Childhood Cancers: Research

Tonia Antoniazzi Excerpts

Monday 7th December 2020 Westminster Hall

[Tonia Antoniazzi (Gower) (Lab)]

I beg to move,

That this House has considered e-petition 300027, relating to research into childhood cancers.

It is a pleasure to serve under your chairship, Mr Mundell, and an honour to lead for the Petitions Committee in this debate. I welcome the large number of colleagues who have put in to speak today, and pay tribute to those who are unable to do so due to the parliamentary covid restrictions. As chair of the all-party parliamentary group on cancer, I really wanted to lead on this petition, as it is one that has touched many parliamentarians and their constituents. Indeed, I was approached by the hon. Member for Calder Valley (Craig Whittaker), who is unable to participate today, who asked me to pay tribute to his constituents Julia and Darren, who lost their beautiful daughter Fifi to childhood cancer. I put on record my heartfelt thanks to the petitioner, Fiona Govan, who lost her grandson Logan to a type of brain cancer called diffuse intrinsic pontine glioma, and to Amanda Mifsud from the charity Abbie’s Army, which was set up following the death of six-year-old Abbie from DIPG in 2011.

Children’s cancers represent under 2% of all UK cancers. Despite this low number, that still means that over 500 children die from cancer each year. It is the most common cause of death in children. The great news is that since the 1970s, mortality has decreased by around 70%, and even with the debilitating side effects of many treatments, that is testament to the achievements of research in saving our children. One caveat to those figures is the massive variation in survival rates by cancer type: 99% survival for retinoblastoma, contrasting with 0% for DIPG. Many forms of cancer affect children, but after speaking to Fiona and Amanda, I am going to concentrate on the disease that took Abbie, Logan and so many others.

DIPG is a highly malignant brain tumour located in the pons, or pontine, area of the brain stem, almost exclusively affecting children. DIPG tumours are one of the most aggressive forms of cancer, and the prognosis for children diagnosed with it is terminal—it has a 0% survival rate. What also struck me was that while there have been huge leaps in the treatment of many other cancers and diseases, nothing can be done to treat DIPG. Neil Armstrong lost his daughter to DIPG in 1962, and since that time there has been no development in treatments, let alone a cure. Thankfully, childhood cancers are rare, but that also means that they do not get the research funding that other cancers attract, and are often seen as too difficult to tackle. As Dr David Walker wrote in The Telegraph in February 2016:

“So-called ‘rare’ cancers are collectively as common as the ‘common’ ones. But the perception that research should be funded according to incidence means that individual rare cancers are doomed forever to receive a fraction of the money.”

As such, the equivalent of a classroom full of children die from DIPG in the UK year after year, while there are no meaningful advances in treatment options and no current UK trials.

What does the petition ask of the Government? Less than 21% of research funding on childhood cancers is provided by the Department of Health and Social Care, and there is little transparency on where the funding goes. To change that, the petitioners want the National Institute for Health Research classification system to include specific cancer types and age data. They also ask for a commitment from the Government on ongoing funding obligations and for a set percentage of other funding to be ring-fenced for research on childhood cancers. We also need to look at reprioritising funding, to make sure that money is being used strategically for actual research—and that it is not spent on infrastructure, as happens at the moment.

We need to take full advantage of the highly accomplished researchers we have in the UK, such as Professor Chris Jones, but they need funding to answer the key scientific questions, such as, how can we do better and how can we help these children? That has been done in other countries. The Australian Government awarded about $9 million in 2019 and 2020 for childhood cancer research, and there have been extraordinary advances in outcomes on some cancers. If we can get that funding, the UK can become a centre of excellence in the field.

Yesterday, Fiona sent me an email with a message from one of the families, who are going through an incredibly hard time with their son Joshua. Josh’s mum, Michelle Beresford-Smart, writes:

“Josh is still with us, but since August has been bedridden and no longer able to communicate. Completely paralysed by the end of September and blind in October and no longer able to swallow. About 10 days ago his breathing changed and this week he was put on a syringe driver. No life, just waiting for the inevitable. Horrendous. Josh… was diagnosed in August 2017 with a tremor in his right hand. The GP told us we were being paranoid! Just a trapped nerve!”

