Cervical Screening

Mark Pritchard Excerpts

Monday 19th July 2021 Westminster Hall

[Mark Pritchard (in the Chair)]

Hon. Members will be aware that social distancing is no longer in operation. I remind hon. Members that Mr Speaker has encouraged us all to wear masks. I also remind hon. Members that there have been some changes to normal practice in order to support the hybrid arrangements that we have today. I remind colleagues participating both physically and virtually that they must arrive for the start of the debate, as I think they have today, and Members are expected to remain for the entire debate, please.

I must also remind Members participating virtually that they must leave their camera on for the duration of the debate and that they will be visible at all times, both to each other and to those of us here in the Boothroyd Room. If Members attending virtually have any technical problems, they should email the Westminster Hall Clerks’ email address, which is westminsterhallclerks@ parliament.uk. Members attending physically should still clean their places when they leave, to ensure that other hon. Members can come into a place that is clean.

[Tonia Antoniazzi (Gower) (Lab) [V]]

I beg to move,

That this House has considered e-petition 317336, relating to cervical screening.

It is a pleasure to serve under your chairship, Mr Pritchard, for this really important debate. I apologise for not being able to be there in person today, but I thank the House for these hybrid proceedings because I was pinged last week.

I will begin by putting on the record my huge thanks to Caitlin, who is Fiona’s sister, for speaking to me last week about Fiona’s case and the way that it has affected her whole family. I also thank Fiona’s friends, Melissa Macdonald and Niamh Foley, who started the petition, and all those who have signed it, which led to this debate being held today.

As a woman, I know that we all sort of dread getting the call-up for our smear test. For most women, it is not painful, but it is uncomfortable and awkward. What can someone even chat about when the nurse is having her little look? But why should it be like that? We have all been there; the nurse has seen it all before. It is just not spoken about, so we feel a sense of shame about it. It is time we stopped being so coy about it, because that may well persuade more women to go for screening and ultimately it may save lives.

Cervical cancer is one of the most common cancers in women under 35, and 99.7% of cervical cancers are caused by human papillomavirus, or HPV. In recent years, testing for HPV has meant that it is easier to identify who is at greater risk from cervical cancer at the earliest stage.

During covid, England had an attendance rate for smear tests of 72%, which means that more than one in four women are not going for screening when invited to do so. The wonderful charity Jo’s Cervical Cancer Trust has a number of ideas to increase the uptake of smear tests, and I suggest that the Minister meets it to discuss ways of increasing the number of women being tested; I know that she has a keen interest in women’s health.

I was really moved when I spoke to Caitlin, because I got a real sense of how difficult it must be to lose a sister, especially at such a young age. Fiona was only 30 when she died. She was married to Andrew and was the mother of two young children. When Fiona died, Ivy was only four and Harry had just turned two. As Caitlin said, Fiona used all her strength to stick around for Harry’s second birthday.

Fiona was called for her first smear test in 2015, but she was pregnant with Ivy and so was told not to go. When she was called again, she was pregnant with Harry, but there was no follow-up to the first appointment. Fiona never received a reminder to go to her smear test in the interim. This situation is not about someone missing appointments when called to attend them; Fiona went to every appointment that she was meant to go to.

Fiona’s cancer was finally diagnosed after a routine smear test in 2018. She did not have any symptoms, but there seemed to be a lot of hold-ups and delays before her cancer was diagnosed. Caitlin mentioned that it could perhaps have been because of Fiona and Andrew moving from England to Scotland that Fiona received her first invitation. That raises questions about communications between the devolved Administrations and about what procedures are in place to make sure that communication between different trusts and devolved countries is clear.

A hysterectomy was performed and Fiona then went through chemotherapy and radiotherapy as a belt-and-braces approach to dealing with the cancer. After that, Fiona had a number of visits to A&E, including one where the doctor later admitted that she knew the problem was cancer and not a hernia, but did not say anything as Fiona was seeing a specialist soon after.

Most of us are not medical experts. We rely on doctors to tell us the truth because we do not know what is going on, and that vulnerability is really exposed when we hear such stories. I know it is extremely rare to hear stories such as Fiona’s, and the vast majority of our doctors, nurses and other health service staff really care, but it is shocking none the less.

Before covid hit, cancer services were already struggling due to severe staff shortages. Despite the incredible efforts by staff, a backlog has built up. Relying on current staff, who again have not had a pay rise, to clear the backlog on top of delivering regular services will only lead to burnout. It is just not sustainable. Research from Macmillan Cancer Support in 2017 showed that 2,500 specialist cancer nurses were needed to maintain cancer services. By 2030, we will need 3,700 new nurses—an increase of 124% on 2017 levels. Those figures will also have been hugely impacted by the pandemic. The Government have come forward with their own cancer workforce strategy, which is inadequate, and I implore the Minister to reconsider the plans that they have and come up with something that will really help those living with cancer.

Everything that happened to Fiona came before the pandemic hit last year. We have heard countless times about the delays in diagnosis and treatment that the last 16 months has caused. Approximately 1.5 million smear tests take place every year. With the pressure on the NHS since March 2020, that could mean 1.5 million women missing out on a vital tool in diagnosing cervical cancer.

