Cancer Workforce and Early Diagnosis

Steve Brine Excerpts

Tuesday 8th January 2019 Westminster Hall

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

That was very decisive of you, Mr Howarth. It is quite cold in here, but the ministerial radiator next to me is doing very nicely. Note to the Box: must get radiator for shadow Minister.

It is a pleasure to serve under your chairmanship, Mr Howarth. I wish everybody a happy new year. I congratulate the hon. Member for Poplar and Limehouse (Jim Fitzpatrick) on securing the debate. It is good to see him again. He has impeccable timing; I am not sure if he knew that the plan would be published when he applied for the debate. If he could let me know how he managed that, I would be very grateful.

The hon. Gentleman and everybody else talked about cancer survival rates. The truth is that they have never been higher and have increased year on year over the last decade or so. The reason for that is not only the investment and policy decisions by the last Government and this Government but, as the shadow Minister said, the hard work of NHS staff up and down our country. They work tirelessly, going over and above to give cancer patients the care and compassion that they need. I place on the record my thanks to them, which was perhaps not said enough in the Chamber yesterday. We are not in the slightest bit complacent, though. At the end of the day, one death from cancer still devastates somebody’s life and their family’s life. We know that we need to do so much more to ensure that we deliver the world-class cancer outcomes in England that all of us want and expect for our constituents.

In introducing the debate, the hon. Gentleman set the tone when he talked about the workforce. He said that the workforce are, in a way, the rock on which to build the church. I will start with that. Where we cannot prevent cancer, which I will come on to, we must ensure that we have the right staff with the appropriate skills and expertise to ensure that patients receive the best care. The NHS is nothing without its 1.3 million staff. It is the biggest employer of trained staff in the world. In 2017, Health Education England published the first ever cancer workforce plan, in which we set out ambitious plans to expand the capacity and skills of the NHS cancer workforce, committing to invest in 200 clinical endoscopists in addition to the 200 already committed to, as well as an extra 300 reporting radiographers, by 2021. However, we know that we need to go much further and do more than that. The Prime Minister set out our new ambitions on cancer in her party conference speech, and we also set out our early diagnosis targets in the long-term plan and our survival targets. As the Secretary of State set out yesterday, the long-term plan is the next step in our mission to make the NHS the world-class employer that delivers the cancer survival rates that we want.

To deliver on those commitments, we have asked Baroness Dido Harding, chair of NHS Improvement, to chair a rapid programme of work for the Secretary of State. She will engage with staff, employers, professional organisations, trade unions, charities in this space, think-tanks, Members and all-party parliamentary groups to build a workforce implementation plan that matches the ambition set out in the long-term plan. She will provide interim recommendations to the Secretary of State by the end of March on how supply, reform, culture and leadership challenges can be met, and then final recommendations later in the year, around the time of the spending review, as part of the broader implementation plan that will be developed at all levels to make the long-term plan a reality.

The hon. Gentleman and others asked about the work of HEE and Baroness Harding. The announcement of the long-term plan superseded HEE’s plans to publish a longer-term cancer workforce plan. HEE will now work with NHS England and Baroness Harding’s NHS Improvement under the plan, led by the baroness, to understand the longer workforce implications for the development of the plan. As I said, recommendations will be made in March, with a full implementation plan published later in the year. I did not say, “Soon.” I cannot give the House an exclusive this morning.

The hon. Gentleman also talked about Sir Mike Richards’s screening review. That will make initial recommendations by Easter this year and be finalised in the summer to, as it says in the plan,

“further improve the delivery of the screening programmes, increase uptake—

I know that the shadow Minister is concerned about that; I am too—

“and learn the lessons from the recent issues around breast and cervical screening, and modernise and expand diagnostic capacity.”

[Theresa Villiers (Chipping Barnet) (Con)]

Will the Minister give way?

[Steve Brine]

I will, but it will mean that other Members will not get a response.

[Theresa Villiers]

Does the Minister agree that a crucial part of success in early diagnosis is for both the NHS and local authorities, with their public health budgets, to have specific strategies to engage with minority ethnic communities to raise awareness of cancer symptoms, and to encourage them to take part in screening programmes? That is an essential part of an effective strategy to improve cancer treatment in this country.

[Steve Brine]

Yes. That is why the House gave all upper-tier local authorities the power to be effective public health authorities with ring-fenced public health budgets—£16 billion during this spending review period. Decisions will obviously be made about that going forward. One reason why we did that was our belief that, for example, my right hon. Friend’s borough will have different priorities and demographics from mine in Hampshire.

It is a statement of fact that I will clearly not be able to respond to every Member’s points in the short time that we have left. I will respond to everybody in writing, as I always assiduously do. I will try to take a few themes in the minutes that I have.

The hon. Members for Easington (Grahame Morris) and for Westmorland and Lonsdale (Tim Farron) touched on radiotherapy. I very much enjoyed our meeting, and I thank them again for their work. I will send the hon. Member for Easington a note with more detail on his point on tariffs, because I know that he and the hon. Member for Westmorland and Lonsdale are concerned about it.

The hon. Gentlemen also talked about the manifesto response. We await the publication of the new radiotherapy specification before we respond. It is an excellent piece of work that will address many of the recommendations made, and we expect it to be published very shortly. I am afraid to say that the long-term plan makes no commitment to a one-off investment. However, it commits to improving access to safer and more precise medicines, including advanced radiotherapy. That document is not the final word. It is a living document that I will work on while listening to all-party parliamentary groups such as their own.

The hon. Member for Westmorland and Lonsdale also talked about the radiotherapy review. There was a phenomenal response to NHS England’s consultation, not surprisingly—a lot of those were from the west country of England. The NHS will plough through that. I am putting great pressure on it to publish its report in response to that, which I am hoping, and am told, will be in early 2019.

The hon. Member for Central Ayrshire (Dr Whitford), otherwise known as the Member for the Irish sea a body of water, talked about prevention and smoking and child obesity and humour. I loved her reference to “poo in the post”. There is a great charity that talks about men’s bits called It’s in the Bag, which is good at promoting awareness of testicular cancer. She is right to talk about prevention. I am the Minister for Public Health and Primary Care, looking at prevention. The Secretary of State has made prevention one of his top three priorities, and she knows that it is key for me.

Smoking is still the biggest preventable killer in our country today, as I said in the House last night in the statutory instrument debate. We have published a world-leading plan on child obesity. We will consult very shortly. I try to be honest with the House at all times, and I hoped to get it out before Christmas, but there is an awful lot else going on and there is only so much I can get out the door at one time. However, I will get the 9 pm watershed consultation out the door. It is damned important that we do that. We said that we will, so we will.

The hon. Lady is absolutely right that prevention is better than cure, which is why the child obesity plan and Cancer Research UK’s work in that space has been very helpful.

[Mr George Howarth (in the Chair)]

I remind the Minister that he ought to leave a little bit of time for the mover of the motion to speak.

--- Later in debate ---

[Steve Brine]

Okay. I will have to close. There is a lot of ambition in the long-term plan, which some people have very kindly said I may have had something to do with. That may be so. However, that ambition is matched by finances, and finances need to be matched by people. We understand that, but it is also about the much wider, holistic approach to prevention, and about staff being part of that. We get that. I hope I have given some reassurances around the work that will be done on that. I will write to Members on the rest of the points raised. I thank everybody for their—as usual—incredible and passionate contributions.