about a Welsh example: my young constituent Emily Clark, who was diagnosed at 16 and subsequently sadly passed away. During the period of her illness, her work in setting up the RemissionPossible initiative resulted in 4,000 more people joining the stem cell donor register. Will the hon. Gentleman praise Emily, and her mother Donna Dunn, who is continuing the work?

[Henry Smith]

My condolences to Emily’s family. There are all too many examples of young people passing away from blood cancer. I pay tribute to Emily’s mother for a fine legacy. It is sad that a young life has been lost to this condition, but wonderful that so much good work has been done as a result. I would be grateful if the hon. Gentleman passed on my best wishes to them.

[John Howell (Henley) (Con)]

I congratulate my hon. Friend on the excellent work he is doing in this sphere. Blood cancer is a bit of a hidden cancer. If someone has a solid tumour, it can be seen and treated and they can see what is happening with it, but blood cancer is difficult to detect. What is he doing to encourage early detection?

[Henry Smith]

My hon. Friend anticipates some of my remarks in a few moments’ time, but he is absolutely right to use the words “hidden cancer”. Blood cancer is very different from solid tumour cancers—that is a key point and problem.

I was going to say that, from four o’clock, right hon. and hon. Members are very welcome to come along to Strangers’ Dining Room for the launch of our report.

[Mark Tami (Alyn and Deeside) (Lab)]

I join others in praising the hon. Gentleman for securing this debate and for the report, which will be published later. I apologise for having to leave, but I am chairing the all-party stem cell group at three o’clock, so everything is coming together at the same time.

Does the hon. Gentleman agree that in this area, as in stem cell research, great progress has been made over recent years, and we do not want to lose that progress? Financial budgets are tight, and we realise that the health service faces many challenges, but we need to keep the research going. There has been great progress in this area and we must not lose it.

[Henry Smith]

The hon. Gentleman has a fine excuse for leaving the debate early, and I endorse everything he says. Future stem cell research is critical; this country has made a good start, but we cannot be complacent in any way, shape or form.

The APPG’s work focuses on blood cancer—as my hon. Friend the Member for Henley (John Howell) said, it is a hidden cancer—on the differences between blood cancer and solid tumour cancers such as breast cancer and prostate cancer, and on the ways in which patient outcomes can be improved with Government, medical professionals and local healthcare bodies working in partnership.

It is not an exaggeration to say that blood cancer is one of the great public health challenges of our time. We know it is the third biggest cancer killer in the UK, the fifth most common cancer overall, and by far the most common cancer among people under the age of 30, as we heard from an intervention earlier.

[Mike Hill (Hartlepool) (Lab)]

I congratulate the hon. Gentleman on securing the debate. On the point of cure, will he celebrate with me the fact that one of my young constituents, Elly-Mae Waugh, aged 12, was confirmed cancer-free in November 2017, having been treated for two years for lymphoblastic leukaemia? Does he agree that there is hope and that there is a need to better finance research into blood cancer developments?

[Henry Smith]

I am delighted by the news that the hon. Gentleman’s young constituent is cancer-free; that is wonderful to hear. There are positive stories that we can draw on. Antonio, the son of our former colleague Sir Nick Clegg, the former Deputy Prime Minister, was fortunately given the all-clear from the blood cancer he was being treated for. I thank the hon. Gentleman for highlighting those positives.

A key factor in ensuring early diagnosis is a greater knowledge and understanding of the symptoms of blood cancer. Diagnosing one of the 137 different types of blood cancer can be complex because symptoms such as back pain or tiredness can, of course, easily be misunderstood or misdiagnosed. Other symptoms of blood cancer include night sweats, weight loss and bruising, and in the first instance can often appear similar to feeling “run down” or having the flu, as was the case with my mother. We thought she had flu for a couple of weeks beforehand, and then she sadly passed away in a very short time.

[Julia Lopez (Hornchurch and Upminster) (Con)]

I thank my hon. Friend for securing an extremely important debate. He talks about the trouble of diagnosing hidden cancers such as leukaemia in adults, but it is sometimes particularly difficult to diagnose cancers in children. Before Christmas I had a sad meeting with a constituent of mine whose daughter Isla Caton has neuroblastoma, a particularly vicious form of childhood cancer. He discussed how it took three months to diagnose her, because she was only showing lethargy and people had come up with various different diagnostic ideas. In Japan, they test children from birth—

[Julia Lopez]

I am sorry, excuse me. Does my hon. Friend encourage tests from birth to diagnose these sorts of cancers?

[Henry Smith]

My hon. Friend raises a very valid point. I mentioned best practice for NHS England and talking with the devolved Administrations, but we also have to go internationally for that best practice. She commented on the difficulty of diagnosis and people having to go to the GP many times before diagnosis, which sadly is a common story.

