Debates between Oliver Heald and Edward Argar during the 2019 Parliament

Victims and Prisoners Bill (Thirteenth sitting)

Debate between Oliver Heald and Edward Argar
Edward Argar Portrait Edward Argar
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I set out key—for want of a better phrase—broad categories of skillsets in terms of judicial experience, probation and psychiatry, but I did say that the board remains free to recruit members from other fields and to appoint independent members it deems appropriate. In the context that the hon. Lady sets out, the board might well deem it entirely appropriate to appoint someone with that sort of expertise to sit on particular cases.

Oliver Heald Portrait Sir Oliver Heald (North East Hertfordshire) (Con)
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I just want to remark—I do not know if the Minister would want to—that the vice-chair of the Parole Board, Peter Rook, wrote a leading text on sentencing in sexual offences. He also did an inquiry into the prosecution of them, so he is very knowledgeable in that area.

Edward Argar Portrait Edward Argar
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I am grateful to my right hon. and learned Friend for his intervention and, as ever, his knowledge. I am grateful that he offers it in his capacity as a Member of this House, rather than being on the clock as a very senior King’s counsel.

The clause also inserts proposed new sub-paragraphs (2B) to (2E) into schedule 19 to the Criminal Justice Act. Those provisions concern the chair and vice chair of the Parole Board. Proposed new sub-paragraph (2B) puts in statute for the first time the period of appointment for the leadership roles, and it aligns the period so that both appointments are for five years, with the possibility of reappointment for a further five years. Currently, the practice is that the chair’s appointment is for three years, and may be extended for the same period, whereas the vice chair’s appointment is for five years, with a five-year extension. The longer period for the vice chair reflects their additional role as an active panel chair and aligns with the usual tenure of appointment for other board members.

We want to align the chair’s period of appointment with that of other members, thereby offering additional protection to the post holder as well as reducing any risk to the smooth running of the board that might arise if its leader were to change relatively frequently. That said, there might be a rare occasion when requiring a change of chair before the end of their appointment period is the best or only option. For that reason, proposed new sub-paragraph (2C) gives the Secretary of State a power to remove the chair from office if it becomes necessary to do so for reasons of public confidence.

A mechanism already exists for the Secretary of State to ask an independent panel to consider dismissing the chair if there are concerns about the post holder’s performance or their ability to do the job effectively. That route remains our preferred approach in the unlikely event that a dismissal is required. This measure in the clause, which enables the Secretary of State to act independently and without referral to a panel, is a last-resort measure to be applied only in the event of a need for Government to act swiftly and decisively. It is not a power that any Secretary of State would ever use lightly, and ideally there will never be cause to use it at all.

Proposed new sub-paragraphs (2D) and (2E) of schedule 19 to the 2003 Act confirm that the chair and vice chair may not return to those posts once their period of appointment has ended except when they are re-appointed immediately after their initial tenure has ended. However, either postholder may be appointed to another role in the Parole Board.

Finally, I turn to clause 47(7), which sets out the functions of the Parole Board’s chair in statute for the first time. The overall intention is both to define the chair’s role as a strategic leadership role and to make it clear that the postholder does not play any part in the board’s decision making when it comes to considering individual parole cases. Proposed new sub-paragraphs (2A)(1)(a) to (g) of schedule 19 provide a non-exhaustive list of functions to be carried out by the chair. Proposed new sub-paragraphs (2A)(2) and (3) prevent the chair from involvement in individual cases. Although it is for the board to decide who will take on any functions currently carried out by the chair that are related to individual cases, we anticipate they will pass to the vice chair or another member of the board.

Victims and Prisoners Bill (Seventh sitting)

Debate between Oliver Heald and Edward Argar
Oliver Heald Portrait Sir Oliver Heald (North East Hertfordshire) (Con)
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The point being made about delay is important. The pandemic was of course a very difficult period for the courts. Is the Minister able to give us any reassurance that the courts will be able to hear these cases more quickly? I suspect one of the reasons for this situation is that, if there is a very long period between the incident and the time of trial and there are counselling notes over an extended period, there is a temptation to see if there is an element of coaching—the hon. Member for Rotherham made that point—or even inconsistent statements, as a period of time has lapsed.

