Children’s Cancer Care: South-East

Stephen Hammond Excerpts

Wednesday 13th March 2024 Westminster Hall

[Munira Wilson]

To pick up where we left off, before we look at the evidence and arguments for keeping this precious service at St George’s, I want to raise the serious questions that have been highlighted around the decision-making process that has brought us to this point. NHS England first publicly expressed its preference for the Evelina proposal at the start of last year, long before it had even launched its public consultation. This has raised concerns that NHS England has created a process in which the views of patients, clinicians and patients’ families have not been seriously listened to and taken into account.

[Stephen Hammond (Wimbledon) (Con)]

The hon. Lady is quite right. I congratulate her on this debate. I have spoken to the Department and NHS England about the process, as there have been real concerns about the scoring and whether that has been based on evidence or preference. There is also real concern that clinical outcomes are not being given quite the highest priority they should be, which will be key if we are looking at the cancer survival rates for young children.

[Munira Wilson]

Absolutely. There is the point about transparency, the fact that it has been predetermined, and the point about outcomes, which I will touch on briefly in my speech.

In a consultation response submitted by Healthwatch Richmond and Healthwatch Merton, the groups concluded that the consultation design was insufficient because it “fails the legal test” for consultation and appears to have no prospect of altering the decision to award the new service to the Evelina. I am therefore keen to hear from the Minister what assessment her Department has made of how NHS England has carried out this process. Further, can she give an absolute assurance to Members that the decision made tomorrow will have been made fairly?

Regardless of the way in which it was carried out, the consultation received over 2,500 responses from affected groups, such as patients, their families, clinicians and professional organisations. Those voices must be heard, and I will seek to ensure that they are. One of the most important themes raised was specialist knowledge and experience of children’s cancer care. It is undeniable that St George’s has invaluable experience to offer: it has already been treating child cancer patients, in partnership with the Royal Marsden, for over a quarter century. Not only is that experience highly valued by patients and their families, but it has resulted in excellent outcomes, as the hon. Member for Wimbledon (Stephen Hammond) said. According to national data collected from intensive care units, St George’s children’s cancer intensive care outcomes are the best for a large unit in the UK. All the institutional knowledge, specialist expertise and professional networks that have been built over decades risk being lost if cancer care were to move away.

Another key theme that was repeatedly mentioned in responses was that the centre should be conveniently located. Travelling via public transport with a vulnerable and immunosuppressed child is both stressful and very risky, so patients and families have repeatedly stressed that a new centre must be easily accessible by car. Anyone who has lived or worked in central London knows how difficult and unpredictable driving in and out of central London can be. However, located in Tooting, St George’s is much easier to access, and has strong road links to parts of the south-east. That is particularly appreciated by those travelling from afar.

Finally, responses highlighted the importance of having most specialisms on a single site. One service that is particularly vital to child cancer patients is neurosurgery, which is required by one in four of them. Currently, out of the two options, only St George’s offers neurosurgery. According to the Children’s Cancer and Leukaemia Group, the fact that the Evelina does not currently provide cancer surgery is not an issue that can be resolved quickly, and relocating surgery services comes with associated risks to both patients and staff. In its consultation response, the British Association of Paediatric Surgeons notes that where that has happened in previous cases, a lack of support and structure has resulted in staff “leaving the relocated unit.”

Further, clinicians have shared concerns that, if children’s cancer care were to move from St George’s, other services could be disrupted, which may create unforeseen consequences for the many areas served by St George’s. By contrast, placing the new centre at St George’s would ensure that NHS services are not overly centralised, but rather evenly distributed across the region. What assessment have the Government made of this crucial clinical evidence and the associated potential risks to the cancer service and other children’s services?

The decision is such an important one because at its heart are children with cancer: a group who have dealt with the most challenging and frightening of circumstances so early on in their lives. In many cases, the children can go on to lead full lives. One such example is Zoe, a teenager who was treated by St George’s when she was just four. She has since recovered and now has dreams of becoming a children’s nurse. She says:

“I’m so grateful to the paediatric staff at St George’s Hospital for looking after me, and for always being there for me throughout my life. Thank you to the nurses who told me to follow my dreams and never give up.”

The experience, expertise and convenience that St George’s offers are extremely valued by patients and those who care for them. That must be reflected in the final decision that is made tomorrow, and that is why it is so crucial that no doubt is cast over whether the decision is being made fairly and transparently. Yet, as I have set out, the way that NHS England has handled the process means that it is very difficult to make that judgment at this point.

