Improving Cancer Outcomes

Debate between Paul Burstow and John Glen

Thursday 5th February 2015 Commons Chamber

[John Glen (Salisbury) (Con)]

It is a great pleasure to contribute to this important debate, because so many of our constituents are eager for us to grasp the underlying issues relating to cancer, to explore how to deal with the inadequate service they sometimes receive, and to address some of the challenges we will face in future. As has been mentioned, Cancer Research UK said this week that one in two people will be diagnosed with cancer. As we heard in the moving testimony from my hon. Friend the Member for Filton and Bradley Stoke (Jack Lopresti), sometimes that diagnosis comes out of the blue; it is random and unrelated to previous medical history. We need to recognise that, but we also need to look at the public health challenges. I will therefore focus my remarks on two points: first, the important role that public health has to play; and secondly, how we can ensure that patients have access to timely diagnostic procedures, regardless of where they live.

Four in 10 cancers are thought to be preventable, which is why it is crucial that we view prevention as one of the best cures and work relentlessly to pursue what is required to reduce the number of people who suffer from cancer. We need to work at changing attitudes to prevention across the population, and keep pressing the message that cancer is not always a disease of chance. The 2011 strategy rightly placed an emphasis on that and on delivering a “whole society” approach. In my constituency, NHS nurses run an excellent annual fair to raise awareness of the link between cancer and factors such as smoking, diet and lifestyle. That proactive initiative by a group of local nurses offers a targeted solution. It is combined with clear national campaigns, such as the successful Be Clear on Cancer campaign, which enable us to reach as many people as possible.

I become very weary when Ministers bring forward sensible measures for dealing with some of the drivers of cancer, only to hear an outbreak of great ideological proportions about what we should be doing. It is undoubtedly critical that we continue the vital research into new treatments, but we must also remember that reducing the prevalence of smoking in the UK by just 1% could prevent 3,000 cases of cancer a year. I therefore welcome the decision to introduce standardised tobacco packaging, at a time when around 600 children start smoking every year. I welcome that on the basis of evidence and as a pragmatic decision, but I also want to challenge the assumption that somehow everyone has a free choice about whether to start smoking. I think there are many communities, in my constituency and up and down the land, where peer pressure to start smoking plays a crucial role. If there is anything we can do to reduce the attractiveness of smoking—which we know is so addictive and distinct from other health pressures—we should get on and do it.

Next, I want to highlight the crucial role of GPs. They are the gateway to wider diagnostic and treatment services, and we need to invest in them. We must invigorate their leadership and role in guiding patients to healthier lifestyles and earlier diagnosis, and therefore to earlier treatment and better outcomes. In 2011, as part of the cancer outcomes strategy, the Government provided £450 million of funding to help GPs access diagnostic tests earlier. The benefit of this investment is clear and will save about 12,000 extra lives every year. However, there are significant inequalities in referrals for diagnostic tests. There is a ninefold variation across GP practices in referring patients for the CA 125 test to identify ovarian cancer, and a fivefold variation in referrals for the PSA test used to identify prostate cancer. I visited a group of GPs in my constituency who were somewhat frustrated when they read the comments of the Secretary of State about wide disparities in diagnostic rates. However, this is not about criticising GPs but about recognising that we have unacceptable differences across the nation. NHS England has proposals to enable patients to self-refer for tests, and to establish multi-disciplinary diagnostic centres that allow patients to have several tests done at once. Those are welcome steps, as is the commitment from the Chancellor in the autumn statement to increase the proportion of funding allocated to GPs.

I pay tribute to the work done by charities across the UK to raise awareness and funds for research—in effect, to carry out life-saving interventions to ensure that even when forms of cancer are very rare, the best possible treatment is accessed. I know from my own modest experience—last week I was a blood stem cell donor—that Delete Blood Cancer UK, the Anthony Nolan Trust, and Love Hope Strength do an enormous amount of work to find matches for patients with blood cancer. On 17 March, we will hold another recruitment event in the House to get more people registered. I commend that to all Members present and to all colleagues. Only half the people in this country who have blood cancer find a match, so we can make a small contribution in that way.

I will conclude by focusing on a concern that I have deep inside me whenever we have a debate on the NHS. The fundamental dynamic is one where the supply of treatments and new procedures is ever growing, people are living longer and longer, and demand will increase. Everything we talk about relies on more money going into the NHS, whether that is more transparency, greater awareness of what cancer rates exist across the country in one year, or how we can differentiate the quality of outcomes for 85-year-olds and 65-year-olds. Wherever we know that inequalities and differences exist, there will be yet more pressure to fund more services and more work. We can try to counter this through bigger public health campaigns and greater awareness of how to live—how not to eat, smoke or drink too much—but we also need to be honest about what the NHS can tolerate in this never-ending dynamic of increased supply of services, increased demand, and increased expectations. The right hon. Member for Sutton and Cheam (Paul Burstow) talked about our coalition partner’s commitment to put up £8 billion, and he welcomed the fact that there will be £2 billion more from April.

[Paul Burstow]

The hon. Gentleman is making the important point that we must debate the resourcing of the national health service. I made the point that removing inexplicable and unfair variation in access to early treatment for cancer will not cost more, but will save money.

[John Glen]

Absolutely, and I was going to come on to that. My fundamental point is that we must change the appetite of the nation for the NHS. Yes, we want it to be there when random events take place, but we must also recognise that if we are to promote better health, everyone in this country has a responsibility as individual citizens to reduce the demands on it. Unless we do that, every five-year forward view will imply further and further increases. We need to be realistic about the fact that, unless we make real changes, we as a country will be presented with profound challenges.