Cancer Treatment

Steve Brine Excerpts

Thursday 19th April 2018 Commons Chamber

[George Freeman (Mid Norfolk) (Con)]

May I say what a pleasure it is to follow the hon. Member for Dulwich and West Norwood (Helen Hayes)? She spoke with great passion and authority.

Thirty years ago this month, my father developed a cough and two months later he was dead from throat cancer. Being a man of that generation and age, he had never taken his health too seriously. He had never been for a check-up and had never received the care and treatment that would now follow, so what I say today is partly for dad. Eighteen months ago, I heard from a childhood friend of mine, Charlie Williams, that he had been diagnosed with the same form of brain tumour that Tessa has. Last week, Charlie posted on Facebook that he did not expect to see the next year out, so this is for Charlie.

I want to start by paying tribute to you, Tessa, for what you said in that remarkable speech. You spoke for us all, and to us all, and you spoke to the patients of this country not only with your condition, but with every other form of cancer—the patients I had a career working with who want us to make a difference for them. They want warm words, yes, and there were no words warmer than yours, Tessa, but they want us to turn the warm words into action. I believe that is the spirit in which we gather in this Chamber today, so this speech, Tessa, is for you.

Having come to this House after a career in medical research, it was my great privilege to be asked to lead, on behalf of the Government, a brain tumour research debate in Westminster Hall two years ago. I say this without a shred of criticism of my officials, who were simply doing their job, but the speech that I was given to read out said, as diligent speeches written by officials so often do, “There is no problem here. Move along. Everything is in good shape. Money is limited.” I read it with great respect, but I also listened to my colleagues with great respect, because unlike officials, we are sent to represent the people who put us here. As Tessa spoke for us all, I think it is our duty to speak always for the people who send us here.

I surprised my officials that day by announcing, as Under-Secretary of State for Life Sciences, that we would indeed create a taskforce to look into brain tumour research, never thinking that 18 months later my great friend the Secretary of State would announce £45 million of extra funding, in addition to the extra funding that he has recently announced on prostate cancer. That is a sign that, if we listen and speak on behalf of the people who put us here, we can make a difference, which is what Tessa wants us to do on her behalf and on behalf of all those people who send us here and the many patients around the country who are more impatient than anybody.

As you and patient colleagues know, Mr Speaker, I had a career in medical research. I want to highlight three important parts of this debate, the first of which is the new models of research that are coming—I was involved in my professional career in developing them. Secondly, I want to highlight the importance of patient voice in that model, and thirdly the importance of bold reforms to accelerate access to new treatments for our NHS patients.

My right hon. Friend the Member for Old Bexley and Sidcup (James Brokenshire) referred to precision medicine. The truth is that the life sciences sector that I joined 25 years ago is undergoing a profound transformation. The sector that I learned about was basically in the business of making blockbuster medicines that work for everybody. It would start with a theoretical drug target and, after 15 years, $2 billion on average and an 80% failure rate, drugs would be developed and eventually brought through regulation to the all-too-patient patients who were waiting for the approval.

In the new model, based on the genomic information that we have and phenotypic hospital records, we are able to look at a population and know which are likely to respond to the drug and which are not. We can start with the patients that we know are likely either to respond or to receive the disease, which means that we can start with the patient. With patient consent, we are able to start with their tissues, their genetics and their hospital records, and we are able not to end with a patient waiting patiently for the system to authorise a medicine, but with patients volunteering up-front to be part of that research.

It has been my privilege in my professional as well as my political career to work with inspired NHS clinicians around the country who have been leading this model. I pay tribute to the work of Cancer Research UK as an organisation, but also to Harpal Kumar, whose leadership of that organisation has been transformational.

We should be inspired by the fact that breast cancer is now 95% curable. We are within living, touching distance of cancer being a preventable disease or a treatable disease. More than 800,000 people are now living and working with cancer: it is not the death sentence that is used to be. We are in the midst of the most phenomenal revolution led by cancer. We should applaud those involved and learn the lessons of how they have managed to do it, largely through genomics and informatics.

I will share with the House a story that illustrates where the value in the new model lies. During my last project before I came to Parliament, I was working with an NHS clinician who, at the end of the meeting, pointed to a shelf in his office and asked me, “Do you think there is any value in that?” I said, “What is it?” He said, “It is all the data from a £25 million study of 250,000 women at risk of gynaecological cancer, funded by the Medical Research Council and Cancer Research UK.” I said, “What have you got?” He said, “All the blood samples, all the genetic samples, and their patient records.” “That should be the Ageing Biomarker company,” I said. “We should form a company around that asset, because it will help us to identify ageing biomarkers.”

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

May I place on record at this point the work that my hon. Friend has done to get us to this point? He is very modest in not saying too much about it himself—although he mentioned the Westminster Hall debate and the way in which he went out on a limb in response to it—but his understanding of the business and this fight has taken us a long way towards where we are today. I hope he can now conclude his speech as he needs to.

