Body Image and Mental Health

Mary Glindon Excerpts

Tuesday 23rd July 2019 Commons Chamber

[Jackie Doyle-Price]

The hon. Gentleman raises an issue close to my heart. When we talk about so-called reality TV programmes, it is as if the people participating in them are normal people. The reality, however, is that they are not normal people. They are semi-professional celebrities who have often undergone enhancements to become attractive to be chosen to go on these television programmes. The whole thing starts to develop insidiously in a culture, making people think that they should aspire to look like that and that it is normal. Everyone is chasing a lifestyle that is frankly not attainable.

We have all enjoyed watching such programmes. I often say that we have become a nation of voyeurs, but perhaps we all need to remind society that there is no quick route to fame, fortune and success—that comes as a result of hard work—and that spending a bit of money on a nip and tuck and a lip filler will not be the route to earning a lot of money. We all need to start to address that, because we have allowed magazines and our media to develop this image. We have been complicit in it happening, because we have enjoyed that entertainment, but we are reaching a position where our society is extremely unhealthy.

The problem has been made particularly acute by the growth of social and digital media, which have increased exposure to unrealistic and unattainable images of beauty. As we all know, when we are browsing on our iPad we can look at one thing and straight away be bombarded with sites that squirrel us down a route where we are exposed to more and more such content. People who are looking at unrealistic body images will see ever more images that they aspire to. There is another insidious thing: a friend of mine was speaking to me only last night and said that she was looking at cosmetic procedures when, all of a sudden, an advert popped on to her screen encouraging her to spend a few thousand pounds so that she could learn to administer lip fillers herself. She thought how horrendous it is that our social media does that.

[Mary Glindon (North Tyneside) (Lab)]

Is the Minister aware of the Be Real campaign’s latest report, “The Curate Escape”, which looks at young people and their images on social media? Two thirds of young people edit pictures of themselves before they put them on social media, and the report makes a lot of really good recommendations. The Be Real campaign has been fantastic in recent years, focusing on health and wellbeing, rather than weight and people watching their weight. If she is not aware of the report, would she like a copy?

[Jackie Doyle-Price]

I thank the hon. Lady for raising that point—I have heard of that campaign. It is disturbing that so many people alter their images. None of us is perfect—God help us if we all were—but for people to think that they need to alter their appearance because they are unhappy with it, and for that to become normalised, is quite a sinister development in society. At the risk of being trite, perhaps we should be telling everyone to learn to love themselves.

Drug Treatment Services

Mary Glindon Excerpts

Tuesday 16th July 2019 Westminster Hall

[Mary Glindon (North Tyneside) (Lab)]

It is an honour to serve under your chairmanship, Mr Hollobone. I congratulate my hon. Friend the Member for Manchester, Withington (Jeff Smith) on an excellent speech and on his commitment to tackle unswervingly the problems associated with drug and alcohol abuse.

I am pleased to speak as co-chair of the drugs, alcohol and justice cross-party parliamentary group that last week considered the Advisory Council on the Misuse of Drugs’ recent report, “Custody-Community Transitions”. The report is helpful in providing advice on how to reduce drug-related harms that happen when people move between custody and the community. I hope the Minister will agree to implement the report’s practical recommendations as soon as possible to ensure continuity of care.

Some simple changes could make a huge difference. For example, it suggests prisoners with complex needs should not be released on to the streets on Fridays. Given that last year only 12% of prisoners with drugs problems left prison with naloxone, which can reverse the effects of overdose, the report recommends that naloxone should be issued to all prisoners with drug problems on leaving custody.

We have record rates of drug-related deaths, yet drug treatment budgets have been slashed and services cut, as has already been said. I am sad to say that my region, the north-east, is the worst affected in England. Today we have heard that drug-related deaths in Scotland have gone up by a staggering 27%. We can only tackle these soaring statistics if substance misuse services are made mandatory and drug treatment budgets ring-fenced.

Instead of investing in harm reduction, we waste valuable resources on an unwinnable war on drugs, treating this as a criminal justice rather than a public health issue. We have excellent examples of a different approach being taken in the checkpoint scheme in County Durham and the Thames Valley diversion scheme. They show effective alternative solutions—not easy options, but positive ways of getting people out of trouble and into treatment. Another innovation to help drug users would be the introduction of drug-consumption rooms—effectively overdose prevention centres—which the Government stubbornly refuse to allow, despite conclusive evidence that they are of massive benefit.

