Childhood Cancer Outcomes
Debate between Jim Shannon and Emma Lewell-Buck(6 months, 2 weeks ago)
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Mrs Lewell-Buck
I thank my right hon. Friend. I know he has spoken movingly before in this Chamber about his son Max. He is right that, for those who are lucky enough to recover from cancer, there is always an after-effect; it remains with them for life and there should be more support. I give way to my other hon. Friend.
Jim Shannon
I commend the hon. Lady on bringing this debate forward. Her constituents should be very proud of their MP and how she has illustrated and put forward the case on behalf of one of her constituents. She has referred to others having big hearts, but I think she has a heart the size of an elephant, if that is possible.
Estimates suggest that around 75% of children diagnosed with cancer survive. However, that statistic has not seen an increase in many years. Does the hon. Lady agree that the 25% who do not survive must never be accepted as a statistic, but must be fought for with more funding and greater research resources, exactly as the right hon. Member for Alyn and Deeside (Mark Tami) has said, and that those must be put in place as a matter of form and not just granted for one or two years? I know that the Minister will respond in a positive fashion, and I commend the hon. Lady on what she is doing.
Mrs Lewell-Buck
I thank the hon. Gentleman for that very kind intervention. He has pre-empted what I will talk about later in my speech.
The Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield), in responding to the debate last year, said that GPs had access to training and that National Institute for Health and Care Excellence
“guidelines are trying to support GPs”.—[Official Report, 26 April 2022; Vol. 712, c. 656.]
However, having access to training is not the same as mandated training, and NICE guidelines are for all cancers. It is widely known that many signs and symptoms of childhood cancer are the same as those for many common childhood illnesses, and that the types of cancer diagnosed in children are different from those seen in adults. In short, those guidelines are not enough.
The Under-Secretary of State also said that, despite some progress in treatment for childhood cancers, for
“conditions, such as rhabdomyosarcoma, that is not yet the case. Research is crucial to how we deal with it in the long term.”—[Official Report, 26 April 2022; Vol. 712, c. 658.]
Yet no breakdown is available for how much funding is directly linked to childhood cancer research, let alone RMS. What we do know is that funding for research of all cancers has dropped from £132 million in 2018-19 to £101 million in 2021-22, and that Great Ormond Street hospital has found that, on average, only 2p of every £1 spent each year on cancer research goes towards dedicated research projects for childhood cancers.
So here we are, over a year later, and it appears that nothing has improved. The Government’s change in approach to their cancer plan has not been welcome either. In February 2022, the Government launched their call for evidence for a standalone 10-year cancer plan for England, which was intended to be a new vision for how we will lead the world in cancer care. Yet in January this year, they announced that cancer would be incorporated into a new major conditions strategy, effectively scrapping the dedicated 10-year cancer plan. As Cancer Research UK said:
“by bundling in cancer alongside other conditions via a short-term strategy, ministers will fail to give cancer the due care and attention it requires… Cancer isn’t a single disease…in medicine it’s one of the hardest problems to solve and scientific discovery takes time… Ultimately, beating cancer requires a long-term approach.”
The Children’s Cancer and Leukaemia Group and Young Lives vs Cancer rightly note that this strategy will not give sufficient attention to children with cancer, and are asking the Government to commit to a children and young people’s 10-year cancer plan addressing diagnosis, treatment, patient experience, research, psychosocial support and living beyond cancer. The Royal College of Radiologists, which represents specialist paediatric radiologists and clinical oncologists, has said that after years of under-investment, the workforce is stretched and shortages are causing backlog and delay.
Access to paediatric radiologists already depends on postcode. In the north-east, there are 0.2 consultants per 100,000 people, compared with 0.7 per 100,000 in London. It takes seven years to train in this specialty, and as a percentage of specialists are due to retire, I am not sure that the Government’s workforce plan will sufficiently address the shortfall in those paediatric specialties. International comparisons show that the countries with the biggest improvements in cancer survival are those with long-term, adequately funded cancer plans. Every single parent who has lived in this painful cancer bubble knows what works, too: proper training, early diagnosis, research and access to treatment.
Children in the Care System: Sibling Contact
Debate between Jim Shannon and Emma Lewell-Buck(4 years, 1 month ago)
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Mrs Emma Lewell-Buck (South Shields) (Lab)
Thank you very much, Mr Speaker, for allowing me time tonight to speak on behalf of the thousands of children in care who are separated from their siblings and the thousands of care experienced adults who had to, and still do, endure this pain.
The relationships that adults deem to be the most important for children in care are not the same as those that are most important to children in care themselves. Government guidance acknowledges that maintaining contact with siblings is reported by children to be one of their highest priorities. Having that relationship ripped away causes them anguish on many levels. An Ofsted study showed that 86% of children in care thought it was important to keep siblings together and that three quarters thought councils should help children to keep in touch with their siblings. Yet shamefully, sibling contact levels in the care system remain woeful.
Jim Shannon (Strangford) (DUP)
The hon. Lady has brought a very important issue to the House for consideration, and it affects my constituents as well. Does she agree with the National Society for the Prevention of Cruelty to Children, which says:
“Sustained contact with siblings can promote emotional stability and wellbeing for children in care. Siblings share an identity, which can promote their self-esteem and provide emotional support while going through care proceedings”?
That is an opinion that should be lent weight, and we must do all we can to provide siblings with a legal right to contact where there has been no accusation of abuse or any other extenuating safety issue.
Mrs Lewell-Buck
I thank the hon. Gentleman for that intervention, and those comments echo the legislative changes that I will propose later in my speech.
