Cancer Strategy

Jo Churchill Excerpts

Thursday 8th December 2016 Commons Chamber

[David Tredinnick (Bosworth) (Con)]

I am most grateful to you, Mr Deputy Speaker, for calling me to speak in this important debate.

I listened with great interest to the hon. Member for Poplar and Limehouse (Jim Fitzpatrick) talking about his experiences of smoking. I gave up smoking before a flight with a parliamentary delegation coming back from Bahrain nearly 15 years ago, and I have never looked back. One of the drivers that made me give up smoking was a conversation with the then Member for Manchester, Withington—I would call him an hon. Friend, but he was an Opposition Member—who is now Lord Bradley. Like the hon. Member for Poplar and Limehouse, I remember smoking in the House. I remember lighting up in a Standing Committee and being reprimanded, but we could smoke in the Library Room C then. I offered the then Member for Manchester, Withington a cigarette in the Tea Room—we could smoke anywhere then, as well as in the Smoking Room—and he said, “David, no thanks. I’ve got an emphysema hospital in my constituency.” That really hit home.

The hon. Member for Scunthorpe (Nic Dakin) is nodding. May I pay tribute to him? He was at the Britain against Cancer conference on Tuesday, which I attended as an officer of the all-party group on cancer. He has served on that group for much longer than I have, and he chaired the meeting in the absence of my hon. Friend the Member for Basildon and Billericay (Mr Baron). Other hon. Members have paid tribute to my hon. Friend, and of course to his wife, who is undergoing treatment at the moment. I want to say what a great job my hon. Friend has done to drive this agenda on the Conservative Benches. It just shows that if you follow something you believe in in this House, you can get dramatic results.

As a politician, I often think that we should be able to sum up something, such as a very wordy report, in just a phrase or a sentence. That may be because of my background in advertising many years ago. Those dramatic results were clearly illustrated by Simons Stevens, when he said that in 1999, 60% of cancer patients survived, but in 2014, the figure was 70%. We went over some of those figures, which I thought were truly remarkable and really very encouraging.

I want to focus on something else that Simon Stevens said, which the hon. Member for Scunthorpe has mentioned. He announced £200 million of funding at the conference:

“The £200m fund has been set up to encourage local areas to find new and innovative ways to diagnose cancer earlier, improve the care for those living with cancer and ensure each cancer patient gets the right care for them.”

That includes aftercare treatment. What do we do when a patient has had chemotherapy and then there is nothing else—they have not been given any other options, so they feel depressed and unhappy?

That is where my main experience in this House comes in, as I have worked on integrated healthcare—holistic medicine, I suppose—with the all-party parliamentary group on integrated healthcare for nearly 30 years. I have been an officer of the group for nearly 25 years, and have chaired it for quite a while. It feels almost as if our time has come. It has now been clearly recognised that part of the cancer package should be a wide range of support. We can see that all over the country. I was at LOROS last week, which is where very ill people in Leicestershire go for their last few days. A range of different therapies were being offered there. That is happening not just in my constituency but in many others.

I return to the conference mentioned by the hon. Member for Scunthorpe—[Interruption.] I see he has now been promoted to the Front Bench. That is the great thing about the Opposition—the Front-Bench team changes so quickly that we can never be sure where any hon. Members are. I remember that when I was a young Member the advice I was given was always to sit in the same place in the House so that the Speaker knew where you were. In that case, it is a wonder that any Opposition Members get called at all, because they are always moving around the Benches. The hon. Member for Scunthorpe has clearly been promoted this afternoon, so congratulations.

One battle I have had over the years has been with the medical establishment about what should be included in treatments on the health service. It has been an ongoing battle against vested interests in the medical establishment who do not want to see money leaking from their own particular silos. That is down to scarce resources. One of the most interesting stalls at the Britain against Cancer conference on Tuesday was about cancer detection dogs. Even I gasped when I saw it—my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who has also had experience of cancer and has contributed so much in her short time in this House to addressing cancer problems, is nodding and smiling. Just as we have dogs in this House—I will not say when or where they go—to detect things that may have been placed here by people who do not particularly agree with what we do, so it is possible to use dogs to detect cancer. If that is possible, I suspect that the authorities in the health service have not run double-blind placebo-controlled trials to establish whether it works. It works on the basis of experience, because the dogs are trained to detect by smell when people have developed cancer.

