Whitsun Recess

Lyn Brown Excerpts

Thursday 24th May 2012 Commons Chamber

[Lyn Brown (West Ham) (Lab)]

I hope that hon. Members will be gentle, because my voice is not as strong as it usually is. I also hope that I can be heard today. It is an honour to follow the hon. Member for Argyll and Bute (Mr Reid), who made an excellent speech about VAT on static caravans. Those of us on the Opposition Benches support much of what he said. I hope that his Government were listening to that speech, which really was rather excellent.

I want to take this opportunity to speak about an issue of increasing concern—breast cancer. I want to focus on three areas: diagnosis, treatment and mortality in my constituency; worrying comparisons with other countries, which raise issues about the effectiveness of cancer services in the UK; and a specific concern about radiotherapy, on which we perform rather badly, compared with other countries.

Let me first set the scene with some facts about breast cancer. As many colleagues will know, it is the most common cancer in the UK, with some 48,000 new cases diagnosed every year. Around 12,000 women and 90 men will die from breast cancer this year. The good news—relatively speaking—is that a generation ago, only half the people with breast cancer survived for five years after diagnosis. Today, eight out of 10 people are still alive after five years or more. That improvement is due to the unprecedented investment made in the NHS, with a shift in emphasis—the right shift—towards prevention and early detection, and the establishment of cancer networks, bringing together specialists to improve the quality of care.

Advances in research, new treatments, earlier diagnosis, breast screening and greater public awareness have all played a part, but it is essential that we keep up the momentum if we are to avoid slipping back. I have spoken in the House before about the inequality in health outcomes that is characteristic of my constituency and other areas with high poverty, poor housing, a poor environment and low educational achievement. Things are improving and health outcomes are getting better, but the gap remains. Although I have a huge hope that the legacy of the Olympic and the Paralympic games will bring an even greater health improvement to my area, as well as economic regeneration, we have to do more, rather than just sitting back and waiting to see whether that happens.

[Claire Perry]

Let me give the hon. Lady a chance to rest her voice. I am grateful to her for bringing this incredibly important subject to the Floor of the House. Would she like to join me in the Race for Life at the beginning of June? We can put on our pink T-shirts, and although I am afraid that I will be walking, she can walk with me and we can raise some money for a worthy cause.

[Lyn Brown]

That is possibly an offer that I cannot refuse. I think that sounds like an excellent thing to do together.

Newham has a lower incidence of cancer than many other areas, but sadly our mortality rate is higher. The London-wide cancer mortality rate is about 112 deaths per 100,000 cases. In Newham it is 123 deaths per 100,000 cases, which is a significantly higher rate than we ought to find. That is clearly unacceptable. The five-year survival rate for women in Newham who have had breast cancer is 75%, which is significantly lower than the UK average of 83.4%. The reason is illustrated, in part, by the take-up rate of breast-screening services. In 2009-10, the take-up rate across England was 73%. Across London it was 62%, but in Newham it was 50%.

Early detection enables treatment in early stages, when the cancer is easier to treat and when women’s chances of survival are higher. In my area, the combination of late presentation and late diagnosis leads to treatment that is, of necessity, more complex and less successful. That is causing the unnecessary deaths of too many women. Those deaths are, frankly, preventable. I will be seeking to ensure that a consequence of the Health and Social Care Act 2012 is not a visible deterioration in health screening services in my constituency. In fact, I will be hoping to see the 50% uptake of screening in Newham increase in the years to come.

I want to turn to international comparisons. I have before me some statistics, which were helpfully provided by the House of Commons Library. These data are drawn from a cancer epidemiology research project on the survival of cancer patients in 24 European countries. The figures need to be treated with some care, given that the most recent are for survival rates for those diagnosed between 1995 and 1999, but they provide a useful snapshot of the five-year survival rate. For England, the survival rate for all cancers at five years was 47.3%, ranking us 17th out of the 24 countries. The survival rate at five years for breast cancer was somewhat better, at 79.7%, but this still ranks us just 13th out of the 24 countries. That international comparison raises some disturbing questions about the effectiveness of our screening, diagnosis and treatment services, and I intend to return to that matter in the future.

One issue that I want to explore further today is the use in treatment of radiotherapy and, specifically, of new and advanced forms of radiotherapy such as intensity-modulated radiation therapy—IMRT. Radiotherapy treatment is more effective in treating all forms of cancer, including breast cancer, especially when the cancer is diagnosed early. It can be targeted on the cancer much more effectively, thus limiting the damage caused to non-cancerous tissue. It is far less invasive than other treatments, it leads to better outcomes and it is a much better experience for the patient.

The use of radiotherapy is more advanced in Scotland and Wales. London is marginally better provided for than the rest of England, but that does not alter the fact that the UK as a whole is woefully behind the best-performing countries in the rest of Europe and the US in using advanced radiotherapy as an effective tool against cancer. Access rates to existing radiotherapy services are already lower than the 50% of cancer patients who it is generally agreed should receive the treatment. We do not even know how many breast cancer patients are able to access the more advanced IMRT.

What assessment have the Government made of the impact of the Health and Social Care Act on the commissioning of radiotherapy, and on the supply of suitably trained radiotherapists? From my perspective, it is entirely unclear where responsibility for the commissioning of radiotherapy will sit in the future arrangements of the NHS. The clinical commissioning groups are far too small effectively to manage it, and the position of the NHS Commissioning Board is obscure.

For radiotherapy, there is no is no equivalent of the big campaigns that we see in our newspapers. It has no equivalent of a big pharmaceutical company to promote it and lobby for new treatments, because there is no profit to be made from it. Radiotherapy is an effective treatment that is widely used in other countries, but it is patchily under-utilised here, to the detriment of cancer patients, and that is likely to be contributing to our relatively poor survival rates. In the absence of an external lobby promoting radiotherapy, I humbly suggest to the House that that responsibility lies here with us.

The issues that I have outlined today go to the heart of the quality of cancer care in this country. They need to be explored in more detail and subjected to more scrutiny so that the service offered across the country can be improved to the level of the very best, and not just the very best in this country, but the very best by international standards.