Mesothelioma

Lord Prior of Brampton Excerpts

Thursday 27th October 2016 Grand Committee

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, this has been another really excellent debate on this subject. I join others in thanking the noble Lord, Lord Wills, for raising it again—it is really important to keep it in the public eye. I thank the noble Lords, Lord Giddens and Lord Alton, for collaring me on this subject many times over the last year. It is one of the privileges of being in this House that one is able to take an interest in these issues and try to do something about them—otherwise, what is the point of being here? The point is to make a difference. What this has demonstrated is that if there is persistence—real, dogged persistence, often in the face of all kinds of tribulations—you can make progress. It has been a long and tortuous journey, as the noble Lord, Lord McKenzie, said, but there are signs of progress.

I shall pick up a few points before I get into my speech. First, I cannot answer the point of the noble Baroness, Lady Couttie, in detail today, but the level of compensation is certainly something I shall look at in view of her comments about the cost of these new drugs. This is probably an issue more for NICE and NHS England than the compensation scheme. The noble Baroness, Lady Walmsley, asked whether we are learning from the reviews of these cases, in view of the importance of time. I will certainly look at both those issues. They are, in a sense, related to the remarks of the noble Lord, Lord Freyberg, about the huge benefits of specialisation. I have the guidance from NHS England on the treatment of mesothelioma here. I shall not read it out today, because there is not time, but the noble Lord’s point about having a centre of excellence and looking at the improved outcomes from people doing these things repetitively, many times, rather than spreading very complex surgery over many different sites, is absolutely true. Having proper data in registries which can be made transparent is also a hugely important driver of change.

The noble Lord, Lord Giddens, and the noble Baroness, Lady Finlay, raised the issue of data. Data are hugely important. In a way, if one looks at all the advances that are coming along in cell therapy, gene therapy and the like, in health analytics and big data, the artificial intelligence and machine learning that come from these offer huge potential for improving healthcare in this country. I should also mention that it is clear that many people here have been touched, directly or indirectly, by this devastating disease. That adds not just poignancy but urgency to our discussions. It is interesting how often a patient’s story can bring data to life—data on their own are not enough. It is when you hear about individuals who have suffered and whose lives have been changed or who, indeed, have died, that it is brought home to all of us just how important it is.

We expect the rates of mesothelioma to increase in coming years, due to high exposure to asbestos in the 1960s and 1970s. The noble Baroness, Lady Finlay, raised the issue of schools. It is the responsibility of the Health and Safety Executive, as she will know. The advice is often to leave it where it is and not disturb it—it is not dangerous to children if it is left dormant. If anyone has any evidence that the HSE is not doing the rounds or that there are local authorities in the country where schools are in need of repair, they should bring it to my attention and I will ensure that the HSE follows that up.

Rates of mesothelioma have increased by nearly five times in Great Britain since the late 1970s. In 2014, there were 2,343 registrations of mesothelioma in England: 1,954 men and 389 women. The incidence is expected to peak in the 2020s but, as has been mentioned, it will remain a significant health problem into the 2050s. It is not a legacy disease. It is going to kill many people over the next 30 or 40 years. In 2014, 2,236 deaths were caused by mesothelioma in England, and the latest survival figures suggest that 46% of men survive for one year, compared with 51% for women. Five-year survival is much worse: only 5% for men and 11% for women. It is a death sentence—there is no getting away from that. Others have mentioned that this is a worldwide issue. One research group estimates that, on average, 14,200 cases are diagnosed worldwide every year, and that will be going up, not down.

On the research aspect, there is some better news. On 16 March, the Chancellor announced an award of £5 million to establish a national centre for mesothelioma research. A number of noble Lords have said how important it is that this is co-ordinated—that various universities and research centres around the country do not all have a crack at it, but there should be a national centre for research. This announcement was in response to an application from Imperial College to urgently address the anticipated imminent high mortality rate among Royal Navy veterans and dockyard workers. The award is one of a series funded by the LIBOR fines that have been made since October 2012.

It is envisaged that the national centre will be a collaboration between four leading institutions which have a major interest in the treatment of mesothelioma: the National Heart and Lung Institute at Imperial College, the Royal Brompton Hospital, the Institute of Cancer Research and the Royal Marsden Hospital. It is pretty impressive standing here naming four institutions that are absolutely world class. This is an extraordinary country when it comes to research. The Marsden, the Brompton and all these institutions are fantastic. They bring together expertise in the genetics of cancer susceptibility and in targets for treatment. Of course, the work being done in genomics will have a huge impact on this in years to come—not quite yet but soon, I hope.

The Department of Health has been in discussion with the British Lung Foundation to work together to bring about the establishment of the research network. The plans are not yet finalised, but the aim, which the department supports, is to attract further donations, to be channelled by the British Lung Foundation so that it can continue its role as the body through which voluntary donations for mesothelioma research are being channelled competitively to the best science centres across the UK. As the organisation which currently administers mesothelioma research grants funded from insurance industry donations, the BLF is well placed to do this. I add my thanks to Aviva and Zurich, the only two insurance companies which have lived up, I think, to a very important moral obligation. We should not give up in our talks with the insurance industry to persuade it. It owes a moral duty but, as pointed out by the noble Lord, Lord Alton, it is not just a moral duty; there is also some enlightened self-interest in this. Maybe the lawyers would like to chip in as well; that would be good.

We understand that on 1 November—next week—the BLF, alongside the Association of British Insurers, will be hosting a seminar in this House on the future of mesothelioma research. The seminar will focus on the previous research which the insurance industry has funded across the UK, how it can be built on, and how to ensure that mesothelioma projects across the country tie into the work of the new national centre. Together, the MRC and the NIHR spend more than £1 billion annually. In 2015-16, they spent more than £3 million on mesothelioma research. I will be sending a copy of this debate to Sally Davies, the Chief Medical Officer, and Chris Whitty, the Chief Scientific Adviser, to ensure that they pick up all the important arguments that have been made today.

Last month the Government announced £816 million over the next five years for the biomedical research centres across the UK. These centres host the development of ground-breaking new treatments, diagnostics, prevention, and care for patients in a wide range of diseases. Around £118 million of the funding will be for cancer research and we would expect some of that to support mesothelioma research. The fact that we have this £5 million ought to attract more money from the more conventional cancer research programmes.

In March 2016 the National Cancer Research Institute co-ordinated a meeting with the British Lung Foundation, the MRC, Cancer Research UK and the Department of Health to discuss research opportunities in mesothelioma. This was followed up with a community workshop at the International Mesothelioma Interest Group meeting in Birmingham in May this year and has led to the formulation of a draft research priorities document. This will be further developed at a second workshop currently scheduled to take place in February 2017.

There is room for hope that some progress is being made here. We have to keep the momentum going and the profile high. I think we all accept that some cancers seem to have caught the public imagination to a greater extent than this one, which in a sense puts a greater obligation on us to keep it in the public eye. I have been delighted to do what I can and will continue to do so. Again, I thank all noble Lords for continuing to raise this very important topic.

Committee adjourned at 5.56 pm.