Nine days after the GP appointment, they were in Great Ormond Street Hospital. Michelle writes:

“My son was 15 at diagnosis. He is now 18. But, as you know, there aren’t any options here in the UK. He did radiation and chemo and then we were lucky enough to get him on the ONC201 trial in New York. We last visited in February 2020, then COVID struck and options were taken away.”

These incredible women told me their stories about making a change for other families and their children who will be affected with poise and passion, and today I am speaking up on behalf of all the families who deal with the tragedy of losing a child. I ask the Government to do the right thing and fund research on rare cancers to give future generations a fighting chance.

The majority of fundraising is done by parents and family-led charities. Earlier today, I heard that Alison Caplan, a constituent of the hon. Member for East Renfrewshire (Kirsten Oswald), lost her son Daniel, aged 17, to DIPG last week. He was a bright young lad who had his whole future ahead of him. His funeral is this Friday and the family hope to help other children who are diagnosed with cancer, especially DIPG.

These are people who have lost a child to a horrendous disease, but still they continue to fight for better outcomes for future generations. They deserve to have their voice heard and I am proud to have been able to speak for them today.

[David Mundell (in the Chair)]

To ensure that everyone can make a meaningful contribution, I am imposing a four-minute time limit.

--- Later in debate ---

[Tonia Antoniazzi]

I thank the Minister for her positive response. As chair of the APPG on cancer, I welcome it, and so do Members across the Chamber, especially my hon. Friend the Member for Easington (Grahame Morris), who works very hard alongside me. I thank the Minister on behalf of Fiona Govan and all the petitioners. We will continue to hold her to account. I thank all hon. Members for their contributions.

Question put and agreed to.

Resolved,

That this House has considered e-petition 300027, relating to research into childhood cancers.

Sitting suspended.

Covid-19: Access to Cancer Diagnosis and Treatment

Tonia Antoniazzi Excerpts

Wednesday 2nd December 2020 Westminster Hall

[Tonia Antoniazzi (Gower) (Lab)]

It is an honour to serve under your chairmanship, Ms McVey. I rise as the chair of the all-party parliamentary group on cancer to talk about the worrying backlog of people who have not yet received a diagnosis of cancer. I pay tribute to the hon. Member for Westmorland and Lonsdale (Tim Farron) for securing the debate. We have been working hard cross-party to raise the issue of cancer services and the backlog, which is an issue really close and dear to my heart and one on which we need to make far more progress. I thank him for his excellent speech and his work.

Despite the amazing efforts of clinicians working in the NHS and additional support from the Government, the backlog of cancer is big and it is real. It was caused by the impact of addressing the first wave of the pandemic. I am not just talking about the backlog of people within the cancer system, which are often the figures that the Government deem to be the backlog. The real backlog is of undiagnosed people yet to come forward and present to the NHS through the three main routes: GPs, screening programmes and A&E.

In “The forgotten ‘C’” report by Macmillan Cancer Support, which uses the Government’s own data, it is projected that there are currently 50,000 missing diagnoses. The hon. Member for Warrington South (Andy Carter) has spoken in great detail about the figures, which I have also had from Macmillan. That means that compared to a similar timeframe in 2019, 50,000 fewer people have been diagnosed. That is a huge amount of people that we cannot ignore.

Macmillan Cancer Support estimate that 33,000 fewer people across the UK started treatment this year than in 2019. Working on the current rates, that backlog of undiagnosed cancer could take 18 months to tackle in England alone, not talking about the rest of the United Kingdom. Macmillan says that

“if cancer referrals and screening do not return to pre-pandemic levels, the backlog could grow by almost 4,000 missing diagnoses every month, reaching over 100,000 by October next year.”

That worries me to the pit of my stomach.

