Cancer Drugs

Jim Shannon Excerpts

Tuesday 20th October 2015 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the availability of cancer drugs.

As the turnout this morning indicates, the subject of the debate is of concern to us all. There are more Members from Northern Ireland present than usual, but that may be an illustration of the concerns of our constituents across Northern Ireland on this matter.

I did some background research before I came down to the Chamber, and I discovered that in September 2013, the British Medical Journal asked:

“Which way now for the Cancer Drugs Fund?”

In July 2015, the Health Service Journal said:

“Cancer commissioning overhaul could save 30,000 lives”

and The Daily Telegraph on 4 September led with the headline:

“Thousands of cancer patients to be denied treatment”.

On 5 September, The Independent reported:

“NHS cuts to drugs fund mean thousands of cancer patients in England will be denied life-extending treatments”.

Finally, The Guardian stated on 23 September:

“UK NHS cancer patients denied drugs due to inflated prices”.

All those headlines highlight a clear problem when it comes to cancer drugs, which is of the utmost importance and which is, unfortunately, too close to home for many of us. There are many organisations that help those affected, but I would like to mention Macmillan Cancer Support, which is very much in my mind. The charity stated that 2.5 million people in the UK are living with cancer in 2015. The fact that that is slightly less than 5% of our total adult population indicates that this problem is enormous. It is hard to find anyone whose life has not been touched by this horrendous disease in some way.

My father, who passed away this year, had cancer on three occasions. He survived all three of them and lived to the ripe old age of 85, having first been diagnosed some 36 years ago. I have always said that the skill of the surgeons, the care of the nurses and the prayer of God’s people saved him on those three occasions. For many of us, cancer is not simply something that others talk about; it is something that affects each and every one of us.

My father is only one example. In my office every week, people come to me who are suffering from cancer. Some are also in the throes of benefits problems; very often, in addition to the trauma of health issues caused by their cancer, people have to deal with benefits difficulties. We have to work out how to get them into the benefits process and take the financial pressure off them at such a crucial time.

[Lady Hermon (North Down) (Ind)]

I congratulate the hon. Gentleman on securing the debate, which concerns the availability of cancer drugs throughout the UK, not simply in Northern Ireland; I am surprised that more Members are not present. Greater availability of off-patent drugs would help in the fight against cancer and reduce cost to the NHS. Will the hon. Gentleman support that call and the private Member’s Bill on the topic?

[Jim Shannon]

I thank the hon. Lady—my hon. Friend—for her contribution, and I am happy to add my support. Indeed, I attended a meeting of the all-party group on off-patent drugs last Thursday, and it is important that we support its campaign.

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

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate the hon. Member for Strangford (Jim Shannon) on securing a debate on an important issue that affects many families—perhaps all families—across the UK. I intervene at this point because the hon. Member for North Down (Lady Hermon) has mentioned the private Member’s Bill that I am sponsoring—the Off-patent Drugs Bill. Would the hon. Gentleman agree that there are problems affecting the prescription of off-label drugs? It happens inconsistently across the country, and there are problems of information and a conservatism about prescribing off-label. Does he agree that those problems are best dealt with by legislation?

[Jim Shannon]

We have hit on an issue that resonates across the whole House. Let us put on the record the fact that there is a goodly representation of other parties today, and those hon. Members are here because they have an interest in the matter. I am pleased to see the Minister in his place. He tells me that I never miss one of his debates, and I do not know whether this is his debate or mine, but we are both here for the same purpose. I am pleased to see the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), in his place as well.

Survival rates are improving, and that development is great for everyone.

[Ms Margaret Ritchie (South Down) (SDLP)]

I congratulate the hon. Gentleman on securing this debate about cancer, which impacts on almost every family throughout Northern Ireland and Britain. Before we proceed to talk about cancer drugs, does he agree that it is most important that we have proper diagnosis and proper testing? As well as widening access to cancer drugs, does he agree that access to testing such as Oncotype testing for breast cancer, and BRCA1 and BRCA2 testing for ovarian cancer, is important, because they will suggest the right type of cancer drugs to prescribe—and, indeed, indicate whether cancer drugs are required at all? We need the diagnosis and testing, and then we need the right type of drugs.

[Jim Shannon]

I absolutely agree. The hon. Lady mentioned ovarian cancer. Most of us from Northern Ireland will know of Una McCrudden, who passed away earlier this year. She was an energetic person who spoke out on behalf of those with ovarian cancer. She survived six years after she was first diagnosed, and all her latter years were put into that campaign. I know that the hon. Lady knew her as well as the rest of us did.

