Coronavirus

Tim Farron Excerpts

Thursday 25th March 2021 Commons Chamber

[Tim Farron (Westmorland and Lonsdale) (LD) [V]]

As my hon. Friend the Member for Twickenham (Munira Wilson) said a moment ago, Liberal Democrats will not support the proposals on the table today. We consider the request for extended powers for the period of time to be an overreach—these are powers the Government do not need, and certainly do not need for a period of six months, taking us right into the autumn.

My great concern is that the Government’s default, knee-jerk attempt to seek these draconian powers for a lengthier period is beginning to fit into a pattern. We saw the Police, Crime, Sentencing and Courts Bill in this place just a week or so ago, under which the Government are seeking powers to incarcerate people for up to 10 years if they protest against the Government. We are also seeing reports of the Government wanting to force carers to be vaccinated, when they have done so by choice already. That shows a complete lack of respect and tenderness towards people who have put their lives on the line for this past 12 months and longer to support others in their deepest moment of need. Of course we now have pub landlords being asked to be, in effect, border guards in their own pubs and to check a vaccine passport.

All this seems to indicate that we have a Conservative party in government that loves talking about liberty until it has to do something about it in practice, and when it comes to dealing with these issues in practice, its instincts are authoritarian. As always, if you care about liberty, you need your Liberals—and so the Liberals are guaranteed to be voting against this draconian set of powers on the table today. It is also worth bearing in mind that I do not think the police are crying out for additional extensions to their powers. What they want is two things: resources and clarity in the guidelines and laws that they do seek to enforce.

Throughout this pandemic the strictness of the laws has not been the issue; it has been the clarity of the guidance. The Government have very often been contradicting themselves, mixing messages and sending out the wrong messages, as well as not keeping the guidance themselves as individuals and therefore setting a terrifyingly awful lead.

I want to make just one suggestion. On the road map out of this difficult time that clearly we are all experiencing as a national community, outdoor education has no place whatever. We know when nightclubs are going to open, but outdoor education facilities in my constituency in the lakes and dales, and across the rest of the country, have no date for reopening. The Government are killing off a vital industry that is there to support our young people. Its skills are especially needed at a time like this, when we want to reconnect young people with a love of learning.

The lack of a date and of bespoke funding is killing off outdoor education. My friend Kirsty Williams, the Minister for Education in Wales, announced just the other day a particular package for outdoor education centres in Wales. There is a package in Scotland and Northern Ireland. Why is there not a bespoke package for outdoor education centres in England today? Today is surely the day for them to do just that.

It is also worth bearing in mind that as people become able to move in significant numbers, as of next Monday, to beautiful places such as the Lake District, we need—and have needed for some months now—investment in popularising the countryside code. That is so that people know how to behave in beautiful places, how to treat the local residents with respect and how to look after the environment that they have come to enjoy. I am pleased that the Government are, as of the Easter weekend, putting resources into the countryside code. They should have done it nine months ago when we asked them to.

My final point is about hospitality and tourism businesses beginning to reopen. They will not all be able to open at capacity when they are allowed to. That is why financial support for them must continue until the autumn.

Health and Social Care Update

Tim Farron Excerpts

Thursday 18th March 2021 Commons Chamber

[Matt Hancock]

I am currently working with the NHS to answer that question, which is a characteristically acute one from my hon. Friend. We are not yet able to answer it simply because the pace at which we can return activity to full, normal levels is not yet clear because the main barrier to that recovery is a combination of infection, prevention and control and the need for staff to get some R and R. We will know more in the coming weeks and months.

[Tim Farron (Westmorland and Lonsdale) (LD) [V]]

There was no mention of cancer in the Secretary of State’s statement, nor a single penny in the Budget to boost cancer services, despite the fact that Macmillan Cancer Support’s figures show the need to increase all cancer services by 10% for a solid 15 months, starting now, to clear the cancer backlog.

Macmillan also says that there are 37,000 people with cancer who are not even in the system yet. Given the scale of this crisis, will the Secretary of State agree to set out an urgent, ambitious and funded plan to catch up with cancer, so that tens of thousands of people do not unnecessarily lose their lives?

[Matt Hancock]

The need to catch up on the backlog is there across all elective operations and of course that includes those for cancer. The good news is that the NHS has worked incredibly hard, especially in this second peak, to make sure that cancer services have remained working and effective as much as possible. Some cancer services have in fact delivered more than their normal pre-pandemic levels of care. The hon. Gentleman is absolutely right that we have to make sure that any backlog is reduced—that is a critical part of what I have been talking about today.

