Oral Answers to Questions

Wes Streeting Excerpts

Tuesday 15th January 2019 Commons Chamber

[Stephen Hammond]

The hon. Gentleman is right to say that volunteers in the NHS provide an invaluable service, but he is completely wrong to suggest that any part of the long-term plan relies on volunteers. There is an expansion in numbers of nursing associates to deal with those vacancies and, as I have said to other hon. Members, we have seen an increase in the number of doctors in GP training. Obviously, he will welcome the £20.5 billion a year that is going into the national health service. That will inevitably mean more doctors and nurses, which is why we are making more training places available.

[Wes Streeting (Ilford North) (Lab)]

2. What progress his Department has made on contingency planning for the UK leaving the EU without a deal.

[Ian Murray (Edinburgh South) (Lab)]

3. What progress his Department has made on contingency planning for the UK leaving the EU without a deal.

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

We do not want a no-deal scenario in our exit from the European Union, but it is incumbent on us to prepare in case. We asked medical suppliers to stockpile a further six-week supply over and above normal levels, and that work is going well. We will continue to work to ensure the unhindered supply of medicines in all Brexit scenarios.

[Wes Streeting]

The Prime Minister’s threatening of this Parliament and the country with no deal is entirely reckless, irresponsible and unnecessary. It is also causing unnecessary fear and anxiety among a range of clinicians and patients who rely on the consistent supply of life-saving drugs. The Secretary of State says that the Government are stockpiling medicines for up to six weeks. Will he do the right thing and commission an independent assessment of those plans so that patients can be reassured? Better still, will he go back to the Cabinet and say that no responsible Health Secretary would allow no deal to take place, no responsible Prime Minister would allow no deal to take place, and this House will not allow no deal to take place?

[Matt Hancock]

It is incumbent on me as Health Secretary and on my team to ensure that we prepare for all potential scenarios. Of course, because of the overwhelming vote of the House in favour of the withdrawal Bill, no deal is the law of the land unless the House does anything else. If the hon. Gentleman is so worried, the best thing that he and all his friends can do is vote for the deal tonight.

Budget Resolutions

Wes Streeting Excerpts

Tuesday 30th October 2018 Commons Chamber

[Matt Hancock]

Yes, and the constructive approach that the hon. Gentleman has taken on this subject with me over many months, and for years before that, shows the progress that we can make. We are putting £20.5 billion extra into the NHS, and making an uplift like that means that we can turn resources towards preventing ill health in exactly the way that he describes. I pay tribute to the work that he has done on this subject.

[Wes Streeting (Ilford North) (Lab)]

Yesterday, the Chancellor boasted of a “jobs miracle”. If there is a jobs miracle, why is the chemotherapy unit at King George Hospital in my constituency closing because of a shortage of chemotherapy nurses?

[Matt Hancock]

We have a plan to improve the cancer workforce and to try to solve some of these problems. Maybe the hon. Gentleman should come over to this side and work with us to put record funding into the NHS. We can only have record funding for the NHS if we have a strong economy.

Paediatric Cancers of the Central Nervous System

Wes Streeting Excerpts

Monday 22nd October 2018 Commons Chamber

[Chris Elmore]

I agree entirely. I am sure the Minister will set out the extra work the Government here and the Administrations in Scotland, Cardiff and Belfast are doing.

The very fact that these cancers are rare often makes it difficult to get a research cohort together, but we cannot allow that to be a barrier to finding new treatments and even cures for such illnesses. The treatments currently available for childhood cancers in the brain or spine tumours range from neurosurgery to radiotherapy, chemotherapy and steroids, and finally proton beam therapy. The course of treatment is tailored to the individual case, with patients typically undergoing multiple treatments. Sadly, AT/RT patients do not typically have good survival rates, and outcomes are poorer if a child has signs of tumour spread at diagnosis. We cannot accurately predict the outcome for any individual child who has developed such a tumour, but children diagnosed who are less than 12 months old are less likely to be able to fight the disease.

It will come as no surprise to hon. Members when I say that the key to fighting this disease in the long term lies in medical research. There are many competing priorities in medical research, with many historic frontiers yet to be conquered, but we must ensure that all forms of illness that cause pain and suffering receive the attention and the willingness to tackle them they deserve. I welcome the announcement from the Department of Health and Social Care earlier this year that the UK will invest £20 million in brain tumour research over the next five years. In addition, Cancer Research UK is investing £25 million to support that work. Will the Minister say what percentage of that funding will be used specifically for research into paediatric cancers?

[Wes Streeting (Ilford North) (Lab)]

I am grateful to my hon. Friend for securing this debate. This year, I have attended the funerals of two very special and inspirational people. One was well known to us in this place: Dame Tessa Jowell, who led a valiant campaign against brain cancer. I welcome the Government’s response to her efforts. The other was my eight-year-old constituent Kaleigh Lau, who waged an equally valiant fight against diffuse intrinsic pontine glioma—a particularly rare form of brain tumour. May I endorse what my hon. Friend says about the importance of specific funding for childhood brain tumours, including rare conditions such as DIPG? May I also through him urge the Minister to look again at support, especially financial support, for families who travel long distances—in Kaleigh’s case, to Mexico—to access experimental, often successful and life-extending, treatment? That needs to be looked at, so that in future the life expectancy of a child depends not on how much money their parents have or can raise, but on whether our Government are prepared to ensure that all children have access to potentially life-extending treatment.

[Chris Elmore]

I agree, and I will touch on the impact on families later in my speech. People talk of the late Baroness Jowell—Tessa—and her legacy. There can be no greater legacy than securing the additional research funding through her campaign on tackling the causes of brain tumours. Of her many great achievements, that has to be the one that will live with all of us the longest.

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[Chris Elmore]

I entirely agree with my hon. Friend. I again pay tribute to her and her leadership not just on childhood cancer but on cancer generally. She is a true heroine of the cause and we are extremely grateful to have her in this House. It is clear that there is positive work being undertaken on this issue, but it has to be said that we can do more, much more, to help to tackle this disease.

