Cancer Treatment: Patient Travel Times

Debate between Jack Lopresti and Tim Farron

Wednesday 10th January 2018 Westminster Hall

[Tim Farron (Westmorland and Lonsdale) (LD)]

I beg to move,

That this House has considered patient travel times for cancer treatment.

It is a great pleasure to serve under your chairmanship, Sir Christopher. I should also like to consider satellite radiotherapies at Westmorland General Hospital.

Almost every story that I have heard or read in recent times about the national health service has been negative. I understand why, given the debate in the main Chamber at this moment, but I sometimes wonder how much this further damages the morale of the thousands of professionals who work in the national health service. So I want to start by paying tribute and saying a massive thank you to those NHS professionals who work tirelessly up and down the country, day in and day out, to look after us and our loved ones when we need it most. I especially want to put on record my appreciation for those who work in cancer care. We have some of the best cancer care in the world. We should all take a moment to recognise the fantastically high standard of treatment that we have in this country, delivered by professionals whose competence and compassion are the hallmark of our NHS.

But here is the problem: yes, we have world-leading treatment, but it is not truly available equally. The availability of care depends hugely on people’s ability to access it. I welcome, and have done so on the record, the £130 million announced by NHS England that is to be invested in improving radiotherapy treatment, and the new service specification, which aims to improve standards across the country. Working in clinical networks and developing specialised services has a strong evidence base, but what is not addressed is the inequality in access to services that already exist. That inequality will only get worse if it is not addressed now by NHS England. I am grateful to the Government that the consultation on allocating that investment has been extended to 24 January, not least because it gives the Minister the chance to amend the criteria and the priorities for allocating services.

I passionately believe that one of the criteria in allocating improved radiotherapy services must be the shortening of the distances that people have to travel, especially for those with more common cancers. My position is backed up by evidence, including a publication in The BMJ in 2016 indicating that outcomes are worse for people who need to travel further. Let me be clear what “worse outcomes” actually means. Worse outcomes can mean patients actively deciding to forgo potentially life-saving or life-lengthening treatment because getting to hospital is just too much of a trauma for them owing to the length and difficulty of the journey that is required. Worse outcomes means choosing forms of treatment that may be less effective than radiotherapy because the nearest unit is too far away. Worse outcomes includes patients failing to complete a vital course of radiotherapy treatment because they simply cannot cope with the gruelling, wearying travelling every single day.

Action Radiotherapy estimates that one in six of us will need radiotherapy to treat cancer at some point in our lives, but easy access to this treatment can depend entirely on a postcode lottery. It is the sad reality that in rural areas of England travel times to cancer treatments can be unbearably long for too many people, and patients are often forced to cover these long distances on public transport. Not everyone has the option of travelling in the relative comfort of a personal car, and even if a person does, driving themselves or being driven, day in and day out for four to six weeks, is a massive challenge. I believe that it is frankly cruel, if we could do otherwise, to force people who are already very poorly to make a two or three-hour round trip every day, for weeks, in order to receive life-saving care.

[Jack Lopresti (Filton and Bradley Stoke) (Con)]

I congratulate the hon. Gentleman on securing this debate. I am a cancer survivor. I survived stage 4 cancer and I had a month of radiotherapy; I had to get the bus most days to get there, and caught a nasty infection because of the travel time, so I fully appreciate where he is coming from. I would like to highlight the cases of families with children with cancer. According to CLIC Sargent there are fewer than 20 treatment centres nationally, and that makes life extremely difficult for families who are having to travel for treatment. Will he pay tribute to CLIC Sargent for the respite care, finance and accommodation that it provides to families going through this terrible process and journey?

[Tim Farron]

I am grateful to the hon. Gentleman for raising those issues and his own personal experiences. As I will come to in a moment, the issues affecting children and young people are even greater. I am very happy to pay tribute to the work and provision of CLIC Sargent and, in particular, to recognise the impact on people with cancer who have young children themselves. Maintaining an income and maintaining family life is an immense challenge, and the distances involved can make it yet harder, so I thank him for that intervention.

In its 2007 report, the national radiotherapy advisory group recommended that cancer patients should have to travel no more than 45 minutes one way—an hour and a half both ways—to receive radiotherapy treatment. This was adopted in the service specification by NHS England, but has since disappeared. Experts in the field maintain that travelling any longer could have a hugely negative impact on treatment outcomes and patient wellbeing. If preventing unacceptable travelling times became a part of NHS England’s criteria for delivering radiotherapy, it would hugely increase our chances of bringing a radiotherapy satellite unit to Westmorland General Hospital in Kendal.