In summary, I will quote Paul Townsley, chief executive of the charity Humankind:

“These challenging times provide an important opportunity to cement the evidence base of what our service users and our communities need, but to achieve this we will need stable funding and commissioning… Government has a duty to act now to ensure treatment services are accessible to all who need them. We call on Government to ensure that substance misuse treatment is a prescribed local public health activity.”

I can only concur.

Medical Cannabis under Prescription

Mary Glindon Excerpts

Monday 20th May 2019 Commons Chamber

[Mary Glindon (North Tyneside) (Lab)]

It is an honour to follow the hon. Member for Reigate (Crispin Blunt), who is so impassioned—that was evident in his speech—and has done so much work on this issue. I think everyone would pay tribute to what he has done.

I congratulate the right hon. Member for Hemel Hempstead (Sir Mike Penning) and my hon. Friend the Member for Gower (Tonia Antoniazzi) on securing the debate and on the work they have done, alongside the End Our Pain campaign, to highlight the importance and urgency of this issue. It is heartbreaking to hear the stories of families who are trying to access medical cannabis, and especially parents whose children are so poorly. I am sure we all pay tribute to them for their persistence in standing up for their children.

[Mr Jim Cunningham (Coventry South) (Lab)]

I pay tribute to the right hon. Member for Hemel Hempstead (Sir Mike Penning). For a long time, he has been campaigning very strongly on this issue—in fact, we met some families he brought down to the House of Commons last year—as, of course, has the hon. Member for Reigate (Crispin Blunt).

If my hon. Friend the Member for North Tyneside (Mary Glindon) watched the news over the weekend, she will have seen a family who had to go to Holland and pay over £1,000 to get the medical relief that their kids need through medical cannabis. The question therefore is: why can we not do the same in this country? Why are we being so slow? A lot of kids are suffering, and some could go into a fit and die if we are not very careful. Does she not agree that the Government have to treat this with urgency?

[Mary Glindon]

I certainly would agree, and that is the case that we are all trying to make today.

I want to highlight the situation for my adult constituent, Lara Smith, who is known for courageously campaigning for the medical use of cannabis by highlighting the problems that she has faced in recent years to access the medicine Bedrocan. Lara is a wife and the mother of three children. She was a paediatric nurse and a county fencing coach before her health deteriorated because of cervical and lumber spondylosis. Over 20 years, she has had 35 different medications as well as a number of operations for her condition. Unfortunately, she has been left with permanent nerve damage, limited mobility and a constant annoying and debilitating tremor in her right hand. Her quality of life has been completely impaired, not just because of her medical condition but particularly because of the drugs that she has been prescribed over the years. This has meant that Lara was not able to be the full-time mother that she wanted to be to her daughters and son.

Fortunately, Lara’s pain management consultant in the north-east prescribed her the drug Bedrocan, and the transformation was such that she was able to come off all her other medications. Her young family said that they felt they had their mam back. The downside is that Lara can access the drug only by travelling to a Dutch pharmacy to collect it. Her arduous journey was shown just last week on “The One Show”—I hope that if people have not seen it, they may be able to on catch-up. She makes the journey every three months and has to notify full details of her prescription and travel to the Border Force. The costs of the medication and travel are expensive for her family, but it is a sacrifice that they have been making for over four years. The changes to the law that were made last November have not gone any way to making it easier for Lara to get her medication.

I raised this issue in Prime Minister’s questions, and afterwards I received a letter from the Minister for Policing and the Fire Service, who said that

“there should be no barriers to patients getting access to the appropriately prescribed medicine. The Department of Health and Social Care…has been working closely with suppliers and NHS procurement pharmacists to ensure that prescribed CBPM are available when needed.”

But that has not been the case for Lara and many other people, as we have heard tonight.

Lara’s private prescription cannot be dispensed by NHS pharmacists. Her consultant has been unsuccessful in obtaining an individual funding request, which Lara is very disappointed about. That was because the hospital trust follows the Royal College of Anaesthetists guidelines, which do not advocate the use of cannabinoids, citing a lack of evidence for effective pain relief, so all the while there has been no progress yet for Lara. Lara did approach an independent pharmacy to see whether it could get access to the drugs and bring them here to dispense them, but the licence fee would cost thousands and the cost would be borne by Lara. It is just beyond her reach.

The current state of affairs remains frustrating for Lara and all the adults and children who need these drugs. I do not know how many more trips Lara can make to Holland—not just on a financial basis, but because of her health—and I am worried about her. The process that the Government have put in place is too protracted. All I can say is that I hope the Minister will heed the words of the motion and particularly the very sensible proposals from the all-party group. This is a case of urgent need. We cannot delay any longer. Please listen, Minister, and please give some positive feedback this evening.