Edward Argar Portrait Edward Argar
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My right hon. and learned Friend is right to highlight the importance of this point. On the big picture of court backlogs, it is important to remember that 90% of cases are dealt with in magistrates courts swiftly. It is the serious cases, such as those we are discussing, that are sent to the Crown court, and that is where we do see delays. There has been investment in Nightingale courtrooms—a new sort of super-court, if I can put it that way—just up the road from my constituency, in Loughborough. We are implementing a range of measures to tackle the backlog. He is absolutely right that the timeliness of a case being heard is a key factor in a victim sticking with the process and being able to give their best evidence. He is also right that the longer the delay, the greater the temptation to seek more “evidence”, more documents, over that period. Timeliness is hugely important.

We will also continue to take action to ensure that victims are not put off from seeking support due to fear that their therapy notes may be unnecessarily accessed as part of a criminal investigation, including through the proposed Government amendment that was alluded to, which will place a duty on police to request third-party materials that may include pre-trial therapy notes only when necessary and proportionate to the investigation.

Victims and Prisoners Bill (Fifth sitting)

Debate between Oliver Heald and Edward Argar
Oliver Heald Portrait Sir Oliver Heald
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Dame Vera was making the point that these matters are not being taken seriously enough, but there is an offence of harassment. That is repeated behaviour, and it can be antisocial behaviour or bullying. That was treated as a serious matter by Parliament—it is a summary offence—and there is also the more serious offence if fear of violence is involved, which has a maximum sentence of 10 years’ imprisonment. Is it perhaps time for the Minister to discuss with the Attorney General and the Home Office whether there is a need for more impetus to be put behind that provision, whether through guidelines or the prosecution college hub?

Edward Argar Portrait Edward Argar
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I am grateful to my right hon. and learned Friend for his intervention. We are discussing these issues more broadly not only with the Attorney General but with the Home Secretary, given the cut-across and the importance that is rightly attached to these issues by those who send us to this place and by Members on both sides of the House. I reassure my right hon. and learned Friend that we are looking cross-Government at how we can make such responses more effective.

More broadly, the Government are taking clear action to crack down on antisocial behaviour and to build confidence that it will be taken seriously and, where appropriate, punished. Backed by £160 million of funding, our antisocial behaviour action plan, published in March this year, will give police and crime commissioners, local authorities and other agencies more tools to tackle the blight of antisocial behaviour across communities in England and Wales. That includes increasing policing in hotspot areas and a new immediate justice programme to make sure that offenders are made to undertake practical, reparative activity to make good the loss or damage sustained by victims, or to visibly support the local community in other ways, such as by litter picking. If things go wrong, the antisocial behaviour case review is there to ensure that those affected can seek a solution from the appropriate agency.

The Government will continue to take action for those who suffer as a result of persistent antisocial behaviour. The vast majority of examples given in evidence sessions and in today’s debates have, however, contained elements that would constitute criminal behaviour, which would therefore mean that the individuals were included in the rights under the victims code and the details that we are discussing in the context of the Bill.

We have sought to be less prescriptive and more permissive to make sure that we do not inadvertently tighten the definition too much. We do not share the view of the shadow Minister that adopting the amendment is the right way to address the point, but we do accept the points that Dame Vera and others made. There are two questions or challenges, which are not, in my view, best dealt with by legislation, but which do need to be addressed. First, who decides what is criminal? Secondly, how do we raise the awareness of authorities and individuals, so that people know their rights and that what has happened constitutes criminal behaviour, even if it is not prosecuted and even if there is no conviction? Therefore, those entitlements and rights are there.

Cancer Diagnoses: Young People in Hertfordshire

Debate between Oliver Heald and Edward Argar
Friday 19th November 2021

(2 years, 4 months ago)

Commons Chamber
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Edward Argar Portrait The Minister for Health (Edward Argar)
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I thank and pay tribute to my hon. Friend the Member for Hertford and Stortford (Julie Marson) for bringing this debate before us, and for raising this difficult issue in a typically dignified and sensitive way. She has done justice to Jessica and her family.

