Conversion Practices (Prohibition) Bill

Debate between Maria Caulfield and Elliot Colburn

2nd reading
Friday 1st March 2024 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

I congratulate the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) on bringing forward this Bill on such an important issue in an area where the Government are keen to make progress.

First and foremost, let me be clear that so-called conversion therapy practices are dangerous and abhorrent and any new legislation in this area must seek to identify those practices as a particular threat to the LGBT community and confirm the illegality of harmful processes intended to change someone’s sexuality. The Government remain committed to an approach that protects everyone from harmful conversion practices, including the transgender community.

LGBT people should be free to live their lives without threat or fear for simply being who they are. Lesbian, gay, bisexual and transgender people are valued and important members of society and harmful conversion practices are inherently wrong and have no place in this country, first because they are abhorrent and, secondly, because they simply do not work. On this, we find strong and welcome agreement across the House and I am pleased that we have been able to have a balanced debate with differing views in all parts of the House. It is important that we lead by example in this place, because there is a wider debate across the country and we have to show that we can debate these sensitive issues in a responsible way.

However, the Government position is that unfortunately this Bill carries a lack of legislative clarity which risks unintended consequences, and the Government are well aware of the complexity of this issue from our own extensive work. I am sure the hon. Member for Brighton, Kemptown will not mind my saying that there have been honest meetings with Ministers and challenges have been discussed, and it is clear that he has wrestled with challenges in his Bill which has gone through various iterations. The Bill as it stands is a genuine attempt to overcome these challenges, but its clauses raise considerable concerns and I will come on to them in detail shortly.

The Government have rightly taken time to carefully consider our own position on these pitfalls and will be publishing a draft Bill on this topic for pre-legislative scrutiny—[Interruption.] I am coming on to that. We expect publication to be after the publication of the Cass review, which will be in the coming weeks.

[Elliot Colburn]

As we have heard throughout the debate, Dr Hilary Cass has said that there is no reason to delay a Bill on conversion therapy; she has said multiple times that there is no reason to await the Cass review to move forward. None of the promises made to bring forward a Bill ever mentioned the Cass review previously. It feels like there are more excuses about why we need to delay this. When was a decision made to now wait for the Cass review, because that is news to many of us?

[Maria Caulfield]

I welcome that valid intervention. I direct my hon. Friend to the Cass website, which says in frequently asked questions:

“The Cass Review was commissioned as an independent review of NHS gender identity services for children and young people. Its terms of reference do not include consideration of the proposed legislation to ban conversion therapy.”

However—[Interruption.] If I may finish, it also says:

“No LGBTQ+ group should be subjected to conversion therapy. However, through its work with clinical professionals, the Review recognises that the drafting of any legislation will be of paramount importance in building the confidence of clinicians working in this area.”

So the review has found evidence that may influence our conversion practices Bill, which is why we are waiting for the report.

Oral Answers to Questions

Debate between Maria Caulfield and Elliot Colburn

Wednesday 25th October 2023 Commons Chamber

[Maria Caulfield]

I thank the hon. Member for that question. That goes to the point raised by my hon. Friend the Member for Banff and Buchan (David Duguid). We need a UK approach. Across the Government, whether in the Department for Work and Pensions or the Department for Education, we focus on trying to improve all avenues for those, particularly women, who want to go into STEM areas.

[Elliot Colburn (Carshalton and Wallington) (Con)]

4. What steps she is taking to help improve the lives of LGBT people.

Covid-19: NHS Support for Prostate Cancer Patients

Debate between Maria Caulfield and Elliot Colburn

Thursday 10th March 2022 Westminster Hall

[Elliot Colburn (Carshalton and Wallington) (Con)]

I beg to move,

That this House has considered NHS support for prostate cancer patients after the covid-19 pandemic.

Ms McDonagh, as your constituency neighbour, it is a pleasure to serve under your chairmanship for the first time in Westminster Hall. I extend my thanks to the Backbench Business Committee for granting time for such an important debate. I also thank the many Carshalton and Wallington residents who came forward to share their experiences of prostate cancer, either having had it themselves or having supported a loved one or friend through it.

Many people in this room and many of those watching will know a male relative or have a friend in their life who has had prostate cancer. I hope this important debate will raise awareness of the need to get yourself checked. There will be many striking statistics mentioned in the debate that will concern Members present, but I am keen to begin with a positive. Cancer survival rates in the United Kingdom have never been higher. Survival rates have improved each year since 2010. Prostate cancer survival has tripled in the past 40 years, with 85% of men surviving for five years or longer. However, the covid-19 pandemic threatens to derail this progress through a decrease in diagnostics, especially for men over the age of 50.

There are over 47,000 new prostate cancer cases every single year, with a man dying every 45 minutes from the condition. Early diagnosis is the key to fighting this disease. The pandemic has resulted in fewer men coming to their GP to get tested for prostate cancer, with the “stay at home” messaging particularly deterring older men, who are most at risk from prostate cancer, from coming forward. While the referral rate for prostate cancer has recovered to 80% of pre-pandemic levels, it still lags behind those for other forms of cancer, such as breast cancer, which is operating at 120% of pre-pandemic levels.

Stark figures from the charity Prostate Cancer UK reveal that there have been 50,000 fewer referrals for suspected prostate cancer patients than the usual trends would predict. The impact of that is incredibly worrying. Some 14,000 fewer men in the UK started treatment for prostate cancer between April 2020 and December 2021 compared with the equivalent months prior to the pandemic. That means that 14,000 men are living without the knowledge that they have the condition, and it means that 14,000 men have not yet started that all-important treatment plan.