Last week, together with my right hon. Friend the Member for Kingston and Surbiton (Ed Davey) and my hon. Friend the Member for Richmond Park (Sarah Olney) I wrote to the Secretary of State requesting that she uses her formal powers to call in this decision should NHS England press ahead tomorrow with awarding the children’s cancer service to the Evelina; and a group of cross-party council leaders from across south-west London and Surrey have done the same.

I conclude by urging the Minister in the strongest possible terms to join that call and to support us in saying that this decision must be called in tomorrow if the Evelina is chosen, because of the serious process and clinical arguments that I have laid out today.

--- Later in debate ---

[Elliot Colburn (Carshalton and Wallington) (Con)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate the hon. Member for Twickenham (Munira Wilson) on securing this debate. As a constituency MP and chair of the all-party parliamentary group on cancer, I am particularly pleased to take part in today’s debate, and I absolutely agree with what has been said so far. Like the hon. Members for Twickenham and for Richmond Park (Sarah Olney) and the right hon. Member for Kingston and Surbiton (Ed Davey), my hon. Friend the Member for Sutton and Cheam (Paul Scully) and I have also written to the Secretary of State requesting that this decision be called in.

I do not want to repeat much of what has already been said, as many other hon. Members wish to speak, but I want to emphasise a few points, particularly the fact that paediatric cancer is incredibly rare and that treating it is a highly specialised service that the NHS provides. I understand that the NHS is concerned about co-locating the deliverables of that care on one site, but as has already been pointed out, and as St George’s keeps saying, that hospital is standing ready to be able to do that. St George’s is investing a lot into its campus, as is the University of London. St George’s stands ready to provide what parents are asking for, and it has 25 years of specialist experience, alongside the Royal Marsden, to do so. Therefore, it would be a mistake to take the decision to move the children’s cancer service to the Evelina.

Like the hon. Member for Twickenham, I am confident that the Evelina is a fantastic hospital with amazing staff and that it does amazing work, but this is about clinical deliverables.

[Stephen Hammond]

My hon. Friend is right: the Evelina is a great hospital. The other point about St George’s is that it not only has a specialism in paediatric cancer; it also has a wider specialism in neonatal and paediatric services. There is a concern that those would be lost if the co-location was based at the Evelina.

[Elliot Colburn]

My hon. Friend is absolutely right. That is a key concern, which is precisely why we want to avoid that happening.

It is also worth stating that St George’s does not just have 25 years of experience. The data really does speak for itself. It has been rated outstanding by the Care Quality Commission for delivering cancer services for children. St George’s proposal is to consolidate the primary treatment centre on to the St George’s site in a new state-of-the-art children’s cancer wing, delivering outstanding facilities to match the outstanding care already provided. The services that matter most for children with cancer are already available at St George’s. For some 80% of children with cancer, St George’s campus can already provide or is poised to provide key treatments that the Evelina will have to take time to develop.

Through its experience and expertise, St George’s can already deliver what parents say they want. The hospital is reliant on that experience and incredibly rare expertise. Only about 20 paediatric oncology surgeons with that uncommon skill are registered in the UK, and three of them are already at St George’s. Parents have consistently said they would prefer the children’s cancer centre to be outside the city centre, with better parking provision; again, that is something that St George’s is already able to provide. We do not need to wax lyrical about how awful the traffic is in central London—we say that every day anyway as we try to get into work.

Consolidating the children’s cancer services at St George’s will be easier and less costly for the NHS to deliver. A large part of the service is already there and the existing non-clinical space can, at relative speed, be transformed into a new state-of-the-art cancer centre. But beyond the financial impact of the individual institution we are talking about, there will be wider costs to the NHS as a whole if it is relocated. St George’s has estimated those costs to be around £2.5 million in the first year alone if the service is moved. That could have an impact on other children’s services, and indeed wider services, that are at St George’s at the moment.

Children’s cancer is distressing, but it is also, from a clinical perspective, not neat or stand-alone and addressing it requires incredible skill. The expert staff supporting these children could end up leaving St George’s Hospital and that would weaken the multidisciplinary teams who are there.

Now, with the increasing investment in the campus—with City, University of London, and St George’s, University of London, having agreed to merge and develop ambitious plans for the campus—the opportunities are stronger still. That is not to mention the expansion of the Institute of Cancer Research in the London Borough of Sutton, which we are so excited to see, and the development of a new acute facility. We have the ability to turn south-west London into a world-leading hub for cancer services, beating the United States in a sense. This is incredible news; we need to be grasping this opportunity, so taking the service away would be a huge mistake.

Given all this, I fail to see a compelling reason why the Evelina would provide better care for children in my constituency of Carshalton and Wallington and further afield. Accordingly, I request that the Secretary of State consider using her call-in powers to review the decision on a reconfiguration if that is the decision taken tomorrow.