Members across the House will remember when our dearly missed friend, the late Baroness Jowell, spoke so movingly, just days before Cian passed away last January, about the need to work much harder to make brain tumour research more effective. Tessa stressed the need to support the Eliminate Cancer Initiative to improve the chances of tackling this rare illness internationally. The creation of a clinical trial network around the world, an increase in the use of active trials, and the use of a global database would help to improve research and patient care. As Tessa so rightly said, through sharing knowledge across borders, and thereby at a local level across medical governance structures, we will be best placed to advance our knowledge of the most difficult and rare forms of cancers, including cancers of the central nervous system.

Making that happen will involve further investment in research into specific tumours such as AT/RT, and international collaboration to ensure that we have the best minds and the most innovative technology working on the most difficult of challenges. I believe the UK Government can be doing more to facilitate that. When Ministers visit other countries abroad, more often than not the two principal reasons for the trip are to further international trade or promote international security, both of which are of course vital. However, it is my view that in discussions with our foreign counterparts the issue of international research must rise up the agenda if we are to have any hope of accelerating our efforts in this area.

[Wes Streeting]

My hon. Friend is being very generous with his time. I am reluctant to introduce Brexit to this debate as we spend so much time discussing it, but on that specific point we have to ensure that we maintain research co-operation with other EU member states, not least so that we get the scale of rare cancers. In the week in which my local NHS trust announced it is closing the chemotherapy unit at King George hospital because of a shortage of chemotherapy nurses, may I gently ask the Minister to ensure that we recruit and retain, from both here and across EU member states, the staff we need to provide the high quality of care and treatment our constituents so desperately rely on?

[Chris Elmore]

I entirely agree with my hon. Friend. I will move on to the big B and the big C shortly.

Many of the children Cian was in hospital with had previously been sent abroad to participate in medical trials, including proton therapy. Will the Minister please look at what more we can do to collaborate with international drug trials and trials of new therapies to ensure that we have the most up-to-date treatments available here in the UK? Just as cancer affects so many people, so our efforts to counter it must include as many people as possible. This is simply not something that we can tackle alone.

Sadly, while the majority of my remarks have been about the big C, I must, as ever, touch on the big B. As we leave the European Union, it cannot be stressed enough how important it is for us to continue to work with our European partners to fund research, and indeed to undertake research ourselves into rare cancers. It is vital that we continue to play our part in EU research and development projects of genuine international importance. We must also continue to work with the European Association for Cancer Research, because we simply cannot sacrifice the potential new cancer treatments we will uncover in the name of, in my view, a misguided sense of regaining sovereignty. Indeed, the current treatment is agreed at EU level. Having first been established in 2002, the treatment was last fully reviewed in 2009. The drugs being used to treat this type of cancer are old in relative terms, showing what a vital role international governance can and will play in helping to improve outcomes in the future. Overall, the message I want to get across today is clear. So many cancers rightly receive a great deal of attention and research funding. I would argue that, just because rarer cancers, such as the one Cian suffered from, affect fewer people, that does not mean that we should not be as targeted or as innovative in our efforts to fight them.

If you will allow me, Madam Deputy Speaker, I would like to mention briefly the brilliant and selfless work Cian’s family have been doing to raise awareness of this particular type of cancer, and their work in fighting for new research and treatments for such paediatric cancers. Cian’s father, Richard, is in the Gallery today. I pay tribute to him and Cian’s mum, Lorraine, and his siblings Dillan aged 11 and Bethan aged 9, for their bravery. [Hon. Members: “Hear, hear.”] From when Cian was first diagnosed in November 2015, to when he was told in June 2016 that the tumours had gone, through to when he sadly relapsed in November 2017, his family have tirelessly raised awareness. His community have fundraised and, since his passing, they have continued their efforts.

I pay tribute to Cian’s family for all their efforts in the most difficult of circumstances. I would like to thank the whole community of Llanharan, the surrounding villages and far beyond, whose support for Cian has been unwavering. The online funding page set up following Cian’s death raised in excess of £6,000, which is going to help the charities who supported Cian and his family throughout his treatment. I am sure you will agree, Madam Deputy Speaker, that this shows what a mark this little boy has made on his local community. Likewise, I am so proud of all the staff, pupils and parents at Llanharan primary school, the school Cian attended, who were so supportive to Cian throughout his journey and who have been there for his parents and friends since. I was privileged to attend the memorial event they held shortly after Cian died. I am always proud to serve my constituents from the many communities across Ogmore, but I have to say that being part of this outpouring of love in the most tragic of circumstances was truly a privilege. I would like to put on record my thanks to Cian’s headteacher, Mrs Price, his class teacher, Mr Arthur, and all his school friends and the wider school community for the support and generosity they have shown Cian and his family. They planted bulbs which will bloom every year in his memory, so that Cian can never be forgotten.

I admit that there is no easy answer to the issues I have raised today. It will not be solved overnight simply by throwing money at it. The sad reality is that while we seek to meet some of the challenges, other families like Cian’s will sadly suffer the same anguish in the future. It is therefore essential that we raise awareness of the symptoms to look out for to ensure that this disease can be caught early, giving those unlucky few the best chance of survival. The National Cancer Institute finds that children who have developed AT/RT may experience the following: headaches, particularly in the morning; nausea or vomiting; fatigue or lethargy; difficulty with balance and co-ordination; and an increase in the size of their head. Because AT/RT develops so quickly, these symptoms can onset incredibly quickly over a matter of days or weeks. The symptoms can also vary depending on their age and the precise location of the tumour.

It is only right that I highlight the fact that many of these symptoms represent common medical conditions in both children and adults and, in the majority of instances, will not mean that a child has developed a brain tumour. If a parent ever has any doubt in their mind, however, I would always encourage them to seek medical advice. In Cian’s instance, he began experiencing stomach pains that were originally thought to have been abdominal migraines. In reality, it was the pressure of the tumour restricting the spinal cord that transmitted the nerve pain on to his torso.

