Cancer Strategy

Part of the debate – in the House of Commons at 3:10 pm on 8th December 2016.

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Photo of Jim Fitzpatrick Jim Fitzpatrick Labour, Poplar and Limehouse 3:10 pm, 8th December 2016

It is a pleasure to follow Henry Smith, who has made a very strong case on blood cancers. I am sure that the Minister was listening and I suspect that he will respond positively.

I congratulate my hon. Friend Nic Dakin on opening the debate. I also congratulate him and his colleague on the all-party parliamentary group on cancer, Mr Baron, on securing it. I echo the hon. Member for Crawley in wishing the hon. Gentleman’s wife and family well in the treatment that they are undertaking.

I had not intended to speak in this debate, but I have received briefings from Action on Smoking and Health and from Cancer Research UK, as well as a copy of the British Lung Foundation’s expert working group report on lung cancer, and I thought that it would be appropriate to reinforce some of the points that they make. I checked that there was no massive pressure on time and that I would be able to make those points were I to catch your eye, Mr Deputy Speaker, so I am grateful to you for calling me.

I thank Deborah Arnott from ASH and Lucy Absolom for their briefings, which I found very helpful. I should point out that I have had four basal cell carcinomas removed from my face. Fortunately, the biopsy on all of them found that they were benign, but my consultant dermatologist has recommended that I wear a hat to protect my Scottish features from the southern sun and the ultraviolet rays, which are even more worrying. Being married to a doctor, I always take very careful notice of any clinical advice that I am given, to avoid the risk of being criticised for not listening to those who are more intelligent and better qualified than me. I thank the good doctors at the Aberfeldy health centre and the dermatology department of the Royal London hospital for their assistance in protecting me.

I will start with the bad news, because all three of the briefings that I have received have many positive things to say about the Government’s cancer strategy. I also think that, on the whole, my hon. Friend the Member for Scunthorpe was positive in his opening remarks. There are clearly some questions to be asked, and I will do so, but the briefings are more supportive than critical of what the Government and the clinicians of NHS England are trying to achieve.

The ASH briefing begins:

The UK’s Cancer Strategy…for England 2015-2020 recommends the publication of a new Tobacco Control Plan within 12 months as a key element of its first strategic priority, a radical upgrade in prevention and public health. If this target had been met a new Plan would have been published in July 2016. However six months on, and a year since the last Tobacco Control Plan expired, there is still no new Plan.”

That is a major criticism in the briefings. ASH goes on to say:

“The previous Tobacco Control Plan achieved its ambitions to reduce smoking rates: adults fell from 21.2% to below 18.5%, 15 year olds from 15% to below 12% and among pregnant women from 14% to 11% or less. The Government must publish a new plan to build on this progress.”

I apologise to the Minister if the plan has been published, but my hon. Friend clearly suggested that it has not, so when will it be published? We would be grateful if the Minister gave us any encouragement that it is due sometime soon. The data show how successful the previous plan was at cutting the number of smokers and, consequently, reducing the exposure of non-smokers, especially children, to second-hand smoke.

I should own up to being an ex-smoker. I started in my early teens, and I gave up at 21.35 hours on 4 November 1980. The fact that I remember the minute does not indicate that I miss it at all. I remember it because it was during a “Panorama” programme that highlighted the legs of a chap who was, it became apparent later, in a wheelchair. The poor gentleman had suffered thrombosis in both legs and had had amputations on both legs. The camera eventually got to his face, and we could see that he was still smoking cigarettes. My then wife was pregnant at the time, and giving up smoking seemed a very sensible thing to do. I had tried to do so 18 months previously, when I gave up for six months. However, I burned my hand badly in a fire, and the first thing I asked as I was being taken to hospital—after six months off cigarettes—was, “Will somebody give me a cigarette?” It took me 18 months to get back off them, but I managed to quit.

When I joined the London fire brigade, two thirds of firemen—as it was in those days—smoked. This is only anecdotal, but 23 years later, two thirds of fire fighters did not smoke. That demonstrates the change in attitudes to health and fitness within the service, and it reflects a similar change in attitudes in society towards smoking. All the positive policies that have been introduced, such as no smoking in public buildings, demonstrate that we live in a society that is completely different from 30 or 40 years ago.

On a new plan for tobacco control, which we hope will be published shortly, I would be grateful if the Minister shared his thoughts ahead of publication on what targets we might expect from 2020 onwards for reducing adult smoking numbers, what budget might be set aside for mass media campaigns and what support might be available for stop-smoking services. Those services reduce health inequalities, because most of the people who access them are from more deprived communities. That will help many of my constituents, appropriately. The last plan clearly worked, and we need a new one.

Cancer Research UK’s briefing states:

“If the strategy is implemented in full then it is estimated that 30,000 more lives could be saved per year by 2020. 11,000 of those lives will be saved through improvements to early diagnosis.”

That is one of the strong points that my hon. Friend the Member for Scunthorpe made. Cancer Research UK stated that it had not seen the progress needed on the plan. On prevention, it states:

“4 in 10 cancers are preventable. We need a radical upgrade in prevention to ensure the future sustainability of the NHS and reduce cancer incidence.”

Cancer Research UK wants the Government to publish the tobacco control strategy without further delay, as does ASH, and it wants the Government to extend existing junk food TV marketing restrictions to the 9 pm watershed to reduce children’s exposure to marketing by more than half. The briefing states that

“urgent action needs to be taken to ensure the NHS cancer workforce is adequately equipped to deal with rising demand and improving care…We welcome the commitment to increase the spend on diagnostics by up to an additional £300 million by 2020, but need clarity over how this is being allocated and used in local areas to improve earlier diagnosis. In addition, the national Diagnostic Capacity Funding must also be continued.”

Those points were also raised by my hon. Friend. The briefing states:

“Cancer waiting times targets are being consistently missed…suggesting there are still thousands of people not having the tests they need on time.”

As I have said, Cancer Research UK has also made a lot of positive comments. On governance and the progress made on implementation so far, the charity states:

“We welcome the appointment of Cally Palmer as National Cancer Director and Chris Harrison as National Clinical Director for Cancer…We welcome the establishment of the Cancer Alliances across the country…We welcome the priority that has been given to earlier diagnosis in the first year and the commitment to invest more.”

Cancer Research UK welcomes NHS England’s proposed investment of £130 million for over 100 replacements or upgrades of radiotherapy machines over the next two years in hospitals in England. It says:

“Replacing the machines will mean that more patients can access the innovative radiotherapy which plays a vital role in curing cancer, slowing the growth of tumours and improving quality of life for cancer patients.”

Its final question is about the Government’s commitment of £300 million by 2020 to improve diagnostic capacity, which was also raised by my hon. Friend. It asks for

“clarification on how this money is being allocated and used in local areas and how its impact is being evaluated.”

As I said at the beginning, not only are not all the comments from respected organisations critical of the Government’s policy, but they are actually complimentary about their policy and approach, apart from for the absence of a tobacco control plan. That key absence has been highlighted by all the charities and research organisations concerned. I want to reinforce to the Minister that there have been lots of positive comments, because this is not just the Opposition being critical of the Government. There are lots of great and positive stories, but there is that one absence.

As my hon. Friend said, and as I have said on behalf of Cancer Research UK and ASH, we want the Minister to answer a number of questions. If he is not in a position to do so today, it would be very welcome if he asked his officials to write to those of us involved in this debate in due course with additional information. I look forward to hearing the comments of the shadow Minister, my hon. Friend Mrs Hodgson, and of the Minister in response to this debate.