Breast Cancer Diagnosis and Services: Covid-19

Kieran Mullan Excerpts

Thursday 12th November 2020 Westminster Hall

[Dr Kieran Mullan (Crewe and Nantwich) (Con)]

It is a pleasure to serve under the chairmanship of a fellow Cheshire Member, Ms McVey. I congratulate my hon. Friend the Member for North Warwickshire (Craig Tracey) on securing the debate.

I think we all agree that the NHS is facing probably the most challenging period in its history. During the previous lockdown, the Government and the NHS leadership were dealing with enormous levels of uncertainty and, like all of us, had in their minds the images of what happened in Italy, with parts of its health service totally overwhelmed by covid cases. Enormous effort was put into preparing the NHS for that possibility: wards were reorganised, whole new systems for moving patients through hospitals were instigated and staff were redeployed. I pay tribute to the hard work, commitment and flexibility shown by so many NHS staff as part of all this. The changes made and the approach taken can only be described as a success, in terms of the NHS managing the wave of covid cases as it did. Our NHS was not overwhelmed, and no patient with covid who needed more intensive treatment was prevented from getting it.

However, we are here to talk about the wider picture of healthcare for our constituents during the pandemic. Colleagues of mine noticed almost immediately enormous drop-offs in patient attendance that simply could not be explained away by the lockdown. The first time I went to help in A&E, the department was quite simply the quietest I had ever seen it. It seems clear that there were people at home experiencing things such as heart attacks and strokes, which do not always present in a calamitous way that would cause one to definitely seek help.

[Steve McCabe in the Chair]

Of course, the debate is specifically on cancer diagnosis, and even in the best and most proactive health systems in the world, the journey often consists of experiencing a wide range of minor symptoms that only over time become apparent as something more serious. That is why it matters that, over the last few months, there has been an inevitable downturn in people seeing doctors and nurses, because people think they can put off seeing them about these symptoms.

In discussing breast cancer, we can at least take some comfort from our relative success in educating people about the symptoms to watch out for, which by comparison with other cancers are a little bit more specific. We have a proactive screening programme, because we know that we can spot cancers earlier and save more lives if people are screened, rather than waiting for symptoms. Most breast screening services were suspended due to the coronavirus, and Breast Cancer Now estimates that, while screening was paused, almost 1 million women missed out on their mammogram, and that around 8,600 women caught up in the screening appointment backlog could be living with undetected breast cancer. Thankfully, screening has now restarted across the UK, and I understand that more than 400,000 women were invited for breast cancer screening between June and August, with thousands more invitations being sent every month.

I will finish by focusing on two points. First, backlogs—I just described them for breast cancer; we have all described them today—affect a wide range of treatments. We must ensure that the NHS gets the additional resources that will be vital for it to catch up on the backlog of care and treatment built up during the lockdown, and which I am afraid is still building up in some areas. The record numbers of nurses and doctors now working for the NHS will be needed, and we will have to deliver on our manifesto commitments to keep building that workforce in primary and secondary care.

Secondly, we must make it clear to the public that the choice is not between tackling coronavirus or tackling the other healthcare needs of our constituents. Tackling coronavirus will allow us to carry on meeting the wider healthcare needs of our constituents. Any hospital faced with a choice between providing critical care for patients very sick with covid, who are at risk of dying there and then, and providing screening and non-urgent treatments will have to prioritise that immediate and critical healthcare need. That is why keeping the coronavirus suppressed is absolutely vital.

The NHS has moved on from where it was at the start of lockdown and every week is getting better and better at doing both things at the same time. We must all carry on giving it the room to manoeuvre that it needs to build on that further, enabling it to look after patients with and without covid, patients with urgent healthcare needs and planned healthcare needs, and patients requiring things such as screening.We will only stand a chance of being able to do that if we can continue to keep coronavirus suppressed, following the guidance that we have all been given—hands, face and space. Let us ensure that it is clear to constituents: this is not a choice between one or the other, but about supporting both groups of patients.