Cancer Strategy

Lisa Cameron Excerpts

Thursday 22nd February 2018 Commons Chamber

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

I beg to move,

That this House has considered the Cancer Strategy.

Thank you, Madam Deputy Speaker, for your guidance. I will try to behave much better timewise in this debate, which it is an honour and a privilege to introduce. I pay tribute to the Backbench Business Committee for enabling the debate, to the all-party parliamentary group on cancer for its timely and extremely important report and, in particular, to the hon. Member for Basildon and Billericay (Mr Baron), who could not be with us today but deserves our thanks for the extraordinary amount of work he has done on this issue.

We in the House are all on the same side against cancer and in our ambition to achieve world-class cancer outcomes. My speech will address—briefly, according to your instructions, Madam Deputy Speaker—the recommendations of the all-party group’s recent report, “Progress of the England Cancer Strategy”. The report received more than 80 contributions from charities and bodies and truly reflects the passion in the sector, but it is also a cry for help, progress and a positive way forward. My speech will address the report’s four main areas of concern: workforce strategy, data, transparency and funding. It is open to colleagues to raise all aspects of cancer care and treatment, but, on behalf of the all-party group and the hon. Gentleman, I will stick to the recommendations in the report.

The report considers progress as we reach the halfway point of the NHS cancer strategy 2015-20 and is the result of an inquiry that the all-party group held last summer and autumn. The inquiry was formally launched at a summer reception last July and the number of written submissions was far larger than anticipated, showing the dedication of those working in the field. Many submissions came from cancer alliances and others on the frontline of the services being provided and identified many pressures and challenges. The evidence from frontline services in particular seemed to amount to a call for help. In its report, the all-party group concluded that although progress had been made since the launch of the strategy, the NHS

“will struggle to achieve the objectives set out in the Cancer Strategy unless corrective action is immediately taken.”

To this end, the all-party group has listed recommendations, a copy of which will shortly be sent to all MPs. The lack of workforce planning emerged as a key concern. The cancer workforce is constantly recognised as the biggest barrier to implementing our strategy. We are all pleased that Health Education England published its report into the cancer workforce in December 2017, but it was originally promised for December 2016. According to written evidence from Breast Cancer Now, the workforce is the greatest challenge in delivering the cancer strategy. The all-party group also heard that transformation funding is being withheld from cancer alliances because of their performance against the 62-day waiting-time target—a new conditionality of funding that emerged only after the bidding process had closed.

[Mr Jim Cunningham (Coventry South) (Lab)]

I appreciate the hon. Lady acknowledging the cancer organisations, such as Macmillan, which often rely on subscriptions. Does she agree—I am sure she does—that the public should be encouraged to give more subscriptions where possible?

[Dr Cameron]

Absolutely. The hon. Gentleman makes an excellent point. These agencies are working on the frontline with people and families at their most vulnerable and deserve all our encouragement, praise and, of course, funding.

In addition to setting out how cancer alliances are to be funded and supported for the duration of the strategy and into the future, the all-party group strongly recommends that the 62-day waiting-time target be immediately decoupled from any release of funding to the alliances. The previously mentioned issues prevent progress in improving cancer care and treatment, which is not our collective vision. The all-party group also heard that improving transparency in priorities and accountability would help to support the delivery of the strategy. At the moment, a lack of clarity and lines of communication are delaying its implementation. Publishing a detailed progress update on each of the strategy’s 96 recommendations would be a positive step forward.

It is generally accepted that the 62-day waiting-time target has been treated as a higher priority among clinical commissioning groups and cancer alliance leaders than survival or stage at diagnosis, as shown by the linkage between funding and performance against the measure. Decoupling funding from process and target performance in favour of a greater focus on outcomes would strongly be in the interests of patients, not least because, if outcomes are good and survival rates increasing, processes will also be functioning efficiently and correctly.

[Bambos Charalambous (Enfield, Southgate) (Lab)]

The 62-day target has not been met since 2014, so the issue has been around for a while. Does the hon. Lady agree that more funding is needed if the target is to be met as soon as possible?

[Dr Cameron]

I absolutely agree with the hon. Gentleman. It is essential that the target be met and that resources be put in to ensure that it is.

