NHS Strikes

James Daly Excerpts

Monday 17th April 2023 Commons Chamber

[Steve Barclay]

The hon. Gentleman raises an important issue, and there is a lot more we can do around the skills mix in the NHS and ensuring that people operate at what is referred to as the top of their licence and make the maximum of the training they have. Often there are restrictions in place. We are looking at physician associates and medical examiners and at the role of pharmacists within primary care, as well as at how we get the right continuing professional development to train people, so that we get more of the career ladder from different roles.

There is a lot that we are looking at, in the context of the workforce plan, around the right skills mix, the right training and job evaluation. That was one of the issues in my discussions with the staff council—for example, there was a particular focus on apprenticeships. Sometimes people take a pay hit when they go into an apprenticeship if they were at the top of their previous band. That is one of the things we agreed to work on with the staff council. Again, I am sure that an area of consensus in the House will be that apprenticeships offer great opportunities for people to progress, and we should not have a financial penalty when people pursue them.

[James Daly (Bury North) (Con)]

Many hon. Members have raised extremely important points, but the central issue is that the reckless and irresponsible actions of two trade unions are putting the lives of my constituents and people throughout the country at risk. The right to strike can never trump people’s right to receive healthcare and not have their life threatened by the actions of left-wing trade unions. Can I ask what my right hon. Friend is going to do to address this issue and to hold trade unions to account if they continue with this appalling behaviour?

Irish Diaspora in Britain

James Daly Excerpts

Thursday 17th March 2022 Commons Chamber

[James Daly (Bury North) (Con)]

It is a pleasure to follow my near constituency neighbour, the hon. Member for Rochdale (Tony Lloyd). I agree with every word he said.

To be bluntly honest, when I thought about what I wanted to say in this debate I was thinking about my dad and my memories of him. When we talk about the Irish diaspora in Britain, we do not see ourselves as different. The Irish diaspora is part of our everyday life. An estimated 6 million people in the UK have an Irish grandparent, which means people will probably have some form of relationship with somebody with an Irish grandparent—they will see them in the shops or at their place of work. We see the Irish diaspora, Irish history and Irish culture every single day.

I could not be prouder of coming from an Irish Catholic background. On my dad’s side, I have two Irish grandparents, Frank and Molly, who came to this country in the 1920s. My dad and his sisters would tell me stories of their early experiences in Lockwood when they first came to live in Huddersfield as native Gaelic speakers. They vividly remembered the abuse, the insults and how they were treated. My dad always told me the story of how his mum once had a bucket of water poured over her head from a house window while she walked down the street. Those early pioneers, certainly in my family, had to go through terribly difficult times, and I am very proud of everything they achieved. The fact that they took the step to come over here to find a job or to make a better life means that I am stood here, and my cousins are all over the country doing whatever they are doing in their lives. I am pleased to say they are all positive, lovely people, and their Irish heritage touches every person they meet, which is a wonderful thing.

On my mum’s side, my great-grandfather John was born in Athlone in Westmeath. He came over here, to Bradford, in the 1870s, so this migration is not just from the ‘20s to the ‘50s; it goes back over many years. He married a Yorkshire lady. Again, without those roots and without people being brave enough to come over here to a place and a country they did not know, without friends, in many circumstances, many of us would not be able to have the lives we have today. When I look at the contribution of the Irish diaspora in Britain, I think it is everything; there are no negatives and there is nothing else to say. Every part of our life as a nation has a little bit of Irish heritage and history within it, because we are all part of a wider story.

Sometimes the best way to elicit and highlight a point in this place is not by going on Google to find out facts, but by speaking from personal experience about the things that people have been through and how they shape the country that we are and the one we want to be. In my youth, I always used to hear stories in my family about Gerald Paddy Slavin—I am looking at the hon. Member for Rochdale, as he may not know this—who came over to Huddersfield, to Longwood, in the 1930s. He is my great uncle—the brother of my grandma—and was born in Aughnacloy. He came across, got a job, worked hard, got married and looked after his family. He served on HMS Nelson during the second world war as a gunner. He was a true hero and a man who served the nations of Great Britain and Ireland in every possible way.