Such gravely concerning figures on the cancer backlog are echoed and supported by Action Radiotherapy, which states that the backlog of patients still waiting for potentially life-saving treatment amid the coronavirus pandemic could be as high as 100,000, with cancer services needing to work at around 120% to clear the backlog over the next two years. Those incredibly sobering and worrying statistics concern me.

In a recent parliamentary answer, the Government stated that they do not recognise those figures and they continually give an overly optimistic view of the current state of cancer services. The Government’s latest cancer waiting times from September 2020 state that urgent referrals were at more than 100% of the 2019 levels. That is over 45,000 people who have received cancer treatment, which is 96% of last year’s levels. Across the period from March to September 2020, over 291,000 cancer treatments were carried out, which was 86% of the level in 2019 and 94.5% of patients with a decision to treat received a first treatment for cancer within 31 days. Those are promising and improving statistics from the delays and disruption we saw in the first period of the pandemic. We cannot deny that.

I take this opportunity to thank the incredible and dedicated cancer workforce that has been indispensable in getting services back nearer to pre-covid levels. That is why we have to call on the cancer workforce and we need to keep them there doing their jobs. They are very precious, particularly at this time. Their efforts have been incredible and it is important to acknowledge their service to patients across the country, and their fantastic efforts in continuing cancer care across the second wave.

From all accounts, we are not seeing the delays and disruption across the board that we saw during the first wave of the pandemic. However, despite the improving situation there are many instances where the performance of the cancer system is operating at a slightly lower rate than before the pandemic. To tackle the backlog, the cancer system needs to out-perform its pre-pandemic performance, which it is not doing in all areas.

For every month that the NHS is working at below pre-pandemic levels, the backlog is building and it is not being beaten. Urgent GP referrals appeared to be roughly back to normal in September, but there were still around 338,000 fewer people not seeing a specialist following an urgent referral between March and September this year, compared to last year. I am rightly concerned about the potential for missing diagnoses. Macmillan Cancer Support estimate that it would take 17 months at 10% above 2019 levels to see 338,000 extra patients, which are striking figures.

The real issue is that Ministers are painting an over-rosy picture of the cancer backlog and trying to refute the claims that a large number of people are not having cancer treatment this year compared with previous years. The Government cannot refute their own cancer waiting times data for those starting first cancer treatment. From March to September, there were 31,000 fewer patients starting first cancer treatment in England, which is a drop of 17% compared with the same period last year.

Let us be clear: there are 31,000 people in England who currently could have cancer, and yet, for numerous reasons associated with the pandemic, have not presented to the NHS with symptoms. That is an incredibly worrying and troubling statistic. Without acknowledgement of the scale of the issue, neither the solutions to the problem nor the resources needed to tackle it will materialise.

Again, while September’s monthly activity was improving, it is still down on last year and so the backlog will continue to grow each month. Month by month, performance is below 2019 levels, which is a huge concern—and a huge and daunting task that is currently being underestimated by the Government.

The national cancer recovery plan, which is yet to be published by the Government, and only runs to March 2021, only uses metrics on the backlog that include those on the 62-day and 31-day cancer pathways, as well as those with longer waits for diagnostics or treatments above 104 days. It in no way estimates the significant number of people yet to present to the NHS. That is the real backlog, which the Government are failing to acknowledge and are failing to take significant and timely steps to address.

While the Government have made some welcome steps in adding additional capacity through the independent sector and just recently committed £1 billion extra in the comprehensive spending review to deal with backlogs in the NHS, it is uncertain how much of that money is allocated to the cancer system. Will the Minister confirm how much of that funding will be spent on beating the backlog in cancer care?

It is clear that the restoration of the cancer system is a priority at the highest levels of the Government and that significant resources have already been allocated to that endeavour, but—it is a very big but—until the Government acknowledge and plan to tackle the monumental scale of the real backlog that is still building, the health outcomes of many thousands of people out there yet to be diagnosed with cancer will be significantly grave and the Government will not be able to meet their ambitious targets for cancer within the NHS long-term plan. Will the Minister acknowledge the scale and reality of the problem, commit the strategic and monetary resources needed to tackle it now and work with key stakeholders such as Action Radiotherapy, the different all-party parliamentary groups and Macmillan Cancer Support, which have been working hard to support those living with cancer and who have been severely impacted by the pandemic?