Covid-19

Tim Farron Excerpts

Monday 22nd February 2021 Commons Chamber

[Tim Farron (Westmorland and Lonsdale) (LD) [V]]

My constituency has the highest proportion of its workforce on furlough of any constituency in the entire United Kingdom. There has been a sixfold increase in unemployment, and it is obvious why. It is because hospitality and tourism is comfortably our biggest employer. We have the Lake district, the Yorkshire dales and vast swathes of Cumbria so beautiful that they could not find a national park to put them in. For the people working in those sectors, the reality is that many businesses have gone to the wall already. Many, many more have survived, and they have done so because of the support that they have received. That was a wise decision that the Government took 10 months or so ago as we entered the first lockdown.

I encourage the Government not to throw away that investment now by penny-pinching towards the end of this pandemic crisis. The simple reality is that, yes, furlough is of vast importance for so many businesses to be able to keep their heads above water, but perhaps a quarter to a third or even more of their outgoings is nothing to do with staff; it is other overheads that they simply have no income or savings left to fund. Those are the businesses that are going to the wall by the week now in Cumbria and other tourist hotspots around the country.

I urge the Government to do four things: first, to extend the business rates holiday; secondly, to extend the VAT cut; thirdly, to extend furlough and to say they are going to do it right now, not delaying it until the Budget next week, because that confidence is what businesses lack, and that is what is pushing so many of them to the wall; and fourthly and finally, a specific grant package to deal with the simple fact that without any income or any savings now many businesses, though they can see the light at the end of the tunnel, might not make it to the end of the tunnel.

I must also make a further plea. After 11 months, what is preventing the Chancellor of the Exchequer from investing something to support the 4,000 people in my constituency—and perhaps 3 million people around the country—who have been excluded from any kind of support whatever, and who now face destitution as they seek to pay the rent or the mortgage and to feed their kids? I am talking about those people who are self-employed, but have been so for less than two years, those who are directors of small limited companies, taxi drivers, hairdressers, personal trainers and the like. Why will the Government not support the excluded? It is not too late for them to do so.

Let me make a final, very local point. As we pay tribute to all those people doing everything they can to serve our communities at times like this, I think about people working in social care and public health as well as the wider NHS, people working in schools, and people dealing with those who face housing need or who are looked after by our local authorities. Today Cumbria’s local government has announced a plunge into a top-down restructuring; what a witless waste of everybody’s time.

Covid-19 Vaccine Update

Tim Farron Excerpts

Thursday 4th February 2021 Commons Chamber

[Nadhim Zahawi]

I will certainly join my hon. Friend in congratulating the Betsi Cadwaladr University Health Board, the GPs and their teams and the many volunteers. I can confirm that Wales and the Welsh NHS will have received the allocation for groups 1 to 4 by mid-February for them to be able to do that, and I commend them for the work they are doing.

[Tim Farron (Westmorland and Lonsdale) (LD) [V]]

Unpaid carers provide a huge service to our community in South Lakeland, especially for the people they care for directly. If they get ill, that is a huge welfare risk for the people they care for. There has been confusion over whether unpaid carers will be prioritised for the vaccine, because although the Government said that they would be in priority group 6, they are missing from other communications, including the summary list in the vaccine delivery plan. Will the Minister clarify once and for all that unpaid carers rightly will be on the priority list?

[Nadhim Zahawi]

We are absolutely looking to make sure that unpaid carers are on the priority list.

Covid-19

Tim Farron Excerpts

Tuesday 12th January 2021 Commons Chamber

[Tim Farron (Westmorland and Lonsdale) (LD)]

I wholeheartedly agree with the hon. Member for North East Derbyshire (Lee Rowley). Careless talk costs lives. We need to be absolutely clear about the science and be behind it.

On a personal level, I do not care whether the Prime Minister did or did not take a seven-mile bike ride yesterday. What I do care about is the lack of clarity. Clarity ensures that people know what is legitimate and what is not. I say that particularly as a Member of Parliament for the Lake district and the Yorkshire dales. I have no problem with people taking short trips to exercise—I think that is what is intended in the advice. I do have a problem with people packing up their car and making 100-mile or 150-mile journeys to exercise in the Lakes, or indeed anywhere else, at this time.

I want to focus my remarks on the hospitality industry. Tourism and hospitality is the fourth biggest employer in the country and the biggest employer in Cumbria by some distance. Undoubtedly, it has been the worst hit industry in this country during the pandemic. In my constituency, we have seen a sixfold increase in unemployment. At one stage, more than 40% of the entire workforce in my constituency was on furlough, largely because of the reliance on that remarkably important industry.

