Health and Social Care Bill

Steve Brine Excerpts

Monday 31st January 2011 Commons Chamber

[Mr Steve Brine (Winchester) (Con)]

I should like to say that it is a pleasure to follow the hon. Member for Eltham (Clive Efford), but I think that those watching the debate can make up their own mind about what they have just heard. I speak as a Conservative who loves the NHS; I am sorry to disappoint the hon. Gentleman in that regard. His comments were a great example of the knockabout that we hear in the House, which the public hate so much. I remind him that every day people die, work in and love the NHS, and they deserve better than what we have just heard.

As ever, time is short, so I will not detain the House. I want to focus on the fight against cancer and to share with right hon. and hon. Members the way I view these reforms. The Bill promises to take day-to-day power and responsibility out of the hands of Ministers and managers and to put it firmly into the hands of GPs. This means that decisions about NHS care will move closer to the patient and away from the remote organisations of which few people whom I and others represent have heard. Even fewer of those people would have the first idea what those organisations do, let alone how to contact them.

In an extremely tough financial climate, even for the NHS, we are talking about removing the bureaucracy of the primary care trusts and strategic health authorities and investing that money in patient care. As I have said in my constituency more times than I care to remember, I am concerned only about protecting the services that my constituents rely on. If they are threatened, I will dust down the placards, but I am not going to rummage around in the shed for one that reads, “Save the PCT”; I do not think that “Save NHS Hampshire” trips off the tongue.

The concept of reforming our NHS so that services and decisions come closer to patients is not one that I find disturbing, and I wish that we could at least start the process of debating this Bill by agreeing on that. However, nothing I have said thus far means that I and many others do not have questions about the next few years as we move to full GP consortia commissioning. Some Members will know that I co-chair the all-party group on breast cancer. We have worked hard since the publication of last year’s White Paper to produce a response. In October we held a health inquiry session at Breakthrough Breast Cancer’s “Westminster Fly-In”. Breakthrough’s CAN members and parliamentarians highlighted the breast cancer patient perspective and focused, as ever, on our vision of a future free from the fear of breast cancer.

The public health approach outlined in part 2 of the Bill will encourage people to be much more proactive about their health. I feel strongly that encouraging greater breast awareness is and must be an important part of that. Most breast cancers are found by women who notice a change, take the initiative and subsequently visit their GP. There is strong evidence that being breast aware—knowing the signs and symptoms of breast cancer and the importance of early treatment—and attending NHS breast screening appointments are two of the most important factors in breast cancer survival in the UK. The third is, of course, treatment. When it comes to screening, we have to do much better in this country. This change in public health must give a strong impetus to local authorities, many of which are big employers of women, as well as to GPs and local employers to come together and make sure that we do better. Women should be given time off work to attend breast screening appointments and providers must recognise that access to screening that works does not always mean nine-to-five, Monday to Friday. That is something we have discussed in our group many times.

Locally, GPs should be encouraging women to be much more breast aware and should make sure that no-shows for screening appointments, which are sometimes as high as 50% in my area, are followed up and that those women are given the support they need to get there. As I have said before, the move to pure GP-based commissioning will sharpen efforts in that regard through much more sophisticated data management and use of the lists that are currently poorly used.

Much has been said in the House and outside about the UK’s low placing in the cancer league tables, and it is often the Eurocare series, which the Secretary of State mentioned, that shows that survival for the four most common cancers in our country are lower than in the rest of Europe. As Cancer Research UK said to me and all hon. Members in its briefing ahead of today’s debate,

“commissioning of cancer services is not as good as it could or should be”,

and I know that Cancer Research UK welcomes, as do I, the recently published cancer strategy.

That superb organisation, Macmillan, tells us that more than 2 million people are living with or after cancer in this country, and by 2030 there will be 4 million. As we all know, cancer is a set of 200-plus different diseases, most of which have highly complex care pathways. I have concerns, as others have said, about the low level of GPs currently with a specialism or particular interest in cancer compared, for instance, with diabetes or mental health.

I urge Ministers, as did my hon. Friend the Member for Basildon and Billericay (Mr Baron) so eloquently a moment ago, to look again at the transition period from 2012 to 2014 to protect the cancer networks until GP consortia are in a position to make better decisions about the support and expertise they require. Solid action from the Government in this regard would reassure many cancer charities, patients and Members.

Finally, we are in danger of presenting the argument as “all that exists in the current NHS is bad or failing,” versus “all is sacrosanct and we cannot touch it.” Neither is true, in my opinion. Let us keep what works, protect it and strengthen it. That is what we are about, but let us remove what does not work and be brave enough to replace it. Do we want to give the Bill a Second Reading, find out more and examine it further, or do we want to turn against change and take the easy road? That would be the real risk. I will support the Bill in the Lobby tonight.