Cancer Services

Debate between Maggie Throup and Steve Brine

Thursday 8th December 2022 Commons Chamber

[Steve Brine]

Indeed. The reason why we had Dame Cally and Professor Peter Johnson, who is the national clinical director for cancer, into the Select Committee a couple of weeks ago is that the NHS has set itself a deadline of next spring—it was this spring—to get back to the 62-day wait. I have everything I have crossed that they can get there, but they need to make it happen. I know they are relentlessly focused on that, and the Minister is relentlessly focused on that, but we have got to help them get there.

The Committee also heard about the challenges facing surgery and radiotherapy services, which makes it rather timely that the hon. Gentleman intervened on me at that point, as I suspect he will speak about it later. Professor Pat Price, who he and I are going to meet early in the new year, is a consultant oncologist at Imperial College in London. She told us that radiotherapy services were lacking staff and machines to be able to deliver the best possible care and that services were struggling to deliver the level of activity needed to catch up with the cancer backlog. I will let the hon. Gentleman expand on that a bit later. Professor Mike Griffin, professor of surgery at Newcastle University, also highlighted workforce shortages as a significant barrier to effective cancer surgery, but he also told us about the organisation of services. Because cancer surgery is often co-located within general, acute and emergency care, it can be subject to delay because of capacity shortage, and that was a particular problem during covid in some places, but not everywhere.

My trust, Hampshire Hospitals, did a brilliant job to keep cancer surgery on track at all times by doing it offsite. I pay tribute to Alex Whitfield and her team at Hampshire Hospitals for the way they organised with Sarum Road private hospital in particular to ensure that patients continued to get their cancer treatment. Professor Griffin called for more ringfenced hubs to be developed so that cancer surgery can continue even when there are severe pressures on acute care, and I hope the Minister refers to that when she winds up.

Growing the workforce, investing over the long term in machines and IT and reorganising services to create more cancer surgery hubs are all in the Government’s gift, which is why we recommended that they consider those actions in developing the 10-year plan. Without a wider focus on removing the barriers to the NHS delivering the best possible cancer treatments, the potential gains of earlier diagnosis might not be realised. Given the number of people presenting with suspected cancer at the moment—it is good that they are presenting, and many of them will turn out not to have cancer— if it is found that they do have it, we need to move on that. That is why treatment is the other side of the same coin.

Just as further progress on early diagnosis will depend on research and innovation to develop new tests, improving cancer treatments will require new and more advanced techniques to be developed and implemented by the NHS. We found in the Committee report that the UK is a genuine world leader in research. There are unique aspects to the NHS that make it an effective partner for research organisations. We also heard that there are significant barriers to researchers accessing the data they need for quick and equitable patient recruitment to clinical trials and for staff having the time they need to take part in research. The Government have set out several steps they are taking to improve access to data and improve flexibility for staff wanting to take part in research, and that is welcome, but research by Cancer Research UK has found that the UK’s recovery from the pandemic in clinical trials continues to be outpaced by other comparable countries.

NHS England told us that supporting clinical research into cancer is not its responsibility, so it is clear that a wider effort is needed to make sure that cancer research taking place in the NHS is well supported and aligned with the priorities for cancer services. That is another reason why the plan is important.

Finally, we heard that there is significant variation in outcomes for people diagnosed with cancer, depending in part on the type of cancer they are diagnosed with, but also demographic factors. The Government told us that they would be addressing these differences through the levelling-up White Paper, but also through the health disparities White Paper, by addressing issues such as smoking and obesity, which are more prevalent in our more deprived communities.

On that, there is a story in today’s press which suggests that Britain has the biggest increase in early onset diabetes in the western world. That is a huge concern. I am not suggesting that diabetes is cancer; I am saying that we have many suggested actions to reduce obesity around junk food advertising and stuff that follows on from the sugar tax. Much of that has still not been implemented. Rumours abound—there are always rumours around here—that the Government are seeking to delay junk food advertising restrictions until 2025. I hope that is wrong. I invite the Minister to respond to that when she winds up and, if not, to take that away.

[Maggie Throup (Erewash) (Con)]

Will my hon. Friend give way?

[Steve Brine]

I give way to somebody who possibly shares that view.