I join my right hon. and learned Friend the Member for North East Hertfordshire (Sir Oliver Heald) and my hon. Friend the Member for South West Hertfordshire (Mr Mohindra), who intervened, in sending my condolences to Andrea and Simon, and to Jessica’s family and friends, following her death. We know that the passage of time can help, but it can never totally remove that sense of loss. I pay tribute to them for the work that they are doing to highlight the issue. It must be very difficult for them and it is humbling that they—through their excellent Member of Parliament, but also in person—have been willing to share this deeply upsetting experience to seek to build a better future for others. I put on record my tribute and gratitude to them.

As my hon. Friend the Member for Hertford and Stortford has set out, Jessica sadly had a very rare form of cancer. I am advised that the timescale and complexity of diagnosis in this case was due to the rarity of the cancer, especially in younger people, but we are always willing to look more broadly and holistically at other factors that we may have some control over that could help to improve diagnosis in the future. It is absolutely right that we do so because, as my hon. Friend said, sadly no one is too young to fall victim to cancer, so it behoves all of us in this House and beyond to do all we can to improve diagnosis.

As my hon. Friend alluded to, we are working nationally on achieving the long-term plan commitment towards early diagnosis of cancer, including rarer cancers or those that are harder to diagnose, in order hopefully to avoid situations such as Jessica’s being repeated in the future. Hertfordshire’s hospital trusts are working extremely hard to that aim. In delivering the long-term plan for cancer, we have the aim of diagnosing three quarters of cancers at stage 1 or 2, and increasing cancer survival rates so that an additional 55,000 people survive their cancer for five years or more. Delivering those ambitions through earlier and faster diagnosis, rapid adoption of innovation and, crucially, the roll-out of personalised care—looking at someone as an individual—will benefit children and young adults across the country.

Alongside this, as my hon. Friend set out, all cancer systems continue to roll out rapid diagnostic centres or rapid diagnostics services, which are an important part of the clinical commissioning groups’ broader strategy to deliver faster and earlier diagnosis, and an improved patient experience. By summer 2021, there were 102 live rapid diagnostic centre pathways across hospitals in England and a further 98 in development, compared to just 12 in March 2020.

To make the discussion rather more local, in East and North Hertfordshire NHS Trust, the services to support and assist patients whose cancer is of unknown primary origin and those who have what are clinically known as “vague symptoms” are being brought together to make best use of clinical resource. Multi-disciplinary team co-ordinators will track patients on their pathways and ensure that the new 28-day faster diagnosis standard is met. Funding has also been put in place to provide psychological support to support patients earlier, at a time when they may be worried about receiving a potentially life-changing—or, tragically in some cases, life-ending—diagnosis.

Herts Valleys CCG is developing services for patients with non-specific symptoms that could indicate cancer—for example, a 12-month pilot of a primary care-led vague symptoms pathway, with direct access to CT scanning. This began in February and is reported to be working well, and the CCG is looking further to develop this work and integrate it more with the acute trust. There is also a significant amount of work on the site-specific pathways through more efficient diagnostic pathways. This goes to what my hon. Friend was saying, as it supports earlier and faster cancer diagnosis by assessing patients’ symptoms holistically—bringing all the symptoms together when considering them, rather than looking at them in isolation, when it would be understandable if a misdiagnosis were made.

Oliver Heald Portrait Sir Oliver Heald
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I want to follow up on the point that I made when intervening on my hon. Friend the Member for Hertford and Stortford (Julie Marson). The project that the Minister is talking about is very good, but I just wonder about disseminating best practice more widely in GP surgeries. Does he think that the idea of having one GP in a practice who takes a lead on cancer—ensuring that the practice is up to date with the latest diagnostics, treatment and so on—is worth pursuing?

Edward Argar Portrait Edward Argar
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My right hon. and learned Friend is also an old friend, so I suspect that he has a slight insight into where I was to be going in a few minutes. I hope to be able to answer that point specifically.

On education in cancer diagnosis within Hertfordshire and on GPs having the necessary skills and keeping them up to date, GPs in the region are encouraged to maintain their knowledge and skills in the field and are supported by Macmillan GPs, who are specialists in cancer care. Cancer education programmes such as Gateway C are available online, and face-to-face education sessions have now resumed, including monthly seminars offered by providers and by Cancer Research UK. A primary care network cancer clinical leads group has also been established to share the latest local issues and best practice.

