Diabetes
Nick Thomas-Symonds Excerpts(5 years, 4 months ago)
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Sir John Hayes (South Holland and The Deepings) (Con)
I beg to move,
That this House has considered diabetes.
What a delight it is to serve under your chairmanship, Mr Robertson. C. S. Lewis, the great Christian writer, said:
“Courage is not simply one of the virtues, but the form of every virtue at the testing point.”
Every day, our constituents—people across Britain—are tested by the challenges that are the effects of diabetes, which is the fastest growing health crisis of our time. There is barely a family in Britain that has not been touched by it. As so many elderly ladies do, my late mother contracted type 2 diabetes when she reached her 70s. I spoke to colleagues from across the House in preparation for this debate, and many of them, including one this morning, said that they had a family member who had been affected by the disease.
In the last 20 years, the number of people in the UK living with diabetes has doubled, reaching 4.6 million. Every day, 700,000 people are dealing with the worst effects, and 700 people are newly diagnosed as suffering from some kind of diabetes. Amazingly, that is one person every two minutes, so this debate is not only necessary and apposite; rather, I would go one further and say that it is essential.
Sir John Hayes
I shall just finish the next exciting sentence and then I will happily give way. By 2025, there could be as many as 5 million people living with diabetes in the UK.
Nick Thomas-Symonds
I thank the right hon. Gentleman for giving way and congratulate him on securing this debate. The statistic for Wales is that one person in 14 is affected. Does he agree that, going forward, we must look at prevention—seeing the warning signs and looking at lifestyle changes—as well as having excellent treatment for those who are formally diagnosed?
Sir John Hayes
Absolutely. I will deal with that during my speech. Information that leads to a better understanding of risk, which in turn leads to prevention, is critical, particularly with respect to type 2 diabetes, which is the type that I mentioned earlier when I referred to my late mother.
I spoke of hundreds of thousands of people who suffer from type 1 diabetes—about 500,000 at the moment, but that could easily rise to 700,000—but of course 90% of sufferers are type 2 diabetics, and prevention is particularly critical in their case.
Cancer Workforce and Early Diagnosis
Nick Thomas-Symonds Excerpts(5 years, 4 months ago)
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Jim Fitzpatrick (Poplar and Limehouse) (Lab)
I beg to move,
That this House has considered early diagnosis and the cancer workforce in the NHS long-term plan.
It is a pleasure to see you presiding over our business this morning, Mr Howarth. I wish everyone a happy new year. I thank the Backbench Business Committee for supporting the bid of a number of colleagues for this debate, and the Chairman of Ways and Means for allowing it. I was lucky enough to be chosen as the chief sponsor, but I recognise the support of other Members in this Chamber. I will try to keep my remarks to 10 minutes or thereabouts.
I am grateful for the many briefings we have had—we have had briefings from the House of Commons Library, Barts Health NHS Trust, Cancer Research UK, Breast Cancer Care, the Fire Brigades Union, Macmillan Cancer Support, Breast Cancer Now, the Royal College of Pathologists, Maggie’s, the British Lung Foundation, the Royal College of Physicians, CLIC Sargent and the Royal College of Nurses. I have had more briefings from interested parties on this debate than on any other in my 21 years here. Interestingly, they virtually all agreed on two basic points. First, they welcomed the fact that the Government have addressed their issues in the 10-year review and, secondly, they welcomed the new investment but asked for more detail about staff training, recruitment and retention.
Running through most of the briefings I received were questions about the publication of the NHS long-term plan, which was promised by the end of 2018. In very timely fashion, the Government published it yesterday. It has focused the debate but not eliminated the need for it.
I want to highlight some of the issues raised in the briefings. The Royal College of Pathologists cited disturbing statistics. Notably, just 3% of services reported that they have enough staff to meet clinical needs, and more than three quarters of departments reported vacancies for consultants. The royal college emphasised the need for early diagnosis and called for increased investment in pathology services, particularly in the recruitment and training of pathologists and scientists. It said that histopathologists should be listed on the shortage occupation list as there is a shortfall in that speciality. The Migration Advisory Committee currently includes no pathology specialities on the shortage occupation list. Placing histopathology on that list would help overseas qualified pathologists to obtain a visa to work in the UK.
Nick Thomas-Symonds (Torfaen) (Lab)
I lost my mother to bowel cancer last year, and I have been campaigning to reduce the bowel cancer screening age to 50. I understand from my campaign and the debates I have had that it is important that we get the pathology capacity right. Otherwise the reduction in the screening age will not work. Does my hon. Friend agree?
Jim Fitzpatrick
I certainly do. I am sorry to hear about the fatality in my hon. Friend’s family. I am sure the Minister will talk about staff and I will come to it later in my speech. Without staff in diagnosis and pathology services, the reduction in the screening age will be pointless.
The Royal College of Pathologists identified a growing demand for pathology services and predicted a 28% shortfall in staff by 2010. Cancer Research UK said, as we all know, that the earlier a cancer is diagnosed, the more likely it is that it will be treated successfully. The Labour Government’s initiative to reduce the time between an urgent GP referral to seeing a cancer consultant to two weeks was a success in ensuring swifter treatment, but 2018 was the first year in which that target was not met. I would be grateful if the Minister told us how the Government expect to address that slippage.