I make some calls for what the Government should do. I have listened to Cumbria tourism businesses over the last few days. First, the Government were right to defer business rates; I ask them to defer business rates for a further year. They were right to cut VAT; I ask them to extend the VAT cut for a further year. They have been right to extend furlough, but even if we ease restrictions in hospitality and tourism after March, they need to consider the continuation of some form of wage support beyond that period. I say that because we have otherwise healthy businesses that will be at the forefront of leading the fightback in our economy once we begin to move out of this crisis period. If we do not back those businesses now, they will be in no state to be part of the fightback. It is the cash that is going to be the problem. It is great for businesses to have the furlough and therefore have staff wages largely covered, but if a third or a quarter of their overheads are not staff-related, even furlough will not save those businesses from going under in the end.

The cash grants that have been made available to businesses at this time are far lower than those given in the spring. We need equivalent levels of investment in cash flow and grant support for hospitality and tourism businesses to those that we had back in the spring. We also need to stop overlooking the 4,000 people in my constituency who would be counted among the excluded. Many are self-employed or running their own companies, and they are the backbone of any recovery; we need them if we are to get out of this mess after the virus is defeated.

Covid-19 Vaccination Roll-out

Tim Farron Excerpts

Monday 11th January 2021 Westminster Hall

[Tim Farron (Westmorland and Lonsdale) (LD)]

It is an honour to serve under your chairmanship, Sir David. I thank the hon. Member for Gower (Tonia Antoniazzi) for her great introduction to the debate. I also thank the hundreds of thousands of people who signed the petition, demonstrating the interaction between the people of this country and the Parliament that seeks to represent them. As many hon. Members have said, vaccination is a light at the end of the tunnel that gives us all a sense of hope, but of course the danger is that that tunnel will be longer for some than for others.

The main topic of the petition is education. People talk about the reopening of schools, but they are open: far more children are being taught in our schools and in school settings today than during the April-May phase of the earliest lockdown, for lots of very good reasons. One reason why schools have been otherwise closed as part of the lockdown is that we recognise that the science shows that although children do not get badly affected by the disease, they clearly spread it.

We are asking teachers, teaching assistants and other school staff to put themselves in harm’s way for good reason, so it is right that they be considered as part of the priority vaccination list alongside others. No one wants to muscle their way to the front of the queue, but we recognise that these are people who are doing an immense service for our children and our country, and who are putting themselves at risk at the same time.

As a Member of Parliament for a very rural constituency, I am aware that delivering a vaccine in a place such as my constituency, which is bigger than Greater London, is a challenge. I am concerned that there are parts of my community where we have yet to get the vaccine rolled out; I ask for the Minister’s intervention, through the CCGs, to ensure that we fast-track site approval. We and the local primary care network particularly want to see delivery of the vaccine at the surgery in Windermere. The primary care network is already delivering it in Grange and in many care homes, but can we get it delivered from the surgery in Windermere as soon as possible? I would like to say the same for the Yorkshire dales end of my constituency: people in Sedbergh in the western dales are having to travel to Kirkby Lonsdale or further to get the vaccine.

It is important, particularly for older people and people who rely on public transport, that we do not overlook rural communities such as ours and that we ensure that the vaccine is delivered close to where people live. Many hon. Members have talked about the importance of community pharmacists; involving them would allow the Government to roll out the vaccine really close to where people live and get it done more quickly.

Although I agree that 24/7 delivery of the vaccine is something that we should be doing, I am deeply concerned because I have talked to health professionals from right across my county and it is clear from the number of sites and the staff that we have that the capacity to deliver the vaccine far exceeds the amount of the vaccine. I would like to hear from the Minister what his strategy is for procuring sufficient vaccines so that we can meet those targets.

I also want to emphasise the importance of data, which people have talked about, so that we can hold the Government to account. For example, I and the whole of the local community would like to know what percentage of over-80s in the LA9 postcode, for instance, have been vaccinated once or even twice. That would ensure that there is healthy competition and would also allow us to hold the Government to account and know whether we will meet the targets. We know that that data exists: NHS England has it, but is not sharing it.

I have talked to local providers of the vaccine through our primary care networks, and they tell me that they could ask a secondary question themselves. They could double-report, but that takes two minutes per patient. That is time when they could be vaccinating patients, so they think that is a waste of time and a duplication. We know that that data exists because it is being collected, so why is it not being shared? Will the Minister guarantee that that information will be made public this week, district by district—indeed, postcode by postcode?

There is a light at the end of the tunnel for all of us, but the tunnel is longer for some than for others. What a great disappointment that the nearly 3 million people who are excluded from financial support through the coronavirus crisis continue to be excluded today. For them, the tunnel is impossibly long. They face deep debt and find it hard to abide by the rules and regulations, because to do so very often means not being able to pay their rent or look after and feed their children. I would like answers to the questions that I have put to the Minister when he makes his concluding remarks.