Great work has been done on ovarian cancer. Only last week, I heard of one of my constituents who had been diagnosed with ovarian cancer and undergone surgery. The operation was successful, and we thank God for that, but many others do not survive. Survival rates are improving, and given that one in two people diagnosed with cancer in the UK survives, we are on the right track. The fact remains, however, that we could and must do so much better.

With innovation in cancer treatments making great strides, it is imperative that we, as representatives of the people the length and breadth of this nation of the United Kingdom of Great Britain and Northern Ireland, campaign to increase the availability of cancer drugs to our constituents. The Minister and I have discussed this many times. Queen’s University in Belfast is one of the leading advocates for innovation in the search for new cancer drugs, and it leads the way in cancer treatment, as it does in many other spheres of life. Today the Chinese President is visiting Parliament, and we have all sorts of other contacts with China, so it is particularly appropriate to highlight the fact that Queen’s University works in partnership with organisations and universities in China to move that work forward.

Cancer knows no creed, colour, race, religion or class. It is an enemy that we have all come together to fight. With that in mind, I hope that we can all come together to give our constituents up and down this nation access to the very best treatment for that common enemy. We are united in our desire to see greater availability of cancer drugs in every postcode area across the United Kingdom.

[Mr Andrew Smith (Oxford East) (Lab)]

I join other hon. Members in congratulating the hon. Gentleman on securing the debate, and I support what he is saying about access to cancer drugs. Is it not also important to underline the fact that the overwhelming majority of successful treatment of cancer is by surgery or radiotherapy, often supported by drugs?

[Jim Shannon]

Absolutely. My father survived cancer three times because of the surgeon, the chemotherapy, the radiotherapy and all the other treatment that he received, and the drugs helped. So, by the way, does a good diet; there are lots of things that we need to do to tackle the disease. I draw the House’s attention to the recent developments in Northern Ireland. Hon. Members will know that health is a devolved matter. My party colleague, Simon Hamilton MLA, the Minister for Health, Social Service and Public Safety, has taken the initiative to release £1.5 million to fund specialist cancer drugs. That will allow for NICE-approved cancer drugs and treatment to go ahead this year.

[Gavin Robinson (Belfast East) (DUP)]

I congratulate my hon. Friend on securing this debate. He mentions the figure that has been secured by our Health Minister in Northern Ireland. Has any thought been given to the amount of money or resources made available to reduce the time individual patients will have to wait before securing the drugs they need?

[Jim Shannon]

I am unable to answer that question effectively and honestly. I know that question will be brought to the attention of the Minister back home and the Minister here will have a response to it. Today’s debate highlights the issue and raises awareness. We have concerns about the long waiting list. As the hon. Member for South Down (Ms Ritchie) said, we need diagnoses early—the earlier the better. I find it frustrating when I hear from some of my constituents who might wait 12 weeks for a diagnosis and perhaps longer for treatment. We need to address that.

[Andrew Stephenson (Pendle) (Con)]

I join other hon. Members in congratulating the hon. Gentleman on securing the debate. I agree with the point that he is making about the availability of cancer drugs across the United Kingdom. Does he agree with me that the environment in which patients are treated is also important? Will he join me in congratulating my local hospital trust, East Lancashire Hospitals, on its commitment to build a new cancer unit at Burnley general hospital with the support of the Rosemere Cancer Foundation?

[Jim Shannon]

As the hon. Gentleman says, there are many good examples across the whole United Kingdom of Great Britain and Northern Ireland, where things are done well. We thank the doctors and nurses, who work energetically, and the many charities.

The national target for accessing these life-changing drugs is 19 weeks. The move in Northern Ireland will go a long way towards enabling the health service there to reach that target. My hon. Friend the Member for Belfast East (Gavin Robinson) was correct that we need to focus on that target. Each day in Northern Ireland, 23 people are diagnosed with cancer and 11 people die of it. According to Cancer Research UK, there were 331,487 new cases of cancer in 2011 and 161,823 deaths from cancer in 2012. That tells us a wee bit about the magnitude of cancer and its importance to every person in the whole United Kingdom. More should be done but I can only welcome the recent developments in the Province. I hope that other areas of the country can follow suit by freeing up the funds necessary and introducing legislation to prioritise fighting this awful disease to the best of our ability.