I turn to specific points highlighted by my hon. Friend the Member for Hertford and Stortford. On face-to-face appointments and the ability to diagnose in that context, £20 million of elective recovery funding has been distributed to cancer alliances in this financial year to help accelerate the implementation of service models that streamline the front end of the pathway and support the management of high referral volumes. Throughout the pandemic, NHS England and Improvement has provided guidance to general practice and continually updated standard operating procedures to ensure that changing services could operate safely. NHS England and Improvement set out clear expectations that general practices offer face-to-face appointments alongside remote appointments—telephone or online—and that clinical necessity and patient preference should be taken into account to determine the most appropriate method.

My hon. Friend raised research and how it could help save lives in the future. NHS England and Improvement is supporting GRAIL’s Galleri trial, where studies have shown the ability to detect more than 50 types of cancers through a single blood test. The Galleri test can, as she said, detect chemical changes in blood as cancer can release small particles of DNA into the blood—known as circulating tumour DNA—which leak from tumours into the bloodstream, to give a vital early warning. The Cancer Research UK and King’s College London cancer prevention trials unit is conducting a randomised control trial along with the NHS and GRAIL. The blood samples from the first subjects in the trial are being obtained at mobile testing clinics in retail parks as well as at various convenient community locations. The trial’s participants must not have had a cancer diagnosis in the last three years. The main trial has now started. As hon. Members will know, I am always cautious about such things, but I am cautiously optimistic and genuinely hope that the trial will yield innovation that will make a huge difference in the ways mentioned by my hon. Friend.

My hon. Friend also raised the central point of GPs handling cases in their entirety or of having a point of contact who can look at a case holistically from the individual’s point of view, with knowledge of all their symptoms, medical history and so on. The general practice contract requires practices to provide a named accountable general practitioner to all registered patients. That GP must take the lead in ensuring that any primary medical services considered necessary to meet the needs of a patient, including appropriate referrals to specialist care and liaison with other health professionals involved in the patient’s care, are co-ordinated and delivered to that patient.

As of 1 April last year, we introduced the supporting early cancer diagnosis service specification for primary care networks to support improvements in rates of early cancer diagnosis. The 2021-22 quality and outcomes framework, which is a reward and incentive scheme for general practices, includes five indicators related to cancer care, including a quality improvement module on early cancer diagnosis. That improvement module was designed specifically to improve referral and safety net practices.

I hope that that answers some of my hon. Friend’s questions. She rightly highlights that there is always more to do in this space, and as we think of Jessica and her family it behoves all of us to continue to work to improve the quality of care provided, improve research, improve early diagnosis and look at each person who comes forward with symptoms or concerns as an individual, bringing all those factors together.

One of the privileges for the Minister responding to the Adjournment debate on a Friday is to speak on a subject outside of their usual portfolio, and this is one such opportunity. It has been a humbling experience, and one that I hope will inspire us all to renewed efforts, thinking of Jessica, to improve services as we go forward.

Question put and agreed to.

Mount Vernon Cancer Centre

Debate between Oliver Heald and Edward Argar
Wednesday 4th March 2020

(4 years ago)

Westminster Hall
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Edward Argar Portrait The Minister for Health (Edward Argar)
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I thank the hon. Member for Harrow West (Gareth Thomas) for securing this debate on the future of Mount Vernon cancer centre. I know that the provision and location of radiotherapy services is of great interest to many hon. Members, and I was delighted to meet my hon. Friend the Member for Stevenage (Stephen McPartland) and my right hon. and learned Friend the Member for North East Hertfordshire (Sir Oliver Heald) earlier this month to discuss aspects of this matter as it relates to their constituencies and their campaigns for a satellite radiotherapy centre, working with Mount Vernon to help serve their constituents.

The hon. Gentleman rightly paid tribute to the work of the staff at Mount Vernon—not just the work that they are and will be doing to help deal with coronavirus, but the work that they do day in, day out, for his constituents and many others. I join him in paying tribute to their work and dedication. He has made a typically courteous but powerful case for investment in that hospital and in the services that serve his constituents. If I may, I will say a little bit about cancer care more broadly before I turn to the specifics of what he has said regarding Mount Vernon.