Cancer Research UK added that it expects new cancer cases to reach 500,000 a year by 2035—right now, it is 350,000. With more cases and more thorough screening measures, our NHS will need more diagnostic and treatment staff. Cancer Research UK highlighted that the promise to produce a workforce implementation plan after the 2019 spending review leaves the status of Health Education England’s upcoming cancer workforce plan unclear. Will the Minister give us more information about how the two initiatives relate to each other?
Macmillan said that it recognises and welcomes the focus on cancer in the NHS long-term plan, including the Prime Minister’s commitment radically to improve early diagnosis. However, it has concerns that the long-term plan will not adequately address the immediate and long-term pressures facing the NHS cancer workforce. It also asked when the workforce implementation plan can be expected this year. I note that the Health Secretary said yesterday that he expects Baroness Dido Harding to report to him by the end of March. I would be grateful therefore if the Minister can confirm that we can expect the publication of the workforce implementation plan by summer this year.
Breast Cancer Now made the point that only 18% of breast cancer screening units are adequately resourced with radiography staff, in line with breast screening uptake in its area. My area of north-east London is covered by Barts Health NHS Trust, the NHS North East London Commissioning Alliance and the East London Health and Care Partnership. Many of the points made by the national charities are apparent locally. Those bodies have made their concerns clear. They have raised the basic issue that cancer outcomes in north-east London are among the poorest in London and the country, and that presentation via the emergency route remains high and is clearly associated with advanced cancer and low one-year survival rates.
In my borough of Tower Hamlets, the one-year survival index of people diagnosed with cancer is 4% lower than the England average, and diagnosis through the emergency route remains high. The local NHS trust has plans to attack that problem with a new early diagnosis centre, which is due to open in December; the introduction of multi-diagnostic clinics, which were first introduced in Denmark and were supported here in the pilot phase by Cancer Research UK; and new faecal immunochemical testing for colorectal cancer in primary care from April this year. It plans a health and wellbeing school spread across the whole of north-east London, based on the principle of making every contact count. It is raising population awareness and screening initiatives, including placing staff to promote screening in GP practices, promoting text reminders for cervical cancer screening, video competitions for schools to promote vaccinations, prostate cancer targets, breast and bowel cancer target ads on Muslim TV channels, and the reintroduction of bowel screening reminder calling and other initiatives.
The North East London NHS Foundation Trust conclusions are relatively simple. The workforce is a key factor in delivering a faster diagnosis standard, expected by 2020 and beyond; earlier diagnosis of cancer needs a resilient and sustainable radiology, endoscopy and pathology workforce; the high cost of living, the lack of affordable housing and the disparity in salaries across London are barriers to recruitment; and there is a need to look at technology such as artificial intelligence and digital pathology, and innovations in careers.
CLIC Sargent raised the problem of diagnosing child cancer and said, worryingly, that more than half of young people diagnosed visited their GP with their parents at least three times before their cancer was diagnosed. That is of particular concern.
Breast Cancer Care also raised the workforce plan, and asked how the commitments of the current cancer strategy and the ambitions of the long-term plan will be met. The Royal College of Physicians told me that, in London in 2018, 27% of physician consultant posts advertised were not filled, and that across the UK a total 45% of advertised consultant posts went unfilled due to a lack of suitable applicants.
The British Lung Foundation made two key points: that early diagnosis is essential because almost half of lung cancers are diagnosed at stage 4 when survival rates are very poor; and that there is an urgent need to train and employ more NHS staff to diagnose lung cancer earlier. The Royal College of Nursing stated that in England there are nearly 41,000 vacant registered nursing posts in the NHS. It predicts that the number will increase to almost 48,000 by 2023 if the Government do not take action.
The Commons Library briefings said that the cancer workforce plan devised in 2017 recommended that action be taken to ensure that enough staff with the right skills are trained to deliver the cancer strategy by 2021. In November last year, the highly respected Professor Sir Mike Richards—NHS England’s cancer director—announced that cancer screening would be overhauled as part of the long-term plan. He also announced a review team to assess current screening programmes and a report is due this summer. I ask the Minister whether that timetable might coincide with the publication of the Government’s workforce plan. The Library stated that there is no measure of the total NHS cancer workforce. Will the Minister comment on that anomaly?
I would be grateful if the Minister addresses the fundamental issue raised in all the briefings: how the workforce implementation plan fits in with the strategy, and when it can be expected. I look forward to his response. He is highly regarded in his post. I look forward to the responses from the hon. Member for Central Ayrshire (Dr Whitford), the Scottish National party spokesperson, and from my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), the shadow Health Minister, and to other colleagues’ contributions.
Nursing: Higher Education Investment
Nick Thomas-Symonds Excerpts(5 years, 5 months ago)
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Eleanor Smith
I do agree, and my hon. Friend will hear me refer in my speech to what he has just said.
Nick Thomas-Symonds (Torfaen) (Lab)
I congratulate my hon. Friend on securing this important debate, and I commend what my hon. Friend the Member for Coventry South (Mr Cunningham) said about the proposition that we need to pay our nurses properly to value them truly. Does my hon. Friend the Member for Wolverhampton South West agree that it is important that we have specialisms too, and that one specialism we require more of across the country is Parkinson’s nurses?
Eleanor Smith
Absolutely. That is where nursing is important. Nurses are becoming specialists in Parkinson’s, Turner syndrome and sickle cell, all of which are specialisms that will be required in the future of nursing.
