Cancer Strategy

Jim Shannon Excerpts

Thursday 22nd February 2018 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) on securing this debate, and I am grateful to hon. Members for their extremely touching, wonderful and very personal contributions. As everyone here can testify, cancer has touched everyone—no family will not be aware of it. In fact, it is said that by 2020 one in every two people will be diagnosed with cancer in their lifetime. My father had cancer three times and each time survived, owing to the skill of the surgeon, the care of the nurses and the prayers he clearly believed in.

We have many problems in Northern Ireland—we all know about the political process—and I am conscious that health is a devolved matter, but I wonder if the Minister could have discussions and co-ordinate with the permanent secretary in the Department of Health, Richard Pengelly, to see if he can help and encourage his Department with the problems facing it. The incidence of cancer in Northern Ireland has increased by 25% in the past 10 years, such that the number of cancer cases each year has reached 9,000 for the first time. That is an indication of the problems.

I thank the many organisations, particularly Macmillan Cancer Support, for the information they have provided to us. There are 2.5 million people living with or beyond cancer in the UK today. The issue is that not all of them are living well: many experience physical, emotional and financial consequences as a result of their treatment. One in four face disability or poor health following their treatment that can persist for many years after treatment has ended, despite the NHS being set up to meet the changing needs of cancer patients and to enable access to the best treatment that is right for patients.

Macmillan is even more conscious of, and concerned about, the financial implications. According to projections in the “Five Year Forward View”, expenditure on cancer services is set to grow by 9% each year, which gives us an idea of some of the issues and takes us back to some of what was said earlier about prevention—I think that the hon. Member for Bristol West (Thangam Debbonaire) and others referred to prevention. We have had cancer patient experience surveys in Northern Ireland for a while now, and it is important that we are able to see what the trusts and CCGs are doing, what the cancer types are and the different aspects of the cancer journey. In England, the cancer patient experience survey has been happening since 2010 and has been proven to encourage hospitals to implement changes, to improve results. That is very important.

I would be very pleased if the Minister came back to us on the following point. Macmillan is concerned that the NCPES will not continue to deliver the same high-quality data, as the current survey model is not likely to be viable under the terms of the national data opt-out model that is scheduled to be introduced in May 2018. It is clear that Macmillan care has concerns. We have collected all the data and all this information through the clinical commissioning groups. The continuation of the cancer patient experience survey in its current format with high-quality, robust data is vital across the whole United Kingdom of Great Britain and Northern Ireland. Again, will the Minister provide the clarity that is needed on the issues that have been outlined on the NCPES to ensure the continued delivery of this essential and robust patient survey? The benefits are there in the data. I thank him for that.

About one in eight people diagnosed with cancer face mental health problems, such as anxiety, depression and post-traumatic stress disorder. Planning is needed to ensure that everyone living with cancer across the whole United Kingdom of Great Britain and Northern Ireland can access the right care and support, whether that means information, financial assistance, vocational rehabilitation or emotional support. Families can give so much of that emotional support, and they do so gladly, but at the same time we need to reach outside that.

Just 68% of people with cancer in Northern Ireland started treatment within 62 days of referral. Again, I am very much in the early diagnosis category and we need that in place. Cancer deaths in Northern Ireland are at the highest level that they have ever been. My party is totally committed to improving the five-year survival rates and believes in targeting resources to tackle deprivation, which is another issue. Cancer incidence rates are higher where there is deprivation.

More needs to be done to provide good continuity of care and to ensure that all patients have supported access to key information about their condition, treatment options and the types of support that are available. Macmillan is funding a second Northern Ireland survey that will be launched in spring 2018. It has invested £7 million in the Northern Ireland specialist cancer nursing plan, because this vital segment of the cancer workforce is not keeping pace with demand. Macmillan recognises that there are shortcomings and it has tried to introduce finance where it can to ensure that things go the right way.

Cancer is the most common cause of death in Northern Ireland. The end-of-life choice is very important. The Northern Ireland cancer registry found that 75% of patients would prefer to die at home. That subject matter is not easy to speak about, but the fact is that this needs to be looked at. Macmillan’s research found that people are more likely to die in the place of their choice when their wishes are recorded and known by their healthcare team. We believe that a new cancer strategy should include commitments to improving end-of-life care and giving everyone who is diagnosed with cancer the opportunity to have advance care planning discussions.

Macmillan has made a number of recommendations, which I will conclude with—it is referred to as the “Delivering Together” strategy. I totally support Macmillan’s reforms, such as producing a detailed implementation plan, including specific actions to improve care and support for people living with cancer and to enhance the patient experience in all trusts and CCGs. It recommends making the recovery package available to everyone living with and beyond cancer, the timely adoption and implementation of NICE guidelines to improve cancer detection, treatment and support, and close working with GP federations to ensure that care is provided closer to home.

The recommendations include long-term cancer workforce planning, integrating health and social care with higher education to attain a more knowledgeable and skilled workforce—it is important to have that—and with effective recruitment and succession across disciplines and settings. They include the better integration and co-ordination of all those things as well, including signposting to the non-clinical support that patients need at each stage of their cancer journey and providing high-quality palliative end-of-life care in all settings on a 24/7 basis. That should begin with cancer patients having the option of advance care planning conversations at the earliest possible stage. The recommendations also include increasing the involvement of people affected by cancer in the development, redesign and delivery of services and a commitment to the ongoing routine use of data collection tools, including the cancer patient experience survey and the peer review programme, to identify any gaps or inequalities in cancer care and pinpoint areas for improvement locally and benchmarking across the UK.

I ask the Minister to take on board all the issues we have all referred to and to do what can be done to help the massive amount of cancer sufferers across the whole United Kingdom of Great Britain and Northern Ireland, so that they have a better journey, a better outcome and better support.