Prostate Cancer UK has warned that, because of that, 3,500 men risk being diagnosed with late-stage prostate cancer. I cannot stress enough the importance of people getting themselves checked if they have symptoms or if they fall into the high-risk categories. Those include men over the age of 50, black African and black Caribbean men, and men with a father or brother who have had prostate cancer.

Sadly, the statistics and anecdotes that many of us will have heard point to the fact that men are far less willing to get themselves checked. Whether that is out of embarrassment or fear, getting diagnosed early can make an enormous difference to survival rates; five-year survival rates for men who are diagnosed with prostate cancer between stages 1 and 3 are over 95%. There are fantastic NHS campaigns, such as the “Help Us Help You” campaign, which has urged people with potential cancer symptoms to come forward for life-saving checks. The second stage of that campaign addresses the fear that often comes with booking the first appointment. Despite the fantastic work that is already being carried out, I hope that the Minister will be able to enlighten us about what more the Government are doing to destigmatise men coming forward to check their symptoms.

While being checked for prostate cancer is important for all men, it is especially important for men of black African or black Caribbean origin. I was taken aback to learn that, while one in eight of all men will get the disease, one in four black men will be diagnosed with prostate cancer in their lifetime; black men are also far more likely to be diagnosed with a more aggressive type. People from black and ethnic minority groups are also 4% less likely to receive radical treatment than people from white ethnic groups.

Through covid-19, we have seen what we can achieve when we work together. Last year, I was proud to host a roundtable in Carshalton and Wallington in collaboration with the NHS, the third sector and community groups to encourage ethnic minority communities to come forward and get the jab. The roundtable was well attended and demonstrated what we could achieve in prostate cancer diagnostics if the Government worked closely with the third sector and community groups to spread awareness.

However, improving awareness requires a corresponding increase in imaging capacity. Imaging services such as multiparametric MRI are critical to achieving earlier diagnoses, which, as I stated earlier, is key to survival. MpMRI scans can confirm or rule out prostate cancer in an accurate and timely manner, reducing the stressful wait for patients and their families. From speaking with cancer charities, I know that the significant variation in access to mpMRI provision is concerning. If we are to bring prostate cancer diagnoses back to pre-pandemic levels—and, indeed, increase them—we must address that postcode lottery. MpMRI provision must, as a minimum, be expanded in line with growth rates prior to the pandemic if we are to get diagnoses back to pre-pandemic levels. The 10-year cancer plan provides a golden opportunity to address this issue.

I have already mentioned the negative impact the pandemic has had on the prostate cancer community, but I am keen to highlight some positives that could be considered in a post-pandemic setting. Prostate Cancer UK has noted that the policy change during the pandemic to grant special access to certain covid-friendly novel hormone therapies for patients was very warmly welcomed by the community. This policy change has been wanted for some time, and it not only kept patients safe at home during the pandemic but improved their care experience, as they spent less time in hospital. Along with the increased interaction between patients and clinicians using technology, the change has made for higher levels of patient satisfaction and experience.

I look forward to seeing greater access to diagnosis and treatment and increased use of technology in my constituency at the London cancer hub, an exceptionally exciting project in the London Borough of Sutton. As a former employee, the Minister will know the Royal Marsden Hospital very well. I will not go over ground that she already knows, as cancer nurse who, I believe, is still practising.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

indicated assent.

[Elliot Colburn]

The Minister is nodding. The Royal Marsden and the Institute of Cancer Research already form one of the leading cancer research and treatment centres in the world. The development plans for the London cancer hub will double the capacity for cancer research on the site, making the United Kingdom second only to the United States. It will be a game changer and will take our cancer research to the next level. It is a prime opportunity to ensure that the reduction in prostate cancer diagnoses remains a temporary blip in the overall effort to achieve early diagnosis for everyone with the condition.

This effort must include the cancer workforce. The Government have already invested money to address the cancer backlog, but the workforce issue must also be addressed. Patients with prostate cancer and their families go through one of the most difficult things in life to navigate. They are desperate for more clinical nurse specialists, who provide holistic, patient-centred care, with the empathy needed in these very dark times. Having access to clinical nurse specialists means that prostate cancer patients are far more likely to be positive about their care and treatment and to receive more individualised treatment plans.

One suggestion to be considered for the post-pandemic NHS is non-medical practitioner-led prostate cancer clinics. Such clinics would not only enhance the clinical pathways in prostate cancer, but relieve time burdens on oncologists and help to reduce costs that can be cycled back into the system. With one in four consultant clinical oncologists reporting risk of burnout, and with covid-19 exacerbating those issues over the past two years, investing in non-medical practitioners or increasing the number of clinical nurse specialists—or both—could be solutions to workforce concerns. I urge the Government to work with NHS England, Health Education England and the devolved Administrations to ensure that professional working groups in the prostate cancer workforce are addressing the workforce backlogs, including with clear training routes for healthcare professionals wishing to upskill.

I appreciate that there is strong interest in the debate, so I am keen to conclude my remarks. If the Minister takes anything away, I hope it is the need to find those 14,000 men missing from the prostate cancer treatment pathway, and to ensure that workforce issues are looked at by the Government. The pandemic has provided the NHS with a unique opportunity to rethink how we provide care not just to prostate cancer patients but to all cancer patients, with greater use of technology and the benefits of covid-friendly treatments that patients have had access to throughout the pandemic.

Finally, the one message that I hope those watching the debate—especially those in high-risk categories—will take away from it is: “Please get yourself checked”. The support available for patients and their families is fantastic, and it is out there. I say to people watching: “You are never alone”. I urge them to book that vital first appointment. I look forward to hearing the contributions from other hon. Members on this incredibly important issue.