I welcome the previous and the soon-to-be-had engagement with the Minister. We appreciate that we are working in unprecedented times. However, I was a little bit concerned to read a letter dated 30 November from NHS England’s cancer programme to the cancer alliances. The letter, which is advice on maintaining cancer recovery, shows the depth of arrangements and efforts that are being made to restore the cancer system and continue with cancer care, but it fails to acknowledge and deal with the huge backlog of people we have spoken about today—those who are yet to come forward for a diagnosis.

The national cancer recovery plan is too short term and has the wrong priorities to deal with the backlog in the long term. That is what we are concerned about; that is why we have come here today to present the issues to the Minister. I look forward to speaking with her, but I ask that this issue is dealt with immediately.

Covid-19 Update

Tonia Antoniazzi Excerpts

Tuesday 10th November 2020 Commons Chamber

[Matt Hancock]

I thank staff at the Royal Derby for the work that they are doing. These are difficult circumstances. One of the reasons why we brought in measures that I know are difficult was to protect the NHS from the increase in the number of cases, which in Derby, as my hon. Friend says, is now higher than in the first peak. Unfortunately, the solution that she proposes is in fact the other way around: the NHS Nightingales provide extra space and extra capacity, but we need to stretch the existing workforce to use them—to staff them—if they are needed. That is another reason to take the measures that we have taken in order to protect the NHS.

[Tonia Antoniazzi (Gower) (Lab)]

Penblwydd hapus, Mr Deputy Speaker.

A number of concerns have been raised today about staffing in the NHS, so may I press the Secretary of State to commit to ensuring that cancer professionals are not redeployed away from cancer treatment and care, so that they can beat the backlog rather than building it even further?

[Matt Hancock]

Yes, that is absolutely our goal—to keep all cancer treatment going during this second phase. So far, that has been successful everywhere; even where hospitals have had to postpone non-urgent activity, they have not postponed cancer treatment. This is incredibly important to me personally, and I strongly support the recommendation that the hon. Lady sets out.

Coronavirus Regulations: Assisted Deaths Abroad

Tonia Antoniazzi Excerpts

Thursday 5th November 2020 Commons Chamber

[Matt Hancock]

Yes, I think this is a really important point, because high-quality palliative care and the question directly of assisted dying that is before the House today are not separate questions. They are intimately tied together and whatever view the House takes on assisted dying—and it is for the House—it is the Government’s intention to support and strengthen palliative care to make sure that we give the very best support for people towards the end of their life.

[Tonia Antoniazzi (Gower) (Lab)]

I welcome the Secretary of State’s clarification today to support people’s choice and their dignity in dying. He has spoken about palliative care at length, and I understand that there is further funding for hospices, but charities, such as cancer charities that support people with those choices, have had to make drastic cuts to their staffing and funding as a result of covid. What conversations has the Secretary of State been having with the Treasury, and what commitment will they make in the November spending review?

[Matt Hancock]

Obviously the hospice sector, which often relies on charity shops in order to fund its services, has had a very difficult year. We therefore have put funding support in and we always keep that under review. I applaud the fact that our hospices are funded both from taxpayers and through a huge amount of philanthropy. It leads to a stronger sector that is rooted in the communities that it serves. Nevertheless, I acknowledge that that has led to some significant challenges this year. We have put more funding in and will, of course, always keep that open to review.

Covid-19 Update

Tonia Antoniazzi Excerpts

Programme motion
Monday 19th October 2020 Commons Chamber

[Tonia Antoniazzi (Gower) (Lab)]

As the chair of the all-party parliamentary group on cancer, I thank the Secretary of State for a recent meeting regarding the Catch Up With Cancer campaign. I, too, pay tribute to those delivering frontline cancer services throughout the pandemic, but the 63% figure that he mentioned does not reflect the totality of the backlog, as the NHS has announced new figures since then. In August, the number of people waiting more than 52 weeks in England continued to surge to more than 110,000—the most in 12 years. The only way that the backlog will go away is through action and resources being deployed to tackle it. What progress has he made to address the need for a boost to cancer services, so that cancer does not become the forgotten “c”?