Cian touched the hearts of all those around him. He was a warm, fun-loving and generous boy. While tragedies like this thankfully do not happen every day, when they do happen, it is only right that we reflect, pay tribute and act to help to ensure that we prevent such instances happening again. Cian was delighted to have met the Speaker during his visit to Parliament and No. 10 Downing Street back in 2016. While I would have liked him to have had the opportunity to return to this House, sadly this will now not be possible. Instead, we must ensure that the House comes together to support those affected by cancer and send a message that our determination to beat it—across all parties—is utterly unwavering.

I thank Members from across the House who have remained in the Chamber to hear Cian’s story and I thank the Minister for taking the time to consider what more we can do about this important issue. The key point I have stressed today is not party political; it is that we must continue to advance our knowledge base across the UK and, most importantly, internationally. By steadfastly supporting the Eliminate Cancer Initiative and redoubling our efforts to find new treatments, and, hopefully one day, a cure for cancers of the central nervous system, we can ensure that Cian’s legacy lives on.

Cian was a young boy with his whole life ahead of him. I appeal to the Minister and every Member: let us help to ensure that more children survive such cancers in his memory.

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[Steve Brine]

I will now take an intervention from the hon. Member for Ilford North (Wes Streeting).

[Wes Streeting]

I am grateful to the Minister for his thoughtful response to the debate. Will he and the Department look carefully at the issue of access to experimental treatment and financial support, and also the issue of control? One of the conversations that I had with Tessa was about how she had to wrest back control over her own choice in relation to risk and access to experimental treatment.

It would be hard enough for adults to make such choices for themselves, but parents are having to make those difficult choices, too. Some parents feel that they are making the best decisions for their children in turning down the opportunity of access to experimental treatment on the basis of an assessment of the risk and the impact on the life that they have left, while others choose to access such treatment in the interests of their children. While there are challenges in respect of the governance and, perhaps, some of the ethics of those arrangements, we must put a bit more trust and faith in parents. When they choose to access experimental treatment, even if the Department will not fund access to the treatment itself, it might be able, reasonably and ethically, to provide more support than it currently provides in respect of the associated costs of, for instance, travel, accommodation and subsistence.

[Steve Brine]

I will look into that. The late Baroness and I talked about exactly that subject. I do not think it is so much about ethics; I think that this must be clinically led. There is a great deal of debate in the clinical cancer community about the toxicity of concurrent treatments. However, I take the hon. Gentleman’s point about the costs, and the importance of supporting parents who must make decisions which are hard enough when people are making them for themselves.

My hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson) mentioned an all-party parliamentary group of which I was a member before I was a Minister. I take all-party parliamentary groups so seriously because I used to lead loads of them. I spent hours writing reports, and, dare I say, I wish that they were sometimes taken as seriously as I take such reports.

It is in all-party parliamentary groups that a lot of good work goes on in the House. Opposition Members, who are not in government at this time, have a huge role to play in moving the dial. The smart Ministers are the ones who say that they do not know everything. The lines that the civil service gives them are often great, but they are not the be-all and end-all. I see APPGs as a brilliant and rich vein of knowledge for me, and I learn a lot from them. So yes, I will look out for my hon. Friend’s work in Together for Short Lives.

My constituency contains one of the best children’s hospice trusts, Naomi House and Jacksplace. My heart goes out to the child hospice movement and my respect for it is ample, and what Together for Short Lives does to represent that movement is incredible.

Dangerous Waste and Body Parts Disposal: NHS

Wes Streeting Excerpts

Tuesday 9th October 2018 Commons Chamber

[Stephen Barclay]

I should clarify that it is not me personally who has terminated these contracts. These contracts with HES are held by the trusts themselves, and therefore it is a decision taken by those trusts.

As I said earlier, there is significant additional capacity within the incinerator landscape to process the waste generated by this contract, and therefore the suggestion in some quarters that this is an issue of a lack of capacity is simply not valid. To be clear, HES produces 595 tonnes of waste a month that goes to incineration, and the NHS identified 2,269 tonnes of incineration capacity, so reports that there is a lack of capacity in the market are not valid.

[Wes Streeting (Ilford North) (Lab)]

I learned from the Health Service Journal that Barking, Havering and Redbridge University Hospitals NHS Trust was one of those affected. It is totally unacceptable that clearly one of Ministers’ objectives was to cover things up for as long as possible to save their own blushes because of the failure of a Government contractor. Members of this House should not learn of such events from the media. We should hear it from Ministers via the Dispatch Box or the relevant Select Committee—or there is such a thing as email.

Ministers have announced that £1 million of contingency funding is to be made available to support trusts affected. Will that be met from existing departmental budgets, or will money be allocated by the Treasury? Further to the point made by my hon. Friend the Member for Leicester West (Liz Kendall), surely it should be the failing contractor that coughs up £1 million, if not more. It should not come from taxpayers.

[Stephen Barclay]

We all learn things on a regular basis from the HSJ, but it seems misplaced to suggest that the hon. Gentleman should have been told about this when we were ensuring continuity of service and putting in place alternative arrangements to ensure that operations could continue at Barking and other hospitals. I have already addressed that point.

As I said, some of the cost—the contingency cost—will be absorbed centrally. The normal cost of clearing clinical waste was borne by the trusts before and will continue to be borne by the trusts.

NHS Long-Term Plan

Wes Streeting Excerpts

Monday 18th June 2018 Commons Chamber

[Mr Hunt]

Obviously, that would be for the CCG to look at; it will focus on anything that allows it to focus on prevention and not cure. I do not know the specifics of that case, but in general there is a strong and important role for community hospitals, although not always doing exactly the same things they have done in the past. Often, they can become local NHS hubs, offering a wide range of services. That tends to be the best way to preserve their future.

[Wes Streeting (Ilford North) (Lab)]

Standing at that Dispatch Box, the Secretary of State made the astonishing claim that when it comes to NHS funding, the Conservatives write the cheques and Labour writes the speeches. Let me tell him about increases in health spending under every Government in my lifetime: a measly 1.4% increase under David Cameron; 2.7% under Mrs Thatcher; even John Major managed a better 4.7%. It was only under the Labour Governments of Gordon Brown and Tony Blair that we saw increases in NHS spending of 5.4%, under Gordon Brown, and 6.1%, under Tony Blair. Does that not demonstrate that we cannot trust the Conservatives on the Brexit dividend and we cannot trust their claims on NHS spending? Until the Conservatives sort out social care and public health spending, the Labour Governments will have a record that this Government cannot even begin to touch.