[Royston Smith (Southampton, Itchen) (Con)]

On the point about people and diagnosis that my hon. Friend just mentioned, is there some weakness within the system that means that GPs are not diagnosing early enough? If so, what does he think should be done about it?

[Henry Smith]

I am grateful to my hon. Friend for his intervention. Yes, that is the problem. One of the issues is just that: the symptoms are all too often commonplace. Particularly at this time of year, many of us are suffering from colds, are feeling tired or have other viruses. I will come on to this later on, but there is a message to GPs that, if one or more of these symptoms is being displayed, they should consider that it could be blood cancer and carry out a relatively simple blood test to try to determine that. Far too often, blood cancer patients have to visit their GPs many times before being referred to hospital.

[Mark Tami]

My elder son developed a platelet rash, which is a common sign of the disease getting to a certain stage. There is a lot of public awareness about meningitis and what to look for, but that rash does not seem to feature in people’s minds, in terms of blood cancer. Does he agree that we probably need to do more to educate not only doctors but the general public on what to actually look for because, obviously, the earlier the diagnosis can be made, the better?

[Henry Smith]

The hon. Gentleman is entirely correct. I am sorry to hear of his family’s experience. The symptoms can often be confused with others, which is why it is important, as was said in an earlier intervention, to stress that GPs should be given the support and the backing to raise awareness of the symptoms. A simple blood test should be offered to assist with early diagnosis for people displaying one or more of these signs, and GP education and training needs to be improved to increase knowledge of blood cancer symptoms.

As was said in an earlier intervention from my hon. Friend the Member for Henley, unlike solid cancer tumours, blood cancer cannot be surgically cut out, and the experience of blood cancer patients is therefore very different from that of those with other forms of cancer. Blood cancer patients are not currently receiving the treatment and support they deserve, which is one of the key points that I hope the Minister will take from the debate.

[Nick Thomas-Symonds]

Does the hon. Gentleman agree that one of the keys to treatment is having as many people as we can on the stem cell donor register? There are 660,000 selfless individuals on it at the moment. We should thank them and also encourage those between the ages of 16 and 30 to sign up.

[Henry Smith]

The hon. Gentleman is again absolutely correct. The stem cell register is vital to our addressing this condition going forward and beating blood cancer in the future. We would all do well to echo his message.

[Mr Philip Hollobone (Kettering) (Con)]

I congratulate my hon. Friend on the tremendous work he is doing with the APPG and also on his superb speech, which I am following closely. One of my constituents, Mr Gaziano, has written to me to say that he suffers from an incurable form of blood cancer called chronic lymphocytic leukaemia, which is apparently the most common form of leukaemia among adults. He makes the same point about the lack of support. Apparently, 66% of people with that type of leukaemia live with anxiety, 50% with stress and 34% with depression, but they are not getting the psychological support from their healthcare teams that they need.

[Henry Smith]

My hon. Friend is absolutely right. I am sorry to hear of his constituent’s experience. He anticipates remarks I will make later, with regard to psychological support for people with chronic, longer-term conditions and the watch and wait approach, as it is sometimes called, for dealing with some forms of blood cancer, particularly in adults.

The Government and NHS England need to address, as a matter of urgency, the specific needs of blood cancer patients and take immediate steps to improve their care. Something that may seem as simple as the terminology surrounding blood cancer can have an effect on ensuring support for patients. As I said, there are 137 different types of blood cancer—we have heard a number of different examples already—including various strands of leukaemia, lymphoma and myeloma. In each of those, one common word is missing: cancer. The lack of that important word when telling somebody they have one of those forms of blood cancer runs the risk of their not fully comprehending the gravity of their condition. The APPG’s report found that clinicians and patients said that the increasing use of the overarching term “blood cancer” has helped patients who have been diagnosed recently to gain a greater understanding, not only of how the disease is part of a wider clinical area but that there is an entire community of health professionals, charities, and patient groups to help them.

I am grateful to all those who took the time to respond to our web consultation and answer the questions, including those on early diagnosis. After analysing the responses, the APPG’s report outlines three main audience groups where increased awareness could benefit patient outcomes. The first is the general public. While greater awareness of the symptoms would lead to people seeking medical intervention sooner, I also appreciate the words of caution from some in the medical profession, who reiterate that this must be handled carefully to avoid undue concern, particularly given the commonality of the symptoms. There is agreement that blood cancer awareness is far behind that of other common cancers, as we have heard.

The second group is GPs. Recognising and diagnosing blood cancer symptoms can be difficult, and many patients reported frustration at having to see their GP a number of times before their blood cancer was diagnosed, as we have heard. The third—as I turn to the Minister—is cancer policy makers. We heard that blood cancer was not always at the forefront of their minds. As such, we seek the extension of policies and initiatives designed to ensure broad benefit to patients with solid cancer tumours to those with blood cancer.

