Ovarian Cancer

Oral Answers to Questions — Health – in the Northern Ireland Assembly at 2:00 pm on 28th November 2016.

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Photo of Edwin Poots Edwin Poots DUP 2:00 pm, 28th November 2016

1. Mr Poots asked the Minister of Health whether she plans to deliver a campaign targeting ovarian cancer. (AQO 744/16-21)

Photo of Michelle O'Neill Michelle O'Neill Sinn Féin

The Public Health Agency (PHA) is delivering a Be Cancer Aware campaign to improve the public's awareness of signs and symptoms of cancer. As part of the campaign, the Public Health Agency undertook a specific ovarian cancer-awareness programme in September 2014 in partnership with Target Ovarian Cancer and Angels of Hope, which is a local charity. That entailed the widespread distribution of leaflets and posters to highlight the signs and symptoms of the illness. The leaflets and posters were distributed to hairdressing salons, bingo halls, pharmacies and GP practices. They helped to raise awareness of the signs and symptoms, in particular among women over the age of 50, and encouraged women to speak to their GP if they experienced any of those symptoms. The Public Health Agency also worked with the late Una Crudden to produce a video calling on women to read the leaflets and make themselves aware of the symptoms of ovarian cancer. The agency has also developed a Be Cancer Aware website that provides information about the signs and symptoms of a range of cancers, including ovarian cancer, and explains what people can do if they are concerned. It also includes signposts to recommended sources of support.

Public awareness of the signs and symptoms of cancer is a key factor in detecting cancers early and increasing the chances of successful treatment and survival. Raising awareness, therefore, could have the greatest impact on patient numbers and tackling cancer in areas of deprivation, where survival has historically been poorest. Prevention and early intervention are very much in keeping with my vision of Delivering Together. We need to support people to keep well in the first place and, when they need care and support, services should be safe and of the highest quality. The Public Health Agency is reviewing available evidence from other cancer-awareness campaigns to help inform the next phase of the Be Cancer Aware programme. However, specific cancer sites are yet to be decided for the next phase of the programme.

Photo of Edwin Poots Edwin Poots DUP

I welcome the Minister's clarification. Una Crudden and Angels of Hope have done tremendous work on raising awareness of ovarian cancer, which is generally known as a silent killer. What importance does the Minister's place on ensuring that what was desired by the late Una Crudden, which is a campaign specific to ovarian cancer, happens? What is her position on that? Does she intend to have a full-blown ovarian cancer awareness campaign as opposed to integrating it with other cancers?

Photo of Michelle O'Neill Michelle O'Neill Sinn Féin

I will obviously put on record that Una Crudden was an amazing woman. She used her own difficult circumstances to highlight ovarian cancer for other women. I commend her for that. I had the pleasure of meeting her; she was an absolutely lovely lady. Quite often, the public tend to listen more when they hear a real human story about someone's cancer journey and how they dealt with their illness.

I do not have a closed mind to the idea of an ovarian cancer-specific campaign, but it is important that we analyse how effective the previous work done on awareness has been and we target our resources to make sure we reach the largest number of people possible. I really believe in early intervention and prevention. We need to do more in the public health agenda. When it comes to reviewing how effective those campaigns are, I am very happy to look at where we can have the greatest impact through patient numbers, as I said, and on tackling cancer in areas of deprivation, where survival has historically been poorest. It is not ruled out. I am happy to correspond with the Member as we develop the next stage of the awareness campaign.

Photo of Jo-Anne Dobson Jo-Anne Dobson UUP

I also remember well, and pay tribute to, the personal crusade of Una Crudden as we approach the second anniversary of her death. Minister, you will be aware of the facts of the more aggressive cancers, but what assurances can you provide us with that new drugs developed here in Northern Ireland will be made available to local patients diagnosed with ovarian cancer?

Photo of Michelle O'Neill Michelle O'Neill Sinn Féin

I think the Member is referring to the cancer drugs fund that exists in England. Obviously, we have our own processes here in the North through the individual funding request (IFR) process that exists to enable access to specialist drugs whose clinical and cost-effectiveness has not been fully established. I think we all realise that the current process has flaws. It should be less cumbersome and a bit more transparent, I think, in allowing access.