Nurses are working in cutting-edge research on ethics, safety, improvements to care and new ways of working. They are leading from the frontline, and as professionals they should be at the heart of strategic policy making. Nursing is at a critical junction in our healthcare and systems, yet the Government are without an independent chief nursing officer after the removal of that critical leadership post from the heart of the Department of Health and Social Care. That is an insult to the nursing profession.
How many of my right hon. and hon. Friends are regularly contacted by their constituents about health and social care issues—people struggling, writing about services being reduced or cut, unable to access support without help? Increasingly, that is happening because there are not enough staff to run things safely. Across the country, nurses are clear that staffing for safe and effective care is their most important priority and their biggest worry.
Ovarian Cancer: Diagnosis and Treatment
Nick Thomas-Symonds Excerpts(5 years, 6 months ago)
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Lee Rowley (North East Derbyshire) (Con)
I beg to move,
That this House has considered ovarian cancer diagnosis and treatment.
It is a pleasure to serve under your chairmanship, Mr Bone. I thank the Backbench Business Committee for allowing the debate, as well as everyone who is here to support this important and timely event—both my colleagues in the Chamber, and everyone in the Public Gallery. The issue is extremely important, and I am privileged to open the debate. This will be the first time since 2014 that ovarian cancer has been debated in either Chamber.
Ovarian cancer is a quiet, invasive cancer, that robs wives, daughters, sisters, mothers and grandmothers of years of their lives, often unexpectedly and quickly, with devastating impacts on their families. Today about 25,000 women are living with the cancer and every day 20 will be diagnosed with it. Despite some progress in recent years the disease still takes away the lives of 4,000 women a year, and hundreds of thousands around the world. Because of its devastating effects its survival rate is, tragically, not as high as everyone would like, and 46% of sufferers do not survive for five years or more.
Nick Thomas-Symonds (Torfaen) (Lab)
I warmly congratulate the hon. Gentleman on securing the debate. To improve survival rates, we need earlier diagnosis. For many years ovarian cancer was known as the silent killer, but there are a number of signs and symptoms. Will he join me in encouraging anyone with those signs and symptoms to see their GP urgently?
Lee Rowley
I absolutely will. That is a timely and important point. I was on Radio Sheffield only this morning talking about the debate with someone from Target Ovarian Cancer. We spent an awfully long time talking about the symptoms, because it is important that people understand them, and are aware of them, so they can get the treatment they need if they are, unfortunately, affected.
All cancers are important. Extremely sadly—sometimes tragically—ovarian cancer tends not to receive the bulk of the attention or funding. That is partly because it does not affect as many people as other cancers, but it is also because of survival rates. The 46% rate of survival beyond five years compares unfavourably with the rate for breast cancer, which is 87%, and prostate cancer, which is 85%. There are simply fewer survivors of ovarian cancer in the UK who could highlight the importance of fighting the disease and succeeding than there are survivors of other cancers. There is a need for people to speak up about ovarian cancer. Thanks to the work of those who are doing so, it has started to receive the attention that it needs. Charities such as Target Ovarian Cancer work tirelessly every day to raise the profile of the disease, support those who have been affected, improve diagnosis and treatment, and work for a cure. I pay tribute to the work of the all-party parliamentary group on ovarian cancer, and in particular the hon. Member for Washington and Sunderland West (Mrs Hodgson), who chairs it. It has been a privilege to be involved in the work and I am grateful to be able to help in a small way.
What is it about ovarian cancer that requires a particular focus? From the work I have seen, there are four things: improving awareness of the disease, as the hon. Member for Torfaen (Nick Thomas-Symonds) mentioned, so that it can be caught earlier; speeding up the diagnosis when it is suspected that someone has the disease; improving the data available for tracking the disease and our progress in the fight against it; and improving the treatment, allowing people to recover and be disease-free more quickly.
Paediatric Cancers of the Central Nervous System
Nick Thomas-Symonds Excerpts(5 years, 6 months ago)
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Chris Elmore (Ogmore) (Lab)
I am extremely grateful to have been granted this important Adjournment debate. In all honesty, I wish I was not having to take part in it, but on 29 January, Cian Case, a six-year-old little boy from Llanharan in my constituency, tragically died after suffering a relapse of an aggressive cancer of his central nervous system. Cian was a young, gentle and happy young boy whose life was lost too early—far too early. It was a privilege to meet Cian at a fundraising rugby match in March 2016. I will never forget his warmth and acute sense of humour about his condition, or indeed the look of joy on his face at the fact that the community had come out in their hundreds to support him.
Cancer is a foe that every single Member will have experience of. Whether it be a sibling, a parent, an aunt, an uncle, a friend or even somebody we have just got to know in passing, Members across this House, as well as the people we serve, will have had cancer touch their lives and will know of its life-shattering effects. There is no good time for anybody to get cancer, but as I am sure you would agree, Madam Deputy Speaker, it is particularly harrowing and particularly life-changing to live through your child’s suffering with, and eventually dying from, this terrible disease.
It may come as a surprise to many Members across the House that, on this occasion, I do not stand here to point the finger of blame at the Government or to take a swipe at the NHS in England, or indeed in Wales. Instead, I seek to tell Cian’s story in the hope that we can work together, on a cross-party and cross-Government basis, to help to ensure that no family has to go through what Cian Case’s family underwent.