On the great battleground with the orthodox proponents of orthodox medicine, the battle line has in recent years been drawn on something called evidence-based medicine. We are told that in the health service medicine should always be evidence-based, and nothing should be used unless it meets that criterion. I had a look at that, and got the Library to look the papers up. It goes back to 1992 and a statement by Professor Sackett that various other academics then ran with—there was a Professor Guyatt also. But when saying how important evidence-based medicine was, Professor Sackett also said:

“Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming tyrannized by external evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. Without current best external evidence, practice risks becoming rapidly out of date, to the detriment of patients.”

It is hardly a secret that we were discussing Brexit in the House yesterday and that we have been very much involved in the whole debate since the summer—and for many of us, a long time before that. One problem in healthcare in relation to the EU has been the imposition of directives on the UK that have negatively impacted support services in healthcare. The traditional herbal medicines directive requires Chinese medical practitioners to show 30 years’ usage of a particular medicine in the UK, or 15 years under other circumstances, and bans a whole range of complex preparations freely available, and produced to very high standards in modern factories, in the People’s Republic of China.

Before I came to the Chamber this afternoon, I was at a Chinese medical clinic. I practise what I preach and have acupuncture once a month. I take Chinese herbal medicine and I think it has kept me away from antibiotics, steroids and other drugs for a good few years. I talked to practitioners about what they are able to do for cancer patients. There is a very long list of types of cancer that can be treated using traditional Chinese herbal medicine: cervical cancer, Non-Hodgkin lymphoma, HIV, colon cancer, head and neck cancer, breast cancer and prostate cancer. The list goes on.

I believe that several of my constituents are alive today because they have used Chinese medicine. It strengthens one’s immune system and is very effective after cancer treatment. It deals with particular symptoms. I asked the practitioner this afternoon what conditions she would expect to be able to alleviate using Chinese herbal medicine and acupuncture. She said: tiredness, lack of energy, fevers, headaches, hypertension, dry skin, seizures and involuntary muscular twitching.

We have to broaden the scope of services available on the health service to help to meet patient demand. I hope the £200 million fund will mean a further widening of the scope of services available. My hon. Friend the Minister, who is new to his post, could do a lot worse than contact the head of the Professional Standards Authority, Harry Cayton. Harry Cayton’s organisation oversees the regulation of 23 different health organisations, including about 20,000 providers. If we go to the trouble of regulating different therapies, or having oversight of that regulation, why on earth do we not use it? What is the point of having a statutory regulator that checks the oversight when we do not actually use its services? That is a great mistake.

My hon. Friend the Minister could do a lot worse than go around the country and look at some of the practices that help cancer patients in remission. One of the best is the award-winning Velindre cancer centre in south Wales. Each year, it sees over 5,000 new referrals and about 50,000 new out-patient appointments. It employs over 670 staff and has an annual budget of over £49 million. The money for that service, which is widely used by doctors, comes not from the Department but from charitable donations. At that centre, they use reflexology, reiki healing, which I have studied over the years, aromatherapy, and breathing and relaxation techniques, and they have spectacular results.

Another wonderful clinic that my hon. Friend would do well to visit—it is a few stops on the District line from here, in Fulham—is the Breast Cancer Haven. It offers a range of therapies to combat stress, and I have attended its sessions. It is wonderful to see people suffering from breast and other cancers being given hope that chemotherapy is not the end of the road and that there is something out there to support them.

Another wonderful organisation of which my hon. Friend should be aware, and which was at the cancer conference on Tuesday, is Penny Brohn UK, the living well with cancer organisation. It has worked hard to produce a report on the long-term impact of its living well course, and the results from the five-year follow-up show a high approval rating among patients. The figures are staggering: 97% of patients reported making positive lifestyle changes after the course; 75% said they had maintained the positive changes for four to five years or were still maintaining them; and 85% said the living well course had enabled them to self-manage their health more effectively.

My hon. Friend, being well aware of Government policy, will know that patient choice is, according to the Health Secretary in the last Parliament, at the heart of the health service. If we are to give patients choice, we have to give them the provision to choose from. I was a member of the Health Committee for the whole of the last Parliament—I chaired it for a while when Stephen Dorrell stood down, before my hon. Friend the Member for Totnes (Dr Wollaston) took over—as well as a member of the Science and Technology Committee, both of which looked at the complex problems of polypharmacy and polymorbidity, which is jargon for too many people taking too many drugs and nobody really knowing what those drugs do. We need to reduce that.

