New Cancer Strategy

Jo Churchill Excerpts

Thursday 19th November 2015 Commons Chamber

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

I am vice-chair of the all-party parliamentary groups on cancer and on breast cancer. I welcome the strategy and the hard work of those who have put it together. Looking at a situation with a fresh pair of eyes is always beneficial, for all the reasons that my hon. Friend the Member for Basildon and Billericay (Mr Baron) pointed out.

My hon. Friend the Member for Castle Point (Rebecca Harris) and the hon. Member for Scunthorpe (Nic Dakin) highlighted one of the problems: there are more than 200 types of cancer, which makes it highly complex to deal with unless we have an overarching strategy. That goes not only for the cancers and their different forms, but for how we approach the use of drugs, research into them, and so on.

The new cancer strategy has the ability to be transformational, inspiring us to lead the world or at least to match those who are ahead of us. That is where we should be in patient outcomes. For me there are positives, but in order to achieve these things we need full implementation and adequate funding. There are some key asks—the national ambition for early diagnosis is probably one of the principal ones. As individuals we can help in diagnosis by presenting early enough. Some 20% to 40% of people find out that they have cancer only when they present at accident and emergency, and by then it is usually too late, so early diagnosis is key. My hon. Friend the Member for Basildon and Billericay referred to the figures for bowel cancer. Some cancers have much better outcomes if diagnosed early. That gives people a better quality of life and a better journey through the cancer path.

The strategy asks for a definite diagnosis within four weeks of referral, to be achieved by 2020. Ensuring that CCGs are held to account for improving one-year survival rates is crucial to drive early diagnosis. How will we hold the CCGs to account and make sure that rates are improving from June 2016? Linked to this is the way in which we improve cancer commissioning, as we have heard. The current picture is fragmented and confused.

Accountability, responsibility and transparency are needed, and with modern advances in medicines and diagnostics flexibility is hugely important, as is communication. Currently no one body or person at local, regional or national level holds responsibility, and this does not aid clarity in the system. Clinicians and patients are liable to fall foul of duplication or fall through the gaps, wasting precious time and resources, which neither the NHS nor the patient on the receiving end can afford.

The creation of cancer alliances can support the commissioning process and ensure that the strategy is delivered. Living with and beyond cancer is a growing challenge. There will be 3 million of us by 2020 and 4 million by 2030. Speaking from personal experience, I know that being a cancer patient is at times a bit of a challenge. Being medicalised is no fun, as I know, but both the new five-year guidelines on living with and beyond cancer and the new quality of life metric that has been spoken about are vital to drive service improvements. As the hon. Member for Alyn and Deeside (Mark Tami) said, sometimes it is the not-so-obvious things that people need help with. His child needed help in comfortably settling back in at school and ensuring that those around him understood the journey, too.

Scan anxiety sits heavily on people who are being tested to see whether they have cancer. The hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) did a lot of work in that area before she came to this place. It puts a great deal of pressure not only on the individual but on their family.

Under the strategy, those living with secondary cancer have emerged as a very distinct group. For example, 36,000 women are living with secondary breast cancer, and to date their needs have been neglected. The ambition of the strategy is to focus on the long-term quality of life, including for those who

“are living with an advanced and incurable form of the disease”.

This highlights the importance of multi-disciplinary teams in planning the care of all cancer patients.

The NHS is changing and adapting. Ensuring that the organisation has the right skills in the right places is the key to delivery not only of our cancer strategy but of many of the ambitions we hold. The strategy asks for everyone to have access to clinical nurse specialists, and I would wholeheartedly support that. Today, as I stand here, I would like to say a huge thank you to our nursing profession—a highly skilled group of people. I know from constituents and others that their professionalism, care, and, at times, very “no nonsense” approach has been as important as anything else in the recovery process.

If the aims of the strategy are to be achieved, working smarter and doing things differently may well be the key. Nurse consultants are now becoming a feature in the profession, and workforce planning will be crucial. The strategy focuses on the needs of older people and those from the black and minority ethnic community, who are often much more reticent about going to seek help. We know that we are living in an ageing society. The upside is that we are living longer; the downside is that there are more health challenges. In 1949, at the start of the health service, 50% of our population died before they were 60. Thankfully, that is not the case nowadays, but the strategy highlights the need to focus on treatment for older people—another sign of the changes in our NHS.

The cancer strategy is to be applauded in calling for a national action plan to address obesity. That is welcome, but there are individual responsibilities too. Obesity is a known causal risk factor in breast cancer and many other cancers. There is good evidence to show that five 30-minute bits of exercise a week, like a brisk walk, would help not only with obesity but with the likelihood of the disease recurring. There is plenty for people to do in this regard.

I would like to mention drug innovation and the cancer drugs fund. How will the cancer strategy’s recommendations on NICE guidelines on the use of bisphosphonates be taken forward? I would really appreciate understanding a little more about how we are going to use off-patent drugs and drugs that have been shown to have a secondary purpose beneficial to cancer patients. I would like to see communication between clinicians, pharmaceutical companies and others so that we can ensure, along with the accelerated access review and the cancer drugs fund, that we are getting to patients, in a timely fashion, the drugs they need and deserve.

Finally, I ask that the right accountability structures are in place, and that the national cancer advisory board ensures that what needs to be done is being done to secure optimum patient outcomes for all.