Nick Thomas-Symonds (Torfaen) (Lab)
I congratulate my hon. Friend on securing this debate, and on speaking so movingly about his young constituent. Having experienced having a seriously ill child, I know that one vital thing in such a situation is the care that hospitals provide not just for the child, but for the parents and the carers who spend a great deal of time there. Does he agree that there should also be a focus on that as we move forward on this crucial issue?
Chris Elmore
I entirely agree with my hon. Friend. I pay tribute to him for the bravery that he and his wife, Rebecca, have shown over William. I am so pleased to see pictures of him now looking so well and on the road to recovery.
Nurse Training
Nick Thomas-Symonds Excerpts(5 years, 8 months ago)
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The Minister for Health (Stephen Barclay)
I pay tribute to my hon. Friend the Member for South Dorset (Richard Drax) for his assiduous campaigning on behalf of his constituents and for securing the debate. Its importance is reflected by the fact that my hon. and learned Friend the Solicitor General and the Under-Secretary of State for Wales, my hon. Friend the Member for Eastleigh (Mims Davies), were in the Chamber to listen to the points that my hon. Friend the Member for South Dorset raised.
My hon. Friend spoke passionately about the training of nurses in England and the pivotal role of training in ensuring that we have a workforce to deliver first-class services in the NHS. With a budget in which two thirds of our spend goes, quite rightly, on our workforce, the importance of that workforce is absolutely critical. Indeed, that was reflected by my right hon. Friend the Secretary of State when he set out his three key priorities for the NHS after taking over that post. He particularly emphasised the importance of the workforce within those priorities.
Nick Thomas-Symonds (Torfaen) (Lab)
I apologise, Mr Deputy Speaker, for not being here at the start of the debate. A number of constituents who have contacted me are clearly concerned about the fact that the demand for nurses is not quite being matched by recruitment at the moment, particularly in the areas of learning disability and mental health. What specifically can the Government do, in addition to what they are doing, to really focus on those two specialist areas?
NHS 70th Anniversary
Nick Thomas-Symonds Excerpts(5 years, 11 months ago)
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Nick Smith (Blaenau Gwent) (Lab)
I beg to move,
That this House has considered the 70th anniversary of the NHS and public health.
It is a pleasure to serve under your chairmanship, Mr Hosie. The 70th anniversary of the NHS is an important time for the country, but it is also a special time for Blaenau Gwent. Aneurin Bevan, and the health service he created, was born and bred in Blaenau Gwent—in Tredegar. Since Nye’s death in the 1960s, Blaenau Gwent MPs have followed in the footsteps of a colossus. We in the borough are immensely proud and fiercely protective of his legacy. When he said he wanted to “Tredegar-ise” the NHS, he was basing his plans on the Tredegar Medical Aid Society, a mutual and an organisation established for all, supported and funded by the people of Tredegar, whether they be miners at the Ty Trist colliery, like my grandfather George, quarry workers at Trefil or nurses at the St James Hospital. If Bevan established an NHS for the 20th century, at this anniversary it is important that we ask ourselves what sort of NHS we need for the 21st century.
Nick Thomas-Symonds (Torfaen) (Lab)
I should declare an interest as a biographer of Aneurin Bevan. Before my hon. Friend moves on to talk more generally about the future, does he agree that the decision to nationalise the hospitals, and the painstaking work that Bevan did in negotiations with the British Medical Association, mean that he truly is the architect of the national health service?
Nick Smith
My hon. Friend has written a terrific biography of Aneurin Bevan. He absolutely captured what Nye did for us all.
On 5 July it will not be good enough just to celebrate the past, the history of this brilliant institution and its architect; we must also look to its future and the challenges it now faces. Many of those challenges have been created by eight years of Tory austerity, which has left our national health service underfunded, understaffed and underprepared. Labour would provide more doctors and nurses and provide a funding level to support the service for years to come. Other challenges cannot be put down to politics. The epidemics of old—diseases once fatal that we have almost eradicated—are being replaced with new health problems that are putting massive strains on our NHS. It is wonderful that people are now living longer, but that also means our population is an ageing one that needs support. As our society gets to grips with caring for our mental health, more people need access to these services than ever before.
Today I want to concentrate on another big challenge: rising levels of obesity, particularly among children. In this case, it is a challenge where an ounce of prevention can be better than a pound of cure. Back in Blaenau Gwent, surveys estimate that 70% of adults are overweight or obese and 11% are being treated for diabetes. Most troublingly, the latest figures from the child measurement programme reveal that last year 15% of four and five-year-olds in my constituency were classed as obese. We should all be worried by that trend, which is being replicated across our country.
Nick Thomas-Symonds
I join my hon. Friend in congratulating all those involved in parkrun. Will he join me in congratulating the volunteers who make parkrun possible in his constituency and in mine in Pontypool and Cwmbran, where I too have taken part in parkruns, but I have not quite reached my hon. Friend’s running level yet?
Nick Smith
I thank my hon. Friend for supporting parkrun. Perhaps we should have a south Wales eastern region parkrun championship at some point in the coming months. He is absolutely right about volunteers and the running club supporters who are out there at 9 o’clock on a Saturday morning, or sometimes on a Sunday morning for the junior parkrun, in parks all across the country. They do a great job in all weather. It is brilliant to see. More than 30,000 runners took part in parkruns in Wales alone last year. It is that sort of activity with cross-body support and backing from our community role models that can make a big difference to making such schemes stick.