[Maggie Throup]

I agree 100% with his concerns about the potential watering down of the much-needed anti-obesity measures. Does he agree that it is important that we reflect what the public want? The public are in agreement with banning advertising on TV for particular foods that cause obesity. If we want to keep the public on our side, surely we have to follow their wishes, as well.

[Steve Brine]

I think that is right. The public are clear on this. I get that there are different views across this House and that there are those who disagree with much of the work that my hon. Friend and I did in government to push some of those measures on preventing obesity. I could agree with them, but then we would both be wrong. At the end of the day, obesity is a driver of diabetes, and obesity is a driver of certain cancers. We must take that seriously. Next year, the Select Committee will be doing a huge piece of work on prevention, and we will be returning to that. I hope that Ministers are aware of that.

The recognition of the importance of health in the levelling-up White Paper is welcome, but without specific actions to address health disparities, this agenda will be at risk, so it is vital that the Government take up the prevention agenda again to stop people developing cancer in the first place. I hope the Minister will have some good news for us on that front, and I recommend that she returns to the prevention Green Paper that we published back in 2019, which contains lots of helpful ideas in that respect.

Public Health

Debate between Maggie Throup and Steve Brine

Tuesday 30th November 2021 Commons Chamber

[Steve Brine]

I do accept that, and I also accept that the scientists who discovered the variant said on the media at the weekend that this was often a less serious disease than the delta variant. However, notwithstanding the point that I have just made about the people whom it has affected in South Africa—younger, unvaccinated people—given that numbers are so small in this country, I fail to see how we will be any the wiser in three weeks’ time. That may explain why the isolation regulations will apply until next March. Perhaps the Minister can enlighten me, through an intervention now or in winding up the debate.

Finally, let me return to the situation in my constituency. I have raised this matter twice in the House. This morning I spoke to the Winchester City primary care network, which is responsible for some 62,000 people who are on its roll. PCN patients will be contacted if they are in one of the Joint Committee on Vaccination and Immunisation’s groups 1 to 9, if they are clinically extremely vulnerable or if they are over 50, and will have been offered a booster. The PCN expects that process to be complete by 17 December, and by the middle of January it will start to offer the booster to others. From that date onwards the booster will be offered to those aged 18 and over, following the welcome announcement from the Secretary of State during his statement yesterday.

Many of my constituents do not live in the area covered by the Winchester City PCN, but have access to vaccinations at the Badger Farm community centre. If they consult the NHS website, they are offered the opportunity to go to Salisbury, Portsmouth or Southampton. That is not easy access to the booster. In my constituency there is no easy walk-in access to it, and I am inundated by questions from constituents about why they cannot have such easy access in Winchester today. The difference between what is being said on television and by Ministers from the Dispatch Box and the reality of the access available on the frontline is growing, and it is a problem.

[Maggie Throup]

rose—

--- Later in debate ---

[Steve Brine]

I know that the Minister has been looking into the matter for me. We have not teed this up, Mr Deputy Speaker, but she is kindly going to intervene.

[Maggie Throup]

I want to reassure my hon. Friend. I heard what he said yesterday, and I have asked my office to look into it further. I will get back to him as soon as I can.

[Steve Brine]

I greatly appreciate that. The Minister is a good friend, and I know she is sincere. This morning I sent her some correspondence between me and the head of the new integrated care system in Hampshire, where we are trying to make progress with this. If “boosterism” works—in the context of covid-19 and this variant, which is where it probably does work—that will be all to the good, but let us get those boosters, and let us make it easy for people to get them.

I will end by reiterating that I am ambivalent about the face coverings regulations, but the isolation regulations concern me greatly. I am concerned about the timing and the conclusion of their application, and about their chilling effect, and unless I hear a very good answer to my question about the definition of “suspected”, I will not support them today.

Covid-19: Government Response

Debate between Maggie Throup and Steve Brine

Thursday 21st October 2021 Commons Chamber

[Maggie Throup]

Plan A outlines the guidance that is in place and that is the guidance that people should be following. It is up to individuals to work out what works for them and what is best for them. Plan B incorporates the mandatory wearing of masks, but we are on plan A.

[Steve Brine (Winchester) (Con)]

The news of the new antiviral treatments that we heard about yesterday is very welcome, as is, of course, the fastest vaccine roll-out programme in the world.