[Mr Hunt]

The hon. Gentleman has just proved my point about Labour making speeches about the NHS. He talked about a “measly” increase under David Cameron; what he forgot to tell the House was that his own party’s plans that year were to cut the NHS budget because of the train crash of an economy that they left the country with.

NHS Outsourcing and Privatisation

Wes Streeting Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Jonathan Ashworth]

My hon. Friend has, with great eloquence, explained why failing to plan properly on the workforce is such a false economy. It means that trusts are spending more and more on locums and expensive agencies.

I trust that no Conservative Member will try to pretend in this debate that it is possible to reduce beds, reduce staff, cut social care and fail to invest while patient numbers are increasing without the quality of care suffering. If any Conservative Member does try to tell us the opposite, they should look at the latest performance standards. The lack of hospital capacity and staffing means that the waiting list has risen to more than 4 million. Simon Stevens, of NHS England, has warned that

“on the current funding outlook, the NHS waiting list will grow to five million people by 2021. That’s an extra million people on the waiting list. One in 10 of us waiting for an operation—the highest number ever.”

The blanket cancellation of elective operations has seen waiting lists rise by nearly 5% compared with last year, and we have waiting times up and performance against targets down. In overcrowded A&Es, in the past year, 2.5 million have waited more than four hours. Just 76.4% of patients needing urgent care were treated within four hours at hospital A&E units in England in March—that is the lowest proportion since records began in 2010.

[Wes Streeting (Ilford North) (Lab)]

Of course, A&E waiting times would not be as long if the Government were investing properly in primary care. In my borough, we have the ludicrous situation of private companies advertising in London underground stations, saying:

“Fed up waiting? Our private GPs can see you now…ONLY £80”.

Does my hon. Friend agree that people should not be forced to pay £80 to see a GP, and they should not be waiting unnecessarily long in A&E because of the Government’s failure properly to fund and deliver the workforce that primary care needs?

[Jonathan Ashworth]

My hon. Friend has hit the nail on the head. The problem is that, when the Government allow our national health service to deteriorate by such a scale and push it into this level of crisis, they are essentially forcing people, often reluctant refugees from a public NHS, into self-pay options. That is what happened last time the Conservatives were in government and it is happening again.

Cancer Treatment

Wes Streeting Excerpts

Thursday 19th April 2018 Commons Chamber

[Heidi Alexander (Lewisham East) (Lab)]

It is a genuine privilege to speak in this debate, and I congratulate my hon. Friend the hon. Member for Croydon Central (Sarah Jones) and the right hon. Member for Old Bexley and Sidcup (James Brokenshire) on securing it. It is entirely appropriate that this debate has been led by two south London MPs. As a fellow south Londoner, may I start by saying what a special place in our heart is occupied by the very noble Baroness Jowell? There are some people we meet in life who radiate positivity, and Tessa is one of them. She has a lightness of step but a firmness of view that is a formidable combination; there was no way those Olympics in 2012 were going anywhere but London! It is right and proper that this House has the chance to debate her latest and perhaps most important campaign: the need to increase research on, and improve outcomes for, individuals diagnosed with brain cancer. The figures on research funding, and the availability of effective drugs and treatment, speak for themselves, and I will not repeat them, as I know time is short.

Last year, I lost two people close to me to cancer. One was my father-in-law, Nigel Ballantyne. I hesitate to say what I am about to say, as I have questioned whether my own grief has skewed my perceptions of the care that he received. I do not think it has. I also hesitate because I wonder whether today is the appropriate time to raise these issues, but I have concluded that Tessa would not want me to pull any punches.

My father-in-law was told that he had lung cancer when he was on his own, in a hospital bed, with only his mobile phone for company. There were complicating circumstances, but there were no excuses. He had struggled to get an appointment to see his own GP and had been passed from pillar to post for months—a situation admittedly not made better by the usual reticence of a 76-year-old man not wanting to cause a fuss, and his understandable desire to go on that holiday that he had been looking forward to. Having said that, the delay in his diagnosis and the way his diagnosis was delivered were unacceptable. He died six days before the general election last year.

Five months later, a good friend died at home after a long struggle. His wife speaks of how she had to fight tooth and nail to get palliative care support in place on the night he died. She described to me a ward that lacked sufficient nursing staff to administer injections without her physical help.

When the national cancer strategy talks about placing patient experience on a par with clinical outcomes and quality of life, it rings a bit hollow to me. I do not want to sound overly bleak, as I know that there are many wonderful examples of good care with positive outcomes, but we do need to be honest. We need to ask ourselves tough questions about how patients are treated on all steps of the care pathway.

Those living with cancer also need more support. Last Friday, my constituent, Amanda Mahoney, whose breast cancer has recurred four times in seven years, came to my advice surgery to ask me to campaign alongside her to change the face of cancer. She said:

“We’re not all bald, we’re not all having chemo. I don’t want to be told ‘sit on a park bench and wait till it gets you.’”

She wants to continue doing the job she loves—she is an outreach worker with autistic children—but her recurring experience has been employer after employer who does not know what to do and a benefits system that seems to make things harder, not easier.

This issue is not going away. This debate is the product of Tessa’s campaigning. She has been able to do what she does best—make her contribution by making those in power sit up and listen. She has been able to continue her working life. Others should be able to do the same, if that is what they want, and employers should be supported to make that happen.

There is so much more that needs to be said, but in the time available it is impossible to do this subject justice, so I will touch on just one other issue, which I know is also close to Tessa’s heart: our impending departure from the EU, which includes our probable departure from the European Medicines Agency and Euratom. Promises were made about extra cash for the NHS after Brexit, but, in stark contrast, Brexit has potentially huge negative implications for cancer research and treatment. We need urgent answers.

