Cervical Screening

Tonia Antoniazzi Excerpts

Monday 19th July 2021 Westminster Hall

[Tonia Antoniazzi (Gower) (Lab) [V]]

I beg to move,

That this House has considered e-petition 317336, relating to cervical screening.

It is a pleasure to serve under your chairship, Mr Pritchard, for this really important debate. I apologise for not being able to be there in person today, but I thank the House for these hybrid proceedings because I was pinged last week.

I will begin by putting on the record my huge thanks to Caitlin, who is Fiona’s sister, for speaking to me last week about Fiona’s case and the way that it has affected her whole family. I also thank Fiona’s friends, Melissa Macdonald and Niamh Foley, who started the petition, and all those who have signed it, which led to this debate being held today.

As a woman, I know that we all sort of dread getting the call-up for our smear test. For most women, it is not painful, but it is uncomfortable and awkward. What can someone even chat about when the nurse is having her little look? But why should it be like that? We have all been there; the nurse has seen it all before. It is just not spoken about, so we feel a sense of shame about it. It is time we stopped being so coy about it, because that may well persuade more women to go for screening and ultimately it may save lives.

Cervical cancer is one of the most common cancers in women under 35, and 99.7% of cervical cancers are caused by human papillomavirus, or HPV. In recent years, testing for HPV has meant that it is easier to identify who is at greater risk from cervical cancer at the earliest stage.

During covid, England had an attendance rate for smear tests of 72%, which means that more than one in four women are not going for screening when invited to do so. The wonderful charity Jo’s Cervical Cancer Trust has a number of ideas to increase the uptake of smear tests, and I suggest that the Minister meets it to discuss ways of increasing the number of women being tested; I know that she has a keen interest in women’s health.

I was really moved when I spoke to Caitlin, because I got a real sense of how difficult it must be to lose a sister, especially at such a young age. Fiona was only 30 when she died. She was married to Andrew and was the mother of two young children. When Fiona died, Ivy was only four and Harry had just turned two. As Caitlin said, Fiona used all her strength to stick around for Harry’s second birthday.

Fiona was called for her first smear test in 2015, but she was pregnant with Ivy and so was told not to go. When she was called again, she was pregnant with Harry, but there was no follow-up to the first appointment. Fiona never received a reminder to go to her smear test in the interim. This situation is not about someone missing appointments when called to attend them; Fiona went to every appointment that she was meant to go to.

Fiona’s cancer was finally diagnosed after a routine smear test in 2018. She did not have any symptoms, but there seemed to be a lot of hold-ups and delays before her cancer was diagnosed. Caitlin mentioned that it could perhaps have been because of Fiona and Andrew moving from England to Scotland that Fiona received her first invitation. That raises questions about communications between the devolved Administrations and about what procedures are in place to make sure that communication between different trusts and devolved countries is clear.

A hysterectomy was performed and Fiona then went through chemotherapy and radiotherapy as a belt-and-braces approach to dealing with the cancer. After that, Fiona had a number of visits to A&E, including one where the doctor later admitted that she knew the problem was cancer and not a hernia, but did not say anything as Fiona was seeing a specialist soon after.

Most of us are not medical experts. We rely on doctors to tell us the truth because we do not know what is going on, and that vulnerability is really exposed when we hear such stories. I know it is extremely rare to hear stories such as Fiona’s, and the vast majority of our doctors, nurses and other health service staff really care, but it is shocking none the less.

Before covid hit, cancer services were already struggling due to severe staff shortages. Despite the incredible efforts by staff, a backlog has built up. Relying on current staff, who again have not had a pay rise, to clear the backlog on top of delivering regular services will only lead to burnout. It is just not sustainable. Research from Macmillan Cancer Support in 2017 showed that 2,500 specialist cancer nurses were needed to maintain cancer services. By 2030, we will need 3,700 new nurses—an increase of 124% on 2017 levels. Those figures will also have been hugely impacted by the pandemic. The Government have come forward with their own cancer workforce strategy, which is inadequate, and I implore the Minister to reconsider the plans that they have and come up with something that will really help those living with cancer.