[Matt Hancock]

The hon. Lady is absolutely right to raise that issue. In my statement, I said that we have managed to reduce the backlog among the longest waiters, those who wait more than 104 days, by more than 63% and among those waiting more than 62 days by 44%. There is further work to do—of course there is—but the NHS has made significant strides on the backlog of people waiting for cancer treatment, and I pay tribute to all the work that it has done.

Oral Answers to Questions

Tonia Antoniazzi Excerpts

Tuesday 6th October 2020 Commons Chamber

[Helen Whately]

The hon. Member makes an important point, as did my hon. Friend the Member for Derbyshire Dales (Miss Dines) a moment ago, about the importance of visiting for those in care homes, and for their relatives and loved ones. We are striking the difficult balance between protecting those in care homes and ensuring that they have visits wherever possible, but these visits must be done safely. I have heard from the sector about the aspiration for some family members to be treated as care workers—for instance, if they visit the care home regularly. As we expand testing, I very much intend that we should test some visitors—and am making the case for doing so—but it is all part of how we expand and use our testing resources.

[Tonia Antoniazzi (Gower) (Lab)]

  If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Matt Hancock)]

On Friday we confirmed the 40 hospitals we will build by 2030 as part of a package worth £3.7 billion, with a further eight new schemes also invited to bid, all to ensure that we protect the NHS long into the future.

[Tonia Antoniazzi [V]]

All I want from the Secretary of State today is a simple yes or no answer. It has come to light that the Northern Ireland authorities have taken unprecedented action and committed to pay for private prescriptions for medical cannabis for severely ill children. Will he do the right thing and follow the example set in Northern Ireland in supporting other children with intractable epilepsy by paying for their private prescriptions—yes or no?

[Matt Hancock]

The hon. Lady has long been a campaigner on this subject. We have made significant progress in terms of expanding access where it is clinically safe to do so. On this, as on so many things, I will make sure that I constantly follow the clinical evidence.

Covid-19 Update

Tonia Antoniazzi Excerpts

Monday 21st September 2020 Commons Chamber

[Matt Hancock]

Yes, giving 10 tests to all schools across the country has proved very popular, according to the feedback that I have had. I am very glad to hear that that is true in my hon. Friend’s part of the world as well. Of course we will continue that, with the right level of tests being sent out to the right types of schools in the right places, and I will make sure that we take into account rurality as one of those factors.

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

On Friday afternoon, the Department for Work and Pensions informed Jobcentre staff that, from today, they have to reintroduce face-to-face 10 minute work search interviews with customers. So, Secretary of State, in the light of the rising number of cases and with everyone meant to be playing their part, is this really a sensible approach to be taking?

[Matt Hancock]

One of the good things about where we are now compared with where we were in March is that, in many areas, we are better prepared. We are better prepared in the NHS. We are better prepared in social care with the winter plan that we put out last week, and many employers and services, such as jobcentres, have been able to develop covid-secure approaches, which means that they can get on with the things that they need to do. The specifics of the question, of course, are for my right hon. Friend the Work and Pensions Secretary, but the principle of how we, as a society, manage to do more things while keeping ourselves covid secure is one that, thankfully, we have been able to develop over the past six months.

Covid-19 Update

Tonia Antoniazzi Excerpts

Tuesday 8th September 2020 Commons Chamber

[Matt Hancock]

Yes, and people will be hearing far, far more about hands, face, space. It is really simple: wash your hands, wear a face covering when you need to and keep that social distance. That is the responsibility of everybody to help us control this virus.

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

The Secretary of State has had four months to respond to a letter I sent as the chair of the all-party parliamentary group on cancer, requesting a national cancer recovery plan. Of course I recognise the extreme strain that covid-19 has put on the NHS and his Department, but people living with cancer—diagnosed and yet to be diagnosed—have been left in limbo. When will the Secretary of State respond to my letter, and when will he make public his Government’s national cancer recovery plan?