The continued ability of British cancer sufferers to participate in pan-European clinical trials is critical, especially for those with rarer cancers. We must ensure that we have a reliable supply of medical isotopes for diagnostics and treatments—that supply is at risk as we leave Euratom. We must not become a second-tier country for access to the newest and the best medicines. The next generation of immunotherapies holds great potential. We cannot willingly put ourselves at the back of the queue.

There are not yet answers to those questions, nor are there answers to the chronic NHS staffing crisis, which is exacerbated by Brexit, yet we are 11 months from leaving. We need a global, cross-border approach to research. We need to be a country that is open to talent and ideas from around the world. We need a properly resourced, adequately staffed NHS that is capable of embracing innovation.

[Wes Streeting (Ilford North) (Lab)]

Will my hon. Friend give way?

[Heidi Alexander]

I am drawing my remarks to a close.

It saddens me that we seem a long way from that aspiration, but if we are to honour the work of people such as Tessa and the memory of people such as my father-in-law, it has to be worth fighting for.

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[Wes Streeting (Ilford North) (Lab)]

I rise today to talk about some very special people with an Ilford North connection. Perhaps even more impressive than crossing the party political divide in this debate, Tessa Jowell crosses an even greater political divide in London— the River Thames. I say respectfully to my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) and her constituents that we actually had Tessa first, because, in 1978, a fresh-faced Tessa Jowell embarked on a by-election campaign there. She was defeated, obviously, by the great tides of national politics of the day but, undeterred, she persisted in 1979.

What was so remarkable when I shared the video of Tessa Jowell speaking in the House of Lords in that powerful debate on cancer was just how many of my constituents responded, not just with great love and affection, but with strong memories of meeting Tessa during that by-election 40 years ago. That speaks so strongly of the warmth, empathy and infectious personality that Tessa has brought to her politics. As so many people have said, that certainly made its mark in so many ways on public policy in this country, but anyone who has ever met Tessa has been personally affected by her, and that is why we are all here today, determined to carry forward her legacy in such an important area.

I also want to talk about my constituent Kaleigh Lau. Today is a very special day for Kaleigh and her family—her father Scott, her mum Yang and her brother Carson. Two years ago today, Kaleigh was diagnosed with a diffuse intrinsic pontine glioma, or DIPG, which is a brain tumour located in the pons of the brainstem, for which there is currently no cure. At the time, Kaleigh and her family were told that life expectancy with DIPG was just nine months and that they should focus on making memories. Well, last month, Kaleigh celebrated her eighth birthday, and two years on from that awful day Kaleigh, her family and her huge band of friends and supporters are determined to make history, not memories, as they battle to defeat DIPG.

Their journey during the past two years has not been easy. I have followed the family through their tremendous ups and downs: the 30 radiotherapy sessions that young Kaleigh experienced between April and June 2016; that awful moment in December that year when Kaleigh was in progression, eight months in; the closeness with which Kaleigh almost got on to the convection enhanced delivery treatment programme through the compassionate treatment route, only to be told at the eleventh hour that the tumour had spread and CED would no longer be possible; the 10 more radiotherapy sessions that she underwent in January and February 2017; and the moment when Kaleigh’s condition declined to such an extent that the family took her on what they thought would be her last holiday, in March 2017.

Today is also an important day for the family because things changed a year ago today when Kaleigh began experimental treatment in Mexico. By her second treatment, she had regained all her functions. Five other UK families followed her to Mexico. Kaleigh was the first European to receive this treatment. More than 50 people around the world have now undergone the same treatment. None of this has been easy and we do not yet know whether this experimental treatment will be successful, but we know one thing for sure: if Kaleigh had stayed in the UK, she would not be with us today.

Kaleigh’s family have spent over £250,000 to fund her treatment so far, and her ongoing treatment costs them £15,000 every four to six weeks. I pay tribute to Kaleigh’s remarkably resilient family, particularly her father Scott, with whom I speak regularly. Scott has a full-time job and is a full-time dad. He is an utterly selfless human being, to such an extent that every time I call him back, without fail his first words are always, “Thanks for calling. I know you must be busy.” I am nowhere near as busy as Scott is, as a father trying to look after and care for his family on top of everything else that they are dealing with. This is why I address my remarks to Ministers.

I thank successive Ministers—most recently Lord O’Shaughnessy—for engaging with Kaleigh’s case, but they will understand the family’s frustration. After three meetings with the Department of Health, two online petition campaigns and a huge fundraising effort to pay for Kaleigh’s treatment, they do not feel that things are really moving forwards. As Scott says:

“How is the UK government going to help Kaleigh now? Not in the future, but now? Without funding we have no treatment. Overnight we have been forced to become an expert on DIPG, a carer, a fundraiser, a counsellor, an adviser, a leader, a beggar. But ultimately we need help from our government to take the burden off us so that we can focus on Kaleigh.”

There are just a few things that I want to say to Ministers in the short time I have left. We need to become a global leader in tackling DIPG, which has already taken over 200,000 children. We can do this through research, spearheading clinical trials and ensuring earlier access to treatment. We need to do more to ensure financial support to access experimental treatment. I understand the ethical dilemmas, particularly where experimental treatment is concerned, but we have to place greater trust in patients and parents who are willing to take risks.

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

I am sure that everyone in the House is paying rapt attention to my hon. Friend’s explanation of Kaleigh’s care and determination, and that of her family. Will he conclude the story and tell us what is going on at the moment?

[Wes Streeting]

I am so grateful to my hon. Friend for that additional time.

If Ministers cannot fund treatment, let us at least look at funding the flights, accommodation and all the additional costs that families face. It was remarkable listening to the comparison between what Tessa has been through and what Kaleigh’s family have been through in this respect. We need better care plans, advice and guidance. Scott has to do it all himself, to such an extent that he has become an adviser to families around the world on top of looking after his own children. We need to do a lot more to ensure consistency.

[Caroline Flint (Don Valley) (Lab)]

My hon. Friend is coming up with some practical suggestions and creative ways of supporting such families. Does he agree that it is important that the NHS thinks sensitively and creatively about how it can support aftercare once Kaleigh and her family come home?