Everything that happened to Fiona came before the pandemic hit last year. We have heard countless times about the delays in diagnosis and treatment that the last 16 months has caused. Approximately 1.5 million smear tests take place every year. With the pressure on the NHS since March 2020, that could mean 1.5 million women missing out on a vital tool in diagnosing cervical cancer.

We know that the rates of covid infection are on the up. Hospitalisations for covid are rising, and some NHS trusts across the UK are already cancelling operations as they are at capacity. The recklessness of so-called “freedom day” in England and the removal of all the measures that have been in place to keep us safe is therefore unbelievable. Putting the immunosuppressed at risk, such as those going through cancer treatment, is downright dangerous, and I am glad that the devolved nations have taken a more cautious approach.

What will the extra pressure on the health service mean? Another delay in getting a smear test. And what will that do to the outcomes for so many young women? What will the Government do to make sure that those women who miss out are not left behind, and to stop a knock-on effect on testing? We are looking at new ways forward. Fiona’s case has highlighted some of the gaps that were there before the pandemic started, and things have only deteriorated since covid hit. We must work together to make sure that cancer services are the best that they can possibly be, and that our cancer workforce is protected and given all the tools that it needs to continue to save lives.

When Fiona got really ill, her daughter Ivy used to ask why mummy had to spend so much time in bed. To stop another family having to answer those questions, I want the Minister to answer the questions that Fiona’s family and friends, and all of those who have lost someone to cervical cancer, need answers to. What procedures are in place to make sure that women like Fiona do not fall through the cracks? How does that work across the devolved nations? What is the current screening backlog? What plans to increase the cancer workforce are currently in place?

Caitlin finished our meeting by saying that any change that could come from this debate—if one life is saved, or if one family does not have to go through what her family have been through—would make it worth it.

[Mark Pritchard (in the Chair)]

Before I call John Lamont, I have to say that even though the attendants have been fantastic in helping with the air conditioning, it is still very warm, so if hon. Members want to remove jackets, they should feel free.

--- Later in debate ---

[Tonia Antoniazzi [V]]

I thank the Minister for her response. I also thank the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for his contribution. As Andrew Mathewson’s MP, he made a heartfelt contribution on behalf of Fiona’s family and all her friends. In the really powerful and very personal speech of my great friend, my hon. Friend the Member for Pontypridd (Alex Davies-Jones), we heard about the serious risks that missing a screening can cause. Her story is a stark reminder of the importance of keeping appointments and being tested regularly.

The hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) touched on many of the groups that are less likely to attend their appointments and the Government’s duty of care to improve messaging to those in harder-to-reach communities. In fact, in her intervention on the Minister, my hon. Friend the Member for Pontypridd highlighted the fact that non-binary and trans men should not miss their cervical screening appointment, and that it is important to record biological sex on medical records to ensure that that does not happen.

The hon. Member for Strangford (Jim Shannon) was very clear in his message that screening is not a test for cancer but a test to prevent cancer. That is a really important message to get across to all women. My hon. Friend the Member for Wythenshawe and Sale East (Mike Kane) highlighted the fact that not one trust in England achieved 80% coverage of the test. He highlighted the work of Hologic, a cutting-edge company in his constituency that specialises in high-volume population screening. We need to take full advantage of that resource when beating cancer.

I echo the call of the hon. Member for Central Ayrshire (Dr Whitford): if you have vaginal discharge or bleeding, go and see your GP—not your MP—and do not wait for an invitation. She also mentioned the 30% to 4.5% reduction as a result of the HPV vaccine. She noted the difficulties that physically disabled people have in attending their cervical smears. The Minister spoke about the self-sampling project that is going to be rolled out nationwide, which is going to be key to getting as many women as possible to attend cervical screening tests. My hon. Friend the Member for Nottingham North (Alex Norris) drew on his vast knowledge of health issues and made a powerful case for building back better our screening capabilities and using all of the available technological advances that have been mentioned today.

In conclusion, I thank the Minister for her comments. I am glad that Members, cross-party and from all of the devolved countries of the UK have been able to discuss this issue sensibly. The bottom line is that we must improve take-up and we must talk about it, because screening saves lives.

Question put and agreed to.

Resolved,

That this House has considered e-petition 317336, relating to cervical screening.