When Nye wanted to Tredegar-ise the national health service, he wanted a service built on community where we all bought in and all had a stake. In that spirit the public health challenges we face 70 years on should not be tackled alone. To truly take care of ourselves, we need a society that sets us up for success, a system that has our backs, a public service that recognises what needs to be changed and how to do it. The Government have a real chance to honour the anniversary of the national health service in the months ahead, not with pomp and ceremony, but with the sort of action that people will celebrate another 70 years from now.
Bowel Cancer Screening
Nick Thomas-Symonds Excerpts(6 years ago)
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Sir Roger Gale (in the Chair)
I apologise to Members for my late arrival; the previous debate finished early and I was under the impression that I was in the Chair only until 11 o’clock.
Nick Thomas-Symonds (Torfaen) (Lab)
I beg to move,
That this House has considered bowel cancer screening.
It is a great pleasure to serve with you in the Chair, Sir Roger, and I am glad that you have taken your seat.
Bowel cancer is the fourth most common cancer in the UK. Sadly, around 16,000 people die from the disease each year. It is estimated that between now and 2035, around 332,000 more lives could be taken by this awful condition. Nearly everyone will survive bowel cancer if it is detected at its earliest stage, but unfortunately only 15% of bowel cancer patients fall into that category.
Jim Shannon (Strangford) (DUP)
I congratulate the hon. Gentleman for securing the debate. Does he agree that early-stage cancers are not only easier to treat, but less costly for a cash-strapped NHS? That is why we need an effective screening programme that includes lowering the screening age to 50 and implementing the simpler and more accurate faecal immunochemical test. That would help to get the earlier diagnosis, to stop the cancer.
Nick Thomas-Symonds
I entirely agree with the hon. Gentleman about the need for an optimal screening programme—I will come to that in a moment.
In Wales around 2,200 people are diagnosed with bowel cancer each year. Nearly half of those are diagnosed at a late stage. Approximately 900 people in Wales will die from bowel cancer every year, but 78% of patients will survive for one year or more, and 58% for five years or more. These figures are not mere statistics; every single extra day with the people we love is a great joy.
I lost my own mother, Pamela Symonds, to bowel cancer on new year’s day this year. She lived just under two years after her formal—too late, I am afraid—diagnosis. She was one of the 10,000 people diagnosed annually at the late stage of bowel cancer. I know only too well the impact that bowel cancer has on families.
Chris Evans (Islwyn) (Lab/Co-op)
I pass on my condolences to my hon. Friend. With all candour, I know what he is going through: I lost my father in 2003 to bowel cancer. He was just 51. Does my hon. Friend agree that we need to start screening people for bowel cancer at the age of 50?
Nick Thomas-Symonds
I absolutely agree with my hon. Friend and I pass on my condolences to him, even though the loss of his father was some time ago.
Along with my father Jeff, my wife Rebecca and my mother’s many friends, I supported her through three arduous rounds of chemotherapy, helping her to achieve her goal of living long enough to meet her grandson, my son William, who was born some three months after she was diagnosed. Owing to the care and treatment she received, her inspirational bravery and her sheer determination, she lived not only to see him born but to see him reach his first birthday in September 2017, and to see her beloved granddaughters, Matilda and Florence, reach the ages of eight and five—precious moments that are now my precious memories.
For families dealing with cancer, time is everything. Those who are diagnosed with bowel cancer have the best chance of surviving—and of surviving for much longer—if they are diagnosed at the earliest stage. This is why screening is so important.
Stephen Lloyd (Eastbourne) (LD)
I thank the hon. Gentleman for securing this important debate. I offer him my condolences on his dear mother’s death. He will be aware of the enormous public petition—it has received 446,000 signatures—that was started all those years ago by Lauren Backler, who also lost her mother. I have supported that campaign for a long time. Does he agree that the evidence is clear that we should be screening at the age of 50, so it is surely time for an end to shilly-shallying from the Department of Health and Social Care? Will the Minister agree to at least pilot screening for bowel cancer at 50? It is obvious that the evidence from such a pilot would be irrefutable.
Sir Roger Gale (in the Chair)
Order. The situation we are in is entirely of my making, and for that I can only apologise. Given that there are so many Members present who might wish to intervene, I am prepared to stay in the Chair for six minutes of injury time to enable the hon. Gentleman to take interventions. I am sure that is illegal, but I am willing to do it, provided that the Minister and the hon. Gentleman, who are in charge of the debate, are prepared to accept that.
The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)
indicated assent.
Nick Thomas-Symonds
I am grateful for that kind offer, Sir Roger. I am delighted to hear that we can continue for an extra six minutes.
The hon. Member for Eastbourne (Stephen Lloyd) is absolutely right. This is a cross-party issue. I believe that his predecessor spoke in favour of the system that he proposes, and the hon. Member for Hexham (Guy Opperman) contacted me to draw attention to the debate that he led back in 2011. There is broad cross-party consensus for looking at the screening age and at more accurate screening methods, which I will come on to.
