Junior Doctors’ Foundation Programme
Debate between Caroline Johnson and Peter Prinsley(3 days, 5 hours ago)
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Peter Prinsley
Some time ago, when I came here, I had working with me an intern, Dr Harry Dunn, who was a medical student at Cambridge University. He graduated last year. He came top, not only of the University of Cambridge medical student cohort, but of the whole of the University of Cambridge, so he was the top student of his year. He was offered a foundation post in Northern Ireland. He chose not to take it, and has now gone into consulting, having given up medicine. That is an extremely sad example of an unintended consequence of this crazy lottery.
Dr Johnson
I congratulate that person on his prowess in university. He is clearly an incredible person, and it is a shame that he has been lost to medicine. I am sure Northern Ireland is a great place to work, and it is disappointing that he did not want to go there, but he should have been able to apply for the jobs that he wanted in places where he wanted to work, and to compete fairly for them. That is a bit stressful and competitive—but getting into medical school is competitive.
You may not know this, Mrs Barker, but the hon. Member for Bury St Edmunds and Stowmarket and I grew up on the same street, in the same town, and went into similar-ish careers. We competed for medical school places and for our jobs. We are all here today having competed against others for election—that is the reality of life. To remove the competition, which is based on meritocracy, and replace it with a random allocation is more unfair and stressful than the alternative.
One of the issues raised about the old scheme was that it was difficult to recruit in some areas. The competition for the best jobs, or at least those perceived to be the best or most wanted jobs, means that some areas of the country and some specialties could find themselves with the people who did not succeed in getting the jobs they wanted. How do we manage that? It used to be managed with rotations. When people went to the interview for specialist jobs, they would be called in one at a time and told, “These are the rotations available. Which one do you want?” The best jobs—the most popular ones—would be mixed with the least popular, so that would mitigate the problem.
There is one issue that I want to raise briefly. Some medical schools in the UK, including Newcastle, have overseas campuses in Malta, Cyprus and Malaysia. Some British people have gone to those branches of UK medical schools and have found themselves completely excluded from places in the United Kingdom under the medical training changes that the Government have made in the past couple of months, which seems wrong. We talked about that when the Bill went through, and the Minister was keen to reassure us that all would be well, but we have found that British students have not been able to get jobs in the British training programme. Will the Minister look at prioritising at least those who went to medical school before the changes for British jobs?
The current system gives junior doctors—resident doctors, as they are called now—no agency, no control, no appeal and no alternative. It is clearly unfair. Could the Minister update the House on how he intends to fix the system?
Brain Tumour Survival Rates
Debate between Caroline Johnson and Peter Prinsley(2 months, 2 weeks ago)
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Dr Johnson
My right hon. Friend invites me to speak outside my area of expertise; I am afraid I do not know the answer to that.
Dr Johnson
I will, particularly if the hon. Gentleman has an answer for my right hon. Friend.
Peter Prinsley
I cannot understand how there can be a relationship between head injury and brain tumour. Repeated injury causes some neurological conditions, particularly for footballers, whom we see getting early dementia, but I do not see a connection between head injury and brain tumour. Does the shadow Minister?
Dr Johnson
It is certainly something that I have read about. I am happy to be corrected by the hon. Gentleman if he feels that my resources are incorrect, but that was certainly one of the suggestions for how to prevent these tumours. I do not think that prevention will necessarily be the major way in which we improve the survival rate. I also do not think that it will be early diagnosis, but I would like to finish talking about that. Regular screening for people with genetic disorders can really help to identify tumours early, and the second thing that can help is access to diagnostic tests. The Conservative Government introduced community diagnostic centres across the country, which increased the number of scanners available to those who needed a scan to identify whether they had a brain tumour. This Government have said that they will double the number of scanners available. Can the Minister comment on whether they are on track with that?
We need the workforce plan, so that we have the people to perform and interpret the scans. I do not know whether the Minister has had any tips on whether the workforce plan is imminent, but can he give us a date for when it is likely to be published? It has been delayed, but it is important. We have the cancer plan, but so much of it is dependent on the workforce plan. Thirdly, opticians have a role to play. Since a South Tees project pioneered in 2015, opticians have been able, during regular eye tests, to identify people who have signs of brain tumours, and to refer them, when necessary. Encouraging people to get regular eye tests may contribute to early diagnosis.
The fourth thing that can help with early diagnosis is symptom awareness—among both the general public and healthcare professionals. I want to talk about HeadSmart, a 2011 programme about the types of symptoms that could help identify a brain tumour. It had quite significant cut-through with both healthcare professionals and the public. It halved the time for a scan, and for diagnosis of children with brain tumours. It also improved the cognition of survivors, but it did not significantly improve the survival rate. While early diagnosis helps a bit, it is very difficult—particularly in children, who are quite neuroplastic, so symptoms appear quite late. The location and type of tumour are more important in the treatment and prognosis, and there are many different types. That makes this area of medicine extremely complicated, so I think the answer is that we need better treatments.
Treatments currently include steroids, chemotherapy, radiotherapy and surgery, but there are many others with promise. Convection-enhanced delivery enables chemotherapy to be delivered across the blood-brain barrier more effectively. Many hon. Members have talked about freezing, and last month there was a debate on the topic of freezing brain tumour samples; does the Minister have an update following that debate? His colleague, the Under-Secretary of State for Health and Social Care, the hon. Member for West Lancashire (Ashley Dalton), said that she would look at the detail and report back, so I hope that he will have an update for us this evening. Gene therapy has also shown a lot of promise, and there has been talk this evening about the trial in which an adeno-associated virus is used as a vector to seek out the glioblastoma cells and use the patient’s immune system to kill the tumour cells. That trial has promise; if it works, it could lead to real improvements in treatment.
Research will be key. BioNTech’s 2023 partnership promised that there would be 10,000 patients in cancer vaccine trials by 2030, but new innovators face barriers. This is a global fight; work is going on right across the globe, and we need to make the UK’s environment one that stimulates and supports research, so that British people can have the earliest possible access to the newest treatments. At the moment, the wider economic picture for research is not great, and we have seen some researchers pull out of investments in the UK. Taxation, national insurance, employment rules and the speed of adoption by the NHS are all factors that I hope the Minister will try to improve.
The hon. Members for Edinburgh South West (Dr Arthur) and for Strangford (Jim Shannon) talked about the devolved Administrations. Could the Minister comment on how he and his team are working with those Administrations to encourage research right across the United Kingdom? I also wanted to talk about rural areas, because it is all very well encouraging trials in the UK or England, but so many of those trials are in the centre of London, or in the other big cities; it is much more difficult for people living in rural areas, such as my constituents in Sleaford and North Hykeham, to access them. Could the Minister please update the House on how he is making it easier for research to occur in rural spots?
The hon. Member for Witney summed it up perfectly when he said that ambition is important, but actions, not words, are the key. We need specific, measurable targets, not just warm words—this Government have been very good at warm words on health, but much poorer on delivery. For the sake of the one in two people who will get cancer, and all their friends and loved ones, I hope that on this occasion, there is more action, not just words.