There is a crisis in this country with antimicrobial and antibiotic resistance—we are not getting new antibiotics into the pipeline—and part of the problem is that we are trying to create new drugs while also trying to reduce antibiotic use. There is a range of other therapies that can help patients stay away from antibiotics. I will not get called to order, Madam Deputy Speaker; I know that this is a cancer debate, but a lot of alternative therapies—I will get to the H word, homeopathy, in a minute—offer options at a time when mainstream medicine is running out of solutions.

I have always championed the cause of homeopathy in this House, and I want to relate that strictly to cancer this afternoon. Homeopaths do not claim to cure cancer, but my goodness they can assist people who have had cancer and who are in remission by helping them to adjust their moods and to deal with anxiety and sleeplessness. It is a great tragedy that a tiny number of people, whom I regard at best as foolish and at worst as wicked, are trying to erase the tiny sum of money—£500 million—spent on homeopathy in the health service. Without looking at the benefits, they argue that it is a waste of money.

We have seen the pressure on institutions at Liverpool and elsewhere. What could be more stupid than to attack a medical system that is widely used in France, that voters went for in Switzerland, and that is used across the world, including in India and Brazil? What is the problem here?

I was in Toulouse to look at British Aerospace work recently, and I found a homeopathic chemist right in the middle of the main square there. Some 90% of pregnant women in France use homeopathy. The Minister must not be bludgeoned by the tiny number of people who use legal threats and resist it. Simon Stevens is now coming up with new money for aftercare for cancer, so we need to look out of the box and consider new possibilities. We are not even looking at some possibilities that are orthodox.

As I said, I am an officer of the cancer group, and I chaired a meeting the other day to hear anxious and anguished professors of medicine from this country talking about a new mainstream treatment called Target for breast cancer. Target is about putting a small device the size of a tangerine on the end of a cricket stump into an incision in the chest. The chemotherapy treats the tumour and not all the other organs in the chest. The professors saw this as a great breakthrough. It was invented in Britain, and it is widely available in Europe. How come NICE has only given it draft clearance? What is going on? Professors of medicine are saying that this is hugely important, yet we are not actually dealing with it.

[Jo Churchill (Bury St Edmunds) (Con)]

On that particular point about targeted interoperable radiotherapy, I too have spoken to these professors, and I understand where they are in the clearance process. I find it a little bit concerning when there is a lack of money in the system. Is my hon. Friend aware that there are half a dozen machines around the country that could deliver that targeted therapy? Perhaps we need to look at what we should do first—whether it is purchasing the machines or giving the clearance in full.

[David Tredinnick]

My hon. Friend makes her point very well. In his excellent presentation, Simon Stevens talked about bringing new equipment onstream for radiography, I believe. [Interruption.] Yes, my hon. Friend was there, and she confirms this. I certainly agree with what she said, and we need to wake up to what is being invented in Britain and used across the world.

I shall conclude shortly, in case anyone else is hoping to catch your eye, Madam Deputy Speaker. I want to finish with a couple of other points. There are other treatments out there, to which people turn in desperation when they reach the end of their conventional treatments. One of them is called oxygen therapy, and broadly speaking it means getting more oxygen than is normally received, from a container. It is not a very expensive treatment, and the information I am getting is that it produces spectacular results when it comes to energising people and improving their sense of self-worth and wellbeing.

My final point is one that I find amazing. In the great cancer hospitals and clinics of this country, diet is seen as a sideline. In some of these institutions, the diet is, frankly, appalling, but I am not going to name of any of them this afternoon. Like most colleagues, I have a big enough postbag already and I do not want to hear the defence. Anyone attending a big clinic in America, such as the Mayo Clinic, can say goodbye to dairy and sugar, and hello to more juices. The Haven in Fulham certainly uses a lot of raw juices and raw vegetables. Diet is absolutely fundamental. When I worked in the computer industry, we used to say “Garbage in; garbage out”—and the same applies to humans. Our outputs as a being—[Interruption.] The hon. Member for Scunthorpe (Nic Dakin) does me the honour of laughing, but it is true. Diet is such a soft ball to hit, is it not? We are spending millions of pounds on all these expensive treatments, but what about telling people to cut back on sugar? Well, there we are.

I have tried to address some of the issues following the landmark speech at a landmark conference on Tuesday. For the first time, we have seen a lot of money set aside for developing aftercare for patients and improving services around mainstream medicine.