Public Health

Tim Farron Excerpts

Wednesday 6th January 2021 Commons Chamber

[Tim Farron (Westmorland and Lonsdale) (LD)]

The proposed restrictions are right. There is no greater freedom than the right to life and we are willing to suspend many freedoms to protect especially those who are vulnerable, and those who work night and day in the NHS and our care settings to protect us. They deserve and require us to abide by the regulations and rules—we owe it to them—not least because we can now see the light at the end of the tunnel.

Given that the vaccination programme is beginning, it is all the more urgent that the Government recognise the importance of supporting the economy and everybody within it throughout the coming months. We know that it is not an ill-defined and possibly indefinite period, but that this will be over at some point in the coming months. That is a source of great joy and should focus the Chancellor’s mind on the support that he needs to give those who are missing out. There are many of them: people who have been self-employed for less than two years; directors of very small limited companies, such as taxi drivers; people who have been on maternity leave. They have been excluded from support. It is an outrage that those people have been left to get into deeper and deeper debt because the Government have yet to devise a mechanism for supporting them. They must do so now. We need those people to build our economy back once we are out of this situation. To let them flounder in poverty now is outrageous and unacceptable.

I would also like the Government to pay attention to the needs and the plight of our outdoor education centres, which are in serious danger of closure. Many have already lost more than a third of their workforce in the past few months. There needs to be a Scotland-style direct grant support payment for those centres so that we can keep them going and they can contribute for years to come.

I also want the Government to come up with a specific and properly funded strategy for dealing with the backlog in cancer treatment. We estimate that 60,000 years of life will be lost to cancer due to the coronavirus pandemic, and it could get worse.

The vaccine is the light at the end of the tunnel. It is wonderful and I pay tribute to everyone involved in making that come to be and in administering the vaccines as we speak. However, the Government are making that tunnel a little bit longer than they need to. It is clear that supply of vaccine to places in South Cumbria is not as good as it might be. Places such as Sedbergh and Windermere have not yet got vaccination centres. Those sites need to be approved.

Finally, given that our teachers are teaching the children of key workers, they should also be vaccinated as a priority.

Breast Cancer Screening

Tim Farron Excerpts

Wednesday 16th December 2020 Westminster Hall

[Tim Farron (Westmorland and Lonsdale) (LD)]

It is a pleasure to serve under your chairmanship, Sir Edward. I thank the hon. Member for High Peak (Robert Largan) for securing this debate. The hon. Member for West Bromwich East (Nicola Richards) made a remarkably good speech, citing her own family’s experience.

Both hon. Members have spoken about Breast Cancer Now’s assessment that almost 1 million women have missed a screening during this period. Its assessment is that that would mean 8,650 women may be out there with undetected breast cancer. Cancer Research UK assesses that screening services are running at 60% capacity. That means the situation is getting worse week by week. A hundred fewer women started treatment for breast cancer each day in May and June than during those months in 2019.

If we look beyond breast cancer, in my county of Cumbria there is a 17% reduction in the number of people starting cancer treatment this year compared to 2019. It is fair to assume, therefore, that roughly one in six people who would have been diagnosed with cancers of all kinds is out there undiagnosed. We know that for every four weeks treatment is delayed, for whatever reason, the chances one has of survival fall by 10%. That delay in treatment can be due to a delay in people coming forward, a delay in diagnosis and a delay in treatment.

Any Government of any combination of colours would have been thrown by the coronavirus. In those early months the messaging was really good and powerful: “Stay at home. Protect the NHS. Save lives.” It often occurs to me that the position of the NHS in British society, the affection in which it is held, was a key driver. I suspect that in another country, where the message might have been, “Protect the expensive private healthcare that you use, through exorbitant insurance models,” would probably have been less compelling. The NHS was a key driver and the Government deployed it well.

Why were we protecting the NHS? We were doing so not only so that we could tackle covid, but so that the NHS could carry on its lifesaving work in every other area. People not coming forward for treatment, for reasons that have been mentioned, such as being scared of being infected or nervousness about being a burden and troubling staff, is a huge part of the reason why the backlog exists.

There were treatment cancellations for perfectly good clinical reasons, as well as those for not good clinical reasons. I am chair of the all-party parliamentary group on radiotherapy, and Members would be staggered if I did not talk about radiotherapy as a treatment for breast cancer and other forms. Radiotherapy is the clean form of cancer treatment. It does not affect immunity and is not likely to open up someone to infection. The amount of radiotherapy being delivered during that period should not have been changed, because people are at no more risk of covid from taking it and, because it is a clean form of treatment, it should be substitutionary. It could be used, and in some cases has been, as a substitute for more risky forms of cancer treatment, such as chemotherapy and surgery, where that was necessary. In some cases, that has happened, which should be noted.