Improving cancer treatment remains a priority for this Government, and survival rates are at a high. Since 2010, rates of survival from cancer have increased year on year, but we know there is more to do nationally. That is why the NHS long-term plan states how the Government will achieve their ambition of seeing three quarters of all cancers—

Oliver Heald Portrait Sir Oliver Heald
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I am grateful to the Minister for giving way, and apologise to the sponsor of the debate, the hon. Member for Harrow West (Gareth Thomas). Does the Minister agree that both of the preferred options put forward for Mount Vernon include a satellite radiotherapy centre in our area of Hertfordshire? I hope that will form part of the Minister’s thinking, as it seemed to during our recent discussion.

Edward Argar Portrait Edward Argar
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I am grateful to my right hon. and learned Friend for his intervention. He is right about the importance of satellite radiotherapy centres for his constituents and for large parts of Hertfordshire. He and others have made a powerful case and I have considerable sympathy for it. I find it compelling and I am looking at ways in which we might be able to deliver on that for his constituents and those of other colleagues in the area.

As I was saying, the long-term plan sets out how the Government will achieve their ambition for three quarters of all cancers to be detected at an early stage, and for 55,000 more people to survive cancer for five years in England each year from 2028. That plan includes providing new investment in state-of-the-art technology to transform the process of diagnosis and boost research and innovation. NHS England has committed more than £1.3 billion in funding over the next five years to deliver the long-term plan’s commitments on cancer.

I suspect that the hon. Member for Harrow West will say, “That is great, but what does it mean for Mount Vernon, my constituents and my constituency?” He has set out the background of what has gone on at Mount Vernon cancer centre, and of the review. He will know that the strategic review of that centre’s long-term future was launched by NHS England and NHS Improvement in May 2019. The review began with an independent clinical advisory group visiting the site and speaking with staff and patients. Its report advised that the current service model was not clinically sustainable, as the hon. Gentleman has said, and recommended that leadership of services from a specialist tertiary cancer provider would be key to future service development and sustainability, staff recruitment and retention, and enabling patient access to clinical trials. I am happy to provide him with more details in writing, if that is helpful. Indeed, if I am unable to answer all of his detailed questions in the course of today’s debate, I will write to him with detailed answers as soon as possible.

The hon. Gentleman asked specifically how the review would work, who was leading it, and who would be involved in it. It is being led by a programme board chaired by the NHS regional director of specialised commissioning and health and justice for the east of England. That board includes representatives from Healthwatch Hillingdon, Healthwatch Hertfordshire, London and the East of England Cancer Alliance, as well as local sustainability and transformation partnerships, clinical commissioning groups and a number of acute hospitals. They all sit on that board and are active participants. If it is helpful to the hon. Gentleman, rather than simply giving him the job titles, I can seek to furnish him with some names—those of the senior leadership, at least.

The hon. Gentleman said that the independent clinical advisory group made recommendations for short-term actions, including addressing urgent backlog maintenance of existing clinical facilities and the strengthening of acute oncology services. The current provider, East and North Hertfordshire NHS Trust, supported those recommendations. In January of this year, following evaluation of proposals from interested trusts, University College London Hospitals NHS Foundation Trust was selected as the preferred provider, subject to a period of due diligence. Depending on the outcome of that due diligence, the contract for running the site should transfer in April next year, with UCLH providing additional leadership support for that site over the next 14 months.

The hon. Gentleman mentioned backlog maintenance, which I have touched on. He is right to have done so, because, as he knows, backlog maintenance has increased in recent years. Although the trust received £33 million of central capital in 2019 to tackle critical infrastructure issues across the estate, monitored by NHSE&I, I know that it continues to be of concern. Although I do not wish to prejudge the future capital settlement and the capital spending review, the hon. Gentleman has powerfully made the point that the capital needs of his hospital and his trust should be considered in any future allocations of capital funding.

The hon. Gentleman raised the issue of access to brachytherapy services, which will be wrapped up in the review that is currently under way. Regarding the future location of services, I can assure him and hon. Members that options for the short-term and long-term future of the centre are being actively considered by the clinical advisory group and NHSE&I, with the local area and the hon. Gentleman’s hospital at the forefront of their thinking. When I write to him, I suspect he might wish me to be a little firmer in my reassurances. As far as I am able, subject to that review, I will endeavour to do so.

