Cancer Treatments

Jim Shannon Excerpts

Tuesday 19th June 2012 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for Southport (John Pugh) on bringing this matter to Westminster Hall.

There is not one of us who has not personally been affected, or who does not have family members affected, by what is referred to as the dreaded big “C”. Last year, my sister, who lives in England, had kidney cancer. The medical services here were good in addressing that and she is on the way to recovery. My father had cancer on three occasions and, due to the skill of the surgeons, his faith and the prayers of God’s people, he got over those cancers and is still here coming up to 83 years old—or young, perhaps, which is another way of looking at it. Our health care system is good at what it does. I want to make that clear.

We have the best palliative care in the whole of Europe. That matter has been debated previously in the House. However, that does not always mean that we have the best cancer treatment in every category and sector. We must look at that.

The hon. Member for Southport spoke about pancreatic cancer. Recently, I met representatives from Pancreatic Cancer UK, who gave me some shocking figures, which are available to all hon. Members. Survival rates for pancreatic cancer have not improved for more than 40 years, making it the most deadly of all cancers diagnosed in the UK, with fewer than 3% of patients surviving beyond five years. Some 8,000 people are diagnosed with pancreatic cancer every year and it is responsible for 5% of deaths from cancer, yet it receives only 1% of research funding. There was a debate on pancreatic cancer in Westminster Hall a month or two ago. It is often regarded as a death sentence—if people get it, their chances are minimal. Perhaps the Minister can tell us what has been done to address that matter in particular.

[John Pugh]

I am glad the hon. Gentleman mentioned that, because two close friends of mine died rapidly of pancreatic cancer. One point made by the people in Liverpool to whom I spoke was that, given the almost invariably fatal outcome from this cancer, it would not be a bad idea if some of the rules regarding drugs approval were relaxed a little bit, so that people could find out what worked, because in this case there is very little to lose.

[Jim Shannon]

I thank the hon. Gentleman for that valuable contribution and agree wholeheartedly. If it comes to the stage where people’s life expectancy is minimal or reduced, I believe that they would be quite happy to take advantage of new drugs, if those were available.

All hon. Members know that finances are finite in the health budget. That being so, we are grateful for the many charities that do such magnificent work, including Cancer Research UK, Macmillan Cancer Support and Marie Curie Cancer Care. However, we must get a handle on our treatment process and outcomes, which can only come through the correct use of funding. I hope that the Minister will tell us how that will happen.

In the NHS document, “Improving outcomes: a strategy for cancer”, published in January 2011, it is clear what the Minister regarded as the way forward:

“In order to achieve these principles we must also ensure that every possible penny of money the NHS has is spent improving the quality of care and outcomes that patients experience. The Government protected the NHS in the Spending Review settlement, with cash funding growth of £10.6 billion (over 10%) by 2014/15. Compared to many other government departments, that puts us in an incredibly privileged position but this is the toughest settlement the NHS has faced in a long time.

At the same time, we need to respond to the longer term pressures the NHS faces; of an ageing population and the new demands created by new treatments and technologies. That means that, as set out in the Spending Review and the 2011/12 Operating Framework, over the next four years the NHS will need to achieve up to £20 billion of efficiency savings. These savings will be reinvested back in continuing to give patients the care that they need.”

Will the Minister say whether we are on target to make those savings? If so, when will that money go back into the system?

The document contains many examples of cost-efficient care, such as people having certain treatments as day procedures and then care at home, which makes a lot of people feel more secure as well as being cost effective. We understand the reasons and the thinking behind that: it is essential that the patient is at the heart of any decision made and any strategy must incorporate this.

I am not an argumentative person—far from it, I try to get on with most people in this world—but the hon. Member for Southport commented on the advertising campaign “Have you had a cough for three weeks or more?” We do not know how successful it was. The campaign has a role to play, and those who have had a cough for more than three weeks might well have a problem. We do not know how many people went to see their doctor and, as a result, have been made aware of problems. That is perhaps a different opinion from that expressed by the hon. Gentleman.

[John Pugh]

I said that all those things need to be reviewed in the light of evidence, that there were good campaigns and bad campaigns, and that evidence decided which category they fell into.

--- Later in debate ---

[Jim Shannon]

The facts will be the number of those who take up the campaign and see their doctors, perhaps ending up with the diagnosis of a problem.

I have read different consultation responses and have seen how different cancer organisations respond. All have been positive that, to improve patient experience outcomes, it will be important for patient experience to be measured and bettered throughout the entire patient pathway. Bowel Cancer UK points out that it is important that patient conditions are not ignored by an overarching patient experience indicator. For example, the overall patient experience reported by patients at a particular provider is likely to be less relevant than the specific experience reported by patients with the same condition. Thus, bowel cancer patients should be consulted about their treatment and given the necessary support and tools to make informed decisions about their care.

I will quickly outline seven suggestions that might lead to improvements in patient experience and care. Steps need to be taken to ensure continuity of care throughout the patient pathway. Key workers and clinical nurse specialists should play a central co-ordination role to achieve that—their involvement is critical. The meaningful data on service performance should be provided, to allow commissioners to make informed choices on the services that they commission and to inform patients about the services that they might wish to access.

Sometimes it is about knowledge and patients’ understanding of how the system can work to their advantage. Tailored patient information should be provided to guide patients through their care, in the form of information prescriptions; that should also include support to self-care, because that is sometimes the best way to deal with their problems and medical condition.

Symptom management should be offered to ensure that patients have the knowledge and tools to look after themselves when they can, but also so that they know when they need specialist support. In other words, when they need to call on the specialist support, they should have the chance to do that.

Patients should be given access to treatments in the most appropriate location for them, whether surgery, radiotherapy or chemotherapy—again, knowing the full choice.

Patients should be offered signposting and support to help them return to work, as well as ongoing support to manage continuing symptoms and the side effects of treatment. We might not always see such things directly, but they are important: trauma, the effect on the patient and their families, the financial implications and knowing about rights to benefits to get through that period, such as an application for disability living allowance.

Palliative care pathways should be considered alongside active treatment and not simply at the end of life. For many of us, palliative care is end-of-life care, but it has another role as well.

Lastly, the end-of-life care strategy should be rapidly implemented. Those seven suggestions are a method for the health system to address the care needed for those who have cancer.

I shall make a quick plug for those who do the experimentation and whose task is to find new drugs, which the hon. Member for Southport mentioned in relation to pancreatic cancer care. Queen’s university Belfast is at the forefront of experimentation in the investigation of new drugs—renowned the world over—and I commend the people there for what they do, and what many others do, because we cannot do without that experimentation to find the new drugs. Nearly every other month a new drug is announced—okay, there might yet be three or four years of experimentation and investigation, but the work of the researchers is tremendous and I commend them for it.

All the responses have been noted and the document that the Minister released is precise, yet more than a year later some feel that we have not moved forward as much as we should have done. Are we achieving better patient-focused care and outcomes? I am not so sure about whether that has been achieved, but the Minister will indicate where we are. That is why I am particularly thankful for the opportunity to debate the issue here in Westminster Hall. We do not need pretty words in a document—if I may use that terminology, and not facetiously—we need action. The Minister must turn all the words into action, and that is why I support the hon. Member for Southport and thank him for bringing the matter before the Chamber today.