When he was in the Army, he decided, or it may have been decided for him, that boxing was the thing for him, so a man who had worked in the mills of Huddersfield and brought up a family—a respectable man—in 1948 fought in Belfast for the heavyweight title of Ireland. He became the heavyweight champion of Ireland, and went on to fight Don Cockell, Brian London and various other people. Within my family and my personal experience of people who have come over to this country and been part of a wider story, here was not only a heavyweight champion, a man who fought the great boxers of the era, but a man who was a respectable, kind, caring father—a good man. Those qualities sum up my experience of the Irish diaspora in Britain. The Irish community where I grew up in Huddersfield, who were a central part of that town’s identity, could tell endless stories about what things were like in Huddersfield and I am sure that there are similarities with what was happening in Manchester.

I could not be more proud of the contribution made by Irish people, over many hundreds of years and continuing to this day. I am lucky enough to have that heritage, and these opportunities, from my relatives who came over from Westmeath in the 1870s. To my grandad Frank, the idea that he would have a Conservative MP as his grandson would be mind-blowing. When they are all looking down, I hope that when they see me, my cousins and all the rest of the family—this applies to everyone, all over the country, who is lucky enough to have Irish heritage—they will say that there was a complicated history, which we could talk about forever, and there were challenges and some awful times, but the sacrifices they made created opportunities for us, which we are enjoying today. I will be forever grateful.

Oral Answers to Questions

James Daly Excerpts

Tuesday 1st March 2022 Commons Chamber

[Sajid Javid]

The hon. Lady has just stood up and said that there is no increase in capacity. I am afraid she was probably not listening a few minutes ago when I said that in the last year the number of people working in the health service had increased by 44,000, and that we had 11,000 more nurses and nearly 5,000 more doctors. As for a plan, the hon. Lady may know that I have already asked the NHS to work on a long-term plan—a 15-year workforce plan. If she really wanted a new workforce plan, she should have thought about how we could fund it, and should not have voted against the increase in spending that the Government proposed.

[James Daly (Bury North) (Con)]

On the subject of NHS capacity, data released by NHS Digital shows that NHS Bury clinical commissioning group had the lowest number and also the lowest percentage of face-to-face GP appointments in England in January 2022. Only 37% of Bury appointments are face-to-face, which is clearly unacceptable and unfair to my constituents. Will my right hon. Friend agree to meet me to find solutions to this serious problem?

[Sajid Javid]

It is a serious issue, and I will of course meet my hon. Friend to discuss it further. He may be interested to know that over the winter the Government provided an additional £250 million in a winter access fund for primary care services throughout the country. That has certainly helped to increase the number of face-to-face appointments, although the omicron wave made the process more challenging. As my hon. Friend suggests, it should ultimately be for patients to choose how they want to be seen.

Special Educational Needs and Children’s Mental Health Services

James Daly Excerpts

Wednesday 9th February 2022 Westminster Hall

[James Daly (Bury North) (Con)]

It is a pleasure to speak in this debate. I thank my hon. Friend the Member for Newbury (Laura Farris) for bringing this important issue forward. I hope that Members will forgive me because, based on the contributions that have already been made, I am going to give a completely different speech from the one I had intended to make.

I certainly do not like doing this, but I feel that I have to bring my personal experiences to the debate. My son is on the autistic spectrum.

[Jim Shannon]

Will the hon. Gentleman give way?

--- Later in debate ---

[James Daly]

It is fine. My wife and I waited many, many months for a diagnosis. When we had the diagnosis, it was a relief, but when it happened we were told, “Well, nothing changes. Just carry on as normal.” We were not referred to services—we have not been referred to services throughout the whole of my son’s time in education. We have been given a diagnosis and essentially asked to carry on as normal. My son is a beautiful boy, and he is in mainstream schooling. He has challenges, but he does not have the complex needs that other families have, and that was it.

I can tell Members from personal experience that the length of time people have to wait for a diagnosis is a disgrace, but in many cases nothing happens afterwards. To help, aid and support my son, we are reliant on the special educational needs co-ordinator at his school. SENCOs are brilliant people, but they often do not have the expertise we would hope them to have in these situations. If the levelling-up agenda is to mean anything—and I fully believe in our Government’s levelling-up agenda—we have to find ways to ensure that those people with challenges in their lives are able to achieve and maximise their potential. I have not raised the issue of my son for any other reason than this: I do not believe that the support that he has received, and that other children are receiving at this moment in time, allows that to happen.

I was in a debate yesterday with many Members who are in this Chamber today. The issue of funding is a very legitimate concern to raise, but my borough in Bury has spent £40 million over the past financial year on special educational needs and mental health. We have to go beyond just saying, “Give more money”. We have to have local accountability, strategies and bespoke support services for each individual child in our country to allow them to achieve their potential.

