NHS: Cancer Treatments

Lord Turnberg Excerpts

Thursday 25th January 2018 Lords Chamber

[Lord Turnberg (Lab)]

My Lords, it has been a real privilege to hear the noble Baroness, Lady Jowell, give such a brave and inspiring speech. I do not know how anyone cannot be very touched by her words. I have long admired her and now more than ever see her as an inspiration. The spirit that she demonstrated so clearly is absolutely characteristic of her. If I may be permitted a personal note, I love the hat.

The noble Baroness makes an impassioned case for the availability of new experimental forms of treatment, and who is there to gainsay her? Cancer Research UK says we need much more research to understand the nature of glioblastomas—and of course it is right too—but meanwhile what are patients to do? It is true that doctors are able to prescribe novel treatments for individuals on what is known as the named patient basis, and the Bill of the noble Lord, Lord Saatchi, a couple of years ago encourages that approach. However, the problem is that many such new treatments are specific for very small numbers of cancer patients and the costs are enormous.

That immediately brings us to the question of funding—we cannot get away from that. The late lamented cancer drugs fund was soon overwhelmed by the high costs of new diagnostics and drugs. The remarkable advances in so-called liquid biopsies, in scanning, in proton beams and in specifically tailored molecular therapies and immunotherapy are all extremely costly, and no amount of juggling with flexible pricing mechanisms and outcomes-based pricing will find the money needed. So I ask the Minister whether the Government will take note of the recommendation in the Select Committee’s report on the future sustainability of the NHS for a new method of funding involving a hypothecated tax system based on national insurance payments. I am sorry to be so controversial.

The average age of your Lordships’ House is 69. That means that almost half of us have or will have had one cancer or another. I have had two and I suppose, statistically speaking, that saves one other from having one. That makes cancer take on an intensely personal meaning for all of us and we are fortunate to live at times when so much more can be done for us than ever before. Unfortunately, it all comes at a cost and we could be doing so much better. As we lag behind in so many ways, in some cases we are complicit in failures that should just not happen.

I finish on a point about prevention, where we might be able to save someone. We have an extremely effective way of detecting women who are susceptible to ovarian and breast cancer. Here I express my interest as a recently retired trustee of the charity Ovarian Cancer Action. Testing for the BRCA gene, the gene responsible for passing on susceptibility, is now offered to close relatives of ovarian cancer patients, but a relative who is not quite so close, with a smaller chance—say 5%—of being a carrier, cannot have the test. If you have a one in 20 chance of carrying a gene such as that, would you not go for a test costing just £175? It is a bargain for the NHS. I ask the Minister: will the offer of such a test now be made to all such at-risk relatives?

Finally, the briefing I have had from Cancer Research UK suggests that our ability to conduct vital cancer research will be compromised after we Brexit from the EU if we cannot ensure the future of cross-border clinical trials, as has been spoken of. Will the Government ensure that we will be able to continue to collaborate seamlessly with centres in the rest of Europe after Brexit?