Health

Mary Glindon Excerpts

Tuesday 14th May 2019 Commons Chamber

[Jonathan Ashworth]

Absolutely. Everybody accepts that advances in life expectancy cannot continue indefinitely, but we need urgent investigation into what is happening here in the United Kingdom. As Michael Marmot, the authority on these matters, says:

“Since 2010, this rate of increase has halved. Indeed, the increase has more or less ground to a halt.”

He goes on to say:

The first thing to say is that we have not reached peak life expectancy. A levelling off is not inevitable. In the Nordic countries, in Japan, in Hong Kong, life expectancy is greater than ours and continues to increase.”

We need to understand what is happening in the United Kingdom. Surely it can be no coincidence that this halt in life expectancy advances has come after nine years of desperate austerity in our society.

Many of us are puzzled by the fact that, although we know that growing up in poverty means that people get sick quicker and die sooner, and we all accept that it is shameful—the Prime Minister accepts that it is shameful and talked on the steps of Downing Street about wanting to tackle these burning injustices—the Government continue to cut public health services by £700 million, including cuts of £85 million in the current financial year.

The stark reality is that these inequalities are costing the NHS £4.8 billion a year, and we are seeing a growing burden of chronic ill health in society. The NHS long-term plan, with its many laudable goals and ambitions, is simply undeliverable without investment in local public health services and a reversal of these deep, swingeing cuts.

[Mary Glindon (North Tyneside) (Lab)]

Does my hon. Friend agree that it is disgraceful that while we are talking about all those cuts to the health service the Government have provided more than £4 billion in tax giveaways to alcohol companies, which is the equivalent of the salaries of 160,000 nurses?

[Jonathan Ashworth]

As my hon. Friend indicates, government is about choices. The Government have chosen to give big tax cuts to some of the richest and most privileged people in society while cutting the public health services on which the most vulnerable rely. That tells us all we need to know about the Tory approach to the national health service.

Acquired Brain Injury

Mary Glindon Excerpts

Thursday 9th May 2019 Commons Chamber

[Chris Bryant]

My hon. Friend is absolutely right. I know that many Members in the Chamber today and others, including Ministers who are unable to participate in the debate due to their ministerial responsibilities, have also visited Headway groups in their constituencies. I have been to the group in Cardiff, which does a magnificent job. This is also about those who work in the NHS and alongside many of the voluntary organisations that do magnificent work. For many people, the work is thoroughly rewarding, because somebody can be taken from complete dependency on others to needing much less frequent support through neuro-rehabilitation, enabling them to stand on their own two feet and have the quality of life that they had before.

[Mary Glindon (North Tyneside) (Lab)]

Will my hon. Friend commend the vocational rehabilitation provided to 10 of my constituents by Momentum Skills in Newcastle? The organisation asked me to pass on its massive support for the “Time for Change” report and its recommendations.

Access to Medical Cannabis

Mary Glindon Excerpts

Monday 8th April 2019 Commons Chamber

[Matt Hancock]

Those guidelines are not a matter for the Home Secretary; they are guidelines in the health space, although the association that writes them does not report directly to me but is independent. Those guidelines do not prevent a physician who is on the specialist register of the General Medical Council from prescribing. If anybody has been told that they do, they do not; it is up to the individual professional judgment of a specialist clinician on the register to prescribe or not.

[Mary Glindon (North Tyneside) (Lab)]

Lara Smith, my constituent, is really upset about what happened to Teagan and her family at the weekend. Lara travels to Holland every three months to get a schedule 2 drug, Bedrocan, for her seriously debilitating illness. It could be imported but, if it was, unfortunately, she would have to bear the licence fee. Will the Minister say whether anything can be done for her?

[Matt Hancock]

Yes. My heart goes out to the hon. Lady’s constituent and her family. One of the purposes of the evidence gathering that we are doing, and of the calls of the national institute for trials, is to provide the evidence on which the NHS could routinely provide those medicines. At the moment, we have the ability for specialists to prescribe in the interim, but I want to get the evidence base in place for the longer term.

Oral Answers to Questions

Mary Glindon Excerpts

Tuesday 26th March 2019 Commons Chamber

[Matt Hancock]

As the right hon. Gentleman knows, I supported and indeed participated in the decision to ensure that access was made legal in the autumn, and I am working right now on trying to make sure that some of the challenges in the system are unblocked. Ultimately, these things have to be clinician led, but my sympathy is with those who are campaigning, whom I have met, because I know of the anguish that this problem is causing.

