Oesophageal Cancer

Debate between Steve Brine and Jane Ellison

Monday 23rd February 2015 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

I congratulate my hon. Friend the Member for Hove (Mike Weatherley) on both securing this debate and moving it in such a personal way and giving us an account of his own experience of this dreadful disease. I am sure his words will resonate with all of us who have listened tonight, and in particular the way he took us on that journey from the first difficult moments of diagnosis through to treatment. It was a vivid and thought-provoking, but also a heartening, account.

My hon. Friend is absolutely right to draw attention to the dedicated and inspirational NHS staff, who work so passionately up and down the country for their patients. How nice it was of him to take the opportunity to put that on record this evening; that was tremendous. Never is the debt of gratitude we owe the NHS staff felt more keenly than when we personally benefit from the care they provide, often at our most vulnerable and weak moments. They are, as he says, not just care-givers, but life-savers in those situations.

My hon. Friend rightly challenged us to do better in this area. Improving cancer outcomes is a major priority for this Government and, as the annual report on our cancer outcomes strategy last December showed, we are on track to save an extra 12,000 lives a year by 2015. That is the projection based on the figures to date. We all want to see the best possible results for all cancer patients, but he was right to highlight the fact that outcomes are particularly poor for patients with oesophageal cancer. I am aware, from all our debates, that this is an area in which we have not seen the sort of movement that we have seen with other cancers. Each year in England, about 7,000 people are diagnosed with oesophageal cancer and 6,000 people are diagnosed with stomach cancer. Those diseases cause around 10,200 deaths in England each year.

We had some exciting news recently: the NHS England cancer taskforce was announced on 11 January. NHS England announced that this new independent cancer taskforce would develop a five-year action plan for cancer services with the aim of improving survival rates and saving thousands of lives in England. The cancer taskforce has been set up to produce a new cross-system national cancer strategy to take us through the next five years to 2020, building on NHS England’s vision for improving cancer outcomes that was set out in the NHS’s “Five Year Forward View”. It was formed in partnership with lots of different cancer charities and other parts of the cancer community, along with other health system leaders, and it is chaired by Dr Harpal Kumar, the chief executive of Cancer Research UK.

The taskforce will cover the whole cancer pathway through prevention, diagnosis and treatment to provide support for those living with and beyond cancer and end-of-life care, as well as covering how all those services will need to develop and innovate. My hon. Friend was right to challenge us to look creatively at different ways of doing things, and that is exactly what the taskforce has been charged with doing. NHS England is assessing the opportunity for improved cancer care and will produce initial views by March—next month—with the new five-year cancer strategy to be published in the summer.

As my hon. Friend emphasised, early diagnosis is absolutely key. Tackling late diagnosis will be an important element if we are to achieve our ambition to improve cancer outcomes, which is why our cancer strategy invested £450 million during this Parliament in improving earlier diagnosis. As his own experience has attested, it can be difficult to diagnose oesophageal cancer, especially in its early stages. I congratulate him again on securing this debate and I hope that there is someone out there tuning into the debate who has heard his words. I am sure that they will help to publicise the message about taking notice of symptoms.

When symptoms do manifest themselves, it is often an indication that the cancer has developed. That is why early diagnosis is crucial. Just under 70% of people diagnosed with oesophago-gastric cancers at the earliest stage survive for at least five years. My hon. Friend has highlighted what it means in human terms for those who are diagnosed at a very late stage. It has been estimated that around 950 lives could be saved in England each year if our survival rates for oesophageal and stomach cancers matched the best in Europe, and that clearly has to be our aim: we have to do better.

NHS England has launched a major early diagnosis programme, working together with Cancer Research UK and Macmillan Cancer Support to test new approaches to identifying cancer more quickly. I hope that that programme will give my hon. Friend some encouragement, because it touches on some of the issues that he has mentioned. It will include offering patients the option to self-refer for diagnostic tests; lowering the threshold for GP referrals; creating a pathway for vague symptoms; and setting up multi-disciplinary diagnostic centres so that patients can have several tests done at the same place on the same day.