For example, bladder radiotherapy treatment is now at 160% of normal levels and capacity. In that area at least, we are using that clean technology to catch up with cancer in that area. The problem is that it is not the case across the board. We do not have figures since summer, but Public Health England has just released figures from April to the summer, which showed a 15% drop in radiotherapy treatments started during that time. That includes starting in April, so that cannot have been a response to fewer people coming through.

The National Institute for Health and Care Excellence recommendations and guidance at the beginning of coronavirus were to stop, postpone or delay radiotherapy treatment—for no clinical reason whatsoever. Some cancer centres followed that advice and people did not get treatment. We know what that means for people’s likelihood of surviving. That 15% drop in radiotherapy treatment will have cost lives. It was unnecessary and it means that the backlog is even greater than it would have been.

Cancer Research UK has estimated that we will unnecessarily lose 35,000 lives to cancer because of the crisis. The British Medical Journal published research a few weeks ago that showed we would lose, as a country, 60,000 additional years of life to cancer, because of the coronavirus crisis.

When breast cancer screening services are running at just 60% of capacity and we are witnessing a 50% reduction in the number of people starting radiotherapy treatment, we see a backlog that can only be getting worse as we speak. I want to endorse what has been said by the Chair of the Health and Social Care Committee, the right hon. Member for South West Surrey (Jeremy Hunt)—that it will take NHS cancer screening, diagnostics and treatment services, as a piece, operating at 120%usb capacity for two solid years to catch up fully with the backlog, to catch up with cancer.

Members will have been as deeply moved as I was by the recent sad death of Sherwin Hall, a 27-year-old father of two, as a result of delayed treatment. His family have been supported by the Catch Up With Cancer campaign, launched by the family of Kelly Smith, who also died far too young as a result of delays to her treatment during this process. Catch Up With Cancer estimates that the backlog might be up to 100,000 people. This is a national crisis on the scale of covid—different, but on the same scale—and it needs a response as ambitious and as urgent as the NHS’s correct response to covid. However, in the comprehensive spending review there was just a single mention of cancer in the entire document.

There are three issues at play here, the first of which is people having the confidence and awareness to come forward, as has been mentioned. The second is the diagnostic process and the third is the treatment. Issue one, the issue of people being brought forward or encouraged to come forward for treatment, is about strong public health and public information messages, and all of us getting behind them and being open about the necessity—as was mentioned, rightly, by the hon. Member for West Bromwich East—for a person to come forward if they have the slightest hint of a doubt that something might be wrong or unusual with any part of their body.

Issues two and three, diagnostics and treatment, need more than an ad campaign. They need more than good public relations and public information: they need money. It has been mentioned that within the CSR, £325 million was set aside for diagnostic machines, but the CSR says that that is

“enough funding to replace over two thirds of imaging equipment that is over 10 years old.”

In other words, it is money to replace some of the stuff that ought to have already been replaced. It is not new—it is not expanded capacity—and yet, when it comes to treatment, we have not got even that.

This was the Government’s opportunity. As chair of the all-party parliamentary group on radiotherapy, along with the Catch Up With Cancer campaign and the all-party parliamentary group on cancer—which I am proud to also be a member of—we made a submission to the Department of Health and Social Care and to the Treasury, calling for an immediate fund to catch up with cancer. That did not arrive, and I am going to shock the Minister by reminding her of a promise that she made me in this place a couple of weeks ago—to meet me and the Catch Up With Cancer team before Christmas, to look at how we can get that urgently needed ring-fenced investment through the spending review and into additional cancer diagnosis and treatments. I would like to hold her to that promise, and I hope she will refer to it in her closing remarks.

Alongside covid, the early diagnosis of women with breast cancer, so that we can treat them and cure them, is an ongoing problem. The United Kingdom is towards the bottom of the league tables for most of the major cancers when it comes to survival. To the Government’s credit, they acknowledged that in the NHS long-term plan released two years ago. Its fundamental aim—the headline part of that NHS long-term plan—was to diagnose more people early with all cancers, including breast cancer, so that we could treat them and cure them, and so that survival rates would be far better than the terrible situation that we have for most cancers in this country now.

I say to the Minister that if we are successful in diagnosing more people sooner, earlier—and we must be successful—we will then need the capacity to treat those people, and we do not have that. Radiotherapy is part of the solution, so it is absolutely essential to invest now in the kit, the technology and—as has been mentioned—the workforce, in order to be able to deliver treatments to those people who have been diagnosed early. How tragic would it be to diagnose maybe tens of thousands more people earlier than we do at the moment, and then not have the kit, the capacity, the staff or the technology to treat them? That is a challenge that the Government can meet, and I hope the Minister will take that on board and do just that.