[Wes Streeting]

That is absolutely right. I pay tribute to Great Ormond Street Hospital and other great NHS services that have supported the family.

As my hon. Friend the Member for Croydon Central (Sarah Jones) said when she opened the debate, we have all been affected by cancer in some way. The worst experience of my life was losing my nan to cancer when I was aged 10. It is a great source of regret to me that I do not still have that great left-wing firebrand who occupied County Hall when Mrs Thatcher decided to shut it down, and allegedly threw a brick at the trucks as they rolled into Wapping. Some of that has rubbed off on me.

I hope that, in looking at what we can practically do to support families, Ministers have heard the powerful contributions made today. I want to say to Kaleigh’s family, to Tessa, and to other families who have been affected by childhood brain tumours that their strength, their courage and their resilience, but most remarkably of all, their enormous generosity of spirit in seeking to help others while they go through an enormous struggle themselves should be an example to us all. Tessa, that is the example that we are following today, and we are determined to make sure that our country gets this right for you.

Oral Answers to Questions

Wes Streeting Excerpts

Tuesday 20th March 2018 Commons Chamber

[Mr Hunt]

I congratulate my hon. Friend on being born five years before the NHS was founded—a very short while ago. Kent is an area that, although it is the garden of England, has some profound challenges in its health economy. One of those challenges is attracting doctors to work in Kent and other more geographically remote areas, so I am very hopeful that this big new announcement for the University of Kent will be a big help.

[Wes Streeting (Ilford North) (Lab)]

The GP-patient ratio in my constituency is unacceptably high, meaning that many people cannot get a GP appointment when they need it and they are turning up at the A&E—not only creating additional pressure but costing more in the process. What is the Secretary of State going to do to make sure that outer-London boroughs such as mine get the GP support that they need, because frankly, the assurances that he has already given are not manifesting themselves on the ground in terms of practical results for patients?

[Mr Hunt]

I appreciate that there are pressures in the hon. Gentleman’s constituency. I think most hon. Members would say that there are pressures in their constituency when it comes to general practice, so what have we done so far? Let me put it that way. This year, 3,157 medical school graduates will go on to specialise in general practice, which is the highest ever, but we still have to do more to improve the retention of GPs who are approaching retirement.

NHS Winter Crisis

Wes Streeting Excerpts

Wednesday 10th January 2018 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for his work as a first responder; that is a fantastic example in his community. We have 1,700 more paramedics than we did seven years ago. My hon. Friend is absolutely right because the role of paramedics has changed dramatically over recent years. It used to be about scooping people up and taking them to hospitals; now, we are treating many more people on the spot. Paramedics have an extraordinarily important role, but it has changed. There is a changed emphasis, as in other parts of the NHS—a move towards doing as much as we can to treat people safely outside hospitals and to keep them at home, because we know that is the safest way.

[Wes Streeting (Ilford North) (Lab)]

I am grateful to the Health Secretary for giving way. The simple fact is that if we want more care in the community, the Government have to stop slashing social care budgets. If we want to stop people appearing at hospital with preventable conditions, we need to stop cutting public health funding. The Government do not have an economic record to be proud of, but even looking at the public spending that is being made, we see that the Government are penny wise and pound foolish.

[Mr Hunt]

I am sorry, but 3 million additional jobs have been created, so we do have a strong economic record, and that is why we have increased funding for social care recently. We have increased NHS funding significantly. As for slashing funding, the hon. Gentleman’s local trust received £9.7 million before Christmas.

Diffuse Intrinsic Pontine Glioma

Wes Streeting Excerpts

Tuesday 14th November 2017 Commons Chamber

[Ian Murray]

I thank the hon. Gentleman for his intervention. I shall come on to the subject of research and development. I have been in the House for seven years, and I live in hope of receiving a positive response from the Treasury Bench. Perhaps tonight we will get that far; indeed, I am sure that we will.

I welcome the research that is being done, but the current lack of sufficient research, available information, awareness of the condition and effective treatments can make DIPG all the more distressing for those diagnosed with it, as well as their extended families.

When it comes to treating the tumours, patients are usually offered courses of radiotherapy over three to six weeks. Because of the dangers of operating on such a critical area of the brain, surgery for some is simply not an option. In the UK, various studies show that chemotherapy is ineffective in treating childhood DIPG, although it is used in innovative ways in other countries, such as Mexico. I shall say more about that shortly.

Because the treatment options are extremely limited, the prognosis for children diagnosed with DIPG is poor. Although each child’s condition is unique, 70% of children with DIPG are not likely to survive for more than a year after diagnosis, and 90% do not survive for two years. The lack of knowledge of the condition means that children and their families are living from day to day. Greater investment in research on the condition might bring us one step closer to finding out more about the specific genes and molecules involved in DIPG tumour formation. That vital research could go on to create innovative new treatments, meaning that 40 more children each year—those who are struck down by the disease—could go on to become the doctors, scientists and even politicians of the future. It is important that we give those children the opportunities that they deserve, and give their families the hope that they need.

The famous astronaut Neil Armstrong’s daughter Karen died of DIPG 40 years ago at the age of just two, yet to date there have been very few advances in the treatment offered, which is devastating for parents. One such story is that of Luke Stewart. Luke is a seven-year-old boy who is happy, healthy, active, kind and caring. He comes from a loving family—mum, dad and two little brothers: Lewis, who is five, and Lochlin, who is just one. In January this year, their world was blown apart when Luke was diagnosed with DIPG. Doctors advised Luke’s mum and dad that he could survive for six to nine months if he received radiation treatment, the only option offered by the NHS in the UK. I cannot imagine what that kind of news does to a parent.

The family were informed that radiation treatment would prolong Luke’s life by only a few months, and that, although it would make him more comfortable, he would not survive. They were advised by the NHS that there were no other treatments available worldwide, or any clinical trials, that could help their son, and that on completion of the radiation treatment he would receive only palliative care. They were broken by that news, but they knew that they had to keep fighting for Luke, so they began to search for hope elsewhere. That was the start of their incredible journey to Mexico to save their son’s life. The journey to Monterrey began when, during a visit to the Chelsea football club training ground, they met a family from London whose daughter had the same condition. They had known of each other from Facebook conversations, but were totally unaware that both families would be at the venue at the same time. The London family were leaving for Mexico within days so that their daughter could receive a new, ground-breaking treatment.