[Steve Brine]

Southampton has been mentioned, as has my constituent Tim Underwood, who leads the team there. What the Minister is saying is absolutely right. Does she agree that regional centres such as Southampton—which do things that, quite rightly, not everyone does—are the key to providing regional areas of specialism to help us to do even better on the diagnosis and treatment of oesophageal cancer?

[Jane Ellison]

In a recent Back-Bench debate on cancer, mention was made of the tension that we all feel as constituency Members between the desire to have services nearby and the recognition that the expertise resulting from seeing lots of cancers, particularly the rarer ones, is really important to developing clinical excellence. We have to be clear that there are areas where concentrating excellence and clinical experience will save lives, and my hon. Friend perhaps highlights one such area. We often underestimate just how few cancers of any kind the average GP sees, and that is especially true of rarer cancers.

Let me go back to the different ways of looking at earlier diagnosis. NHS England’s aim is to evaluate these innovative initiatives across more than 60 centres around England to collect evidence on approaches that could be implemented from 2016-17. In 2013, Macmillan Cancer Support, partly funded by the Department, piloted an electronic cancer decision support—CDS—tool for GPs to use in their routine practice. It covers lung, colorectal, pancreatic, oesophagus and stomach, and ovarian cancers. Following the pilot, the CDS tool has been refined and is currently installed in more than 1,000 GP practices across the UK. It is designed exactly to deal with the point about helping people who do not see certain things very often with those diagnostics. Macmillan is working with software companies to adapt the CDS for different IT systems and make it available to GPs as part of their standard software offer.

I just wish to mention the Be Clear on Cancer campaign, which I am glad my hon. Friend the Member for Hove mentioned.

Breast Cancer

Debate between Steve Brine and Jane Ellison

Tuesday 25th November 2014 Commons Chamber

[Steve Brine]

May I thank the Minister for thanking the three big breast cancer charities? Breakthrough, with support from the others, provides the secretariat for our all-party group. She will be aware of the work of CoppaFeel and its “Rethink Cancer” campaign. Treatment and survival are obviously critical—today’s debate is about that—but prevention is clearly better than cure. Will she take this opportunity to endorse CoppaFeel’s work in educating young women, and men, to spot the signs and symptoms of cancer early so that we can prevent primary breast cancers from developing in the first place? She will know that Kris, who runs CoppaFeel—she has a terminal diagnosis—is passionate about this, and has done so much to put it on the agenda for young women in this country.

[Jane Ellison]

I certainly pay tribute to all those who are trying to drive awareness of this issue. There are a number of very important campaigns. Prevention is so important; for example, it was good that it was right at the heart of the recent NHS “Five Year Forward View”. There is a lot more to do, and I have recently had discussions with some of the breast cancer charities about how we use their reach and undoubted public credibility, which is enormous, to raise awareness more about some of the things that people can do on the prevention front, as well as about their important work on care and drugs. I join my hon. Friend in paying tribute to those campaigners.

The NHS is treating more people with cancer than ever, as I have said. Survival rates for breast cancer are improving, with more than 85% of women with breast cancer in England and Wales now living for more than five years. The work that all the charities have done in that regard is really important. They have all made significant contributions, but we know that more needs to be done, and that is the focus of this debate. We need to catch breast cancers earlier, and to avoid the risk of secondary breast cancers. We also need to improve the detection and treatment of secondary breast cancer, as my right hon. Friend has highlighted.

My right hon. Friend spoke very movingly about pain and its management. I am sure that we all agree that our NHS doctors and nurses do everything that they can to alleviate pain. In fact, it was good to see from the 2014 cancer patient experience survey that only 1% of patients reported that they did not think that hospital staff did everything they could to control their pain. Indeed, 86% of patients—the highest level in the four surveys so far—reported that staff did everything they could to control their pain. She is right to say that referral to specialist palliative care services can provide more by way of effective pain relief. The NHS must do what it can to ensure that women with secondary breast cancer have access to the right services. She is also right to highlight the room for improvement on that.