Covid-19

Tim Farron Excerpts

Monday 14th December 2020 Commons Chamber

[Tim Farron (Westmorland and Lonsdale) (LD)]

Point taken, Madam Deputy Speaker. Thank you very much for calling me.

This has been the most peculiar of years. When we look at the media coverage of where we are with the virus, the vaccine, all the political issues that go alongside that, and the challenges over how the Government are handling things—well, badly or indifferently—many of us overlook what an appalling tragedy this has been and continues to be. Sixty-four thousand people in this country have lost their lives. Around 600 people or more in my county have lost their lives, and I knew dozens of them. One thinks about those people for whom Christmas will be not just lonely, difficult and challenging because of the restrictions we are all under, but a time of deep distress because they have lost someone close to them in the last nine months. When we see debates about the necessity of lockdown or restrictions of one kind or another, we need to remember what it is we are seeking to do: it is to save lives, and it will continue to be to save lives.

The tragedy that has hit my community, as it has every other community, feels almost too much to bear. We are a community where the average age is 10 years above the national average age in the United Kingdom. We are an area that, after London, is the next most visited place in the United Kingdom—the Lake district. Arguments are made about whether that meant that we had a higher than average incidence of the virus early on. We do not know that; what we do know is the way in which communities have responded to the virus.

In community after community, whether in our large town of Kendal, in Windermere, Grasmere, Ambleside and Sedbergh or in smaller places like Dent, Coniston, my own village of Milnthorpe, Arnside and Grange—everywhere I could mention in my patch, which is bigger than Greater London, and by the way I could mention another hundred—people have stepped up to take responsibility and have been desperate to meet the needs of their neighbours, though their own needs may be very significant. I pay tribute to every single one of them. I am proud to represent the south lakes and to represent those communities. Diverse though they are, they are also utterly determined to support one another.

There are so many within those communities who deserve our thanks and support, such as those working in care homes. I talked to one lady who worked in a care home, and not even a particularly large one, in my community. Back in April, on one night she saw nine residents lose their lives—in a single night. That was a tragedy for every single one of those people and every single one of those families. What does that mean? What does it feel like to be somebody who works in a place like that, administering love, care and concern for people as they go through their last moments? What is the cumulative impact on the mental health and wellbeing of people working in those communities?

We say thank you very often, and it is right that we do so in this place, but I want people who work in care homes, personal carers and those who work in the health service to know that we are not saying it glibly—we really, really mean it. We are utterly in their debt for the way they have cared for people at their moment of greatest need.

I think also of another group of people in a community like mine, where unemployment has gone up nearly sevenfold over the period of the pandemic: people who work for the Department for Work and Pensions in the jobcentre. They are people who serve people—people who perhaps were living in a state of relative comfort back in February or March, and then discovered that everything had collapsed around them. They are there for people at a moment of desperate need. They are not the only people, but I just want to draw them to the front of our attention. I thank those people on the frontline who have been supporting others who found themselves in need of benefits when they never thought in advance that they would.

I could say so many things about those who have stepped up to the mark at this time, but I also wish to pay tribute to those who have ensured that we have got to a stage where a vaccine is imminent—it turns out that we do need experts, after all. I am utterly indebted to those people, be they in this country or elsewhere, who have used their expertise and brilliance to do in 10 months what we would normally expect to take 10 years. Here is the thing that concerns me: we are close, potentially, to seeing light at the end of the tunnel and we can almost sense people beginning not to dip for the tape but to just let their guard drop. On behalf of everyone in this Chamber and beyond, I just want to say that this is the moment for utmost vigilance.

My dad was sharing that very thought with me the other day and he made the analogy with those tragic people who fell in the hours before the guns stopped on 11 November 1918. What a particular tragedy it was to be those who died at the end when the end was in sight. That is what we have ahead of us now, which is why if we need to tighten up restrictions over Christmas, miserable though that may be, we must think, “For pity’s sake, don’t we want our loved ones to see summer? Aren’t we prepared to make some restrictions now?” We know we are not going to have to live with this for years and years. We know that the light at the end of the tunnel is now visible. That is a glorious thing we can cling on to, but it is not an excuse to let our guard down—in fact, it is the opposite of that.

I want to encourage Ministers to think carefully about how the vaccine is administered. Of course, it should go first to those who are the most vulnerable, and those working in care homes and in the national health service. I have talked about the scale of my constituency, so it is great that we are likely to have a centre in Kendal and in Windermere, and we are looking at centres being rolled out through the primary care network, through GP surgeries and the like. I encourage the NHS within Lancashire and south Cumbria to ensure that there are centres in places such as Grange-over-Sands and Sedbergh, and other more rural, remote parts of Cumbria, so that this is not hard to access, particularly for people who are older and more vulnerable.