[George Freeman]

That is very kind. I take the hint from my hon. Friend.

The assets that we have in our health system are phenomenal assets to drive this research model, and I think it is our challenge to release them, but in order to do so, we need patient consent. However interventionist we are as Ministers, we as a system will not and cannot release data on tissues and genetics without patient voice. This research model requires us to empower patients and the charities that speak to and for them. I would like us to think about setting up disease portals in which patients can slide the consent bar on their phones, share their records, and help the charities to drive research.

Finally, we need to accelerate the uptake of innovative medicines in the system, which is what the accelerated access reform that I put together with my right hon. Friend the Secretary of State was all about. I dream of—I think we are within touching distance—a model in this country enabling the NHS to use its genomics and data to drive research. If we reform NICE to drive accelerated access, we give Tessa and the people for whom she spoke the legacy that they really want. We will make this country the leader not just of research, but of accelerated uptake of new treatments.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

On one of the hottest days for a long time, and certainly the hottest day of the year so far, being inside the House of Commons and listening to some of the speeches that have been made has been an absolute privilege. It has been an experience that I, as a Minister—let alone as a Member of Parliament—will remember for a long time.

Let me first thank the hon. Member for Croydon Central (Sarah Jones) for securing the debate. I thought she spoke brilliantly, and set the tone for the last two-and-a-bit hours. But we should not beat around the bush: we are all here primarily because of one person. That person is, of course, Baroness Jowell, who is present, sharing the Chamber with us, and whose strength and grace in the face of her illness have done so much to raise public awareness of the challenges of diagnosing and treating brain cancer. I do not have a long history of knowing the Baroness—in fact, I met her for the first time on Monday—but I am already well aware of her strength of character and her determination to make a difference in this latest campaign.

Like all Members, and especially, I suppose, as the current Minister responsible for cancer issues, I was captivated by the speech that Tessa made in the other place about her latest battle. Our debate today has been emotive and constructive, and I am grateful to the many Members who have had the opportunity to pay a similarly worthy tribute to Tessa’s bravery and determination in the House of Commons. For me—and many Members have said the same—perhaps the most memorable line of the Baroness’s speech in the other place was this:

“In the end, what gives a life meaning is not only how it is lived, but how it draws to a close.”—[Official Report, House of Lords, 25 January 2018; Vol. 788, c. 1170.]

She is giving that line great meaning.

As has been mentioned many times, Tessa also referred in her speech to the importance of living with cancer—living longer with cancer, but living with cancer. As one who was motivated to go into this business in the House by fighting and losing far too many battles against cancer, I would say that, for all of us who are diagnosed with cancer, we are never just our cancer. Tessa is not just her cancer, and she is not just the cancer campaigner that she is now. She is still a mum, and she is still a wife. You spoke at the start, Mr Speaker, about the love. There has been one hell of a love bomb here today. When I have been able to, I have looked over at the Under Gallery, and I have certainly seen some love there this afternoon. It has been incredible and very moving to see it.

I think that what made that line in the speech in the other place so remarkable is that Baroness Jowell has given so much to our country, from being my predecessor as the first ever public health Minister to giving the country one of its greatest cultural events in London 2012. Through her enthusiasm and courage, she is driving people in the country and around the world to confront not just one of oncology’s most difficult challenges, but one of medicine’s most difficult challenges. We should not underestimate what a difficult challenge brain cancer is.

Let me say on behalf of the Government that we will do everything possible to meet the challenge. Those who know me as the cancer Minister know that I am impatient and determined—as is the Secretary of State—to do well, to do better, and then to do better again in fighting the big C, or cancer, or whatever we choose to call it. I say that not out of arrogance or ministerial bluster—I write my own speeches—but because I believe that this challenge is one that we can overcome. I was truly inspired when meeting the Baroness for the first time on Monday at the inaugural meeting of the UK brain tumour steering group, so ably chaired by my colleague Lord O’Shaughnessy, who I know has already become a firm friend of hers. So in my brief remarks I shall focus on three areas where we will do more, and which sum up pretty much what every Member covered in their speeches.

The first area is research. On 22 February, just a month after the Baroness’s powerful speech, Department of Health and Social Care Ministers met Tessa and representatives from the Eliminate Cancer Initiative at the Cabinet Office to try to find solutions to improving outcomes for people fighting brain tumours. That very day the Department’s task and finish working group into brain cancer research published its report on brain cancer research in the UK, setting out how to increase the level and impact of research into brain tumours going forward. The group was set up in 2016 and was chaired by the Department’s chief scientific adviser Professor Chris Whitty. It brought together clinicians, charities, patients and officials to discuss how, working with our research funding partners—key in this—we can address the need to increase the level and impact of research into brain tumours.

To back the report, as all Members will know, the Government and Cancer Research UK together announced an investment of £45 million over the next five years to turbocharge research in this area. This will begin—but only begin—to make up for the historical lack of research in this field and further strengthen a number of our existing centres of excellence in places such as Cambridge and the Institute of Cancer Research here in London.