Recent research undertaken by the Centre for Social Justice suggests that more than 70% of looked-after children with a sibling in care are separated from that brother or sister, which is not surprising when the average number of sibling foster carers is one per local authority and some have none at all. For those being cared for in children’s homes, the number of children separated from their siblings is a staggering 95%. It is also worth noting that we do not know the true scale of that heartache, because the Government do not think it is important enough to record and gather data on how many siblings are not in contact with each other in the care system.
Considering that the Government’s misguided, ideological austerity agenda has led to them presiding over a record 78,150 children in care, a shortage of foster and residential placements and less overall capacity in the social care sector, it is likely that the real picture is far worse. It is against that backdrop that sibling contact is so important.
The groundbreaking Children Act 1989 requires local authorities to allow a looked-after child reasonable contact with their parents, but there is no parity of provision for a looked-after child’s contact with their siblings. If siblings cannot be placed together, they should have exactly the same rights to contact defined in primary legislation as they do with their parents.
Many siblings who come from neglectful or abusive backgrounds state that the only constant positive, reassuring and enduring relationship they have is with their siblings. After all, they have a shared experience together. No matter how horrific, those experiences are ones that only they will ever truly know about. Often for younger siblings their protector—the one and only person who has ever kept them safe—is their sibling. While it is not appropriate that an elder sibling should take on that role, it is a fact that they often do. Separating siblings in those circumstances can have consequences for placement stability and create an anxiety for both the younger and the elder sibling. If all they have both ever known is adults who cause them harm, those initial days in placement until they feel safe with their new carers are the most precarious. In that context, it is only right that sibling contact is given the same prominence as parental contact. It cannot be right that our primary legislation gives more weight to a child’s contact with those who may have, or who have, caused them significant harm than it does to contact with their siblings, who are totally blameless.
I vividly remember and will have etched on my brain forever—although I wish I did not—the times when, as a practising social worker, I removed children from their family homes. A promise I gave to them, and to all the children I worked with, was that if I ever made it to this place I would not let them down, and that is what leads me to this debate tonight.
Removing children from home is one of the most traumatic and heartbreaking experiences. It can be emotional overload for professionals, let alone the family. There is often a police presence, violence, tears and utter confusion. Once calm and away from their home, you are left with children alone in your car, having to explain to them by some roadside that not only are they going to be living somewhere else for an open-ended period, but they are also going to be separated from their siblings. That is the most painful part of all: no matter how you explain the situation, children often feel that it is the end not only of their family relationships but of their relationship with their siblings. With each one of the children you drop off at their respective placements, you see a muted relief that they are safe, but a deep sadness that they are alone. The wheels of social services then spin into action. Solicitors for the parents and the courts demand contact as enshrined in legislation for parents. It is done with urgency, but in a resource-poor environment, what has to be done is often what is done first. Guidance that recognises the importance of maintaining contact with siblings takes a back seat and is deemed a lesser priority.
Of course, some children will see their siblings at their parental contact, but that will often be only three or four times a week for one hour. Sibling contact tends to be rare, and at times may be only monthly, for one hour. At the end of the care proceedings children may be reunited with their parents at home or placed for permanence with their siblings, but the complications that a lack of previous consistent contact can bring to those new arrangements may have implications for placement breakdowns and dire consequences for the wellbeing of the entire family.
I am sure the Minister will remind us that Government guidance recognises the importance of maintaining contact between siblings when they are in separate placements, but we all know that guidance is no substitute for a clear duty. If the Government really valued and understood sibling relationships, they would allow their voices to be heard loud and clear with the full force of primary legislation. By simply amending section 34 and schedule 2 to the Children Act 1989 to include siblings and half-siblings, they would ensure that upsetting, harmful and costly cases could be avoided.
In one such case, five siblings had been in a placement together for five years. The fostering team agreed to move them to another authority with their carers, but then ripped the children’s worlds apart just before the move, advising them that they would be split up and that two of the siblings would go to a new placement. An advocacy service acting for the children took the case to court. The judge deemed that there was a case for judicial review, as article 8 of the European convention on human rights had been breached. The local authority eventually compensated the children, but they were never reunited, and spent the rest of their childhoods not only apart from each other but with zero contact. Two of the children never settled, and suffered immense feelings of loss not just for their siblings but for their former carers. How any Minister cannot grasp the opportunity to stop such utter destruction of children’s lives is staggering.
Throughout the passage of the Children and Social Work Act 2017, the then Minister, now the hon. Member for Eddisbury (Edward Timpson), said that the Government harboured concerns that the changes that I was proposing—along with a plethora of experts and organisations—would not provide the flexibility for a case-by-case consideration of contact, but of course they would. The welfare checklist and other safeguards to ensure that parental contact is in the child’s best interest would apply in the same way to siblings. The Minister also promised that the Government would look at the anomaly in the Care Planning, Placement and Case Review (England) Regulations 2010, which do not provide for contact with siblings who are not looked after. Three years on, however, no changes have been made.
In the year in which we celebrate the 30th anniversary of the Children Act and the United Nations convention on the rights of the child, amid continued criticism of the Government’s appalling record in respect of our most vulnerable children, the new Minister could prove that the Government care about children and are ready to break away from the damaging trajectory they have been on for the last 10 years. She could commit herself to enacting one small yet profoundly important and significant legislative change. I just hope that in her response to my speech she will not let me down, but, more importantly, I hope that she will not let down the thousands of children who are currently having zero contact with their siblings.