[Mary Glindon (North Tyneside) (Lab)]

5. What assessment he has made of the effect of prescription charges on the health and wellbeing of people with asthma.

[The Minister for Care (Caroline Dinenage)]

Extensive arrangements are already in place to help people afford NHS prescriptions. Those include a broad range of prescription charge exemptions, for which somebody with asthma may apply.

[Mary Glindon]

More than 90% of people on low incomes say they struggle to afford their prescriptions, and 71% told Asthma UK they skipped their asthma medication due to cost. Given the health inequalities in this country, will the Minister investigate that injustice?

[Caroline Dinenage]

People on low incomes who do not qualify for an exemption may be eligible for either full or partial help with prescription charges through the NHS low-income scheme. In addition, for those who do not qualify for that, the prescription pre-payment certificate is available, under which everybody can get all the prescriptions they need for only £2 a week.

NICE Appraisals: Rare Diseases Treatments

Mary Glindon Excerpts

Thursday 21st March 2019 Commons Chamber

[Mary Glindon (North Tyneside) (Lab)]

It is an honour to follow the hon. Member for Reigate (Crispin Blunt).

I thank the Backbench Business Committee for agreeing to the debate. I also congratulate my hon. Friend the Member for Blaydon (Liz Twist), who is, as she said, my fellow member of the all-party parliamentary group for muscular dystrophy. She made a lucid and compelling case for the review of the NICE appraisal process.

I have had the honour of chairing the APPG for several years. It works closely with our secretariat, Muscular Dystrophy UK, and with patients and carers, on a number of issues that affect the lives of those with muscular dystrophy and other neuromuscular conditions. Perhaps one of the most important issues that we consider is the ability of patients to access treatments for their conditions.

For more than a year, access to the drug Spinraza, manufactured by the company Biogen, has been the focus of the APPG’s concerns about, and frustrations with, the NICE appraisal process. Spinraza is the first and only treatment for patients with spinal muscular atrophy, a rare inherited neuromuscular condition that leads to the gradual loss of the ability to walk, move, breathe and swallow. It currently affects about 2,000 adults and children in the UK. There are several types of SMA, with type 1 being the most severe, usually resulting in the death of infants before they reach their second birthday. However, clinical trials of Spinraza have had amazing results for many of the patients who have tried it. It has been so positive for children with type 1 that over two years ago Biogen opened its global expanded access programme to provide the drug free to type 1 patients.

Spinraza is currently available across 24 European countries and in the US, but for patients in this country access to the drug is being held up by lengthy delays to the NICE appraisal process.

[Mr Jim Cunningham (Coventry South) (Lab)]

Does my hon. Friend agree that the hon. Member for Reigate (Crispin Blunt) is right that there needs to be a new model, and more importantly that something must be done about the cost of drugs? We cannot carry on with the escalation of the cost of these drugs because, as the hon. Gentleman said, that affects many families in different ways.

[Mary Glindon]

That is true, and I think it will be highlighted again and again in this debate.

The delay for patients in this country is made all the more frustrating because the Scottish Medicines Consortium approved Spinraza for children with SMA type 1 last May, and it now has a new ultra-orphan pathway and has speedily reassessed Spinraza, and as a result children and adults with SMA types 2 and 3 will be able to access the drug from next month.

In England the Spinraza appraisal has already been going on for 14 months. In January last year NICE announced that the pathway for the drug would, sadly, be the single technology appraisal, used for common diseases, rather than the highly specialised technology appraisal, which has been spoken about and is used for rare conditions. On 14 August, all hopes were shattered when NICE announced that it did not recommend funding by the NHS as the clinical effectiveness of the drug was not proven and the price was too high.

NICE launched a consultation and held a committee meeting in October to review all responses. There was still no progress for patients. Then, following a previous announcement, on 1 November Biogen closed the expanded access programme for type 1 to all new infants, so although 80 children remain on the programme, any child born after that date with type 1 has no access to this life-saving drug. The process drags on, and NICE had its third committee meeting earlier this month, but as yet no information has been published.

Biogen maintains that the STA process is not appropriate for rare disease medicines, because the smaller patient populations in rare diseases make it inappropriate to expect treatments to achieve the same cost-effectiveness thresholds as medicines in disease areas with much larger patient populations. It has also pointed out that it is very difficult to measure the quality of life in a young paediatric population. However, that is a major determining factor in the STA process, so it is a stumbling block in approving Spinraza. The company still hopes that a managed access agreement can be reached with NICE and NHS England.