The National Institute for Health Research spent £137 million on cancer research in 2016-17, the largest investment in any disease area. However, according to Brain Tumour Research, even though brain tumours kill more children and adults under the age of 40 than any other cancer, as has been said, just 1% of the national spend by all cancer research funders on cancer research has been allocated to brain cancers. That is why—as everyone has said today—we want to move quickly on beginning further research, and I am pleased to say that the NIHR began inviting applications for the new funding this Monday. We urge researchers to apply, and help us generate the breakthroughs that could give hope to the thousands of people diagnosed with brain cancer every year in our country.

My second point is on data sharing. We know that, due to the rarity of many types of brain tumours, it is vital that we use patient data more effectively—the hon. Member for Hove (Peter Kyle) spoke very well about that—ensuring that it is shared safely, securely and lawfully not only between the NHS, charities and academia, but between like-minded countries internationally. The UK has a proud history as a proponent of open data and data sharing, and I give my Government’s commitment to work with the Eliminate Cancer Initiative and partners nationally and internationally to make this a reality on brain tumours. The ECI made the point at our meeting on Monday that patients’ data must be given for the common good, not the almighty shilling; I know that Tessa shares that sentiment. Tessa’s daughter, Jess—who is also here today and whom I met on Monday—said that we support and advocate the sharing of data not as an end in itself, but as a vital means through which to improve patient care and develop new treatments; she is of course a chip off the old block and absolutely right.

Baroness Jowell exemplifies the ambition we have, and we will carry it forward. In the Houses of Parliament tonight, Tessa will launch the global universal cancer databank, and has committed to be the first donor to that databank, which we hope can catalyse the sharing of data across the world and save the lives of many. My right hon. Friend the Secretary of State will be pleased to be there.

Thirdly, and most importantly, I want to touch on patient engagement. We must ensure that patients are at the centre and heart of our work on brain tumours, so we will build on the existing work to develop a clear timeline and plan for reducing the time to diagnosis for brain tumours, which is as important in this cancer as in all others. We will also implement new models of patient care, such as the Cambridge model, and the national roll-out of innovative new tools such as the 5-ALA ‘Pink Drink’, which is very important. The National Institute for Health and Care Excellence is currently developing a new clinical guideline on brain tumours, which includes the use of 5-ALA, with publication expected in July. We will also redouble the Department’s efforts to ensure there are appropriate and ethical frameworks to allow patient access to experimental medicines, and allow for the re-purposing of drugs and the acceleration of the development of new patient-focused adaptive clinical trials, which is so important.

Many Members have spoken so well in this debate. I will not list them all, but it was a pleasure to see my right hon. Friend the Member for Old Bexley and Sidcup (James Brokenshire) back in his place, making his first speech from the Back Benches in a long time. I worked closely with him when he was in the Northern Ireland Office; he is one of the nicest guys in Parliament and he spoke brilliantly about #KeepOliviaSmiling—and it was good to see my right hon. Friend smiling again. He talked about ring-fencing money in the NIHR for brain tumour research for children. The level of research spend in a particular area, such as child-specific tumours, depends on the number and scale of successful funding applications. He will be aware of our joint announcement in February, which included the opening of Cancer Research UK’s new children’s brain tumour centre of excellence at the University of Cambridge. Maybe he will go along and have a look at that at some point.

My hon. Friend the Member for Congleton (Fiona Bruce) spoke well about prostate cancer, and I was proud that we were able to make that announcement last week. My hon. Friend the Member for Torbay (Kevin Foster) spoke about the ACE programme. I have said before that I do not easily get excited at the Dispatch Box, but I am genuinely excited about these new ACE multidisciplinary diagnostic centres. When people present to their GP with vague symptoms, these centres will provide a chance for them to get in and get an answer—a diagnosis or an all-clear—quickly. I visited one of the ACE centres, at the Churchill Hospital in Oxford, in February this year. The enthusiasm that I heard from the clinicians and patients there gave me real hope, and hope is a key word in today’s debate.

I should like to conclude by once again thanking everyone who has made such positive contributions to what has been a really memorable debate. I recognise that we are only at the start of our journey to beat brain tumours, but now is the time for patients, the NHS, charities and industry to come together—as we in this House have done today—both nationally and internationally and to redouble our efforts. The funding we have committed for additional vital research, and our ongoing work to look at every aspect of diagnosis, treatment and care, will help us to deliver ever more positive treatment outcomes for people with brain tumours, but we have a long way to go. This is of course happening alongside our system-wide transformation of cancer services in England through the cancer strategy, which we have debated at length here many times.

Baroness Jowell has been the catalyst for this rapid activity on brain tumours, and it is incumbent on us all to continue to work closely together over the coming months and years to build on this legacy. She is here today, and I know that she will be watching us closely. As Theodore Roosevelt once said, now is the time for

“painful effort…grim energy and resolute courage”

to beat this terrible disease. And, as I always conclude: for team cancer, the fight goes on.