A community such as mine, which relies so heavily on tourism, with half the workforce working in tourism, has been deeply hit by the coronavirus. We operate on a feast and famine basis in hospitality and tourism, with the winter famine and the summer feast, and then back to the winter famine. The problem for us is that we have had three winters in a row. The Government’s investment in hospitality and tourism early on was of real benefit. Those £10,000 grants ensured that many businesses that would have failed were able to take advantage of the unlocking through the summer, so July and August were not a bad couple of months for hospitality and tourism in the lakes and the dales. I suggest to the Government that their failure at this point to repeat that grant support on that scale risks throwing away all the advantages they got from supporting hospitality and tourism in the early part of the year. What is the point of investing billions into it only to let those companies die in the next couple of months, so that when we are able to get back to some kind of normality, rather than having a hospitality and tourism industry ready to fight back and bounce back, we may have a bunch of dead businesses? So I encourage the Government now to repeat those £10,000 loans, to support hospitality and tourism.

I also encourage the Government to recognise the challenges faced in areas such as mine, which have been in tier 1 and are now tier 2, and are adjacent to tier 3 areas. The Lake District and Yorkshire Dales are in tier 2, but our neighbouring huge communities, the big population centres, are tier 3 So we are not compensated in the same way as businesses in tier 3 are, but we are massively affected by the fact that people in tier 3 cannot travel to take advantage of the wonderful facilities available in south Cumbria. I encourage the Government to consider making sure that support is provided.

[Jim Shannon]

With the advent of the vaccine for covid-19 almost here, does the hon. Gentleman feel that an extra push at this time for the goal of being covid-free should be what we all focus on? If we do that—collectively, singly and all together—we can make it happen, and that should be the positive message we are trying to send out from the Chamber tonight.

[Tim Farron]

I am grateful to the hon. Gentleman for his intervention. The fact that we know that the vaccines are now on their way surely changes how we look at all this. It means we now know we are not throwing billions and billions into a pot where we will never see the bottom. We know some kind of end is in sight, so what a terrible waste of tens of billions of the public’s money it would be, were we to be penny pinching in the last part of this pandemic. That is why we should back hospitality and tourism, which is the fourth biggest employer in the country and the biggest employer in Cumbria. It is essential to our economy as a whole and is worth £3.5 billion to the Cumbrian economy every year. This is the point; to invest in hospitality and tourism to see us through to the end.

In my community, there is a preponderance of businesses afflicted by having been excluded from support. Something like 4,000 people in my constituency alone were given no support. We are often talking about people who became self-employed in the past 18 months or so—the directors of small limited companies, hairdressers, personal trainers, taxi drivers and the like—but got nothing throughout this period. People on maternity leave have had their support cut at one end or the other. Often, these are the people—the entrepreneurs—who we will desperately rely on to build back our economy once we are through the coronavirus. Not only is it lacking in compassion for the Government to not back those people who have been excluded, but extremely stupid when they are the engine of our recovery, or at least they would be, if only the Government would help them.

A source of employment and a very important sector within my constituency and constituencies like mine is the outdoor education sector. It has been overlooked in many ways, although I am pleased to be part of the all-party group that the hon. Member for Aberconwy (Robin Millar) chairs, which is looking at how we can support outdoor education.

It is worth bearing in mind that about 15,000 people work in outdoor education around the country, and 6,000 of them have lost their jobs already, largely because residential stays have effectively been banned by the Department for Education under advice from the Department of Health and Social Care. I understand that, although I would argue that residential stays at outdoor education centres are at least as safe as children going to school in the first place.

It is important that we save our outdoor education centres, which are hugely at risk at this point, not only because it is right to save them, but because this is the moment to deploy them. I and others in this Chamber have talked about the impact this period has had on the mental health of young people and their disengagement with education. Those children have lost three months at school, but some of them went back two years as a consequence of all this. In our outdoor education centres, we have the skill and talent to engage young people in learning, to foster a love of learning, to improve their mental health and wellbeing and to engage them with the education process again. Will the Government bring forward a specialist package, as they have in Scotland, to make sure that we lose no more outdoor education centre jobs and protect all our outdoor education centres?

Finally, I will say a couple of words about health in general, but in particular mental health. In my constituency, we saw the closure of our adult mental health ward, the Kentmere ward, at Westmorland General Hospital for covid reasons. We understand why that is the case, and we are pleased that the foundation trust is now putting £5 million into redeveloping that service and opening again within the next year. I encourage Ministers to put pressure on the Lancashire and South Cumbria NHS Foundation Trust to make sure that happens as soon as possible, and also to ensure that it remains a site to support people of all ages and all genders with mental health problems. It is incredibly important that we do not end up at the end of all this with a more exclusive and less accessible mental health service available in South Lakeland.

