Cancer Care

Debate between Jim Shannon and Nicola Richards

Tuesday 14th March 2023 Westminster Hall

[Nicola Richards]

I totally agree. Any statistics and data that we can gather will help us to improve services and understand the landscape when it comes to who is affected and when cancer can recur, and it is important that we take all that into account. It is important to have a long-term plan for making our cancer services fit for what is to come. They need to cope with the increased demand, and deliver the world-leading outcomes that patients deserve.

Last year, the Government declared war on cancer. They announced a 10-year plan to ramp up our cancer services and make them the world leader that they ought to be. However, we now know that our plans for cancer care will become part of the five-year major conditions strategy. Although it is clearly important to take a holistic approach to caring for people with life-threatening diseases, there is no killer like cancer. We must ensure that our strategy addresses the key elements of what would be a world-leading cancer care system: research, prevention, diagnosis, treatment and care. I will first discuss one of the most important elements that we need addressed in the strategy: diagnosis.

Finding cancer early and commencing treatment is key to survival rates. For instance, 90% of people diagnosed at the earliest stage of bowel cancer will survive for five years or more, compared with just 10% of those diagnosed at the latest stage. Furthermore, almost everyone diagnosed with breast cancer at the earliest stage can receive treatment and live for five years or more, whereas only three in 10 women diagnosed at the latest stage survive for more than five years. The picture also varies by region. Unfortunately, if someone lives in the west midlands, they are statistically less likely to survive for five years or more after being diagnosed with lung cancer than those across England on average, and all combined mortality rates are significantly higher than average, too. Those stark figures hammer home the need to make sure that we detect cancer and commence treatment at the earliest opportunity.

I welcome the commitment from the Secretary of State for Health and Social Care that the strategy will shift our model towards the early detection and treatment of diseases. I also welcome the ambitious target set to diagnose 75% of cancers early by 2028. I look forward to reviewing how the strategy will address the need for greater capacity in the breast screening programme, ensure that all women at elevated risk of breast cancer are included in the national breast screening programme, and raise the proportion of all cancers that are diagnosed early; at present, just under 60% are.

Of course, it is not enough to detect cancer in its earliest stage. We also have to make sure that people receive treatment promptly, especially after urgent referrals. Much work still needs to be done in that area. Only 54.5% of people starting their treatment after an urgent referral do so within the 62-day target, and around 2,100 people have waited more than 104 days to begin their treatment. In my constituency of West Bromwich East and the wider Sandwell area, there is a mixed picture when it comes to meeting those important targets. It is welcome that our local health service met the two-week target for referring urgent suspected cancer cases to a specialist. However, like much of the rest of the country, other targets, including the 62-day standard, were not met. When I compare those statistics with the survival rates that I mentioned, it is obvious that we have to do more to ensure that people start treatment as early as possible. A critical element of that is ensuring that cancer services are sufficiently well staffed.

It would be remiss of me not to honour the people who work day in, day out, providing care for cancer patients across the country. We have all relied on them to care for us and our loved ones, in sometimes the most desperate circumstances, and to provide comfort for us in our time of need. I put on the record my thanks to the Mary Stevens Hospice in the constituency of my hon. Friend the Member for Stourbridge (Suzanne Webb); it looked after my mum in her last days, and held a last-minute wedding blessing for me and my now husband at my mum’s request.

We need to address the shortfalls in the workforce that are affecting our success in improving cancer outcomes. We have a shortfall of both clinical oncologists and radiologists, who are vital to the effort to diagnose and treat cancer patients in the earliest stages. It is so important to tackle the workforce issues with long-term plans to recruit and train the staff we need to tackle cancer properly. I welcome the Government’s NHS long-term workforce plan, which commits to addressing those and many other issues across the NHS workforce. I ask the Government to ensure that the necessary funding is provided to meet those commitments.