Oral Answers to Questions

Stephen Hammond Excerpts

Tuesday 17th October 2023 Commons Chamber

[Will Quince]

The hon. Gentleman is hugely passionate on this subject. As I said, integrated care boards are responsible for meeting the health needs of their individual populations, and that includes capital allocation. The 2021 spending review set aside £12 billion in capital funding, and since 2016 over £160 million has been invested in radiotherapy equipment, but of course I want to see more investment in this important technology and the necessary upgrades across England. I very much look forward to our meeting, where we can discuss that further.

[Stephen Hammond (Wimbledon) (Con)]

11. What recent progress NHS England has made on implementing its paediatric cancer strategy for London.

[The Minister for Health and Secondary Care (Will Quince)]

Following Professor Sir Mike Richards’s review, it is now a national requirement for all paediatric cancer services to be co-located with a children’s intensive care unit. The current principal treatment centre for south London and the south-east does not meet those requirements. NHS England has launched a reconfiguration process to identify a new location, which includes a public consultation. The future centre will achieve world class outcomes for children with cancer. I would be very happy to meet Members whose constituents may be affected to discuss that further.

[Stephen Hammond]

I am grateful to the Minister for that offer, because that would have been part of my question.

[Mr Speaker]

Then you don’t need to ask it.

[Stephen Hammond]

But in true style, Mr Speaker, I was hoping for two bites at the cherry. [Laughter.]

In my recent discussions with the management of St George’s Hospital, one concern about the consultation is that the specialist paediatric cancer surgical unit based at St George’s may be lost if the current proposal goes through. That would potentially affect real outcomes for a number of children. Will the Minister have a look at that and explain to me whether he is concerned about the current scoring by the NHS?

[Will Quince]

I thank my hon. Friend for his supplementary question. While I cannot pre-empt the outcome of the consultation, which closes on 18 December, I can assure him that there will be no sudden changes in the way patients receive their care. Any move will of course be carefully planned with the full involvement of current teams, and clear information will be provided for parents and families. NHS England will help as many experienced staff as possible to move to the future centre, and I can reassure my hon. Friend that that centre will build on all the strengths of the existing service and provide the best quality of care for patients.

Hospice Services: Support

Stephen Hammond Excerpts

Wednesday 14th June 2023 Westminster Hall

[Paul Holmes]

I thank my right hon. Friend for her intervention. She tempts me to talk about issues that I will come to later in my speech—it is only a couple of pages away, I assure you, Ms Nokes. She is right that hospices have not been included in the energy support given to other charities, even though their services are energy intensive due to the equipment they use. Her point is well made and will be recognised in her constituency.

The energy bill for Mountbatten has risen by an eye-watering £250,000—a fivefold increase—and there has been no additional financial support. One might think that that is surely as high as prices can go, but a London-based hospice has forecast that its energy costs will increase by almost £300,000 a year due to inflation pressures. A north London hospice told Civil Society Media that it faces an energy bill of £433,000 in 2023-24, based on predicted energy costs.

Adult hospices are not the only ones affected by this issue. As my hon. Friend the Member for Winchester (Steve Brine) said in his letters to the Department of Health and Social Care, there is also uncertainty about the children’s hospice grant—a vital source of funding that represented an average of 15% of children’s hospices’ income in 2021-22.

[Stephen Hammond (Wimbledon) (Con)]

My hon. Friend is absolutely right about the pressures on the sector, which also affect St Raphael’s in my constituency. The Government have been generous with the children’s hospice grant, but it runs out next year, and the lack of certainty is the problem. We would really like the Minister to stand up and say that she will renew the grant after 2023-24, which would provide a huge amount of certainty for the sector.

Urgent and Emergency Care Recovery Plan

Stephen Hammond Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

As the hon. Gentleman will know, the additional funding that the Chancellor announced in the autumn statement will lead to an uplift in health funding for Northern Ireland through the Barnett consequentials. On the flexibility within that, the hon. Gentleman will know that I agreed flexibility when I was Chief Secretary; it will of course be for Treasury colleagues to look at the requirements for ongoing flexibility within Barnett consequentials.

[Stephen Hammond (Wimbledon) (Con)]

I warmly welcome what my right hon. Friend has said. He is right to recognise that one of the long-term impediments to discharge is the disconnect between the NHS and social care and local authorities. Will he confirm that, to ensure that the additional money is well spent, the integrated care boards will be not only responsible for the establishment of the hubs and extra care packages but properly monitored and held responsible for their performance and for generating value for the extra money that is being put in?