I support one of the things that the Labour party said yesterday, and I support what the Government are doing. We have many family hubs, which I support, and they provide fantastic support for this agenda. The shadow Minister, the hon. Member for Dulwich and West Norwood (Helen Hayes), talked yesterday about mental health hubs. We can call them anything we want, but every town in our country needs a bespoke, 24/7 support service that schools, individuals and families can turn to in the knowledge that they are not just a statistic—they are human beings—and so that local services can respond to the individual needs of each individual child, who we must cherish.

Children’s Mental Health

James Daly Excerpts

Tuesday 8th February 2022 Commons Chamber

[James Daly (Bury North) (Con)]

There have been some excellent speeches, but in three minutes, I cannot cover all the points that I would like to cover in this important debate. The hon. Member for Twickenham (Munira Wilson) made an excellent point, if I understood her correctly, about local accountability. Too often in this place, we simply debate in terms of figures—£100 million, £80 million, £90 million—but we need to develop bespoke services that are available 24 hours a day, seven days a week to address the bespoke characteristics and the bespoke challenges that face people in our constituencies.

I will not recite a lot of facts. I just want to say that CAMHS in Bury is manned by two social workers with mental health training. There is a clinical psychologist post, for which we have been looking for somebody since 2020, and there is another full-time person. So for a borough of 200,000 people, we have two full-time social workers, one manager, one full-time person and no one else providing support for the young people in our constituency. It is no wonder that constituents contact me and say, “There is nothing and we are at the end of our tether” and all the other phrases they use. It is no good my standing here, going through a prepared speech with a lot of political soundbites about that. We have to find the solutions. Those solutions will be different in Bury, in Twickenham and in other places throughout the country. There has to be local ownership of that. The funding has to be invested in a way that gives the best support we can to local people.

I was very interested in the shadow Minister’s opening statement. For a long time, I have called for what I describe as a special educational needs and mental health hub for Bury because that model is very interesting, but we heard no details about it from the shadow Minister. I do not say that as a criticism, but what is the detail? Who will be housed in those hubs? What services will they provide? The idea of 24-hour holistic care covering not only education, health, social care, but employment opportunities and mental health care is an interesting and passionate idea that we should all join together to take forward. I do not think the Government can be criticised in that respect because family hubs are established on exactly the same principle. I welcome the Government’s commitment to that and I hope that more hubs will be rolled out and funded.

The Minister, who is an excellent man, would not forgive me if I did not say the following. I am chair of the all-party parliamentary group on nursery schools, nursery and reception classes. An early offer, early intervention in schools and an under-fives service: having support at that early stage is fundamental and I know he is committed to investing in that.

Oral Answers to Questions

James Daly Excerpts

Tuesday 13th April 2021 Commons Chamber

[Jo Churchill]

I thank the hon. Lady and would like to extend my good wishes to Greg for this treatment. There has been £8.8 million committed so far based on the NIHR programme and academy spend. The important thing is the quality of the applications. Brain tumours are invidious, and we need to do more and we need to go faster. I will look at her suggestion, but I am aware that there are already experts sitting on the panel.

[James Daly (Bury North) (Con)]

What steps he is taking to tackle obesity among (a) adults and (b) children.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

Helping people to achieve and maintain a healthy weight is one of the most important things we can do to improve our nation’s health. That is why we published our healthy weight strategy last summer. We are taking forward actions from previous chapters of the childhood obesity plan, as well as further measures to get the nation fit and healthy, protect against covid-19 and protect the NHS. Question 25 on the call list is grouped with Question 26.

[Mr Speaker]

Yes, but unfortunately Jonathan Gullis is not here. You managed to jump in before James Daly could speak. Not to worry. We will go to James Daly.

[James Daly]

Thank you, Mr Speaker. Encouraging an active lifestyle is a crucial part of tackling the obesity challenge that our country faces. Does my hon. Friend agree that local authorities, working with partner agencies, should invest in iconic community venues such as Gigg Lane in my constituency to house a wide range of public health services and provide inspirational settings for young people to take part in sport, no matter what their background or personal circumstances?

[Jo Churchill]

I agree wholeheartedly that we should encourage all children to make sure that they can take part in sports and enjoy the outdoors. Regular physical exercise is important for the health and wellbeing of young people, and the local community has an important role to play in developing facilities. That is why the Government launched a £150 million community ownership fund, to ensure that communities across the UK can benefit from the local facilities and amenities that are most important to them. That includes community-owned sports clubs and sporting and leisure facilities that are at risk of being lost without community intervention, and I urge my hon. Friend to work with his community to ensure that he has those facilities locally.