On the major conditions strategy, I hope that the Government will take into account the wealth of views expressed by Cancer Research UK and other key organisations in the cancer community in last year’s call for evidence, and ensure that the strategy lays the groundwork for a longer-term strategy on cancer that also tackles inequalities.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for securing this debate. Four in 10 cancers across the UK are preventable. We all know that. Action to prevent cancers will save lives. Northern Ireland—this is not the responsibility of the Minister, by the way—has no smoke-free target. We need a strategy to stop people smoking, to encourage young people not to start smoking, and to fund research and support programmes. Does the hon. Lady agree that we must have a UK-wide smoke-free target? Despite health being a devolved issue, we have to be on the same page to create a national target to prevent some of the deadliest cancers that so many people suffer from and lose their lives to. She is very much committed to that, as am I.

[Nicola Richards]

I completely agree. It is important that we do wider work around prevention, so that when someone who has a history of cancer in their family presents themselves to the NHS, they are taken seriously and their health is evaluated at the earliest stage. That could save the NHS a lot of money and the individual and their family a lot of pain and suffering.

In my constituency of West Bromwich East and the wider Sandwell area, we have worse health outcomes than other areas of the country, as I mentioned. Combined mortality rates for all cancers are higher in the west midlands than the English average. That situation must improve. We have a fantastic opportunity to level up healthcare in our area through the new Midland Metropolitan University Hospital, which will open to my constituents in West Bromwich in the coming year. It is one of a number of new hospitals that this Government are delivering to help level up healthcare. It is vital that we properly equip new and existing hospitals, so that we can tackle waiting times and improve outcomes for patients.

One of the more high-tech solutions, of which we need to see more, is radiotherapy. I recently attended an event in Parliament hosted by Radiotherapy UK and learned more about this form of treatment, which is known to be extremely cost-effective and less invasive. It costs around £3,000 to £7,000 to cure a cancer patient using radiotherapy. West Bromwich Albion legend, Bryan Robson, also attended the event in support of radiotherapy, and I had the opportunity to have a brief chat with him to discuss how the treatment saved his life. During the event, I signed the declaration asking for more action to tackle waiting times and in support of radiotherapy.

The major conditions strategy is an opportunity to refocus on this type of treatment and to ensure that it receives the necessary investment, so that many more people around the country have the option of radiotherapy to treat their cancer. Although having world-leading facilities is vital, they must be backed up with the world-leading strategy we need, and staffed with the people who provide the excellent levels of care that we know our workforce can provide when they are given the right tools. I therefore welcome the Government’s plans to ensure that we tackle the health inequalities between our regions, and I look forward to hearing more about what that means for cancer patients across the country.

I welcome the positive steps that we have already taken to improve cancer care in this country. Evidence suggests that countries with the best cancer outcomes are those that adopt long-term cancer-specific strategies. I therefore hope that the major conditions strategy will commit to improving outcomes for cancer patients and their families, as well as paving the way for a long-term strategy on cancer care that will make our services the best in the world.

Immigration and Social Security Co-ordination (EU Withdrawal) Bill

Debate between Jim Shannon and Nicola Richards

Report stage & Report stage: House of Commons
Tuesday 30th June 2020 Commons Chamber

[Nicola Richards]

I agree with my right hon. Friend. Obviously, we want to reduce the numbers on immigration. We were not able to do that while we were members of the European Union, but overall, it limited the number of countries and the areas that people were able to come from and that is what we are putting right now.

On new clauses 7 and 8, I  hear the concerns of colleagues across the House, but I am pleased to hear that the Home Office already looks to avoid detention altogether where this is possible through community engagement programmes, and that detention is only really made where there is a reasonable timescale for the removal of an individual. I agree that detaining an individual indefinitely is wrong and should not happen.

Our current dual immigration system is simply not fit for purpose and does not serve our interests as a country. That is exactly what the people of West Bromwich East tell me. From Friar Park to Great Barr, people have been saying the same thing—that the EU does not and did not work for us. It became a one-size-fits-all club, especially with regard to immigration, and we have had enough.