[Steve Barclay]

As a former Minister in the Department, my hon. Friend speaks with great experience on these matters. He is right that the crux of the plan is now in its delivery. As I alluded to in my statement, a key component of that is more transparency in the data so that he and colleagues throughout the House can hold to account not only the ICBs but the local authorities. We need to bring those two datasets more closely into alignment.

Oral Answers to Questions

Stephen Hammond Excerpts

Tuesday 1st November 2022 Commons Chamber

[Helen Whately]

Care workers should be properly paid for what they do, the skills they bring and the compassion they bring to their work. That includes being paid at least the national living wage, which was increased by 6.6% in April. I am also increasing the Care Quality Commission’s oversight of local authority commissioning, and we have created a £1.36 billion market sustainability and fair cost of care fund, which will ensure that local authorities always pay a fair cost of care.

[Stephen Hammond (Wimbledon) (Con)]

Early access to scans and testing can prevent more serious illness, improve health outcomes, reduce health inequalities and reduce pressure on the acute sector. Will my right hon. Friend prioritise increasing the number of diagnostic centres across the United Kingdom and support my campaign for the establishment of one in Wimbledon town centre?

[Will Quince]

My hon. Friend is right to say that we are supporting the NHS to deliver up to 160 community diagnostic centres by March 2025, 89 of which are already operational, as part of £2.3 billion of capital funding, delivering around 2 million additional scans so far. Community diagnostic centres are closer to people’s homes in the hearts of communities, and they will help us not just to reduce and bust the covid backlogs but to tackle health inequalities.

Health and Social Care Leadership Review

Stephen Hammond Excerpts

Wednesday 8th June 2022 Commons Chamber

[Sajid Javid]

My hon. Friend rightly never misses an opportunity to make the case for his local hospital. I have heard him carefully and I am happy to meet him to discuss it.

[Stephen Hammond (Wimbledon) (Con)]

I thank my right hon. Friend for his statement and for the report. Recommendation 4 talks about a standardisation of appraisal. Does he agree that cutting out variation in performance is key, and will he therefore confirm that the recommendations from Tim Briggs’s “Getting It Right First Time” report will be embedded in that standardisation procedure?

[Sajid Javid]

I agree with my hon. Friend: that recommendation for a standard appraisal system, which, remarkably, does not exist at the moment, is of particular importance, like all of the recommendations. I agree with the emphasis he puts on that.

Public Health

Stephen Hammond Excerpts

Tuesday 14th December 2021 Commons Chamber

[Sajid Javid]

I do need to plough on, but I will take some interventions a bit later.

For the reasons that I have set out, I believe that the responsible decision is to move to plan B in England, drawing on the measures that we have held in contingency to give more time to get those boosters into arms. These are not steps that we would take lightly. I firmly believe in individual liberty and that curbs should be placed on our freedoms only in the gravest of circumstances. Not only that, but I am, of course, mindful of the costs that restrictions can bring to the nation’s health, to our education and to the economy. So it is vital that we act early and we act in a proportionate way, doing whatever we can to build our defences and to preserve greater freedom for the long term. I am confident that these measures are balanced and proportionate, and that they still leave us with far fewer restrictions than are in place in most countries in Europe. I can assure the House that we will keep reviewing the measures that we have put in place and we will not keep them in place for a day longer than we have to.

[Stephen Hammond (Wimbledon) (Con)]

Specifically on the regulations, given the regulation on refusal of entry, the small number of venues and the large number of exemptions and the lack of protection for double-vaccinated people, why not make it a necessity for everybody to show a lateral flow test, rather than showing double vaccination?

[Sajid Javid]

If my hon. Friend allows me, I will come to that point shortly.

I said a moment ago that we will not keep measures in place for a moment longer than we need to. For example, now that there is community transmission of omicron in the UK and that omicron has spread so widely across the world, the travel red list is less effective in slowing the incursion of omicron from abroad, so I can announce today that, while we will maintain our temporary testing measures for international travel, we will be removing all 11 countries from the travel red list, effective from 4 tomorrow morning.

I wish to turn to the details of some of the regulations before the House. Regulation No. 1400 proposes extending the use of face coverings. In October, UKHSA published an updated review of the evidence on the effectiveness of face coverings and concluded that there is good evidence that they can help to reduce the spread of covid-19 when worn in the community. The regulation proposes extending the legal requirement to most indoor settings, including theatres and cinemas. They are not required in places where it would not be practical—for example, in hospitality settings such as cafés, restaurants, pubs, nightclubs or other dance venues, or in exercise facilities such as gyms.