Much of the work on blood cancer awareness is undertaken by the charity sector. To that end, I pay tribute to the Spot Leukaemia campaign organised by Leukaemia CARE, which I am pleased to say was supported by my local community through Crawley Town football club, which made the cause its charity of the day at a game just last September. I ask the Minister for his assurance that the Department of Health and Social Care will engage with such campaigns, to ensure that the full power of his Department and the NHS can be used not only to work in partnership with such charities but to give greater consideration to non-solid tumour cancers when developing policy.

If blood cancers are taken into greater account, it will lead to improvements in the patient experience. As we heard in an earlier intervention, the patient experience of those with blood cancer differs from those with other cancers. The sad reality is that some patients with some chronic blood cancers will never be cured. They will instead require treatment for the rest of their lives, with the cancer managed as a long-term condition. Patients who have had access to a clinical nurse specialist have been clear on the role that a CNS has in the patient experience. Indeed, respondents to the APPG’s report were clear that access to a named CNS was the single most important factor that improved their experience.

Again, the charity sector is working to support patients in this area. By April, the Anthony Nolan charity will have funded nine CNS posts in stem cell transplant centres across the UK. These specialists provide support for patients, including assistance in getting back to work or school, as well as dealing with the physical and emotional aspects of a stem cell transplant—a potentially curative treatment for blood cancer, as we heard in an intervention, for which I am grateful.

Some patients will be put on a watch and wait programme, as I mentioned earlier. That literally means that a patient’s blood cancer is monitored, and it can sometimes take years for it to reach a point where treatment can start. The very nature of such a scenario will place unbelievable pressures and strain not only on the patient fighting that cancer, but on their family, friends and wider support network.

Tailored psychological support, which I am grateful to my hon. Friend the Member for Kettering (Mr Hollobone) for mentioning, needs to be made available for patients—particularly those on a watch and wait regime.

[Julia Lopez]

My hon. Friend talks about the wider strain beyond the physical. Does he agree that a huge financial strain is often placed on families? The family in the case I raised earlier had to spend a lot of money on takeaway food, the congestion charge, parking and hotels just so their daughter could receive what can be very intensive treatment.

[Henry Smith]

My hon. Friend is absolutely right to raise the spectre of the financial burden, as well as the psychological pressure that patients and their loved ones face when undergoing treatment. There can often be expensive visits into London or other major city centres to undergo treatment.

I pay tribute to organisations such as Macmillan, which is very worthy of our support and does amazing work for those with not only blood cancers but all chronic and terminal conditions. I ask the Minister for his assurance that, as recommended by the cancer strategy, all blood cancer patients have access to a clinical nurse specialist or equivalent model of support.

One of the points raised in the two oral evidence sessions held by the APPG last September was the work of charities to provide support for patients and their networks. As my hon. Friend the Member for Hornchurch and Upminster (Julia Lopez) said, a lot more support needs to be given to patients and their families on issues not related to treatment, such as financial advice, so that they can devote their time and energy to getting better.

I have mentioned a number of organisations, but I reiterate the fine work of Macmillan, which offers help to cancer patients and their families up and down the country. In my constituency of Crawley this week, one of the charity’s information hubs will be open in the County Mall shopping centre until Saturday. Its staff are on hand, as they are all the time, to answer questions about symptoms, side effects or any other issue relating to support locally.

We can be thankful that an increasing number of blood cancer patients are living for many years after their diagnosis, and I thank hon. Members for giving examples from their constituencies. The cancer strategy says that all cancer patients will have had access to the recovery package by 2020. That helps patients after their treatment has finished, so that they can return to their normal lives as much as is possible. Of course, there must be recognition that patients can go from having regular access to a healthcare professional while receiving treatment to feeling like they have no support at all after treatment ends. It has been described as like falling off the end of a conveyor belt, with no one to talk to about after-effects, dietary needs and the everyday activities they had enjoyed before treatment started.

I come back to the issue of how blood cancer is different from solid tumour cancers. I hope the Minister and his colleagues at the Department of Health and Social Care will work with NHS England to consider how all patients can benefit from aftercare support, including ensuring that the recovery package takes into account the differences. It is difficult to go from, in some cases, constant access to a CNS during treatment, including communication being available by mobile phone, emails and texts, to support coming to an end when a patient is sent home. There are long-term effects of blood cancer that need to be taken into account.

In particular, for patients treated with a stem cell transplant, the transplant itself is only the beginning of a long journey to rebuild their lives. By 2020, it is thought that there will be more than 16,000 people living post-transplant, and a significant proportion of those people will experience long-term side effects of their treatment. They will require specialist support, and it is incumbent on us to ensure that people across England receive it with greater consistency.