Officials are working with the clinicians, who obviously have the expertise, to develop a new individual funding request process. That new process will ensure that any individual funding requests are clinically assessed and scrutinised by a regional committee to give assurances that clinical judgement and patient care are at the heart of the process. It will also improve access to these drugs, provided that there is a compelling clinical case.

We always have to be aware that reforming the individual funding request process and increasing access to drugs not fully endorsed by NICE will carry a significant cost at a time when the health and social care budget is facing real pressures. Let me be very clear, all cancer drugs that have been recommended by NICE for routine use in the health service are available in the North. It is only for those that have not been recommended by NICE that patients are asked to use the individual funding request process.

My predecessor established the clinically led task and finish group to reform the process and went out to consultation. I aim to introduce the new arrangements during 2016-17 on a phased basis. Over the next number of months, we will have the new process rolled out. For me, it has to be transparent and people need to know how to access the help that they need.

Photo of Ian Milne Ian Milne Sinn Féin

What impact is the current Be Cancer Aware campaign having?

Photo of Michelle O'Neill Michelle O'Neill Sinn Féin

A range of topics are covered in the campaign evaluation, including awareness of cancer advertising and symptoms and knowledge and recognition of the relevant campaign material. The aim is to look at changes in recognition and knowledge between pre- and post-campaign interviews. For each Be Cancer Aware campaign and targeted cancer site — for example, lung, bowel and breast — there is a comprehensive evaluation process that covers a number of different indicators. Together, that gives us a detailed picture of the potential campaign effects. The indicators used in the Be Cancer Aware evaluation are, for example, how the campaign reached individuals, public awareness of the signs and symptoms of cancer, the number of people being referred urgently for suspected cancer by GPs and the proportion of urgent referrals that result in a cancer diagnosis. Evaluations have shown that each campaign phase has had a good campaign reach through the population. Other important measures of campaign outcomes include the stage of the disease, the diagnosis and survival rates. Data for these indicators take much longer to come through and are not yet available.

Photo of Mark Durkan Mark Durkan Social Democratic and Labour Party

Last year, a report by the Target Ovarian Cancer charity highlighted that women in the North have the worst survival rates and the worst chance of having access to a clinical trial than elsewhere on these islands. Is that still the case?

Photo of Michelle O'Neill Michelle O'Neill Sinn Féin

In comparison rates with, for example, England, we do not perform as well. I am not sure about the South. I am happy to provide that detail to the Member. Suffice to say that, whenever it comes to awareness, we have to do everything that we possibly can on awareness campaigns. Whether that is for ovarian cancer, lung cancer, breast cancer or any of the other cancers, it is important that we reach as many people as possible and that we drive home that early intervention and early detection message. We all know that, if cancer is discovered earlier, the chances of survival and getting support are obviously a lot higher.

I am happy to write to the Member with the specific statistics. For the record, I will make sure that we thoroughly review the impact of the campaigns that we have had to date and make sure that, when it comes to future campaigns, we target those areas where we absolutely can make a massive difference.

Photo of Chris Lyttle Chris Lyttle Alliance

When he was Health Minister, it was my privilege to present Edwin Poots with a thousand-strong petition for a targeted stand-alone ovarian cancer awareness campaign, not least because of the vital importance of early diagnosis and accurate GP referral. At that time, we were told that being part of the Be Cancer Awareness campaign would be the approach to take.

Photo of Danny Kennedy Danny Kennedy Deputy Speaker

Will the Member ask the question, please?

Photo of Chris Lyttle Chris Lyttle Alliance

Therefore, I ask the Minister to consider in her review whether being part of the Be Cancer Awareness campaign rather than a targeted stand-alone campaign was the best approach? Is she willing to meet with a deputation of women who are affected by ovarian cancer to include them in that review?

Photo of Michelle O'Neill Michelle O'Neill Sinn Féin

The review work happens across the PHA, and I am quite sure that it will be very happy to meet with the women who have been impacted and who actually know how it is to go through an ovarian cancer diagnosis. I am very happy to engage with individuals and my door is open. It is important that, if we are going to have awareness campaigns, we target them where we can make the best effect. So whether that be a stand alone campaign or as part of Be Cancer Aware, I am open for that conversation.