Prostate Cancer

Debate between Steve Brine and Simon Hoare

Wednesday 6th February 2019 Commons Chamber

[Simon Hoare]

I am very grateful that the Minister is setting this out in his customary detail. In a circumstance in which all those conversations have taken place, if the patient says, “Thank you doctor, I hear what you say, but I am entitled to have this test, and I want to have this test done,” will the Minister confirm that GPs are obliged to make the referral, rather than saying, “Well, I’ve heard what you said, but I am your doctor and I am not going to let you have it done”?

[Steve Brine]

We do not often use the term, “No decision about me, without me” any more, but I always remember the former Health Secretary—now Lord Lansley—using that a lot, and that is still very true. A patient over that age has every right to request a PSA test, and certainly even more so if they believe that they have symptoms. I would be very concerned about a GP refusing it—I think it would be extremely unlikely for one to do so in such instances—but any patient has the right of travel. Every patient has the right to change GP if they are not satisfied with the relationship that they have. If my hon. Friend did know of an instance of that, I would be very interested to hear about it—as, I suspect, would the Royal College of General Practitioners —but I would be very surprised.

I want to touch on screening, which we talk about a lot at the moment, and I will come on to why. Because of the limitations of the PSA test, there is currently no national screening programme for prostate cancer. In 2016, Prostate Cancer UK, which has been rightly lauded this afternoon, began work to help to develop tests that could form part of a national screening programme. This would potentially involve better blood tests, which are currently in development, combined with more advanced scanning. It is hoping to make that happen in the next five years—nothing happens quickly in this space unfortunately—and I am sure that we all welcome their efforts.

Members will be aware—I have spoken about this quite a lot in the House recently; we have had a number of cancer debates since Christmas—that Sir Mike Richards is leading a review for the Secretary of State of our current screening programmes. As part of that—I met Sir Mike last month—we will consider how we can make screening smarter, targeting those most at risk. We expect that Sir Mike’s work will have positive implications for future programmes. He is an incredibly experienced and respected figure in this space, and I hope that his work will enable us to roll screening out faster when the evidence base is there to support it. I am very hopeful and ambitious about that work, as I know Sir Mike is.

Let us talk about public awareness campaigns, which my hon. Friend mentioned in opening the debate. The Government have to do all that they can to raise awareness of prostate cancer and target high-risk groups, while recognising that there are limitations on how much the public will listen to public health messages from Ministers at the Dispatch Box—I know that it is hard to believe that people do not take this all to heart, but they do not, so we work with our partners.

In 2014, along with Public Health England, we worked on the phenomenally successful “Be Clear on Cancer” campaign, which has had a number of iterations, on prostate cancer in black men. The campaign messaging included:

“1 in 4 black men will get prostate cancer”,

which was one of its tag lines. It urged black men over 45 who were concerned about their risk of prostate cancer to visit their GPs. The campaign evaluation showed that it had stimulated new conversations about prostate cancer among families and the black community. Public Health England has made all the materials developed for the campaign available online, so that groups and other organisations can use them locally if they wish. They are very striking and powerful, and we believe that they were very successful.

We also welcome the work that Prostate Cancer UK is doing with the Football Association to raise awareness through their “relegate prostate cancer” campaign. It is fronted by high-profile celebrity football figures, including the England football manager, Gareth Southgate, and includes the slogan:

“One man dies every 45 minutes of prostate cancer”.

Anyone who can stay awake for “Match of the Day” on a Saturday night—thank goodness for the repeat on a Sunday morning—will see very many people, including the pundits and the managers interviewed afterwards, wearing the badge that I am wearing today. Members will be very familiar with that badge, which demonstrates the widespread support that Prostate Cancer UK has in continuing to raise awareness of this disease.

Let me turn to research, as I come to a conclusion. Research has played a crucial part in the advances that we have made in cancer survival over the past four decades. More than 15 years ago, the Department identified the need for further research into prostate cancer, and we have since worked closely with Cancer Research UK—it was here this morning; I was pleased to pop into its drop-in—Prostate Cancer UK, the Medical Research Council and others, through the National Cancer Research Institute, which is a strategic partnership of the major UK funders of cancer research. NCRI spend specifically on prostate cancer research increased from £17.1 million in 2011-12 to £26.5 million in 2015-16.

Investigatory Powers Bill

Debate between Steve Brine and Simon Hoare

Tuesday 15th March 2016 Commons Chamber

[Steve Brine (Winchester) (Con)]

My thoughts on this legislation can best be summed up in three ways: first, it is about time; secondly, it is very much a Bill of our time; and thirdly, I of course wish it was not needed at all. The measures contained in the Bill should have been on the statute book in the previous Parliament, of which I was a Member, but history records why they were not.