I move on to the issue of new treatment access and research on the differences between blood cancers and solid tumour cancers. It is important to remember that blood cancers are often not treatable using surgery or radiotherapy. Blood cancer is therefore more dependent on the development of and access to new drugs in order to continue enhancing patient outcomes.

The process of how the National Institute for Health and Care Excellence and the drug manufacturers negotiate can affect patients. Where NICE has offered negative draft guidance on a particular cancer drug that, after further negotiations between NICE and the manufacturer, changes to final positive guidance, the period when patients are left to think that potentially life-changing or life-saving treatment may not be available can cause huge anxiety. Our report calls for final negotiations to be undertaken before negative draft guidance is published.

I have mentioned the work of the charity sector in supporting blood cancer patients. That is perhaps most significantly represented by the financial investment made by blood cancer charities to fund research, develop a good research base and ultimately produce relatively good survival rates. I ask the Minister to ensure that further support is given to that research, to not only provide financial backing but ensure that blood cancer patients are at the heart of cancer policy.

I am conscious of allowing other colleagues the opportunity to make substantive remarks, but on the subject of NHS commissioning, local decision makers should look for opportunities to bring care for chronic blood cancers closer to the patient where appropriate. I will be writing to my local clinical commissioning group in Crawley to share a copy of the APPG’s report, and I encourage colleagues to do likewise with their respective CCGs.

I am sure that all of us here today can name people in our local areas, as many hon. Members have, who have experience of dealing with blood cancer in their family and working to raise funds for those who want to make life easier for patients and their support networks. In my constituency of Crawley, I am grateful for the work of the Mark Henry Archer tribute fund at Bloodwise, which was set up by my constituent Jayne Archer in memory of her late husband, Mark, who sadly lost his battle with lymphoma in 2010.

I mentioned at the start of my speech that blood cancer is the most common cancer among people under the age of 30. Someone can be in the peak of physical fitness and it can still strike. Just a week into this new year, Juan Carlos Garcia lost a three-year battle with leukaemia. He was just 29 years old and a professional footballer who had played in England for Wigan Athletic and at the 2014 World cup for Honduras. Blood cancer quite simply can strike anyone at any time.

I would like to thank the patient advocate and medical professionals who took the time to come to Parliament and answer the APPG’s questions at our evidence sessions last September. I also express my sincere gratitude to Bloodwise for providing secretariat support to our APPG, assisting blood cancer patients up and down the country, and playing a leading role in the research that is necessary to improve outcomes and the patient experience.

I know that many people in this room will be aware of one family that has been affected by blood cancer in the last couple of months. The Sky Sports presenter Simon Thomas and his eight-year-old son Ethan lost their wife and mother Gemma, aged just 40, last November. Just three days after being diagnosed with acute myeloid leukaemia—the same form of blood cancer as my own mother—Gemma passed away. Incidentally, my mother’s diagnosis came just hours before her death. Our thoughts are with Simon, Ethan and their family and friends, and every patient affected by this disease.

It falls to each of us here to make sure we redouble our efforts to bring as much help, comfort and support to blood cancer patients as possible, and I ask the Minister for his continued diligence in such matters. I have seen at first hand how quickly those who have blood cancer can be taken from us. In a previous debate that I was fortunate to secure in Westminster Hall on 7 July 2016, I said:

“I look forward to ensuring that the issue of blood cancers is further advanced and that awareness is increased.”—[Official Report, 7 July 2016; Vol. 612, c. 395WH.]

With the progress of the APPG and the support of colleagues here and those who will be attending the launch of the group’s report from 4 o’clock in Strangers’ Dining Room, I am pleased to stand here today and say that we are making great strides. There is much more to be done, and we will continue to make progress.

[Several hon. Members rose—]

--- Later in debate ---

[Henry Smith]

In the remaining moments of this debate I would like to express my gratitude to you, Mr Wilson, for chairing this very informative and useful debate. I am grateful to right hon. and hon. Members for their speeches, interventions and the many personal accounts that really highlight the importance of ensuring that we properly tackle blood cancer for all our loved ones across the country. I also have real gratitude to those voluntary sector organisations and charities that have been mentioned today for their remarkable work on behalf of so many people and for supporting the all-party parliamentary group on blood cancer. I am also grateful to the many patients and families who have contacted me and have supported the all-party parliamentary group with our report, which—I will mention it one more time—will be launched in the Strangers’ Dining Room in the next few minutes. I thank them for their input.

This is obviously a very emotional issue for many people, and I pay tribute to the courage of patients and their families. Those who have lost loved ones through blood cancer leave a fine legacy in ensuring that we fight—I join the Minister in using that word deliberately—blood cancer, so that we can ultimately find cures and better treatments. Finally, I am grateful to the Minister for his thoughtful reply, his work on cancer issues in the Department of Health and his fine legacy of work in the past.

Motion lapsed (Standing Order No. 10(6)).