In England and Wales, cancer remains one of the biggest killers, causing 29% of all deaths. Progress has been made and all progress is welcome, but it is opportunities like today when we can really make a difference to the lives of individuals and families from all walks of life. Recent developments across the water—here—are deeply concerning. In September, 16 drugs were removed from the Cancer Drugs Fund list in addition to another 16 drugs that were removed from the list in January.

[Nick Thomas-Symonds]

I congratulate the hon. Gentleman on making that point. Does he agree with me that the removal of Abraxane from the national Cancer Drugs Fund list is particularly concerning given that pancreatic cancer patients, 80% of whom are diagnosed when the cancer has already spread, are often left with a finite and small amount of life? A drug such as Abraxane can make a significant difference to those people and that decision should—I hope it will—be reversed in future.

[Jim Shannon]

The hon. Gentleman must have helped me put my notes together because I have written that one down. It was one of my next points. Yes, we are concerned about that. I look forward to the Minister’s response on that point because, quite clearly, it is hard to understand why Abraxane should be removed given that it at least extends the life of many people.

[Sir Oliver Heald (North East Hertfordshire) (Con)]

On that point, a very small number of conditions are very fast-acting. Pancreatic cancer is one of them—six months, on average, between diagnosis and passing away. Does he agree with me that NICE needs to find some way to capture the importance of an extra two months? An extra two months to somebody who only has six is time to settle their circumstances and come to terms with the situation. It is a very important two months and somehow that needs to be captured.

[Jim Shannon]

I could not have said it better. That is exactly the issue for many in the House and for those outside who have to deal directly with these issues.

Moves such as the removal of the drugs prevent thousands of cancer sufferers across England and Wales from being able to access the quality treatment they deserve. Thousands of people are disadvantaged, thousands of families are losing out and thousands of normal people are in despair. Today, we need to give them hope, an advantage and life itself.

The Government have said that the manufacturers of drugs recommended for removal from the Cancer Drugs Fund will have an opportunity to reduce their costs. Negotiations are under way. I am keen to hear the Minister’s response on that. I would like confirmation that patients already receiving a drug that will be removed from the Cancer Drugs Fund will continue to be treated with that drug. Clinicians certainly indicate that they consider it appropriate to continue treatment. The patient needs to be assured that the system is such that those who are on the drugs will continue to be. I had written down the point about pancreatic cancer. The hon. and learned Member for North East Hertfordshire (Sir Oliver Heald) is absolutely right. I thank him for his intervention.

We are living in times when we are all being asked to tighten our belts but when it comes to issues like this, we simply cannot put a price on doing what is right. Given the consequences for patients, it is imperative that we act sooner rather than later. A long-term and sustainable system for cancer drugs is essential and, while we build that, we have to keep doing what we can to improve the lives of those suffering right now. That starts today with this debate. The debate has been happening outside the Chamber and today is an opportunity to highlight to issue in the Chamber.

I am particularly looking forward to hearing the Scottish National party spokesperson today because I was talking to the hon. Member for Central Ayrshire (Dr Whitford) last night at a different debate. She was unable to attend today. The Scottish National party, Scotland and its Parliament have led the way in how cancer drugs can be allocated. There are lessons to be learned from Scotland so the SNP’s comments will be particularly pertinent.

We have an opportunity to do what is right. Today we have an opportunity to make a difference and to affect normal, everyday people’s lives in a positive way. We need to seize that opportunity. Let us use this House for what it was designed for—to help the people we represent. Cancer can strike anyone. It is indiscriminate and that is why we should be doing our best to get what is best for our constituents.

With the working group on the Cancer Drugs Fund currently suspended, it is important to remember that each minute we fail to make progress on the issue we are failing a British citizen suffering from cancer. I need not remind the Chamber of the ultimate consequences of patients being denied access to life-extending treatments. The longer we delay consultation on the new system, the more lives we are failing. Having said that, it is important that we consider the outcome and results rather than just the intention of the actions we take. The Cancer Drugs Fund did great work when it started and the intention of the fund was most honourable. However, we all know of the budgetary constraints that made the Cancer Drugs Fund sustainable, which is why we need to have an open and rational discussion about how to progress.

I should have said this at the beginning, but I will do so now: I thank the hon. Member for Scunthorpe (Nic Dakin), who attended the Backbench Business Committee on my behalf on a Monday about two months ago. I was unable to be over here on that Monday but he did it for me so I thank him publicly for that opportunity.