Vaccine Roll-out

James Daly Excerpts

Thursday 21st January 2021 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. Before I call James Daly, I just want to say that I want to try to get everybody in, so we probably need to speed up a little bit.

[James Daly (Bury North) (Con) [V]]

Will my right hon. Friend join me in thanking Bury Council, our local CCG, NHS staff, medical practitioners and all those involved in the vaccine roll-out in Bury, Ramsbottom and Tottington? Approximately 19,000 vaccinations will have been given by the end of this week across the borough of Bury, and we are confident that all frontline workers and care home residents will be offered the vaccine by Sunday. It has been and continues to be a magnificent effort.

[Matt Hancock]

That is absolutely fantastic to hear. Across Greater Manchester as a whole, 187,947 vaccines have been done. It has been a huge effort, and I am very grateful for my hon. Friend’s support.

Covid-19

James Daly Excerpts

Tuesday 12th January 2021 Commons Chamber

[James Daly (Bury North) (Con) [V]]

May I put on the record my thanks to Will Blandamer, Lesley Jones, Jeff Schryer and the whole team in Bury for the roll-out, at high speed, of the vaccine? We are confident that the four priority groups will be vaccinated by February, and that is a great achievement. It is a true community effort, and they have the thanks of all of us in our community. Our excellent Vaccine Deployment Minister confirmed to me in a meeting yesterday that the Pfizer vaccine gives 91% protection after the first dose, and the Oxford-AstraZeneca vaccine gives 80% protection after the first dose but 100% protection against severe infection.

In the time that I have, I would like to talk about how we remove the restrictions that are blighting our businesses and impacting our daily lives. The hospitality sector has gone through hell during this pandemic, and we need to take all necessary steps to continue the economic support that is needed and to remove restrictions on that sector at the earliest opportunity.

The financial steps that we need to take include extending the business rates holiday for pubs to the financial year 2021-22, and extending the VAT cut beyond 31 March 2021 and expanding it to cover alcoholic drinks. We must never forget the thousands of pounds that hospitality sector businesses have spent creating covid-secure environments. In my area, there is virtually no evidence of widescale transmission of covid in those settings. With the vaccinations that I talked about being rolled out in February, we must look to reopen those facilities at the earliest opportunity, and certainly before May.

I also ask the Chancellor, as part of his considerations leading up to the Budget, to consider support for small businesses, which have to power our economic recovery. We have provided substantial support—over £260 billion—for our economy, but some businesses do not have the support they need. Small business people in my constituency who have been paid quite legally in dividends and fall under the threshold for the self-employment schemes need help. I urge the Government and the Chancellor to take every opportunity to provide further financial support to protect thousands of jobs, not only in the hospitality sector but in those small businesses that my constituents and many others throughout the country have spent their lives building up. They need our help now.

Covid-19: Lung Cancer Pathway

James Daly Excerpts

Wednesday 2nd December 2020 Westminster Hall

[Derek Twigg (Halton) (Lab)]

I beg to move,

That this House has considered the effect of the covid-19 outbreak on the lung cancer pathway.

The effect of the covid-19 outbreak on the lung cancer pathway is of real concern and has been brought into sharp focus by the UK Lung Cancer Coalition’s report, “Covid-19 Matters”. I will refer to that report as well as to discussions with Martin Grange, Professor Mick Peake OBE and Dr Robert Rintoul from the coalition.

When we discuss health matters in Parliament, we often focus on policies, funding and statistics. Of course, those are important, and I will discuss them later, but when we speak about a specific disease that most people will have little knowledge of, we should explain its impact on patients and their loved ones. In doing that, I will share a real example of a lung cancer case. The patient concerned had a persistent cough for a few weeks. After prompting from their family, they went to see the GP. The GP prescribed some medication and advised them to come back in two weeks if the cough persisted. It did. The GP sent the patient for an X-ray and, the next day, called the patient in to see him. It did not look good—there appeared to be a large tumour in the right lung, and it had spread.

The patient was given an urgent referral to the local acute hospital. Tests were done, and they confirmed stage 4 small cell lung cancer, which had also spread to the rib, liver and lymph glands. The consultant told the family as sensitively as he could that it was terminal and that, at best, the patient would have six to nine more months of life. The oncologist said he wanted the patient to try some chemotherapy, but it had risks. If a patient gets an infection, it could cause serious complications. Unfortunately, the patient developed an infection and was rushed to hospital the following day, very poorly and in great pain.