The truth is that NICE’s emphasis on cost-effectiveness stands in contrast to the focus on more flexibility and data gathering for future review, which has allowed Spinraza to be approved in Scotland and across Europe. A recent report by MAP BioPharma, “Access to orphan medicines”, highlighted that 75% of rare disease medicines recommended by NICE through an STA between 2013 and 2017 were due largely to rare cancer drugs that are covered by the cancer drugs fund, and none of the only six non-cancer orphan drugs reviewed by NICE through an STA has received a recommendation in line with full marketing authorisation.

The report makes five recommendations for the NICE STA methods review: making changes to the evidence requirements for orphan medicines; drawing from the HST methodology to consider introducing a sliding incremental cost-effectiveness ratio up to £100,000; considering adapting the evidence review group for orphan medicines; embedding formal opportunities for negotiation between companies and NHS England; and considering interim recommendations in line with the cancer drugs fund and the new Scottish ultra-orphan pathway. MAP BioPharma points out that those adaptations would help to level the playing field so that patients, clinicians and companies could be sure that all treatments for rare diseases would be considered under a fair appraisal and that access would not be held back as a result of treatments being referred for an inappropriate appraisal. I hope that those recommendations will be given due consideration by NICE, NHS England and the Department.

Meanwhile, for those awaiting a decision on Spinraza, the anxiety continues. They include families such as that of my seven-year-old constituent, Sam McKie, who has type 2 SMA. Sam loves playing wheelchair football and has played since he was three. He now plays for the Newcastle Magpies wheelchair championship team and is as good as many of the adult players. In fact, he is so good that, in November, the Newcastle United Foundation named him as its disability player of the year. Sam’s dad, Gary, wrote to me, and his words reflect the views of everyone affected by SMA. He said that

“children are facing an agonising and uncertain wait for approval whilst their condition deteriorates. Gaining early access to this drug could see Sam get stronger and gain new abilities. The SMA community would love to be able to access this drug to give our babies and children a chance, a chance they surely deserve. This drug is available now, and timely procedures are stopping our children from accessing it, this is wrong. Please help us.”

Will the Minister hear Gary’s words? Will he take action to ensure that delays do not happen in future? And will he work with Muscular Dystrophy UK and other charities towards making NICE take on board MAP’s recommendations, to help to create a new and fairer system, like that in Scotland, that will deliver for patients like Sam and, as Gary McKie says, give them the “chance they surely deserve”?

Health and Care Professions Council: Registration Fees

Mary Glindon Excerpts

Thursday 14th March 2019 Westminster Hall

[Liz Twist (Blaydon) (Lab)]

It is a pleasure to serve under your chairmanship, Mr McCabe. I thank my hon. Friend the Member for Coventry South (Mr Cunningham) for securing this important debate, which I am glad to have the opportunity to speak in. For many years, it was my privilege to work with many healthcare professionals, so I take a keen interest in this subject. I was happy to add my signature to the letter to the HCPC to oppose the, at the time, 18% proposed increase in fees.

It is right that healthcare professions should be regulated and that those bodies should be independent of the Government, which means that fees must be attached to the registration. Having set fees, however, those bodies must have a view to the people and the professions that they regulate. Many people covered by the Health and Care Professions Council are not big earners, despite playing an incredibly important part in our healthcare system, and they are often missed out when we talk about healthcare workers.

We talk about doctors and nurses, but we rarely talk about all the other NHS staff who are integral to our healthcare system. I have worked with paramedics, occupational therapists, dieticians and many others, who are an important part of that healthcare team. In the last 18 months, I have had personal experience in my family of the great work they do—on stroke rehabilitation, for example. It is important work, but the pay is not great. Typically, people are paid at band 5, which starts at £23,000 a year, so we are not talking big bucks.

[Mary Glindon (North Tyneside) (Lab)]

My hon. Friend is making a good argument about the different levels of pay. Does she agree that one of the most unfair arguments for raising the fees is that they are lower than for other professional bodies? Dentists and doctors get paid much more money, so there is no fairness in that comparison.

[Liz Twist]

I agree with my hon. Friend and I will come on to that point later.

Although we in this House talk about how valuable healthcare workers are in all kinds of debates, the fact is that their pay has not kept in line with the real cost of living, so an 18% increase in registration fees is huge and out of all proportion with the pay increases that they have had in recent years. Most of them do not have a choice about whether to register; they must be registered to be able to work. The increase will bring the total increase in registration fees to 40% since 2014, which is incredible.