My hon. Friend the Minister has a great opportunity to make his mark in the House. His Department is, I believe, the fourth largest employer in the world. I think the Red Army comes top and McDonald’s second; I expect another burger provider comes third; and my hon. Friend is presiding over part of an organisation that comes fourth. His brief gives him enormous opportunities to improve the quality of life of cancer patients in this country, and by the time he has finished, there should not be just an increase in the cancer survival rate from 60% to70%—his target should be 80%.

Madam Deputy Speaker, I rest my case.

--- Later in debate ---

[Bob Blackman]

When the change in law came through, a number of people objected to it, saying that it would not be enforceable. I remember back to my childhood when both of my parents were smoking in the car in front of me. It was difficult then as a child to say, “Please, will you not smoke, because I do not like it?” It was just easier to open the window. I do not want children to go through that. It is right and important that we changed the law in that way, as we know that second-hand smoke is a key killer of young lungs. It was a significant development—and a development that people did not think would happen. People did not think that we could introduce this change and get it through both Chambers, but I am delighted to say that we did it and that it was the right thing to do.

[Jo Churchill]

I thank my hon. Friend for providing such a powerful case. I could not agree with him more. To my way of thinking, banning smoking would do me, but we probably cannot go that far. Does he agree that the broader point of health economics is also important? Lung cancer is not the only issue. There is also emphysema, pulmonary disease and so on. If we sort out the tobacco issue, we could make much broader savings across the health service.

[Bob Blackman]

There are aspects of that with which I agree. The reality is that tobacco is the only product in the world, which, if used in the way that was intended, will kill us. Therefore, controlling it is vital.

We know as well that those with complex medical needs have the highest smoking rates. I am talking about people who are unemployed, who have mental health conditions, and who are in prison. I am also talking about the people whom I am championing at the moment—the homeless. All of them are much more likely to smoke than others, and they are also more likely to have the most health problems as a direct result. It is quite clear that the most disadvantaged members of society are more likely to smoke and therefore suffer cancer and other health-related problems as a result. Clearly, we need to take action. Quitting smoking reduces the likelihood of having cancer. It is also key that lungs can recover if one gives up smoking. We must encourage people to give up smoking and, more importantly, to try to prevent young people from ever starting. The hon. Member for Strangford (Jim Shannon) told us what happened to him as a five-year-old. I would not advocate that as a shock treatment. None the less, it is quite clear that stopping people starting to smoke is the best way forward, rather than trying to get them to give up later in life.

The recent report “Smoking Still Kills”, which was endorsed by no fewer than 129 organisations, recommended that, as a target, we should reduce adult smoking to less than 13% by 2020 and to 5% by 2035. I take the point made by my hon. Friend the Member for Bury St Edmunds (Jo Churchill): that is not ambitious enough. We should be going for a smoke-free Britain, or, rather, a smoke-free United Kingdom. I must get my phraseology correct.

To achieve that target, we need mass media campaigns, which the Department of Health has ceased. We need stop-smoking services to be encouraged, promoted and funded across the UK, and local authorities should enforce the necessary activities and to do their job. We know that mass media campaigns are extremely effective and cost- effective in prompting people to stop smoking and in discouraging young people from starting. In 2009 we had funding of just under £25 million for anti-smoking campaigns, but by 2015—last year—that had been reduced to £5.3 million. That is a false economy.

If we had much better funding for mass media campaigns, I am sure we could reduce the incidence of smoking far more. Equally, we know that stop-smoking services across the UK have been highly effective in reducing smoking rates. Smokers are up to four times more likely to quit if they have support from specialist groups and smoking services, compared to quitting cold. The hon. Member for Poplar and Limehouse referred to when he gave up smoking, and he can remember the time and the date when he did so. Most people who have smoked in their adult lives have difficulty giving up and they need help and support. We should ensure that that is available.

The sad fact is that right across the UK smoking cessation services are either having their funding reduced or being closed altogether. That is extremely regrettable. I suggested to the Chancellor that by putting just 5p on a packet of 20 cigarettes and using that money to fund smoking cessation services we could provide all the money that is needed to continue smoking cessation services across the United Kingdom. That, to me, would be a very sensible investment indeed.

Funding for trading standards has fallen from £213 million in 2010 to £124 million now; the teams have been cut to the bone and the number of staff working in trading standards has been reduced radically. That means fewer local controls to target illicit tobacco in the way we should, to prevent some very nasty products from being used by people across the United Kingdom. That is a retrograde step. We need to invest in those services to make sure that we deliver better health outcomes.