I have said in the House before that we Black Country folk are proud of our diverse communities and we value those foreign nationals, both from the EU and elsewhere in the world, who help to deliver a world-class health system. I am really pleased that the new points-based immigration system will not just allow, but actively welcome a range of health professionals to this country. Our NHS simply would not function without the dedicated army of foreign nationals who work in it. We can see this on display in every hospital across the country, including Sandwell General Hospital, which serves so many of my constituents so well. The Bill allows us to further protect our treasured health service, as we can go beyond the strict arrangement that we have been bound to while in the EU by adding more flexibility to the way that we recruit our doctors and nurses. So we should embrace this opportunity.

This short Bill is the natural precursor to the immigration framework that we want to operate under once the transition period ends. It is surely right that, in an open, tolerant meritocracy, such as the one we have in Britain, we should have an immigration system based on skills rather than nationality. I also welcome the Immigration Minister’s commitment to a “digital by default” system. I know from my own casework that this has been a difficulty for some people and I am pleased that we are looking to make these necessary changes.

A simpler, fairer immigration system is what the Bill will pave the way for. I think that it is a landmark moment, given the strength of feeling about immigration in our communities, and it proves that the Government are getting on and delivering on their promises. This is democracy working at its very best. We are stripping away the old and allowing ourselves to be bold and ambitious moving forward. I want the people of West Bromwich East to know that this is what we voted for and it is what we are delivering on. I commend the team at the Home Office for their work, and I commend the Bill in its current form.

[Jim Shannon (Strangford) (DUP)]

Like many others, I have been inundated with briefings and questions regarding the Bill, and I understand the importance of us all getting things right today, if possible. We certainly must, at all costs, protect our social care sector.

I was very happy to add my name, along with my hon. Friend the Member for Belfast East (Gavin Robinson), to new clauses 3 to 10, in the name of the right hon. Member for Haltemprice and Howden (Mr Davis). I hope that he presses these amendments to a Division and that the Government perhaps will accept them, even at this late stage. I feel strongly about the time limit on immigration detention. New clause 3 would hopefully change that to protect people by having a period of 28 days. The other proposals relating to bail hearings, the criteria and duration are also important, and it is so important that we get this right.

I have seen the existing pressure on the social care workforce in my constituency, and one thing is certain from their side: there is not the staff or structure to carry all that is required. The social care workforce will need to expand to deliver the Government’s laudable commitments. It is important to note that the number of staff needs not only to rise to reduce the over 120,000 vacancies that currently exist, but to increase considerably over a sustained period to meet the Prime Minister’s pledge to give every older person the dignity and security that they deserve. The current system leaves a large number of vulnerable people going without any help.

Research by the Nuffield Trust indicates that providing just one hour per day to older people with higher needs who currently get no help would require approximately 50,000 additional home care workers in England alone, never mind Northern Ireland, Scotland and Wales, and providing two hours per day would require 90,000 extra workers.

Although it can be argued that the economic impact of covid-19 will pull in more domestic workers, it is far from clear that that will create the permanent step change needed to deal with the loss of migration, fill the vacancies and grow the workforce all at once. In her new clause 29, the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper) has put forward a solution, and I hope that there is a cross-section of people in the House who will pursue that.

Analysis of the data by the Nuffield Trust shows that, from 2009-10 to 2018-19, almost half—46%—of the expansion in the social care workforce across the UK was accounted for by people born outside the United Kingdom. That is a case for why we need an immigration system that enables those people to come in and help our social care system. In regions with the greatest projected future need for social care, such as London, not only has the proportion of EU staff increased over time, but migrant staff now make up a large proportion of staff, with more than two in five care workers from abroad.

I remind the Minister very gently and respectfully that countries such as Australia and Canada have long employed points-based immigration systems and have introduced a range of special migration programmes out of necessity, including to help the long-term development of the domestic workforce. New Zealand has an agreement with the residential care sector under which it may offer more generous visa terms, such as longer stays, for a range of key jobs, including personal care assistants and care workers. In exchange, employers develop plans to boost the domestic workforce.

Having seen vulnerable people struggling to care for themselves, and yet knowing the difficulties of securing an adequate care package, I welcome this opportunity to speak on this matter. I hope that the Government listen to Members’ pleas in relation to the new clauses that have been tabled. They were tabled for the right reason—to do what is right today.