I welcome the fact that the Cancer Drugs Fund will become operational once again from April 2016, as I welcome any provision of care for cancer sufferers, but it is imperative that we develop a long-term solution that commits us to those who depend on cancer drugs for the extension of their life and for their families. Very often—I see this in my constituency office and I know that other Members do—we see the impact on the families. There are enormous financial, emotional and physical pressures.

[Ms Ritchie]

Is the hon. Gentleman aware that the UK National Screening Committee, which advises the devolved Administrations and the NHS in England on clinical trials, started a process of clinical trials last year? At the debate that I had in this Chamber on 4 November last year, I was told by another Minister in the Department of Health that that evidence base would be assessed for future treatment and diagnostic purposes. Does the hon. Gentleman agree that it would be useful if the Minister, in summing up, advised us of the results of those trials, which could then lead to better treatment and decisions on possible cancer drugs?

[Jim Shannon]

The Minister’s staff are taking notes, and hopefully he will be able to respond positively.

During the transition to the new system, cancer sufferers who were not registered with the Cancer Drugs Fund prior to suspension are not able to access the benefits of the CDF, which is deeply concerning. The second round of delisting will see a further 16 drugs delisted. As the CDF is suspended, patients who did manage to get registered are losing out on drugs that could potentially have been listed and may have been vital to their treatment, which is of concern to everyone in this House.

This is clearly an emotive issue that goes to the heart of everyone here and our constituents across the United Kingdom of Great Britain and Northern Ireland, which is why so many people are in this Chamber today. I thank each and every Member for their interventions and contributions. I look forward to the contributions to come.

Action is urgently needed, but we also need a sensible, rational and robust exchange on how to deliver this positive initiative in a sustainable manner that allows us to have a positive, long-term impact on those who are suffering. I look forward to the contributions of the shadow Minister, the hon. Member for Denton and Reddish, and particularly the Minister, for whom I have the greatest respect. I look forward to his reply with all the positive answers that we want so much.

[Several hon. Members rose—]

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Life Sciences (George Freeman)]

It is a pleasure to serve under your chairmanship, Mr Hollobone, at this early hour of the morning. I know that many Members would have liked to have been here for this debate. I suspect that if the debate had been scheduled for the main Chamber, we would probably have half-filled it, given the level of interest. I am delighted to have the chance to respond.

First, I congratulate and pay tribute to my friend, the hon. Member for Strangford (Jim Shannon). He is, as a number of colleagues have observed, a tenacious campaigner on this subject, and I am glad that we have kept up our record of 100% support for each other. He is a parliamentary champion of this cause, and it is a pleasure to work with him on it. He spoke powerfully about his own family’s experience of cancer, as did the hon. Member for Denton and Reddish (Andrew Gwynne). I am sure many Members from all parts of the House have experience of cancer. My father died of throat cancer when I was 19. It is a disease that still, despite all the progress, robs families and stalks the land. I will say something in a minute about the progress that has been made, because it is stunning.

I suspect when many of us were children, that word—cancer—normally spelled a quick and tragic death. Now, more than 2 million people living in Britain have had a cancer diagnosis. Cancer Research UK and all those involved in cancer research have achieved extraordinary things, but it is still a diagnosis and treatment that people dread. Cancer is a serious cause of early death, and it was powerful to have heard such cross-party support for cancer research.

As the hon. Member for Strangford and others observed, cancer does not respect any boundaries, whether they are of geography, income or party politics, although I make the point that it heavily correlates with health inequalities. Many colleagues in the House with constituencies with particularly high incidences of cancers also have constituencies with particularly a high incidence of poverty generally. There is a strong link between life chances and poverty and health and health inequalities. I observe that the Petitions Committee has received a petition on Abraxane, which is a symptom of how widely the concern on this issue goes across the House.

I will try to deal with some of the issues that have been raised. The truth is that the field of cancer research has pioneered the model of 21st-century drug discovery and life science research that is transforming how the sector works. That is driven principally by breakthroughs in genomics, genetic science and informatics—the ability to develop treatments and diagnostics based on being able to predict which patients will respond to which drugs and which patients are likely to be predisposed to a particular disease. Such breakthroughs and the use of big data, big informatics and genomic insights into the use of genomic biomarkers are allowing us to redesign the way in which drugs are discovered and developed. Cancer has led in that field partly because cancer is itself a genetic disease and because of the extraordinary work of Cancer Research UK and various other charities. I pay tribute to their work and leadership not only in deep science, but in the policy-making framework on treatment, diagnosis and care. I will talk about the cancer strategy that CRUK has helped us to put together in a moment.