On the patient experience for women with secondary breast cancer, the results of the 2014 cancer patient experience survey show improvements in many areas, with 89% of all patients reporting that their care was either excellent or very good. As my right hon. Friend said, there are two specific references to secondary breast cancer in the NICE quality standard. The first states that people who develop it should

“have their treatment and care discussed by the multidisciplinary team”,

and the second states that people with recurrent or advanced breast cancer

“have access to a ‘key worker’, who is a clinical nurse specialist whose role is to provide continuity of care and support”—

she mentioned that—

“offer referral to psychological services if required and liaise with other healthcare professionals, including the GP and specialist palliative care services.”

NICE clinical guidelines represent best practice, and we expect commissioners and clinicians to take them into account when making decisions, including on the provision of cancer nurse specialists. On the whole, breast cancer patients reported a more positive experience than many other cancer patients, and 93% were given the name of a clinical nurse specialist. My right hon. Friend is right to highlight the fact that we are not doing as well for patients with secondary cancer or a recurrence of cancer—those patients reported a worse experience and were less likely to have a clinical nurse specialist. NHS England is working with NHS Improving Quality, Macmillan Cancer Support and strategic clinical networks to improve the cancer patient experience and spread good practice across hospitals providing cancer care. That includes support from a clinical nurse specialist for those with secondary breast cancer.

Tobacco Packaging

Debate between Steve Brine and Jane Ellison

Thursday 28th November 2013 Commons Chamber

[Jane Ellison]

We are not persuaded that legislation is the right way forward on that matter. There is still a lot of room for education, and I am sure that the hon. Gentleman would like to believe, as I do, that when parents are made aware of the dangers of smoking in cars when children are present, they will wish to desist from doing so.

[Steve Brine (Winchester) (Con)]

I welcome the Minister’s statement. In September, I visited the Cancer Research UK centre in Southampton to meet my constituent, Tim Underwood, who leads the oesophageal cancer team there. I suspect that the team will be pleased to hear today’s announcement. Will she assure us that, whatever happens at the end of this process, it will remain the Government’s intention resolutely to prevent young people from picking up this habit that kills in the first place?

[Jane Ellison]

Preventing children from smoking is a major priority for the Department of Health and for the Government, and my hon. Friend is absolutely right to suggest that, irrespective of this piece of policy—important though it has the potential to be—the Government are committed to spending significant amounts on public health campaigns and all the other mechanisms available to us to prevent children from smoking.

Cycling

Debate between Steve Brine and Jane Ellison

Monday 2nd September 2013 Commons Chamber

[Steve Brine (Winchester) (Con)]

I was fortunate to sit on the “Get Britain Cycling” inquiry earlier this year. There was huge interest in what we were doing. When we started the inquiry, we were the best trending name on Twitter. I pay tribute to my hon. Friend the Member for Cambridge (Dr Huppert) for securing this debate and to Adam Coffman, who put so much work into making it a professional, Select Committee-style inquiry.

In the short time available to me, I will focus on three areas: vision and leadership, which for me is where it starts and ends; the design issue; and the summer of cycling in my constituency. I am extremely proud of the report and believe that it stands up really well. Having read it again in writing these remarks, I think that it will age well. We launched the report in April and the Government responded last week. In the light of everything that has happened since we produced the report, I think that is more relevant now than when we launched it.

On leadership, it is no coincidence that one of the first points in the report is the need for

“vision, ambition and strong political leadership”.

As the hon. Member for Dudley North (Ian Austin) said, we recommend the appointment of a national cycling champion. I share his regret that that recommendation was not accepted in last week’s Government response. It is all too easy to regard such things as somebody else’s responsibility. The Minister need not look further than City hall, where Andrew Gilligan is the Mayor’s cycling champion, for a good example of how a cycling champion can work.

[Jane Ellison (Battersea) (Con)]

I thank my hon. Friend for his comments. Does he agree that leadership at a local level is important? I have seen the difference in my borough as the political leaders have started to take this issue much more seriously and to engage much more vigorously with local cycling campaigners. That really makes a difference.