Participation rates remain an issue. We should send a very simple message to people: “Please do not ignore your bowel cancer screening kit, which could save your life.” There is no doubt that we must also do more to raise awareness of symptoms. Bowel cancer is often mistaken for other conditions, such as irritable bowel syndrome. That only reinforces the point that a number of hon. Members have made about the importance of highly accurate screening.
Previously, the standard screening test was considered to be the faecal occult blood test—the FOB test, as it is known—and all men and women between 60 and 74 received a home test kit, but that has been changing across the country. The best available test is now the faecal immunochemical test—the FIT—which can detect more cancers and can be set to different sensitivity levels, enabling any traces of human blood that are found to be investigated. The Royal College of Pathologists sent me a useful briefing, in which it indicates that it would expect a 45% increase in demand on pathology if the test were set at one level, but a 480% increase if it were set at a more sensitive level. That sensitivity level is important.
The Welsh Government are introducing the FIT from March 2019. I believe that it was due to be introduced in England in April. I hope that the Minister can update the House on when that will happen. I hope that there will be a decision for Northern Ireland soon. Of course, Scotland already screens people using the FIT at age 50.
Lady Hermon (North Down) (Ind)
As ever, it is lovely to have you in the Chair, Sir Roger. We forgive you, of course.
My youngest sister had bowel cancer. Mercifully, she had an early diagnosis because she had a wonderful GP. The hon. Gentleman mentioned Northern Ireland. In the continued absence of a functioning Northern Ireland Assembly, will he and his colleagues, and colleagues from other parties, please support the very active campaigners in Northern Ireland who, like me, wish to see the screening age for bowel cancer reduced to 50?
Nick Thomas-Symonds
I am pleased to hear the good news that the hon. Lady’s sister was able to recover well. Of course Members across the House should look to support those campaigners. I am in favour of consistency across the UK. One of the great things about devolution is learning from best practice in different parts of the United Kingdom, and people in Northern Ireland absolutely should benefit too.
There are other differences in testing. In England and Scotland, people aged over 75 can obtain a screening test by calling a free bowel cancer helpline. In England, a one-off bowel scope screening is promised for those aged 55, but only around half of areas currently offer that. Will the Minister update us on how progress towards all areas being covered can be sped up?
As I indicated in answer to the hon. Member for Eastbourne, there is cross-party support for reviewing the age at which testing starts. I ask the UK Government and all the devolved Governments to look at and keep under review the age at which screening begins—that is crucial—and the sensitivity of the tests that are used. It seems to me that reducing the screening age, which many Members have pointed out, and increasing the sensitivity of tests are the two uniting themes.
Lilian Greenwood (Nottingham South) (Lab)
My hon. Friend is making a powerful argument. Like him, I lost my mother to bowel cancer when she was only 53—an age I am now approaching. Does he have evidence on whether there should be a lower screening age at least for those of us with a family history of bowel cancer, even if the screening programme cannot be extended to everyone under 60 or 55?
Nick Thomas-Symonds
I absolutely agree. Although we all want a blanket reduction in the screening age across the United Kingdom, there are a number of risk factors for bowel cancer, one of which is family history, and we certainly need to look at having flexibility around the country so that screening can be done earlier where those risk factors are present.
The charities Bowel Cancer UK and Beating Bowel Cancer seek an optimal screening programme for men and women from 50 to 74. They rightly point out the importance of early diagnosis and the real opportunity to reduce the number of people who die from this awful disease.
Julian Sturdy (York Outer) (Con)
I pay tribute to the hon. Gentleman for bringing forward this debate at what must be a difficult time for him. My sympathies are with him. A member of my close family—my father-in-law—is suffering from bowel cancer. Thanks to the superb support of the NHS, we hope he is on the road to recovery. That has brought home to me the importance of early diagnosis. I just want to put on the record the fact that I would support the hon. Gentleman on a cross-party basis to ensure that we bring down the screening age and improve testing wherever we can.
Nick Thomas-Symonds
I am sure that all hon. Members would join me in sending their very best wishes to the hon. Gentleman’s father-in-law. I would be grateful if the hon. Gentleman passed those on. I welcome the cross-party support for reducing the screening age. I referred to Bowel Cancer UK, and I should point out that I have been pleased to do a number of runs to raise money for that charity through sponsorship.
I realise that we must deal with two other things to ensure that lowering the screening age and improving the screening process across the UK is effective. First, pathology capacity must be increased, because there will obviously be vastly more samples to deal with. Secondly, we need high-quality colonoscopy capacity to deal with the increased numbers of people referred on for further investigation as more sensitive tests yield further results that need to be checked out.
Liz McInnes (Heywood and Middleton) (Lab)
I extend my condolences to my hon. Friend on the sad loss of his mother. I worked in pathology before I became an MP, and I am grateful to him for mentioning it and the increase in capacity that will be required if it is found to be indicated clinically that we need to reduce the screening age to 50.
Nick Thomas-Symonds
I am grateful to my hon. Friend for her sympathy and for bringing her experience to bear on the debate. Such increased capacity will be so important.
That we need to be ambitious on pathology and colonoscopy capacity should not deter us from the ultimate goal, however; I want to see every eligible person across the United Kingdom have access to the best and most effective screening methods, so that we can finally defeat this cancer. Saving lives—giving more families more precious moments with their loved ones—should be the only incentive we need to make progress.