The role of charities is growing in this space. I recently opened a combined laboratory in Cambridge shared by Cancer Research UK and MedImmune, a subsidiary of AstraZeneca. We have seen partnerships and collaborations between charities and companies before, but this was a joint laboratory, jointly funded with a joint research committee. It is a sign of where this landscape is going. We will see charities become the gatekeepers of patient power, patient tissues and patient genomic information, and gatekeepers of the patient asset in this new landscape of patient-centred research. It is a very exciting time for medical research charities.

Pioneering cancer research has made many cancers diagnosable and treatable diseases. As I have said, more than 2 million people now live with cancer. Diagnosis is still poor in pancreatic and colon cancer, and in many cases there is no proper cure, but about 98% of breast cancers are treatable and curable. That is a stunning breakthrough and I am sure that over the next 20 or 30 years we will see all cancers quickly reach that point. We need to recognise the extraordinary improvements in this field. The role of genetics and informatics is welcomed by the Government. We are doing everything we can through our life sciences strategy, set out by the Prime Minister in 2011, to drive this new landscape.

We have made groundbreaking commitments with the Genomics England programme. We are the first nation to commit to sequence the genomes from 100,000 NHS patients and combine that with clinical data. We have made groundbreaking commitments to open up our data sets to drive this model of 21st-century research. It is important that all of us who understand the power of that work also support it, because our constituents worry about the use of data. We need to make sure we safeguard individual patient data, and we need to make sure we unlock the assets of the NHS throughout the United Kingdom so that we are a genuine powerhouse in the 21st-century model of patient-centred research.

I want to pay tribute to the work of Northern Ireland scientists, academics and companies. The hon. Member for Strangford mentioned the Experimental Cancer Medicine Centre at Queen’s University. He is absolutely right that it is a world-class centre. I visited earlier in the year to commend, congratulate and support the team there. Sometimes the sector appears to be more interested in Oxford, Cambridge and London than in the extraordinary world-class centres out on the corners of the United Kingdom. I went specifically for that reason. The work there is not only world class in terms of the deep science on the cell mechanisms of cancer, but, in embracing the unified life sciences strategy research and treatment, the centre has helped to pioneer leadership in stratified medicine, pulling in inward investment and, interestingly, taking the patient catchment for the lower quartile of cancer outcomes to the upper quartile. That is a sign of how research medicine drives up clinical standards.

[Jim Shannon]

I visited Queen’s University in Belfast in the summer. They told me that they wished to see more partnerships and relationships with other universities, including on the mainland. The funding strand needs to be encouraged and we need to be a part of that. Will the Minister take that on board? I am sure he knows all about it, but I simply remind him.

[George Freeman]

The hon. Gentleman makes an important point. I will be discussing the matter with the Minister for Universities and Science and the Medical Research Council. We need to make sure that we move to a more networked and collaborative model of science funding. Traditionally, we have tended to fund established centres of excellence, which is important, but we also need to make sure we build networks. Cancer networks in research and treatment have been incredibly powerful in driving the advances that we have discussed. He makes a very good point. I was delighted to see the leadership of the Queen’s centre recently recognised by Cancer Research UK with a £3.6 million grant.

I want to talk about the wider landscape of cancer treatment and then turn to the drugs question.

--- Later in debate ---

[Jim Shannon]

Thank you for chairing the debate, Mr Hollobone. I thank all right hon. and hon. Members who participated. A vast array of excellent knowledge was on display today from those who gave speeches and made interventions. Some great ideas were put forward, particularly that of the hon. Member for Foyle (Mark Durkan) about combined purchasing power. The Minister and shadow Minister were both on to that; it is something we can use better to develop the existing innovative drugs policies across the whole United Kingdom. I draw particular attention to the advances being made at Queen’s University Belfast, which we should combine with progress in the rest of the United Kingdom.

The contributions from each and every Member were valuable, detailed, informative and compassionate. It is important that we put on the record our thanks to the charities and other contributors. We are all moved by the e-petitions, which show that there is clearly a deep interest in the best way to fund cancer drugs. We have tried to ensure that patients at their weakest are the focus of the debate. I thank the Minister for his comprehensive reply. We look forward to helping our constituents across the whole United Kingdom of Great Britain and Northern Ireland.

[Lady Hermon]

rose—