[Matt Hancock]

I will respond right away. I am very glad that the hon. Lady has raised this issue. It is something that I have been doing a huge amount of work on, along with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill). We have been working on it intensively and, as I say, the backlog has come down by about half, but clearly there is much more to do.

Coronavirus Response

Tonia Antoniazzi Excerpts

Monday 20th July 2020 Commons Chamber

[Matt Hancock]

We are undertaking that research into immunology. It is incredibly important for people, like me, who have had the disease to know the likelihood of getting it again and of transmitting it again. Both are very important for obvious reasons—one for personal health; the other for public health—but it is not just about the antibody response; is also about the T-cell response. Both of those are different parts of the immune system responding. We are making progress in our understanding of that, but not yet enough to be able to recommend that people who have had the disease, or have antibodies, act in any different way from the rest of the community.

[Tonia Antoniazzi (Gower) (Lab)]

On 26 June, there was letter to the Secretary of State from the co-chairs of the all-party parliamentary group on access to medical cannabis under prescription about the desperate plight of epileptic children due to covid. On 9 June, there was an urgent email to the Under-Secretary of State following a meeting at the suggestion of the Secretary of State in this House on 2 June. On 22 May, there was a joint letter from eight cross-party chairs of cancer APPGs about an urgent need for a covid national cancer recovery plan. I have received no replies to any of that correspondence. Does the Secretary of State just not like me, or does that point to a bigger issue with his Department?

[Matt Hancock]

We have spoken about that in this House. It is absolutely true that during the peak of the crisis the Department was working incredibly hard and absolutely flat out, and we are now working hard to catch up on our correspondence.

Health and Social Care Workers: Recognition and Reward

Tonia Antoniazzi Excerpts

Thursday 25th June 2020 Commons Chamber

[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

I beg to move,

That this House has considered e-petitions relating to the recognition and reward of health and social care workers.

The Petitions Committee is delighted to have been allocated this business time today. On behalf of more than 4.6 million people from across the country who have signed petitions relating to this pandemic and other issues, let me say that we hope this is now the first of many debates we will be able to have, as 29 petitions are waiting to be debated and more are heading toward the 100,000 signature threshold—the petitioners’ concerns must be heard.

I am honoured to be leading this debate today on recognising and rewarding our health and social care workers. Indeed, the first ever e-petition debate in Parliament was on contracts and conditions for NHS staff, back in September 2015. I also believe we could hold this debate 10 times over, to recognise the contribution of so many during what has been an incredibly challenging time for our country. I am thinking of those who have kept our public services going—those in the police, the fire service, local government and other government departments, who have been working tirelessly to ensure that the support that is needed gets to households and businesses—and those who have been working in our shops, ensuring that we can all get essential supplies. There are so many people to recognise and thank for their service.

It is absolutely right that every week for 10 weeks, we came together especially, as a country, on a Thursday evening at 8 o’clock to recognise and clap for our carers. It was incredibly moving every time. Taking a moment to stop and reflect on the lives lost to covid-19, but also on those many lives saved through the tremendous skill, care and sacrifice of health and social care workers right across our country, we must never forget a frontline on which more than 331 NHS and care workers across the UK died as a result of covid-19. Indeed, it is concerning that we do not know exactly how many health and care workers have sadly lost their lives, because the Government are not producing consistent figures. That is one of the things that I ask the Minister to update the House on in her response.

Yet, as so many people have contacted me to say, those same people have been saving lives and caring for us day after day, long before this horrendous virus presented itself. It is absolutely right that we should clap and thank them for their extraordinary service during this period, but we must also recognise that a clap and a thank you is not enough. It was not enough before this pandemic, and it certainly is not enough now.

[Tonia Antoniazzi (Gower) (Lab)]

Will my hon. Friend join me in commending the Welsh Labour Government who recognised the efforts of care workers in Wales during covid by paying them £500 more? Many people could benefit from that. Will she also join me in calling for the Government not to make them pay tax on that £500?