We desperately need a new tobacco control plan and programme so that we can see the radical targets that are needed and the investment required across the United Kingdom. We should be setting out our stall—we want a smoke-free United Kingdom not by 2035 or beyond, but by 2020 or 2025. We can achieve it with the right programme. The key point is that if we deliver this plan, we will cut the rate of cancer deaths and the number of people suffering from cancer, which will reduce the burden on the national health service and allow us to take that money from the health service to use on the more difficult cancers that colleagues have mentioned. Those cancers are difficult to spot, difficult to treat and need specialist drugs and specialist treatments.

--- Later in debate ---

[Jo Churchill (Bury St Edmunds) (Con)]

I, too, thank the Backbench Business Committee for allowing this debate. I also thank the hon. Member for Scunthorpe (Nic Dakin) for the way he introduced it, which has allowed us to conduct it in the tone that we have.

I came to this place after a journey with this disease, but I have been amazed since I have been here. The hon. Member for Bristol West (Thangam Debbonaire) has fought the disease and now sits back in her place, and very welcome that is. The news about the hon. Member for Blyth Valley (Mr Campbell), too, is welcome. I have heard my hon. Friend the Member for Lichfield (Michael Fabricant) talk about his journey with the disease. My best wishes go to my hon. Friend the Member for Grantham and Stamford (Nick Boles), who is on the journey at the moment. It is unusual not to see my hon. Friend the Member for Basildon and Billericay (Mr Baron) in the Chamber, and my thoughts and prayers go out to him and his wife at this time.

Cancer is interesting: you don’t pick it, it picks you. We have heard from many Members that some cancers are preventable, but there are over 200 cancers. The debate often gets channelled towards rare diseases or prolific diseases such as breast cancer, prostate cancer or lung cancer—one of the big four. However, the debate we have had today is very broad, and I welcome that.

My hon. Friend the Member for Bosworth (David Tredinnick) said we are doing better, which we are, but we could do even better, and I would like to return to the issue of research, which was brought up by my hon. Friend the Member for Castle Point (Rebecca Harris), to see how we might do better there.

I welcome the commitment to the strategy. Implemented, it could be transformational, which is why I hope we will hear about better implementation. The “Five Year Forward View” shows that funding for cancer services will go up by 9%, reaching £13 billion by 2020-21.

As we have heard, one in two of us will suffer from cancer by the end of this Parliament, and 2.5 million people in this country are living with the disease. A question the strategy does not necessarily address properly is how we will care for those people. How will we deal with the survivors affected by it—625,000 people will be, as was mentioned earlier—who will carry forward some form of disability or hardship from having the disease? How will we deal with palliative care? Have the sustainability and transformation plans looked into palliative care and how we can address the needs of people who are looking towards the end of their lives?

I would also like to highlight teenage cancers, although it is usually breast cancer that I talk about in this place. I have a young friend for whom a year on means something different. She wrote to me on Sunday, after I said I was talking in this debate. I thought of her because, on 11 December last year, young Emily was diagnosed with cancer.

She said:

“Last year in December I was diagnosed with ALL Leukaemia. It was a very scary time for me and my family. But something that makes going to hospital that little bit nicer is how lovely the nurses are.

However, there were a lot of horrid bits during the start of treatment, such as hair loss and sickness.

Although, I still have two years to go of treatment to go on treatment, it is a lot less intense now I am in maintenance. The majority of chemo is in tablet form at home, one hospital visit a month and the HORRID, HORRID steroids, also once a month for five days!

I know that the steroids work as one of the main chemo therapy treatment - but they make me put on weight, feel emotional for no reason and sometimes cross and angry at my mum, who is my absolute rock and is always there for me, so that makes me feel very sad!

If I could change anything about the chemo it would definitely be; to not feel sick and not take steroids!”

Emily is a year on in her journey. I am sure I can speak for everybody in wishing her lots of success for a great journey.

One of the best things we can do for young people is to educate them. Education is a theme that has come out of this debate. I will not go over the comments by my hon. Friend the Member for Harrow East (Bob Blackman) and the hon. Member for Poplar and Limehouse (Jim Fitzpatrick) about smoking, which they discussed so well, but merely say that education in that regard is important. Nor will I go over education around food and nutrition, which, as we have heard, is worked on by the Penny Brohn institute and The Haven.