As hon. Members know, one issue that the NHS is facing is staff shortages in certain areas. It cannot be ignored that something such as this increase can only be a disincentive to staff looking to do those important jobs. As other hon. Members have said, another key issue is the impact of social workers. They are currently covered by the HCPC, but they are about to go off to their own regulatory body. The significance of that should not be lost. While it will mean a reduction in income, of course, it will also mean a significant decrease in the number of fitness-to-practise cases, which are inevitably expensive to prepare. Currently, 25% of HCPC registrants are social workers, but more than 50% of fitness-to-practise cases are in the social work field. That significant factor should be taken into account when the HCPC considers its fees.

On fitness-to-practise cases, I well remember from representing people how devastating it is for any health professional to face a complaint or a fitness-to-practise case, but many people are being held in limbo waiting for their case to be heard, or even awaiting a decision that the case should not be pursued. A 2018 report by the Professional Standards Authority for Health and Social Care was critical of the HCPC and suggested that cases were being referred to the fitness-to-practise panel by its investigation committee too readily. The report stated:

“In our review of its performance this year, we set out our concerns about how the HCPC approaches the discontinuance of cases. Our view was that the approval of discontinuance decisions by the HCPC (with no additional information or evidence being presented since the decision of the Investigation Committee to refer the case) may indicate that the Investigation Committee is failing to identify when there is no case to answer.”

Clearly, that has a significant impact on the professional under investigation and on the operation of the HCPC, and is a factor in costs.

As other hon. Members have mentioned, the proposed 18% increase will have a disproportionate impact on part-time workers, who are predominantly women and mostly in the NHS, because it is a flat-rate fee. That does not seem reasonable.

We hope that the Health and Care Professions Council will listen to the comments made in the debate. Unison has also made some suggestions that the HCPC should consider. First, there should be a pause in implementing the decision to increase fees until the impact of social workers moving away can be assessed. It will clearly be a significant factor in the future, so it seems appropriate that the full impact should be known before an important decision to increase by 18% is made. Secondly, I am told that the Health and Care Professions Council has £18 million of cash reserves, which should be used to allow the impact of the move of social workers to be considered before fees are raised. Thirdly, there should be a more stringent look at other means of raising revenue, rather than just increasing fees.

The Health and Care Professions Council carried out a consultation on the fee increase. By its own admission there were 2,398 responses, many of which opposed the proposed increase. The HCPC has written to explain its position to those of us who signed the letter that we wrote before it made the decision. In that letter, it compared its fees with those of other healthcare regulators. Frankly, that comparison is not valid, as my hon. Friend the Member for North Tyneside (Mary Glindon) has already said. A comparison with the fees paid by dentists, which are £890 a year, or doctors, which are £390 a year, is completely misleading. Typically, HCPC registrants will be paid vastly smaller salaries, so it is not just apples and pears, but apples and strawberries. There is a real mismatch and disparity in the comparisons being made, so they are not valid.

As other hon. Members have, I call on the Health and Care Professions Council to reconsider its position and to agree to Unison’s suggestions as a way to avoid the 18% increase in fees.

Prostate Cancer

Mary Glindon Excerpts

Wednesday 6th February 2019 Commons Chamber

[Simon Hoare]

The hon. Gentleman is absolutely right, and I will turn to diagnosis in a moment.

Let me return to the point I made a moment or so ago about fear. We will all have had family and close friends experience being given a diagnosis of prostate cancer or, indeed, other cancers, and the first thing is always to face that in a very black mood and think that there is absolutely no cure. However, we know that there are scientists—clever men and women—striving every day to find such cures. Indeed, life expectancy post an early diagnosis is of course getting better and better. Rightly, we place huge emphasis on breast and cervical cancers, but I suggest to the Minister that, in the shape of male cancers, we need to up the game in communication and education as well.

Some statistics on prostate cancer, provided by Prostate Cancer UK, may be of help to the House. Prostate cancer is the most common male cancer in our country: 47,000 men are diagnosed each year. One in eight men will get prostate cancer, and every 45 minutes one man dies of it in our country. Men over 50—I turned 50 this year, so I do not know whether—[Hon. Members: “No.”] I know; it is almost impossible to believe. I am not sure whether I should therefore declare an interest, but men over 50 are more prone to it, particularly if they have a family history.

A statistic I have learned—I am yet to find any particular reason for it—is that black men are far more at risk of contracting prostate cancer: one in four will get it. Someone’s risk of prostate cancer is heightened—again, this was a new fact to me—if their mother or their sister has had breast cancer. I wonder how many people recognise that and see that, if a female in the family is diagnosed with breast cancer, that should act as a spur for them to go and have a test. In 2016, 11,631 men died of prostate cancer in the UK alone.

At our party conference last year, my right hon. Friend the Prime Minister said:

“The key to boosting your chance of surviving cancer is early diagnosis… Through our Cancer Strategy, we will increase the early detection rate… We will do it by…investing in the very latest scanners.”

