Cancer Care (England and Wales)

Tessa Munt Excerpts

Tuesday 12th February 2013 Westminster Hall

[Alun Cairns]

I am grateful to my hon. Friend for sharing those data. In interventions, hon. Members have talked not only about pre-screening, awareness, social issues and treatment, which I will focus on, but the aftercare that is needed, the emotional support that is provided, and the need for and responsibility and role of a whole host of agencies, including those in the charitable sector.

Returning to the point about treatment, I had been comparing the different approaches to breast cancer in England and Wales. The wait before seeing a consultant in England is 10 days. It is interesting to note that the Welsh Government removed 10-day monitoring in 2006. Although data are recorded locally, they are not published nationally. In the interests of transparency, it would be helpful if those data were published to allow fair and just comparisons. Waiting time targets improve survival outcomes, reduce emotional distress and improve the quality of life for people with cancer and those who turn out not to have cancer.

There are similarly alarming figures for prostate cancer. Five-year survival rates can be higher than 80%. There are no figures comparing the rates of the home nations, but the side-effects of the sort of treatment one receives for prostate cancer can be significant and can have a huge impact on future lifestyle. Again, there is a different approach to prostate cancer care in the two nations.

I want to draw attention to the availability of treatment. There was significant attention some years ago to access to brachytherapy. Even when it was finally approved by the Welsh authorities, after having been widely available in England, Scotland and Northern Ireland, the threshold for intervention was much higher in Wales. As far as I know, that remains the case.

Currently an identical debate is focused on robotic surgery. A constituent who suffers from prostate cancer, who is qualified medically and who consulted widely before making the decision with his clinicians on the most suitable form of treatment for himself, wrote to the Welsh Health Minister. He shared a copy of the letter with me, in which he said:

“I was both surprised and disappointed to find that this option is not available to Welsh men in Wales and that a significant number of Welsh men are opting to go to England, where this technology is established and available throughout the country.”

[Tessa Munt (Wells) (LD)]

Does my hon. Friend accept that if that kind of treatment—be it robotic or radio surgery—was available perhaps in a location such as Bristol, it would be accessible for patients in south Wales, along the M4 corridor and elsewhere, and those who go down the M5, right the way through to Cornwall?

[Alun Cairns]

My hon. Friend makes a valid point about the need for joint working and better co-ordination between the health services. Devolution can provide valid comparisons to establish the success of various treatments, but on many occasions there is a need for joint working where capital investment is needed, allowing patients to benefit from a different sort of intervention, but with shared responsibility between the two organisations.

I was talking about my constituent who had wanted robotic treatment for prostate cancer. He was later forced, in his stressful situation, to raise the £13,000 necessary to receive the form of treatment that he thought best suited him. I am pleased to report that the outcome of the treatment was positive.

The Wales Minister argued that if local heath boards do not provide treatment routinely, people could follow a process for individual patient funding requests. The panel meets monthly, which hardly reflects the urgency of some cases. I am not aware that any case of robotic treatment has been successfully applied for.

That leads me on to the cancer drugs fund, which is available in England but not in Wales. The fund allows clinicians and patients to prescribe and receive the latest drugs. Again, that is not available in Wales, where there is a cumbersome process to seek such a prescription.

The Rarer Cancers Foundation reported that 24 cancer treatments that are not routinely available in Wales may be available in England through the cancer drugs fund. It concludes that people in Wales are five times less likely than people in England to gain access to a cancer drug that is not routinely available. It also states that if the same approval rate occurred in Wales as it does in England, 159 cancer patients in Wales would gain access to life-extending treatment, instead of the 31 recorded. I raised the issue with the Welsh Health Minister, and she reported that establishing such a fund would reduce the money available for treating other serious conditions, as in England. I find that worrying, and I would be grateful if the Minister could address that point in her response.

That deficiency applies to other cancers, too. Selective internal radiation therapy is an innovative treatment for inoperable liver tumours. Although the University hospital of Wales in Cardiff is part of the UK-wide phase 3 clinical trial, not one patient from Wales has been funded for treatment. The patients under trial have been financed by the cancer drugs fund, yet the hospital is in Wales and demonstrates the expertise that exists in Wales in the field.

Survival rates for pancreatic cancer also differ significantly, and I could go on at length about those. When it comes to five-year survival rates for pancreatic cancer, Wales scores better than England. Unfortunately, that tends to be the exception rather than the rule. Those differences are worrying, and had I referred to Scotland and Northern Ireland selectively, I would have been able to paint a more alarming picture, but that is not the point; it is not about the politics of the issue, but about sharing best practice and getting the right treatment for the right people.

The motivation for the debate came from individual cases in my surgery. Having researched the data, I was forced to bring the matter to the House’s attention. I hope the Minister and Members present will be able to use their influence on colleagues here and elsewhere to raise standards, allay fears and improve survival rates for cancer patients.