The hon. Member for Strangford (Jim Shannon) mentioned diet. Every oncologist I have ever had through all three of my journeys has spoken about the need to look after oneself through a good diet, keeping fit and exercise. We do our young people a disservice if we do not help them to lead better and healthier lives. I want to understand how the Minister is looking across Departments to make sure that this is addressed in the policies of the Department for Communities and Local Government and the Department for Transport through cycle paths, trim trails, and right across the piece so that we can all lead healthier lives.

I am pleased that the industry is responding by reducing adverts for children and so on, and I would like this to go further, but parents have a huge part to play in their children’s lives. We have a huge part to play in our own lives with regard to what we eat and how we make choices about whether we smoke or have that extra beer or extra pie. There is some self-responsibility involved. If the Minister will do his bit by helping to educate people a little more through public health information, I am sure that we will step up to the mark and do our bit as well.

I welcome the setting up of cancer alliances and the appointment of Cally Palmer, the excellent head of the cancer taskforce. Early diagnosis is fundamental, as the hon. Member for Scunthorpe pointed out, because it gives us better outcomes, but the Government must set out, with NHS England, how funding will be strategically allocated. For example, will we be able to use mobile diagnostics and molecular diagnostics? I note my interest as chair of the all-party parliamentary group on personalised medicine, and vice-chair of the cancer APPG and the breast cancer APPG. If we could see who would benefit from the use of drugs, we would stop waste. For example, only 20% of women with breast cancer would benefit from Herceptin. Will the Minister address the point about the use of innovative technologies raised by my hon. Friend the Member for Castle Point?

How can we utilise the workforce in a more strategic approach? Macmillan, Cancer Research UK and 20 other organisations have developed eight principles on this. We need a workforce that is fit for the future, with people who understand the changing landscape that we are dealing with. I welcome the £130 million put into radiotherapy machines, but I would like to know that we have the radiographers who can work those machines and optimise their use.

More of us survive living with and beyond cancer, but metastatic cancer, in particular, is a type that we need to learn more about. That brings me on to the use of data. The Teenage Cancer Trust would welcome clinical trials with young people. There is a lack of data on metastatic breast cancer.

[Rebecca Harris]

My mother-in-law passed away from secondary metastatic breast cancer after opportunities to diagnose her were missed. It has been brought to my attention that we do not keep very good records or data on metastasized breast cancer. The cancer pathway does not provide a specialist nurse for those with breast cancer, and we do not seem to provide a specialist nurse for those with metastasized breast cancer, either.

[Jo Churchill]

I agree with my hon. Friend. People who are diagnosed with metastatic cancers—not only of the breast, but across the piece—feel like they are dropping through the cracks. They do not necessarily get a clinical nurse specialist, so that is another area for the specialist workforce to address. We need to make sure that we catch people on the journey, because it may be iterative. People may feel fit and well, but then find that they have to use the services again, so our approach needs to be flexible.

My hon. Friend has mentioned the importance of the ecosystem of research, hospitals and patients. My hon. Friend the Member for Crawley works hard with the Bloodwise charity, which is truly emblematic of an empowering organisation that works with the patient, clinician and researcher to help drive understanding. That is one way of giving UK plc a huge advantage. The hon. Member for Strangford has said that we need to look at the ecosystem, which is not just about cancer treatment at the end, but about researchers, universities, those brilliant students and staff whom we welcome from Europe and everyone in the pharmaceutical industry and charities working collaboratively to get the best outcome possible. That is how we will start to rise up the table and be as good as Sweden and other countries whose patients have truly fantastic outcomes.

Timely interventions can help recovery. I want to understand how recovery packages are being rolled out, because the issue of the workforce is critical.

The hon. Member for Bosworth (David Tredinnick) has mentioned alternative therapies, which can be useful, but this is a space in which charities can help people. Only this week, the Countryside Alliance Foundation took women who have received treatment fly-fishing. They find that the experience of being outside, doing something physical and enjoying nature gives them a huge sense of wellbeing. Personally, I do not think that it is a question of either/or; it is a question of joining them together.

Finally, I know that this is not the Minister’s area, but I would like him to take it back with him. I welcome the cancer drugs fund, but I am worried about those who benefit from combined treatments. Melanoma Focus has said that people on combined treatments may be disadvantaged, because not all of them will have access to the cancer drugs fund. I hope that the fund will be flexible and that the matter will be addressed.