The all-party group also found that access to detailed and timely data is critical for the strategy’s success, particularly in relation to data for rare and less common cancers. Strong concerns were also raised about how future data protection regulations might affect surveys, such as the cancer patient experience survey. The value of the cancer patient experience survey should be emphasised, along with outcomes from patients. We must hear from those who are experiencing services; they know how to improve things. In addition, the ageing UK population cannot be left out of the conversation. The cancer patient experience survey suggests that older people are less likely to have access to a clinical nurse specialist. Additionally, older patients are less likely to know the full extent of their illness. Age discrimination must come to an end, especially in cancer care.

The all-party group recommends that the NHS and Public Health England’s data team work to produce more timely cancer data and make them publicly available. It advocates that the Government ensure that the cancer patient experience survey and other such surveys can continue in a way that allows patient experience to be considered on a par with clinical effectiveness, rather than leaving patients without sufficient information regarding their cancer and care.

Furthermore, for specific cancers such as breast cancer, there are key priorities for delivery in the cancer strategy. It must ensure that data are collected for people living with incurable secondary cancer; that everyone with secondary breast cancer has a specialist nurse with the right skills and expertise; and that everyone has access to the right support after finishing treatment for primary cancer, so that they are able to live well after breast cancer. We should not ignore the fact that the strategy has had positive effects. In the last year, 16 cancer alliances and three vanguards have been established, and £200 million has been made available to them for earlier diagnosis and post-diagnosis support. In addition, 23 NHS trusts have now received new and upgraded radiotherapy machines. However, as the report makes clear, much more work still needs to be done.

In the few minutes that I have left, I want to speak a bit more about less survivable cancers. The Less Survivable Cancers Taskforce was in touch with me prior to today’s debate. It is made up of Pancreatic Cancer UK, the British Liver Trust, the Brain Tumour Charity and Action Against Heartburn, covering oesophageal cancer, and Core, covering all digestive diseases. The staggering 55% gap in morbidity is absolutely unacceptable. Much, much more must be done. Recently, I lost a very dear uncle to pancreatic cancer. As a family going through that experience, we know that we need much more research and much more specialist understanding. We need investment in those areas—it is absolutely crucial. I want to ensure that other families have a better chance of an improved survival rate, and I pay tribute to my own uncle for his courage in coping with that condition right to the end.

Hospice care is also absolutely essential. We must ensure that families and patients have dignity at the end of life. That is imperative. I have watched far too many family members die in hospital beds, surrounded by other patients with the curtain screens drawn, to know that that is not dignified and that where possible, we must improve services and access to hospice care.

I pay tribute to the Teenage Cancer Trust—we often think of cancer as an illness that affects older people, but young people are also diagnosed with cancer—which does fantastic work. Vanessa Todd in my constituency is an absolute advocate for the Teenage Cancer Trust. Although GPs may not expect a young person to come with such symptoms, which are perhaps not easily identifiable, it is something that we can increase awareness of to make sure that diagnosis is very quick and timely for young people to improve their prognosis.

I thank everybody and, again, I thank the all-party group. It has been a privilege to open the debate for the hon. Member for Basildon and Billericay, who leads the group on these issues so well.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Before I call the next speaker, I say to hon. Members that I am going to try to continue my experiment of seeing whether people will self-regulate and behave in a decent, honourable fashion. That means taking eight to nine minutes, and not 13, 14 or 15 minutes. I trust the well experienced Mr David Tredinnick to do so first.

--- Later in debate ---

[Dr Cameron]

Today’s debate has been so profound and amazing, with so many personal contributions. I have been absolutely astounded by the breadth and depth of knowledge across the House and the absolute dedication to the cancer strategy right across these Benches. I am assured that we will work together, taking things forward very positively and making a difference.

It is important that we have discussed the fact that cancer cuts across the lifespan and recognise the serious issues for young people and their experience of cancer. We also looked at not just the physical aspects, but the mental health aspects and the support that is required. We talked about the fact that treatment has to be holistic and evidence-based.

I wish to commend the valuable contributions from charities and our NHS staff. To be honest, their support is invaluable because they are on the frontline. I also wish to mention the very personal contribution of the hon. Member for Lincoln (Karen Lee). She made such an amazing speech today. I am sure that, given her experience, she will go on to support and assist so many people, and I am delighted that she is a cancer ambassador. I am sure that many people will benefit from that in the future. Once again, I thank her and everybody here today, and I look forward to working with them on this issue.

Question put and agreed to.

Resolved,

That this House has considered the cancer strategy.