The hospital gets the pain management wrong. The patient is admitted, but it is another 24 hours before the pain management team sees the patient to get control of the situation. A “no resuscitation” form is signed, but the patient recovers from the infection and goes home. However, more infection occurs in the lung. The lung collapses and the infection gets worse, filling the lung with pus, and the smell is awful. The patient must go to another hospital to have a drain inserted into their chest, but it does not always drain the pus in the way intended, so the patient needs to return to the hospital on several occasions to have the drain looked at. As the lung has filled up with so much fluid, it occasionally needs to be drained by the brilliantly caring specialist nurse practitioners. Despite all that, the patient finds some inner strength in the final few weeks and manages a bit of travel to tick off a couple of things on their bucket list. They then give a knowing nod to the family to say, “I assured you that I could do it.”

Then there is the inevitable weight loss, loss of appetite and puffing up of the face from steroids. After being reduced by one course of chemotherapy, the cancer comes back with a vengeance and quickly spreads to many parts of the body. The family feel helpless and just want to do everything they can to help support the patient and show their love. The patient is brave and more concerned about the impact on their children than on themselves. The pain management and care from the GPs and district nursing team is exceptional. Eventually, in just 48 hours, matters take a turn for the worse. On the final day, in a matter of hours, the patient slips into unconsciousness. The end comes, just over six months from diagnosis. The family feel numb, and the intense grief and sadness take over. This is the reality of lung cancer.

Lung cancer is the leading cause of death in the UK. Approximately 35,000 people die every year with lung cancer, which is more than the figure for breast cancer and bowel cancer combined. Despite the high mortality associated with lung cancer, it is not the most common cancer in the country. Breast cancer is the most common cancer but is generally diagnosed earlier—by stage 2—resulting in a much higher survival rate. That is not the case for lung cancer. Some 49% of lung cancer patients are diagnosed at stage 4. Late diagnosis is the main reason why lung cancer is the cause of most cancer deaths in the UK. Patients present so late because symptoms do not appear until stages 3 or 4

Like other cancers, the earlier the detection, the more likely the survival. Only 19% of lung cancer patients will survive beyond one year if they are diagnosed when the disease has spread. We know that the people most likely to suffer with lung cancer are 55 and over. They are likely to live in an area with high pollution levels and to have been a smoker at some point in their life. As the lungs are so large, symptoms often become apparent only in the latter stages, which results in small tumours, cancerous or benign, having no instant impact on the person. It is only when the tumour grows larger that it begins to affect the lungs’ ability to function, which is when and why the coughing begins. Something as simple as a cough is often the first symptom when a patient sees their GP, but they might be sent away with antibiotics. As symptoms present so late, the speed of diagnosis is of the utmost importance. As we exit the pandemic, it is likely that we will see a backlog of lung cancer cases.

[James Daly (Bury North) (Con)]

The hon. Gentleman is giving a very powerful and articulate description of the appalling disease that is cancer. The petition that forms the basis of today’s debate comes from my constituent Andrew Jenkinson, whose wife Emma sadly died of brain cancer during the pandemic. His concern regards the ongoing issue of patients receiving cancer treatment during the difficult period that we are in. Will the hon. Gentleman join me in paying tribute to Mr Jenkinson for the tireless work he has done to bring this issue to people’s attention not only at the local level in my constituency of Bury North, but nationally?

[Derek Twigg]

I will of course pay tribute to Mr Jenkinson, and I offer him my condolences on his loss. The hon. Gentleman raises a very important point about the impact of the pandemic on cancer treatment and survival, and I will shortly address that in more detail.



It is vital that we do not take risks with people’s health and that we ensure that a proactive approach is taken. There is widespread concern that, during the covid-19 pandemic, there have been too few face-to-face appointments. Lung cancer experts have told me that they believe that face-to-face appointments are important for referring people for urgent fast-track checks, and that they should resume as soon as possible. GPs need to see patients and patients need to know that they are receiving a full and thorough examination when they present to their doctor with problems.

My constituency has one of the highest lung cancer rates in the country. It is also a hotspot for other respiratory diseases such as chronic obstructive pulmonary disease and asthma. Widnes and Runcorn are old industrial towns that are famous for their former Imperial Chemical Industries plants. Many of the older generation suffer from the pollution that they inhaled as children and young adults. Those people, who were also encouraged to smoke in the 1950s and 1960s, are most likely to suffer from lung cancer. Simply, the situation that they find themselves in, through an accident of birth, puts them at a higher risk of developing lung cancer.