Nick Thomas-Symonds
I am grateful to the Minister for his tone and constructive approach. May I press him for a little more detail? He said that FIT will be introduced in England in the autumn, but when will we get closer to a precise date?
Steve Brine
I cannot give the hon. Gentleman the precise date today, but I know of his and other Members’ interest in the matter, and as soon as I can give that date I will tweet it and tag him. I assure Members that I will let the House know as soon as I have the date, and I have a funny feeling that Members will be watching closely for that.
On lowering the age for screening, many right hon. and hon. Members and their constituents are concerned that the age at which we invite people for bowel screening should be 50 rather than 60. Such concern is sometimes driven by personal experience of the impact of cancer on families as well as on constituents. The hon. Member for Eastbourne (Stephen Lloyd) feels particularly strongly about the issue and has worked on it for a long time—I worked with him a lot during his first iteration as an MP, and it is good to see him in his second chapter. I thank him and his constituent Lauren Backler, who sadly lost her mum to bowel cancer, for personally delivering to my Department last week a petition on the screening age with, as he said, 400,000-plus signatures. I was in my constituency; otherwise, I would have come down and got it myself. I saw him on “ITV News Meridian”, our local news, walking up Victoria Street with the petition. I thank him for that and will take great note of the petition. We will, of course, consider it carefully and respond in due course, but I hope what I will say today will give him some cause for optimism.
When the bowel cancer programme was introduced in 2006, it focused in the first instance on those aged 60 to 69, and then in 2010 it was extended to 70 to 74-year-olds. When we consider that eight in 10 cases are in over-60s, we can understand why that was the starting point, but that does not have to be the end point. It is therefore crucial that the clinician looking at the bowel following a finding of blood in a stool is as skilled an expert as possible, and the NHS has to make sure there is enough clinical capacity to follow up referrals.
The hon. Member for Torfaen rightly mentioned NHS England capacity, which is critical. To boost clinical capacity in the NHS in England, Health Education England has recently pledged to fund the training of 400 clinical endoscopists by 2021, which will significantly increase the endoscopy capacity in England and is a key part of the jigsaw.
This decision to screen from the age of 60 was also based on the fact that, as I have said, the risk of bowel cancer increases with age and people in their 60s are found to be most likely to complete a testing kit. However, that does not have to be the end of the conversation. Therefore, five years ago, in 2013, we started to introduce bowel scope screening for those aged 55. In the research that underpinned that decision, those who took up the offer of a bowel scope test and follow-on treatment reduced their chances of dying from bowel cancer by more than 40%. Those are good stats. Now, with the introduction of FIT, we have an important, evidence-supported opportunity to consider the totality of the bowel cancer screening programme and maximise the benefits of bowel cancer screening.
Nick Thomas-Symonds
One of the issues with the scope test is its geographical spread: as I understand it, at the moment only about half of England is covered. First, will the Minister comment on when it will be extended? Secondly, I would welcome his commitment to reviewing screening in its totality.
Steve Brine
I will indeed ask the question that the hon. Gentleman raises about geographical spread. It is a key point.
I am pleased to say that the UK National Screening Committee is now considering how to optimise bowel cancer screening using those two evidence-based testing methods, namely bowel scope screening and FIT. It will advise on the optimal strategy—the hon. Gentleman rightly used that term—for England, this summer. To inform that advice, it ran a consultation, which ended on 9 April. That focused on whether the current evidence supports a change to the current tests approved for use in bowel screening programmes. In particular, it considered whether an optimal bowel screening programme should use both BSS and FIT. Both those screening methods require significant numbers of highly trained people and significant amounts of hospital resources in the NHS. With the introduction of FIT, it is therefore timely to carry out further work to decide the best combination of tests for the English programme; that includes the issue of sensitivity. I know that there is a lot of debate in the clinical community about the range and the number of people affected. We must get that right.
I am pleased that as part of its deliberations, UKNSC will also consider the most appropriate age at which FIT screening will start. It would be wrong of me, however, to pre-empt its recommendations or, as the hon. Member for Eastbourne said, to announce an exclusive from Westminster Hall. However, it is being considered and Ministers, including the Secretary of State, take a close interest. That is as clear as I can be. We are clear that recommendations must be achievable, so the availability of high-quality follow-on tests—colonoscopy and pathology—will be central to ensuring that we can turn the benefits of a better test into thousands fewer people getting and dying from bowel cancer. I am asking NHS England to consider that carefully. It knows of my clear interest in the matter.
I am thankful that survival rates are improving year on year, with about 60% of bowel cancer patients now surviving for five years or more, compared with about 25% 40 years ago. That is a significant change. As hon. Members have said, early diagnosis is vital—for all cancers, but certainly for bowel cancer—which is why the independent cancer taskforce included driving a national ambition to achieve earlier diagnosis among its six strategic priorities in the cancer strategy for England, which I am passionate about implementing. We remain on track to deliver that priority and to deliver every one of the 96 recommendations in the strategy by 2021. We are, of course, thinking about post-2021 as part of the long-term vision for the NHS, which the Prime Minister spoke about at the Liaison Committee recently.
We hope that the introduction of FIT as the primary test in the bowel cancer screening programme later this year will further enhance the drive towards early diagnosis and ensure that we catch more cases of bowel cancer early and allow for better treatment outcomes.