We voted to break our manifesto commitment in order to give the NHS billions of pounds more of our constituents’ money, primarily to deal with the covid backlog, yet there is a depressingly familiar drumbeat on moving towards plan B and plan B+, and plan C is in the papers today—as mentioned by the shadow Secretary of State, the right hon. Member for Leicester South (Jonathan Ashworth)—without mention of a penny of that new money.

May I ask the Minister about jabbing our young people? The Joint Committee on Vaccination and Immunisation came up with one piece of advice and the chief medical officer was asked to come with another one, until we got the answer that we wanted from him; does the Minister think that has something to do with why parents are confused? What more can she and her office do to convince the parents of teenagers that vaccination is in the interests of the young person? That will hopefully then drive up vaccination rates as vaccines go online according to the schedule in schools.

[Maggie Throup]

I reassure my hon. Friend that there is a lot of communication through schools and directly to parents and children to ensure that they understand the importance of 12 to 15-year-olds receiving their jabs, which will protect not only them but their loved ones.

Stroke Services

Debate between Maggie Throup and Steve Brine

Tuesday 5th December 2017 Commons Chamber

[Steve Brine]

I echo the hon. Gentleman’s sentiment that that work is critical. I mentioned the Act FAST campaign, which was a heavily evidenced public health campaign showing that the quicker we act after the event, the better the outcome, so he is absolutely right to highlight that issue. However, I am conscious of time, so I am going to press on.

My hon. Friend rightly spoke about mechanical thrombectomy, which he called a game-changer, and he is absolutely right. To continue and build on our stroke service success and to address the costs associated with stroke in England, which was one of my hon. Friend’s first asks, it is imperative that we keep identifying and developing innovative treatments and cutting-edge procedures.

In mechanical thrombectomy, or MT as we shall know it, we have an innovation that we believe can significantly improve patient outcomes, and my hon. Friend spoke about that. In April this year, NHS England announced that it will commission mechanical thrombectomy so that it can become more widely available for patients who have certain types of acute ischaemic stroke, which is a severe form of the condition. My understanding is that work by NHS England is now under way to assess the readiness of 24 neuroscience centres across the country. It is expected that the treatment will start to be phased in later this year and early next year, with an estimated 1,000 patients set to benefit across the first year of introduction. Overall, this will benefit an estimated 8,000 stroke patients a year and save millions of pounds in long-term health and social care costs—my hon. Friend was absolutely right to point out the rising costs to NHS England around this condition.

As the clinical director for stroke at NHS England has said, we are committed to fast-tracking new and effective treatments that will deliver long-term benefits for patients. For me, this treatment is just one example of many that we believe have the potential to tangibly improve patient care and to address rising costs.

[Maggie Throup]

Will my hon. Friend give way?

[Steve Brine]

I am going to press on, because we have to finish at a certain time, but I thank my hon. Friend for her contribution earlier.

Stroke services are an important part of the range of vital services delivered in the part of Essex represented by my hon. Friend the Member for Southend West. It is important that his constituents have the right access to the right care at the right time, which in this case means specialist acute and hyper-acute stroke units. As he knows, and as we have discussed in Adjournment debates previously, there is a lively debate in his local area about the best way to configure services in order to meet these needs. As ever, he makes a powerful case for Southend, which he says has shown itself to be both safe and effective, and I have no reason to doubt his word.

My hon. Friend’s second big question was about what we are doing to transform services. Sustainability and transformation partnerships are absolutely key in this regard. STPs cannot but help in improving stroke services; they have a huge part to play. STPs should bring the local population, NHS organisations and local authority bodies together to propose how they, at a locally designed level, can improve the way that their local health and care is planned and delivered. These local areas have been encouraged to take a collective view of the local health system so that they can explore how best services within the local area, including stroke services, can be streamlined and centred around the patient, and determine what configurations are necessary within each local area to deliver the best possible care. My hon. Friend’s description of turf wars does not surprise me, although it does disappoint me. If he wishes to raise anything specific with me, I ask him to write to me about it. As the Minister responsible for STPs, I do not want to see this happening, and if I can help with it, I will certainly do so.