It is not widely known that people who have never smoked can also be the subject of the disease. In fact, non-smoker lung cancer is the eighth biggest cancer killer in the country and is responsible for about 6,000 deaths a year—I was shocked to find that out. We have come to believe that only people who have smoked can develop lung cancer, but that is simply not the case.

In an article for the Journal of the Royal Society of Medicine, Anand Bhopal, Michael Peake, David Gilligan and Paul Cosford discuss never-smoker lung cancer, which they note is increasing in absolute and relative terms compared with the decline in smoking. Their research shows that, although second-hand smoking is a contributing factor, it is not the main reason for that. They also note that never-smokers feel a stigma about their diagnosis. We must work to destigmatise lung cancer, particularly as the number of never-smoker patients rises. At the same time, publicity campaigns would help to raise the profile of that silent killer among never-smokers. As we know, there has been some good progress in the battle against second-hand smoking.

[Yvonne Fovargue in the Chair]

It is not only never-smoker lung cancer patients who need to be destigmatised, but smokers and ex-smokers, who can feel blamed for having lung cancer. As I said, decades ago—for a generation of people—it was acceptable to smoke. There needs to be more support and positive encouragement to quit. The message should ultimately be that it is better to be safe than sorry.

GPs need to make more referrals for chest X-rays to increase the chance of early diagnosis. They should screen patients to target those most at risk, and the Government should provide them with more resources. X-rays are relatively inexpensive and quick for the NHS to perform. They are often available in the local community, as is the case in my constituency, so they cause little if any inconvenience to the patient.

The pandemic will have adversely affected the detection of lung cancer. As we know, a new continuous cough is one of the main symptoms of covid-19. It is not unreasonable to suggest that people out there could have been suffering with, and potentially died from, lung cancer during the pandemic without any diagnosis or treatment. They could also have presented too late. It is vital that people who have had a cough for longer than three weeks see their GP.

There was a staggering 75% drop in the number of patients urgently referred to lung cancer specialists during the first wave of the pandemic. During that time, 55% of UK lung cancer specialist nurses or team members were redeployed or unable to work as a result of covid-19. It is estimated in the UK Lung Cancer Coalition’s “Covid-19 Matters” report that at least one third of lung cancer patients have already died since the beginning of the pandemic. There is also a chance that some of those deaths were labelled as covid-19 due to similar symptoms.

The Government should heed the advice of the UK Lung Cancer Coalition and pilot a “Be clear on lung cancer and covid-19” campaign to increase awareness of potential lung cancer symptoms and increase the confidence of the public across the UK to engage with the healthcare system early. The UK Lung Cancer Coalition also wants national NHS bodies to support the resumption of lung cancer screening programmes at the earliest opportunity. When will they resume? There was a report in the Health Service Journal yesterday of a shortage of equipment and staff.

The UK Lung Cancer Coalition pushed to increase the five-year survival rate from 16.2% in 2017 to 25% by 2025. It felt that target was achievable, but now believes that is unattainable by 2025 because of the pandemic. It is clear that the pandemic has had, and will continue to have, a detrimental effect on lung cancer patients.

Lung cancer patients are also at particular risk of contracting viral infections such as covid-19 because of their underlying condition and the immunosuppression associated with many lung cancer treatments. The Health Service Journal reported yesterday that, since the start of the financial year, two-week wait referrals for lung cancer stand at 18,400, down 42% from 32,000, in the same period last year.

Paula Chadwick, the chief executive of the Roy Castle Lung Cancer Foundation, told me that since the start of the pandemic it has seen the requirement for support significantly increase. Calls to its Ask the Nurse helpline have risen by 93%, with patients and carers understandably anxious, with questions about shielding, diagnosis and treatments. Recognising the effect of covid on lung cancer, the foundation took action, accelerating and extending its activity for the Lung Cancer Awareness Month campaign. It also launched the Still Here campaign, with the aim of increasing awareness of the disease and symptoms—as the foundation says, for example, a cough does not just mean covid—and encouraging those with symptoms to contact their GP.