That gave the Stewart family renewed hope. They researched the entire programme, which is called intra-arterial chemotherapy. Catheters are placed in the basilar and femolar arteries, and systematically deliver drugs approved by the Food and Drug Administration into the brain stem. The treatment has also been combined with intrinsic and T-cell immunotherapy. The Stewart family left for Mexico at the beginning of May, when they witnessed Luke’s condition deteriorating rapidly. This was the only hope that they had to offer him at that time: it was their last hope. Not only were they in emotional turmoil, having to deal with such a devastating situation, but they had to fundraise continually to secure money for the treatment.

[Wes Streeting (Ilford North) (Lab)]

The London family to whom my hon. Friend referred are constituents of mine, the Lau family. No one can imagine what a family goes through following a diagnosis of this kind, but I have been struck by how much more pressure is placed on families who are willing to move heaven and earth—and literally move across the earth—to ensure that their children have access to treatment that could potentially extend their lives, but at considerable cost. Does my hon. Friend agree that the Government should look urgently at what can be done to make sure that no families who can have access to treatment are prevented to do so by financial barriers?

[Ian Murray]

Absolutely, and that is one of my key asks of the Government. Indeed, when a family are put in a situation where they are about to lose their child, they only have the hope of trying anything they can find, and many families, including my hon. Friend’s constituents, have made the journey to Mexico.

When Luke arrived in Mexico with his family, it made him the seventh child worldwide to receive this ground-breaking treatment; he was also the second child from the UK. The website makingdipghistory.com is where people can see more about this condition and its history.

Luke’s clinical condition on his arrival in Mexico was extremely serious. This once active, confident and independent little boy could not walk properly, was constantly falling over, and was always tired, and his previously happy demeanour had changed completely. During this period, he regularly talked to his parents about dying—no words a parent should hear from their child.

The family spent four months in Mexico. During this time Luke received six IA treatments and four immunotherapy treatments. The costs associated with these treatments and all living and travelling expenses were self-funded by the family as the result of the generosity and financial support they received through their justgiving.com page.

During this period, Luke’s clinical condition improved dramatically; he was outgoing, happy, walking without any risk of falling over, running, playing with his brothers, communicating normally with his family, and making no further mention to his parents about dying. In the time that Luke had been receiving his treatment, his tumour had shrunk, the cancer activity was lower, his new cell generation was high, and his cyst had shrunk and become pure fluid. His clinical improvement means that he can live life as a seven-year-old in the knowledge that he is 11 months past diagnosis, a point at which the NHS said he would not survive. As if it was a miracle, he is now back at school. It is too soon to tell, but Luke’s improvement is an enormous step in the right direction. Cancer treatments are by their very nature evolutionary, so do we not need to embrace this treatment instead of ignoring it? Luke’s parents had no hope—their son would die. They had to at least try. Luke and his mum, and often his grandad, Robert, now require to go back to Mexico every five weeks for a period of five days to ensure that he continues to receive these ground-breaking treatments.

Before and after each treatment, Luke gives a sporty thumbs-up to tell the world on Twitter that he is okay, and now people from all over the world are posting selfies at #thumbsupforluke. We can follow everything about Luke at his Facebook page, “Help Luke make history”.

It is important to highlight the incredible resilience of families, just like Luke’s, who do not take no for an answer and carry on fighting, searching for access to treatments that could save their child’s life. The family have asked me to express their heartfelt thanks to all who have supported Luke’s crowdfunding campaign, which has managed to raise over £180,000 of the £350,000 to fund his treatment in Mexico. There is no NHS or other Government resources to financially support families when they have to have treatment elsewhere outside the NHS.

So what about the future? Not only do advances in research help progress new treatments, but that will also allow us to instil awareness of this rare condition throughout our healthcare system. This will help us improve the level of support we provide to the family. It is usually left to the parents and families to search the internet for ways to find help, with most healthcare providers in the UK left with their hands tied, with limited treatments to offer. As I have mentioned, Luke’s family were incredibly lucky to have such a successful crowdfunding campaign, but that is not available to everyone, and they still need more help.

The level of support for families is simply not good enough. We need extra support as soon as a child is diagnosed, and it must be support which recognises the fast-acting nature of the disease. Families will experience extreme pressure on their relationships, as they have to come to terms with understanding such a rare condition, as well as the huge financial turmoil that can come with a diagnosis. DIPG, as well as other childhood brain tumours, have a huge impact, and that is why I am asking for more investment, and more research and development to create that awareness and hope of a cure.

So may I ask the Minister to look at developing greater incentives for research and development into DIPG, so that families and children can access the support and information that they require at their time of need? May I also raise the critical issue of funding for research as a whole? Following a debate on childhood brain tumours in this House last year, it is very welcome that the Government set up a working group, looking at how to increase the impact and quantity of brain tumour research. I look forward to the group’s second report, which is due to be released imminently; perhaps the Minister can give us some guidance about when this report might be released.

I acknowledge that a significant amount of money is already contributed through the National Institute for Health Research and the Medical Research Council, but much more needs to be done, and quickly. I hope that the Budget at the end of this month will contain an allocation for this kind of research. Some progress is being made with a programme called Instinct, involving pioneering research by experts from Newcastle University, the Institute of Cancer Research and the University College London institute for child health, which looks at high-risk childhood brain tumours, including DIPG. This extremely important effort is led by Dr Chris Jones, who has extensive experience in understanding the genetic basis of these tumours and what is driving tumour growth.

Can the Minister confirm that when the UK leaves the European Union, the UK medical research community will continue to have access to critical EU funding and collaborative programmes once Horizon 2020 has ended? Given Luke’s example, and the fact that the family have had to go to Mexico, it is essential that co-operation on research is global, so that every child in need of help can access it, no matter where they are. Could Luke’s case be the pathway for better treatments and understanding of DIPG here in this country?