Much guidance has been issued to the system from us at the centre to help support STPs in making these crucial local reconfiguration decisions. My hon. Friend’s associated STP, Mid and South Essex, is making good progress and has recently been rated through our STP dashboard as being in the top half, so it is a top-half-of-the-table team among STPs. Mid and South Essex’s stroke services compare very well with the best, in many ways, but, as he says, we could be doing much better. One area that it has identified for improvement is that none of the three existing hospitals currently has the right number of specialists to provide the level of specialist stroke unit care that is being proposed. That goes to the heart of some of the examples that he gave from the consultant he has been speaking to.

I welcome the fact that organisations within my hon. Friend’s area, and other STP areas across England, are working in partnership to develop proposals that can really benefit those who matter most—the patients. There are proposals currently out for consultation in his area, which obviously my hon. Friend the Member for Rochford and Southend East (James Duddridge) takes a very close interest in as well. I look forward to seeing the results of that consultation in due course. Knowing my hon. Friends, I feel almost certain that we will be back here discussing that at some point.

I mentioned the tangible progress that has been made in improving both the quality and delivery of stroke services, with evidence-based public health campaigns and really strong, well-organised local services, but there is so much more to do. Patient mortality has indeed fallen, compliance with the standards has risen, and patient experience and satisfaction continues to improve. This is a pathway on which I expect us to continue. New services that my hon. Friend is absolutely right to raise, such as mechanical thrombectomy, can really help us in achieving this. He said what a fascinating piece of medical technology that is. Putting the mesh into the groin for it then to travel through to have such an impact is truly incredible. We are very clever, in many ways.

How this is being delivered is changing, and that is important. The STPs are providing a new way of working. They can be controversial because they involve difficult decisions around reconfiguration, but they should involve local organisations, local services, local people, and local MPs. Local MPs who are not involved in their STPs should ask themselves why not. STPs, and the whole reconfiguration process, are a huge opportunity for us. Locally led commissioning enables local need to be taken into account in decision making about the shape of all services. It can result in very strong local services that can meet these needs, and nowhere is that more important than in stroke care. It is a system that drives improvement in all patient care, and that is what we are about. I thank my hon. Friend for bringing this debate to the House, and other hon. Members who have contributed.

Question put and agreed to.

Oral Answers to Questions

Debate between Maggie Throup and Steve Brine

Tuesday 14th November 2017 Commons Chamber

[Maggie Throup (Erewash) (Con)]

6. What plans his Department has to improve care for people with lung disease.

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

Me now, Mr Speaker. Improving care for people with lung disease is crucial to this Government. We do not need reams of new plans or strategies, but continued action to implement existing plans, including the NHS outcomes framework, which details NHS priority areas and includes reducing deaths from respiratory disease as a key indicator. Key initiatives include the implementation of quality standards on idiopathic pulmonary fibrosis, asthma and chronic obstructive pulmonary disease, and a national pilot to improve care of breathlessness.

[Maggie Throup]

I thank the Minister for that answer, but I think that more probably still needs to be done. Last month, I launched the British Lung Foundation’s latest report into idiopathic pulmonary fibrosis. Delayed access to diagnosis, support services and care is still commonplace for people with IPF and other lung conditions. Will the Minister agree to meet me and the British Lung Foundation, which is leading a taskforce for lung health, to establish what more can be done to address the issue?

[Steve Brine]

I thank my hon. Friend, who speaks with great passion—I know that she has tragic personal experience. I will be meeting the British Lung Foundation shortly, and I am happy for my hon. Friend to join that discussion or part of it. As I said, one of the NHS’s priority areas, as set out in the outcomes framework, is reducing early deaths from respiratory diseases such as IPF. I understand that the number of cases has risen in recent years, which is rightly a cause for concern. She is right to raise the matter, and I look forward to meeting her.

Oral Answers to Questions

Debate between Maggie Throup and Steve Brine

Tuesday 4th July 2017 Commons Chamber

[Maggie Throup (Erewash) (Con)]

I was delighted to hear that, in answer to my hon. Friend the Member for Boston and Skegness (Matt Warman), the Minister was positive about the progress of genome screening. On a recent visit to Nottingham University, I saw similar techniques applied to Alzheimer’s research. Will he back using the process for that, as well as for cancer diagnosis and treatment?

[Steve Brine]

The chief medical officer’s report—I am sure that my hon. Friend will read it in due course—is clear that this is an exciting new innovation in medicine. We will tackle cancer first, but there is real potential for applying it to rare diseases and the other disease that she mentioned.