We know that the rates of covid infection are on the up. Hospitalisations for covid are rising, and some NHS trusts across the UK are already cancelling operations as they are at capacity. The recklessness of so-called “freedom day” in England and the removal of all the measures that have been in place to keep us safe is therefore unbelievable. Putting the immunosuppressed at risk, such as those going through cancer treatment, is downright dangerous, and I am glad that the devolved nations have taken a more cautious approach.

What will the extra pressure on the health service mean? Another delay in getting a smear test. And what will that do to the outcomes for so many young women? What will the Government do to make sure that those women who miss out are not left behind, and to stop a knock-on effect on testing? We are looking at new ways forward. Fiona’s case has highlighted some of the gaps that were there before the pandemic started, and things have only deteriorated since covid hit. We must work together to make sure that cancer services are the best that they can possibly be, and that our cancer workforce is protected and given all the tools that it needs to continue to save lives.

When Fiona got really ill, her daughter Ivy used to ask why mummy had to spend so much time in bed. To stop another family having to answer those questions, I want the Minister to answer the questions that Fiona’s family and friends, and all of those who have lost someone to cervical cancer, need answers to. What procedures are in place to make sure that women like Fiona do not fall through the cracks? How does that work across the devolved nations? What is the current screening backlog? What plans to increase the cancer workforce are currently in place?

Caitlin finished our meeting by saying that any change that could come from this debate—if one life is saved, or if one family does not have to go through what her family have been through—would make it worth it.

[Mark Pritchard (in the Chair)]

Before I call John Lamont, I have to say that even though the attendants have been fantastic in helping with the air conditioning, it is still very warm, so if hon. Members want to remove jackets, they should feel free.

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[Jim Shannon (Strangford) (DUP)]

It is pleasure to serve under your chairmanship today, Mr Pritchard, as I often have in this Chamber, and I very much look forward to the Minister’s response. I very much look forward to speaking in this debate on cervical cancer screening.

I stand here to speak on behalf of my female constituents, whom this directly affects, and I speak in complete support of the e-petition, which had 146,000 signatures. Cancer is a tragedy that all of us know only too well. I am sure it has touched the lives of everyone in the room today. I am sure the Minister will not mind me saying that she has been directly affected, and we are very pleased to see her here as a survivor.

We must take every necessary step to catch cases sooner rather than later. The petition for Fiona’s law applies to women in England. However, I speak on behalf of my constituents and the women of Northern Ireland. It is estimated that some 3,200 women will be diagnosed with cervical cancer every year in the UK. Eighty people in Northern Ireland are diagnosed every year, and roughly 20 to 30 of those women will, sadly, pass away from the disease. The Public Health Agency in Northern Ireland has said that early detection and treatment can prevent seven to 10 types of cervical cancer. As the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) mentioned, Northern Ireland offers screening every two years. I would like to see it done better. I would like to see it every year; that is the best way to do it. The request is for early detection and treatment as the way to prevent cervical cancer.

It is important to remember that screening is not a test for cancer; it is a test to help prevent it. That is what we are trying to do, and that is why, to assist in preventing cervical cancers, we must do more to ensure that women have screening appointments regularly. Current legislation states that women between the ages of 25 and 49 will be invited for screening once every three years, and those aged 50 to 64 every five years. That is in line with the NHS’s long-term plan to detect 75% of cancers at stage 1 or 2.

I cannot stress enough the importance of screening appointments for women. First, I can only imagine that it is not a comfortable or easy procedure to go through, but I do believe that the prolonged interval of three years only increases the anxiety. Secondly, yearly screening would allow for more effective diagnosis, but it also provides an opportunity to make a procedure that a lot of women dread having more familiar and comfortable, if that is possible.

The UK’s leading cervical cancer charity, Jo’s Cervical Cancer Trust, report that 51% of women admitted to delaying their screening, that 24% delayed for over a year and that 9%, one in 10 women, have never attended a screening. Those are shocking figures, but they are understandable at the same time. These are lives being lost, and because of the frequency of cervical screening it is getting worse.

There needs to be more communication about screening so that people are aware of what they are going into. That would then provide confidence and would increase the numbers attending, which would ultimately result in lives saved: more mothers, more daughters, more sisters, more grandmothers and more wives living longer and healthier lives. My wife went through it. She did not for one second wish to go. She found the whole thing very uncomfortable and, honestly, a little embarrassing. Obviously, we encouraged her. My mother encouraged her, and I think that probably helped—from lady to lady is probably better. She went for the tests and got the all clear.

Cancer of all kinds has destroyed lives and families for too long. We must do all we can to increase early diagnosis, as the petition calls for, especially in the light of the impact of the pandemic, which has seen a further decrease in screening figures. We need to get back on our feet and allow women yearly screenings. I urge the Minister to undertake discussions with the UK National Screening Committee to ascertain why it feels that women do not warrant screenings every year.

To anyone who is offered a cervical cancer screening, I say please go. I say to the Government that the encouragement from the Minister will start here. More must be done to get more frequent appointments, more awareness of the benefits and more discussion around the appointment itself, because there is nothing more promising than the prevention of disease.

[Mark Pritchard (in the Chair)]

Before I call Mike Kane, there has been a slight adjustment to the call list. I will call Dr Philippa Whitford after Mr Kane, and then Alex Norris.

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[Mark Pritchard (in the Chair)]

Would colleagues please leave the room via the door marked “Exit” and observe social distancing? Thank you again to our excellent technical teams.