The number of children dying from cancer each year in the UK has fallen in the last 20 years, but we must not stop here. Research is the key to our progress. It is not right that the rarer a cancer is, the less attention is paid to the funding of research. There must be a unified approach in applying the progress that is made. The rarity of such conditions means that they accumulate to a far smaller market for pharmaceutical companies, which tend not to supply the drugs that are required. Research and development is difficult, particularly in relation to children.

I know that it would mean a lot to Luke and his family if the Minister or even the Prime Minister could meet them to talk about their experiences and listen to their views on how research, funding and information in this area might be improved to secure a better future for all children with DIPG. Will the Minister make that commitment to meet the family? I would like to finish by paying tribute to the resilience of Luke and his family, and of all the other families who continue to fight for their children. I hope that this debate has made a small dent in raising awareness of DIPG and other killer cancers in children. Luke has a chance, his parents have hope, his extended family have pride, and we all watch and admire their strength, resilience, dignity and love for Luke. Let us use this half hour of valuable parliamentary time to make a difference to all families who are affected by DIPG and similar diseases, and to give those children hope.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

I pay tribute to the speeches of the hon. Members for Edinburgh South (Ian Murray) and for East Lothian (Martin Whitfield). The House needed to hear about the bravery of Luke and Alex, and no one could fail to be moved by their courage and the courage of their families or by the commitment of the community in raising the much needed funding for their treatment. I thank both hon. Gentlemen for bringing those stories to life, and my thoughts go out to the brave boys and their families and friends. I agree with everyone who has spoken that research is crucial in the fight against cancer, and childhood cancers in particular. Nobody wants to hear the news that those families heard about their children, but the fact that they are approaching things with so much hope is quite inspirational, and I have the utmost respect for them.

To bring the House up to date with what the Department of Health is doing, research is absolutely critical, which is why the Department invests a billion pounds a year in health research through the National Institute for Health Research. The Department also works closely with a wide range of partners for research funding. Spending on cancer research specifically has risen to £137 million in this financial year, which is the largest NIHR spend in any disease area. However, the challenges of increasing research into brain tumours persist, and I wholeheartedly agree that that research is essential in order to improve treatment for sufferers and their families. The hon. Member for Edinburgh South referred to the Westminster Hall debate on brain tumours in 2016, and the Department has established a task and finish group on brain tumour research to investigate what more can be done. I am pleased that that report will be published before the end of the year. It has been slightly delayed—not because we are obfuscating, but because its impact can be increased by taking a little more time. I hope that that will reassure hon. Members.

The hon. Member for Edinburgh South and the hon. Member for Ilford North (Wes Streeting) both referred to the treatment in Mexico experienced by their constituents, and I acknowledge that that has come at great expense to the families and could not have happened without the generosity of the many people who have been inspired by the stories. I can tell the House that leading experts from Great Ormond Street and Alder Hey Children’s Hospital, as well as their colleagues from Europe and the USA, have reached out to the team in Mexico to better understand the treatment that is being given to patients. Without further data and discussion, it is not possible to say whether the exact treatment being offered in Mexico could be considered in the UK as part of a clinical trial, but I can assure the House that there is certainly an openness among UK experts to understand more about the treatment, which I hope will be welcomed.

[Wes Streeting]

I am grateful to the Minister for giving way on that point. One of the important functions that Great Ormond Street provided for Kaleigh Lau’s family was support when she was back in the UK. Immense pressures on Great Ormond Street at one point meant that a lack of access to beds and support led to a delay in her being admitted to the hospital. Will the Minister ask her officials to look at that particular issue? The nature of the condition and the time pressures—there is often a lack of time—make some of those delays even more stressful to the family. The Minister ought to probe and examine that issue.

[Jackie Doyle-Price]

I acknowledge the hon. Gentleman’s point, but the stress would be removed if we could actually investigate whether the treatment could be offered here, rather than have people travelling to Mexico. My priority will be to encourage discussions to enable that to happen.

Turning to some of the research that is happening at Great Ormond Street, which is the centre of excellence where we want childhood cancers to be tackled, research is being undertaken to develop T-cell immunotherapy delivery to tumours and selective therapies based on the molecular profiles of tumours. The research centre at University College London is also researching tumour markers and drug uptake. I am pleased to say that the NIHR clinical research network is supporting the NHS to deliver three clinical trials of new treatments for children with diffuse intrinsic pontine glioma. In the summer, Cancer Research UK announced its intention to fund up to two brain tumour centres of excellence to support multidisciplinary research, and the NIHR stands ready to provide full support to those new centres, together with other centres already funded by other charities, in delivering their research in the NHS. The working group is chaired by Professor Chris Whitty, the Department’s chief scientific adviser. The report is being finalised, and it should be ready before Christmas.

We know that early diagnosis is essential for all cancers if we are to provide the best treatment and support from the very start. I therefore welcome initiatives such as HeadSmart, which is working to increase awareness of the common signs and symptoms of brain tumours in babies, children and teenagers. The Department encourages the use of that initiative by professionals to signpost specialist advice, if needed, and the Department has promoted the awareness campaign with colleagues in NHS England, health visitors and school nurses.

The Government are also funding a radical upgrade of equipment to treat cancer, including £130 million to modernise radiotherapy across England. In April 2012 the Government announced a £250 million investment to build proton beam therapy facilities at the Christie Hospital in Manchester and at University College London Hospitals. The more precise targeting of radiotherapy afforded by this treatment means that higher doses can be delivered with fewer side effects and fewer long-term consequences, which is particularly important for paediatric patients.

We support the Less Survivable Cancers Taskforce, which also launched earlier this year. The taskforce aims to raise awareness of five cancers, including brain cancer, where survival rates have remained stubbornly poor for decades. The taskforce is also working to increase the number of clinical trials and treatments approved for those cancers as well as the level of research invested in them.

Despite the difficulties involved in researching new treatments for diffuse intrinsic pontine glioma, important studies are under way.