[Mary Glindon (North Tyneside) (Lab)]

I congratulate the hon. Gentleman on securing this important Adjournment debate. As well as early diagnosis, this is about people’s awareness that they themselves may possibly have the symptoms. When my husband was diagnosed, he just thought he had a chill. Unfortunately, his is incurable, but he thought no more about it than that he had a chill. An even more important issue than having screening is that we should be aware of our bodies.

[Simon Hoare]

The hon. Lady makes an incredibly telling point, because unless people know what the full range of symptoms are, they do not really know what they should be thinking and whether one of those symptoms or a combination of them should actually trigger a visit to their doctor in the first instance. I think she is absolutely right that we need a better understanding.

This goes back to a point I made a moment or two ago. Because this is a below-the-waist issue and we men get frightfully embarrassed about those sorts of things, we are inclined to say that it might just be something else or that it will pass, and so on. However, for too many people, it is left too late to have any meaningful, beneficial outcome as and when they eventually go to see their GP and then trigger the referral process.

--- Later in debate ---

[Steve Brine]

We do not often use the term, “No decision about me, without me” any more, but I always remember the former Health Secretary—now Lord Lansley—using that a lot, and that is still very true. A patient over that age has every right to request a PSA test, and certainly even more so if they believe that they have symptoms. I would be very concerned about a GP refusing it—I think it would be extremely unlikely for one to do so in such instances—but any patient has the right of travel. Every patient has the right to change GP if they are not satisfied with the relationship that they have. If my hon. Friend did know of an instance of that, I would be very interested to hear about it—as, I suspect, would the Royal College of General Practitioners —but I would be very surprised.

I want to touch on screening, which we talk about a lot at the moment, and I will come on to why. Because of the limitations of the PSA test, there is currently no national screening programme for prostate cancer. In 2016, Prostate Cancer UK, which has been rightly lauded this afternoon, began work to help to develop tests that could form part of a national screening programme. This would potentially involve better blood tests, which are currently in development, combined with more advanced scanning. It is hoping to make that happen in the next five years—nothing happens quickly in this space unfortunately—and I am sure that we all welcome their efforts.

Members will be aware—I have spoken about this quite a lot in the House recently; we have had a number of cancer debates since Christmas—that Sir Mike Richards is leading a review for the Secretary of State of our current screening programmes. As part of that—I met Sir Mike last month—we will consider how we can make screening smarter, targeting those most at risk. We expect that Sir Mike’s work will have positive implications for future programmes. He is an incredibly experienced and respected figure in this space, and I hope that his work will enable us to roll screening out faster when the evidence base is there to support it. I am very hopeful and ambitious about that work, as I know Sir Mike is.

Let us talk about public awareness campaigns, which my hon. Friend mentioned in opening the debate. The Government have to do all that they can to raise awareness of prostate cancer and target high-risk groups, while recognising that there are limitations on how much the public will listen to public health messages from Ministers at the Dispatch Box—I know that it is hard to believe that people do not take this all to heart, but they do not, so we work with our partners.

In 2014, along with Public Health England, we worked on the phenomenally successful “Be Clear on Cancer” campaign, which has had a number of iterations, on prostate cancer in black men. The campaign messaging included:

“1 in 4 black men will get prostate cancer”,

which was one of its tag lines. It urged black men over 45 who were concerned about their risk of prostate cancer to visit their GPs. The campaign evaluation showed that it had stimulated new conversations about prostate cancer among families and the black community. Public Health England has made all the materials developed for the campaign available online, so that groups and other organisations can use them locally if they wish. They are very striking and powerful, and we believe that they were very successful.

We also welcome the work that Prostate Cancer UK is doing with the Football Association to raise awareness through their “relegate prostate cancer” campaign. It is fronted by high-profile celebrity football figures, including the England football manager, Gareth Southgate, and includes the slogan:

“One man dies every 45 minutes of prostate cancer”.

Anyone who can stay awake for “Match of the Day” on a Saturday night—thank goodness for the repeat on a Sunday morning—will see very many people, including the pundits and the managers interviewed afterwards, wearing the badge that I am wearing today. Members will be very familiar with that badge, which demonstrates the widespread support that Prostate Cancer UK has in continuing to raise awareness of this disease.

Let me turn to research, as I come to a conclusion. Research has played a crucial part in the advances that we have made in cancer survival over the past four decades. More than 15 years ago, the Department identified the need for further research into prostate cancer, and we have since worked closely with Cancer Research UK—it was here this morning; I was pleased to pop into its drop-in—Prostate Cancer UK, the Medical Research Council and others, through the National Cancer Research Institute, which is a strategic partnership of the major UK funders of cancer research. NCRI spend specifically on prostate cancer research increased from £17.1 million in 2011-12 to £26.5 million in 2015-16.