Going forward, we need a strategy that gets us back on target to achieve the five-year survival rate of 25% set by the Lung Cancer Coalition. We need campaigns to encourage people to visit their GP if they have symptoms of lung cancer, especially if they live in high-risk areas. The battle to end lung cancer will be a long and painful journey. Every year that we fail to reach the 25% target, people will be dying who would have had a longer life. Memories that could have been made will be taken away. Families that could have been spared grief will have to endure the pain of losing a loved one. That needs urgent action, before that progress turns out to have been made in vain.

In summary, lung cancer should be a top priority as we move out of the pandemic. A shocking 75% fall in urgent referrals is deeply worrying. We must ensure that urgent referrals are at the pre-pandemic level as soon as possible. We need the return of face-to-face consultations, so that patients can have confidence in the treatment they are receiving and the right diagnosis. We need to ensure that places such as Halton, which has a high prevalence of lung cancer, are prioritised for a programme of targeted screening and chest X-rays.

That would mean targeted campaigns, such as those suggested by the UK Lung Cancer Coalition, to encourage those at risk to see their GP, while also encouraging GPs to take a more cautious approach, when someone in an at-risk group presents with a cough, in the years and months to come.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is a pleasure to serve under your chairmanship, Ms Fovargue. I congratulate the hon. Member for Halton (Derek Twigg) on securing the debate and sharing patients’ stories, showing not only the huge care delivered by the NHS workforce but the challenges for patients, as they struggle to get a diagnosis and navigate the system. In the patient’s story that the hon. Gentleman articulated, there was already spread: not only was the disease at stage 4 but was metastatic, so affected different sites in the body.

All these things pose a challenge, and the hon. Gentleman very articulately laid out the challenges of late diagnosis and how we can improve. The UK Lung Cancer Coalition report articulated how we must not lose the progress that we have seen over the past 10 to 15 years, but must absolutely focus on the aim to extend survival up to 2025. I hope I can reassure him that the initial measures that we took at the beginning of the pandemic, because we did not know what we were dealing with, have not been the focus since June, when we began to refocus and double our efforts on trying to ensure that cancer patients can have full access to services.

There are still some challenges. I have had conversations with thoracic surgeons. There are particular challenges with the trajectory of this disease, because of where it is on the body and some of the aerosol-generating procedures that are needed in diagnosis and so on. I can say to the hon. Member frankly and honestly that we are aware of those issues and we are working hard to get back not just to where we were, but, as I think Professor Peake said, to a normal that is better than what we had at the start.

I also pay tribute to the constituent of my hon. Friend the Member for Bury North (James Daly), Andrew Jenkinson, and add my condolences for the sad loss of his wife. I congratulate him on his energy in campaigning. It is often the biggest tribute someone can give to a person they love, to try to drive forward and make things better for others.

[James Daly]

I thank the Minister for those kind comments, which will mean a lot to Mr Jenkinson. His petition is titled:

“Ensure access to treatment and screening for all cancer patients during Covid-19”.

We know there have been challenges and the pandemic has thrown up things we never dreamt we would be dealing with. Will my hon. Friend offer some assurance that the issues that Mr Jenkinson highlights in his petition are being addressed and that there are positive signs going forward?

[Jo Churchill]

I will indeed come to that, and hopefully give him and others the reassurance that we are focusing hard on making sure that we not only deliver, but learn from the pandemic. That was highlighted in the Lung Cancer Coalition report as well. Where we can make improvements to speeding up delivery of diagnoses or treatment, we need to make sure that we do so.

Lung cancer is one of the country’s most invidious cancers and it is important that it is diagnosed as early as possible, for treatment to be successful. As the hon. Member for Halton highlighted, it is one of the worst cancers for being diagnosed too late, largely at stage 4, and it has often spread. The challenge then is that treatment options are reduced because of the grade of the cancer.

When someone does present, it is vital that they are referred swiftly for further diagnostics, remembering that we are in a pandemic with a disease that attacks the respiratory system as much as anything. I have stood here talking about teenage cancers and diagnostics and treatments already this week. Not all cancers are the same; they all need a bespoke approach. It is important to remember that.

I spoke to a thoracic surgeon at the cancer hub during the summer. He explained to me in some detail the challenges, but also the opportunities now before us. I thank the cancer workforce for all that they have done through the pandemic and their continued effort to restore services. It has been a herculean effort and they have really flexed the service, joining together in cancer hubs and ensuring that areas are covid-secure for patients. Part of the challenge is to encourage patients to come forward for tests. If someone has a persistent cough, or signs of other cancers, they need to do something about it.