I say it is a Bill of our time. Sadly, the bad guys have always wanted to do us harm. In the internet age, it of course gets harder to deal with them—it requires us as a society to ask ourselves even tougher questions about the compromises required—but that does not mean we can bury our heads in the sand. Whether or not this Parliament acts, the world will continue to be a dangerous place and our many enemies will continue to use the very latest technology to try to get at us. We cannot stop the world because we want to get off.

It seems to me that the opponents of the Bill break in one of two ways, or perhaps both—that we have rushed to get to this point, and that insufficient safeguards are in place for the powers granted. As a youngish researcher, I worked on the Regulation of Investigatory Powers Bill 16 years ago. I remember the claims that it was rushed, was not needed and, above all, would usher in some Orwellian nightmare. I did not believe that then, and I do not believe it now. The intention to bring forward this legislation was set out clearly in our successful manifesto last year.

[Simon Hoare]

My hon. Friend makes the very important point that this legislation was in our manifesto. Given the slightly academic approach to law enforcement taken by our friends in the other place, does he share my hope that, because the Bill is a manifesto commitment, they will not seek to hold it up, given its urgency?

[Steve Brine]

I think the other place will enjoy being described as taking an academic approach. Yes, this very clear security measure was in our manifesto, and I think that message will clearly go along the corridor.

As the Home Secretary said, the Bill follows no fewer than three reports, published last year, which concluded that the law in this area was not fit for purpose and needed reform. We have heard much about the Anderson report today. We have had the ISC report and we have heard from its Chairman, my right hon. and learned Friend the Member for Beaconsfield (Mr Grieve). We have also had the RUSI independent surveillance review. Further to all that, the draft Bill was subject to pre-legislative scrutiny by three parliamentary Committees, which made some 86 recommendations about how it might be improved.

As we have heard, the Government have accepted many of the recommendations. There has also been a general election. I know that the Minister for Security and his team have done a huge body of work in bringing the proposals—Bill-ready, as they now are—before the House today, so I think it is some stretch to say that the measures have been rushed before us. Furthermore, I think our constituents should be reassured that, after all of that, we have a better Bill. It has been stress-tested by all the work I have mentioned, and we have the lengthy process of parliamentary scrutiny ahead of us.

The Government say that the only new capability provided for in the Bill is the ability to require retention of internet connection records. That is certainly the area that has most caught the media’s attention. Oversight for the operation of the surveillance powers in the Bill is also reformed compared with the legislation—RIPA—that it supersedes. The new double lock means that, for the first time, the commissioners will bring an element of judicial oversight to the process of issuing warrants. I am happy with that, but I want to hear more from the Government about the practicalities of those oversight arrangements, and to be sure that the judicial commissioner will not merely look at the decision-making process that a Minister has gone through, thereby undermining the significance of the authorisation procedure.

I have no issue with Britain’s spy agencies and those parts of the police that investigate serious crime having these powers. I think that they have earned the right to be trusted, and I take the Home Secretary at her word when she says that they have foiled serious terrorist plots in the UK since November 2014. I do, however, have concerns that these powers will end up also being used for trivial purposes by those in our town halls and local constabularies who may think that they are in an episode of “Spooks”. I know that that is not the intention of the Bill, which seeks to keep us safe and equip the spooks to do their job in the 21st century—as I am sure the Minister will reiterate when he winds up the debate—but I do not want this Bill to become its own public relations disaster due to a mission creep that was never intended in its drafting.

Time is short, so in conclusion, there will always be strong emotions about a Bill such as this. Some will believe that we are presiding over an increasingly all-seeing state that reaches into our lives too much, and others will think that these measures do not go far enough. Many of our constituents will take the view that, if someone has nothing to hide, they have nothing to fear, and I have some sympathy with that. The truth is probably somewhere in between. As I said at the start of my remarks, I wish that a Bill such as this were not necessary, but it is, and a wealth of evidence suggests that the law in this area needs urgent revision. The bottom line is that we as a society give something away in return for our freedom, safety and security. That is a choice we make as an elected House of Commons and as elected representatives. There is always a compromise between liberty and security. It is unhelpful to present this issue as being all one way or all the other way. On balance, having looked at the evidence, read the Bill and talked to Ministers, I think that it contains the right combination of measures, and I will support it tonight.