[Mary Glindon]

On research, does the Minister think that those who are diagnosed with cancer should be encouraged to take part in clinical trials that aid research and help us to find ways to halt or even cure these horrendous diseases? I think this is underplayed and that we should encourage as many people as possible to help with research by themselves getting involved in trials.

[Steve Brine]

I am happy to agree with the hon. Lady. In her work on brain cancer, the late Baroness Jowell made the point about stimulating new research projects, and that work has been incredibly successful, including subsequent to her death. She also spoke a lot about clinical trials. Anybody diagnosed with a cancer for which there is no significant treatment would want to load the gun with the trial bullet, but there are challenges there. There is only so much that one can do, and there is a toxicity issue with moving from trial to trial that patients do not always fully appreciate, but in consultation with one’s oncologist and physician absolutely it has a critical role to play. Without trials, we would not have any of the treatments we have today, so I thank the hon. Lady for raising that point.

My hon. Friend the Member for North Dorset said that women’s cancers, such as breast cancer and the gynaecological cancers, perhaps get more Government attention. I have to disagree. Last April, the Prime Minister pledged £75 million towards clinical trials for prostate cancer, which will focus on improving early diagnosis and survival rates as well as exploring options for different treatments for men affected by the disease. We expect 40,000 men to be recruited to new research projects with this cash boost. I hope this demonstrates our ongoing commitment to male cancers as well as female cancers.

I am the first guy to hold the post of Public Health Minister in a long time, possibly ever, and it is true that there is a lot of focus on female cancers, but I am determined to raise the bar for men’s health generally, but for male cancers in particular, which is why I was pleased to mention the all-party group earlier.

Alongside the £75 million for research, in 2016-17 the NIHR clinical research network recruited patients to over 90 trials—the hon. Member for North Tyneside (Mary Glindon) raised the point about trials—and other studies on prostate cancer, so there are a lot of trials in this area. The NIHR biomedical research centre at The Royal Marsden here in London and the Institute of Cancer Research also have a five-year £3.1 million prostate cancer research theme.

I started by saying that we do not know everything about prostate cancer. We hope to see these projects deliver more personalised diagnosis, treatment and care of men with prostate cancer through better understanding of the molecular and genetic pathways that determine the non-uniform nature of prostate cancer. The prostate testing for cancer and treatment—ProtecT—trial was the largest publicly funded clinical trial ever to take place in the UK. NIHR funding to date is £40million, which is quite a significant sum.

I agree with what my hon. Friend said about the workforce. The NHS is nothing without the 1.3 million staff on whom patients depend day and night, and for no group is that more true than for cancer patients. We will not achieve our cancer ambitions without an increased cancer workforce, which is why the Secretary of State has commissioned Baroness Dido Harding, working closely with Sir David Behan, who used to lead the Care Quality Commission, to lead a number of programmes to engage with key NHS stakeholders to develop a detailed workforce implementation plan. Baroness Harding and Sir David will present initial recommendations to the Department in March, and these will consider detailed proposals for growing the workforce rapidly alongside the implementation of the NHS long-term plan, including that early diagnosis of cancer target I mentioned.

In connection with that, my hon. Friend mentioned cancer nurse specialists. Health Education England is working to expand the number of cancer nurse specialists and to develop their competencies and routes into training. This will mean every cancer patient having access to a CNS or other support worker by 2021, which I think he will agree is a very good thing.

I have covered today just some of the many initiatives the Government are undertaking in our significant efforts to tackle prostate cancer for many of our constituents, including my friend. I hope I have given the House some information today and a promise of some more. The Government remain totally committed to maintaining and improving cancer survival rates. Prostate cancer is the second-biggest cancer killer among men and is right at the top of our list of priorities.

Finally, I could not close without paying tribute to Prostate Cancer UK, led by Angela Culhane, and the work it does on research and early diagnosis and in supporting men with prostate cancer and reassuring them that they are not alone and that there is often a way out. As cancer Minister, I have been told many times by cancer patients that the cliff edge of an all clear is every bit as bad as the original diagnosis. Owing to our successes, people are living much longer and perfectly normal and full lives after cancer, but we need to support them better, so I pay tribute to the work of Prostate Cancer UK. Its work is invaluable, as is that of all those members of staff who make the NHS what it is. I thank everybody for taking part in today’s debate.

Question put and agreed to.