The hon. Gentleman also talked about staffing issues at the hospital. Existing clinical leads at Mount Vernon have increased their leadership duties at the hospital alongside their clinical responsibilities. Recruitment of a full-time clinical director will take place in conjunction with the new provider, once it is appointed. The hon. Gentleman mentioned the business case for appointing additional staff to the acute oncology service that has been developed and submitted to NHS England. My understanding is that the business case has been approved and recruitment has begun. I will take up with NHS England his request that he have sight of it and—ideally from his perspective, I think—that it be made publicly available. I do not know what the answer will be, but I will certainly ask that question, because it does not seem an unreasonable request.

Regarding whether the three linear accelerators due for replacement this year are going to be replaced, my latest understanding is that although East and North Hertfordshire NHS Trust has not yet agreed its full capital programme for the 2020-21 financial year, it has identified a requirement for capital funding, which the board will consider in that context. As soon as I hear the outcome of those decisions, I will write to the hon. Gentleman, who, as ever, makes his case politely but forcefully. More broadly, as he will be aware, NHS England has invested £130 million in the modernisation of radiotherapy across England, ensuring that older linear accelerators—that is, radiotherapy machines—used by hospitals are upgraded. We have made significant progress. I think the hon. Gentleman’s request acknowledges that, but he is essentially saying, “Yes, I have been given a promise, but please make sure that the delivery follows.” The decision on the trust’s investment priorities rightly sits with the board, and we will wait for that decision, but I will make sure that what the hon. Gentleman has said is communicated to the board. I suspect he will make sure of that as well, but I will ensure that the board is aware of his views.

The hon. Gentleman suggested quarterly updates to track progress against a basket of key indicators or asks in the context of the action plan. I hesitate to give a clear commitment until I have had the opportunity to talk to the trust and NHS England, but what I will say—I hope gives him an indication of my thinking—is that it sounds like an eminently practical and reasonable request to ensure that he, other interested parties and his constituents are kept informed about and engaged with a process that will, of course, be of concern to them but also of interest as well. It sounds reasonable—I am not aware of a factor that makes it unreasonable—and I will certainly press that point, because I think it is a sensible way forward.

In response to my right hon. and learned Friend the Member for North East Hertfordshire, I have touched on satellite radiotherapy centres. Alongside working with the Mount Vernon Cancer Centre, we are proactively looking at providing satellite radiotherapy centres for his constituents in the northern part of Hertfordshire and around Stevenage. It is too early to say exactly how we might do that, but I am determined to work proactively with colleagues to see if we can achieve it.

We are committed to the digitisation of paper records, which the hon. Member for Harrow West mentioned, to enable effective patient care and enhanced patient safety. The digital transformation plan, which will include the digitisation of patient care records, is under way for Mount Vernon’s main acute services and is expected to conclude in May 2020. I understand that the commitment to do that—to support and fund it—remains unchanged. If anything has changed, I will make sure that he is updated as appropriate.

There are a number of hon. Members present. I suspect they are not here to hear my or the hon. Gentleman’s eloquence, but possibly that of other hon. Members and, indeed, my right hon. Friend the Financial Secretary to the Treasury, who will take part in the debate that will start in a few minutes. Given the interest, however, I will see if it is appropriate to put in the Library a copy of my letter to the hon. Gentleman so that it is on the record.

If the hon. Gentleman thinks it would be useful, I am happy to meet him and to visit Mount Vernon with him to meet the staff, to hear the executive team’s thinking on what is going on, and to see it for myself. He raised a number of detailed and precise questions and important points. In the short time I have had, I have sought to reassure him and address a number of them, but I look forward to the opportunity to give him a more detailed answer in writing following the debate, and to visit him.

I reassure hon. Members that cancer, and improving cancer treatment and care, remains a key priority for the Government and the Department. We, along with NHSE&I and other arm’s length bodies, are working hard to ensure that the hon. Gentleman’s constituents and those of all hon. Members are provided with the best care.

Although cancer care and cancer services are the responsibility of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), given that a large amount of what the hon. Gentleman has talked about relates to performance and to capital and funding, which are in my portfolio, I will endeavour to maintain a personal direct interest in the issue, in partnership with my hon. Friend, to make sure that we both give it the attention it deserves and that he and his constituents have a right to expect.

Question put and agreed to.