I spoke in the debates yesterday and this morning, and I know only too well the devastation that Mr Jenkinson must be feeling. The particular concern with lung cancer is the overlap with covid-19 symptoms. That was highlighted in the Lung Cancer Coalition report and by a plethora of clinicians. To that end, we have updated 111 protocols. If somebody has received a negative covid test but has a persistent cough, it may indicate lung cancer and they are directed to appropriate clinical care. One challenge has been a sustained fall in people coming forward for lung checks, with the number of people seeking checks at only 76% of pre-pandemic levels. This is about ensuring that we encourage people to come forward, driving forward campaigns such as the Greater Manchester Cancer Alliance and the Northern Cancer Alliance’s campaign “Do It For Yourself”. Ensuring that people are aware of the signs and symptoms is really important, and has an impact on the number of lung cancers diagnosed and treatments started. I cannot stress enough that if individuals do not come forward, we cannot get them into the optimal pathway, which has shown real improvements in how we can help people through their cancer journey.

I was pleased with the £150 million of capital funding issued to regions in October to invest in diagnostic equipment such as MRI and CT scanners. Again, that was very much called for. I know that instant referral to a CT scan is an objective of the report, but getting the equipment so that we can start to deliver quicker routes is part of the issue. The further £325 million for new diagnostic equipment in the spending review, once we know exactly how it is going to be allocated, will, I hope, result in more delivery of diagnostics into cancer care. It is vital that we use that money to maximise equipment in as many places as possible so that individuals can be treated as rapidly as possible.

We know that access to earlier diagnostic screening improves clinical outcomes and that the late stage is really one of the challenges. That is why I am really pleased to see the hugely successful pilots of the targeted lung health check programme rolled out. Those pilots offered places such as supermarket car parks and lorries where people could easily access a check, particularly in areas of high prevalence or high inequalities, making it as simple as possible for somebody to get a check. There were dramatic improvements in those attending and huge upturns in the number of people diagnosed. The pilots were paused due to covid-19, but I am really keen that we turbo-charge them now that we have them back on track, so that they operate more broadly as soon as is safely possible. The programme will be rolled out to 23 clinical commissioning groups, focused on areas with some of the highest rates of mortality from lung cancer.

Because I am short of time, I will not repeat what the hon. Member for Halton said, but we know that we have regional variation, and we need to target more effectively for lung cancer where we have those problems. It is important that we do that geographically in the light of the need to minimise trips to the hospital, particularly for people who may be more vulnerable to covid-19. Radiotherapy services have made use of fewer fraction protocols as evidence has emerged.

The focus on recovery has been on embedding the use of hypofractionated treatment. In addition, the NHS is supporting providers to accelerate the delivery of stereotactic ablative body radiotherapy for non-small cell lung cancer and oligometastatic indications, starting with the treatment of non-small cell lung cancer. In some cases, that is an alternative to surgery. Again, I think the report picked up on that. The challenge is that if someone gets covid-19 at the same time as they are having the surgery, it dramatically increases the mortality rate.

It was right to react at speed. Where clinicians say, “We need to be doing it this way,” we have tried to give the direction so that they can. Individuals can safely go to their GPs. If people have worrying symptoms that could be cancer, GPs are open for business and ready to help patients. It is about ensuring that the “Help us help you” campaign from earlier in the year delivers and gets more people coming through the door so that we can treat them quicker.

Covid-19 Update

James Daly Excerpts

Programme motion
Monday 19th October 2020 Commons Chamber

[Matt Hancock]

It is very important that people come forward for testing. As the Chancellor of the Duchy of Lancaster said yesterday, of course, the vast majority of people not only come forward for a test, and want to come forward for a test, when they have symptoms, but want the isolation arrangements to be enforced fairly so that everybody isolates when they need to. That is the reason that we have taken the approach that we have, which I set out to the House several weeks ago.

[James Daly (Bury North) (Con)]

Since the beginning of the pandemic, there has been no recorded covid-19 outbreak in public houses in my constituency. Taking into account low national rates of transmission in pubs, when my right hon. Friend is in negotiations with colleagues from Greater Manchester, will he think very carefully before closing these covid-secure environments, which have spent thousands to ensure that they are secure, and cease introducing extra restrictions that will make trading an impossibility?

[Matt Hancock]

Nobody has stood up for the pubs and hospitality businesses in Bury more than my hon. Friend, and he makes an important argument about outbreaks. We also have to look at the backward contact tracing data, and at where measures to bring the virus under control have worked. I will happily have a further discussion with him to try to make sure that we can get the right set of measures and the right balance.