NHS Blood Cancer Care
Nick Thomas-Symonds Excerpts(6 years, 3 months ago)
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Henry Smith (Crawley) (Con)
I beg to move,
That this House has considered blood cancer care in the NHS.
Mr Wilson, it is a pleasure to serve under your chairmanship.
Like many people in this room today, I have lost a family member to blood cancer. Five and a half years ago, my mother died from acute myeloid leukaemia, also known as AML, an extremely short time after diagnosis. I have been touched by the many stories of families in Crawley and nationwide who have contacted me to share their own experiences of losing a family member to blood cancer. With conditions such as AML, there is an incredibly short time—sometimes just a matter of days—between being diagnosed and this form of blood cancer taking a life.
It was with those stories in mind that in 2016 I was pleased to set up the all-party parliamentary group on blood cancer. I place on the record my thanks to all colleagues, including those who left Parliament last year, for their work in getting the group up and running and in starting our inaugural inquiry on NHS blood cancer care. While the inquiry, held last year, and the report, to be launched in the Palace of Westminster right after the debate, focus on the implementation of the cancer strategy for England, we are keen to learn from examples of good practice in Scotland, Wales and Northern Ireland and have made approaches to the devolved Administrations accordingly.
Nick Thomas-Symonds (Torfaen) (Lab)
I would like to talk about a Welsh example: my young constituent Emily Clark, who was diagnosed at 16 and subsequently sadly passed away. During the period of her illness, her work in setting up the RemissionPossible initiative resulted in 4,000 more people joining the stem cell donor register. Will the hon. Gentleman praise Emily, and her mother Donna Dunn, who is continuing the work?
Henry Smith
My condolences to Emily’s family. There are all too many examples of young people passing away from blood cancer. I pay tribute to Emily’s mother for a fine legacy. It is sad that a young life has been lost to this condition, but wonderful that so much good work has been done as a result. I would be grateful if the hon. Gentleman passed on my best wishes to them.
Henry Smith
The hon. Gentleman is entirely correct. I am sorry to hear of his family’s experience. The symptoms can often be confused with others, which is why it is important, as was said in an earlier intervention, to stress that GPs should be given the support and the backing to raise awareness of the symptoms. A simple blood test should be offered to assist with early diagnosis for people displaying one or more of these signs, and GP education and training needs to be improved to increase knowledge of blood cancer symptoms.
As was said in an earlier intervention from my hon. Friend the Member for Henley, unlike solid cancer tumours, blood cancer cannot be surgically cut out, and the experience of blood cancer patients is therefore very different from that of those with other forms of cancer. Blood cancer patients are not currently receiving the treatment and support they deserve, which is one of the key points that I hope the Minister will take from the debate.
Nick Thomas-Symonds
Does the hon. Gentleman agree that one of the keys to treatment is having as many people as we can on the stem cell donor register? There are 660,000 selfless individuals on it at the moment. We should thank them and also encourage those between the ages of 16 and 30 to sign up.
Henry Smith
The hon. Gentleman is again absolutely correct. The stem cell register is vital to our addressing this condition going forward and beating blood cancer in the future. We would all do well to echo his message.
Medicines Regulation
Nick Thomas-Symonds Excerpts(6 years, 5 months ago)
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Helen Goodman (Bishop Auckland) (Lab)
I beg to move,
That this House has considered the future of medicines regulation.
What a pleasure it is to see you in the Chair, Mr Davies. I am very pleased that you have been elevated to the Panel of Chairs. Yesterday, the European Parliament agreed to move the European Medicines Agency from London to Amsterdam. Today, we are asking the Minister to tell the British Parliament what will happen to medicines regulation in this country after we have left the European Union. My concern arises from the fact that I have a GlaxoSmithKline plant in Barnard Castle in my constituency that employs 1,200 people. Winston Churchill decided that production should take place in the middle of the Durham countryside, so it would not be hit by Hitler’s bombs; I certainly hope that it will also survive the Government’s Brexit.
Nick Thomas-Symonds (Torfaen) (Lab)
I congratulate my hon. Friend on securing this timely and important debate, and declare an interest as the chair of the all-party parliamentary group on off-patent drugs. Does she agree that, irrespective of what happens with the Brexit negotiations, the Government should guarantee that any patient who needs access to drugs will not wait any longer as a result of Brexit?
Helen Goodman
In one sentence, my hon. Friend gets to the nub of the issue; I will probably take 20 minutes to reach it. He is absolutely right. The problem is that the Government did not make a plan, and as yet have not resolved how they will regulate medicines from 1 April 2019. I have been asking about that for a year. We have had no clear explanation, no policy statement, and no impact assessment. The Government refused to debate the matter in the course of the legislation for triggering article 50. We have not been able to debate it properly as part of the scrutiny of the European Union (Withdrawal) Bill, which is in Committee today, in parallel with our debate.
We are therefore extremely interested to hear what the Minister will say, especially as two months ago there were leaks from the Department of Health that the Secretary of State was flirting with the idea that we should leave the EMA and join the American Food and Drug Administration. I was particularly surprised that that was being floated, because the Association of the British Pharmaceutical Industry has said consistently that it thinks that we should be aligned with EMA standards. Alignment with Europe on regulation of medicine does not simply mean having the same rules on exit day; it means having a mutual recognition agreement with the EMA, and continued alignment of future regulations as they change, which they inevitably will.