Regulation No. 1416 would mean that anyone over 18 would need to show a negative lateral flow test to get into a limited number of higher-risk settings, unless they were double vaccinated. As I announced to the House yesterday, however, in the light of new data on how vaccines respond to omicron, our intention is that boosters will be required instead of two doses as soon as all adults have had a reasonable chance to get their booster jab.

Covid-19 Update

Stephen Hammond Excerpts

Thursday 21st October 2021 Commons Chamber

[Maggie Throup]

The Government have clearly laid out our autumn and winter plan, and that is what we are sticking with.

[Stephen Hammond (Wimbledon) (Con)]

I thank my hon. Friend for her statement today and her confirmation of the Government’s plans. I particularly welcome the £162.5 million for social care. Can she confirm that that will also have a package for discharge, as well as extra staff, because that will then allow the NHS to concentrate on fighting the backlog and this disease, rather than having the beds blocked?

[Maggie Throup]

There will be further details of this additional funding shortly, but it will be to encourage more people to become care workers and to support those in place already, so I am sure it will achieve exactly what my hon. Friend has requested.

Health and Care Bill

Stephen Hammond Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[Stephen Hammond (Wimbledon) (Con)]

I want to make three quick points in my short contribution today.

The NHS is a great institution because it has wonderful, dedicated and selfless people working in it. That was recognised by the Department in the people plan, on which clause 33 builds. I had wanted to make other comments about the workforce but, frankly, they have made more ably by my right hon. Friend the Member for South West Surrey (Jeremy Hunt). I support exactly what he said. I encourage the Minister to listen to his comments about the need for a long-term plan and perhaps for the duty to be shortened in time, as well as about Health Education England. All my right hon. Friend’s comments were admirably sensible, as we have come to expect.

I welcome the new powers of direction, and I want to counter some of the criticism in the House about them. The newly merged NHS England and NHS Improvement have a range of new functions. Despite what the shadow Secretary of State, the right hon. Member for Leicester South (Jonathan Ashworth), said, it is clear that the powers of direction will apply only if they are in the public interest and if they relate to the functions. Given the new scope and scale of those functions, it seems right that accountability—and possibilities for the accountability needed in the future—be put in place.

Likewise, I encourage the Secretary of State not to listen to criticisms of political expediency and political interference with respect to reconfiguration. All too often, it is not political expediency but political acrimony that trumps political need. All too often, reconfiguration that would benefit our constituents and the health of this nation is held up. Far from meaning that every bedpan in the NHS will be looked at, reconfiguration is a sensible move. Quite rightly, the reconsideration will still be done by the Independent Reconfiguration Panel, and it is right that if the Secretary of State has the chance to look at those reconfigurations earlier, it should too. I strongly encourage my right hon. Friend to ignore the criticism and to proceed with that power.

My third point is on the prevention aspect of the Bill, which I warmly welcome. Obesity is a UK-wide health crisis. More than 60% of adults in the United Kingdom are above a healthy weight. Some of the measures may well be discussed in Committee, and there may well be some changes in Committee, but the thrust of the measures is correct. We in this country need to recognise that health outcomes and inequalities are affected by not tackling prevention. The Bill starts that; I warmly welcome it, and I will be happy to support it.

Covid-19 Update

Stephen Hammond Excerpts

Tuesday 6th July 2021 Commons Chamber

[Sajid Javid]

The Government have made more than £90 billion of additional funding available to deal with the consequences of the pandemic. Much of that has gone to the NHS and other parts of the healthcare system, and it is helping in every aspect, including with those sadly suffering with long covid. Younger people are, of course, affected by the virus—no one could pretend otherwise—but the hon. Lady will know that they are less affected and impacted than older people in their communities. That is why older people have been the priority in the vaccination programme. One of the reasons that the date of 19 July was set was to allow every adult to get their first jab. Yesterday I announced the decision to shorten the time period between jabs from 12 weeks to eight weeks, so that some more people, including all the younger people to whom the hon. Lady referred, can get the full protection of a double dose by September.

[Stephen Hammond (Wimbledon) (Con)]

May I thank my right hon. Friend for his statement today? He will know that the normal winter preparedness programme is just about to start. Will he confirm whether he will examine the medical evidence for vaccinating people under the age of 18 as part of this year’s programme? What extra measures might he also put in place regarding social care and discharge, to ensure that the pressure on beds, which normally increases, is taken care of this winter?

[Sajid Javid]

My hon. Friend is absolutely right to raise the issue of the normal winter pressures. The measures that we had for the pandemic mean that this winter there will be less immunity from flu and other viruses that tend to come around in winter, so we are actively making plans in that regard. There were already plans in the Department when I arrived. I am reviewing those plans and this matter will be a priority.