Finally, cancer. We have learned during this period that there is a backlog in cancer treatment of around 100,000 people. Cancer Research UK estimates that 35,000 additional deaths may happen as a consequence of covid through people dying as a result of cancer. We believe that for every four weeks’ delay in diagnosis and, indeed, in treatment starting, we see a 10% drop in the likelihood of surviving that cancer. I want to encourage the Government to look carefully, if belatedly, at the comprehensive spending review submission that the all-party parliamentary groups on cancer, including the radiotherapy group that I chair, put to the Treasury, but which the Government did not match or fund. That proposal would allow us to massively expand radiotherapy, which would be a way not just of treating people who would normally expect to get radiotherapy but of ensuring that we substitute for those other treatments that are not possible due to covid-19. It would be an absolute tragedy if we ended up losing tens of thousands of people to cancer through this period because the Government did not catch up with cancer when they had the chance to invest and to do so.

Covid-19: Access to Cancer Diagnosis and Treatment

Tim Farron Excerpts

Wednesday 2nd December 2020 Westminster Hall

[Tim Farron (Westmorland and Lonsdale) (LD)]

I beg to move,

That this House has considered access to cancer diagnosis and treatment during the covid-19 outbreak.

It is a great pleasure to serve under your chairmanship, Ms McVey. I am grateful to have the opportunity to raise this issue. Of the many vital issues discussed in this place in recent months, the impact of covid-19 on cancer treatment must be at the very top of the list for importance to families right across the United Kingdom. I want to start by saying very clearly that there is a national cancer crisis—a backlog that we need to catch up with urgently—so I will be concluding my speech by asking the Minister to meet me and the clinical advisers who support the Catch Up With Cancer campaign as a matter of priority in the coming days.

Since the start of the pandemic, organisations, charities, frontline NHS staff and MPs have been urging the Government to invest in cancer services to prevent a national tragedy in cancer. Indeed, the experts we work with warned at the start of the pandemic that tens of thousands of people were set to die as a result of cancellations, delays and disruptions to their treatment. Sadly, it looks as though those warnings have been proved right, although for thousands of families it is not yet too late for us to catch up with cancer.

I have two main points to address. Both relate in large part to the covid-induced backlog and the apparent failure to make addressing it a central feature of the Chancellor of the Exchequer’s comprehensive spending review just last week. The first point I would like to address today is the scale of the cancer backlog itself. All the feedback from the frontline and from our expert clinical advisers strongly suggests that the Government and NHS management are repeatedly failing to grasp the true size and scale and danger of the backlog. The Government and senior NHS managers keep saying that services are back to normal levels and that good progress is being made on the backlog, but all the evidence from frontline staff provides a clear picture that it is just not true to say that we are back to normal.

Even then, the simple fact remains that, with the scale of the backlog, “back to normal” is nowhere near good enough anyway. Even if services were back to pre-covid levels—we contend that they are not—it would be mathematically impossible to have caught up. Why? Because the flow of patients was all but stopped for several months, but cancer, of course, did not take a break. It kept striking people at the same rate it always does, so the only way we can catch up with cancer is to have services super-boosted to levels in excess of pre-covid capacity. We estimate that cancer services need to be running at something like 120% of pre-covid levels for two solid years to catch up. That view is shared by other keen observers of this problem, such as the chair of the Health and Social Care Committee, the right hon. Member for South West Surrey (Jeremy Hunt). But the brutal reality is that services are not yet even at their pre-covid capacity. In September, treatment was at only 94.5% capacity, and as long as the treatment rate continues to be below 2019 levels, the cancer backlog will continue to grow.

We are hearing from frontline staff that services were not yet back to normal before the recent lockdown in November. One cancer centre has told us that during that lockdown, referrals have yet again “fallen off a cliff”. Analysis from Macmillan Cancer Support, using the Government’s own monthly cancer waiting times data, shows that during the pandemic around 1,000 fewer people in south Cumbria and Lancashire will have had their first cancer treatment, compared with the same period last year—a 17% drop—which suggests we are missing one in six people with cancer. There is no serious doubt about what is happening to those missing people. Their cancers will have grown and spread and, in many cases, become incurable by the time they are identified and by the time, if at all, they are treated. Across the country we hear of patients presenting with more advanced cancers due to not being seen early enough. Some staff tell us that they have never seen such advanced cases.

The all-party parliamentary group on radiotherapy, like all the all-party groups on cancer, is strenuous in its insistence on a consensual and collegiate approach, and sees Ministers, especially the Minister here today, as partners and not opponents. I am grateful to the Minister for her courtesy, her willingness to engage and her very clear concern. I am also grateful to all Members here and to those who are not present but who dearly wanted to be. Many are absent because this Chamber is not yet enabled for virtual participation. They include the hon. Members for North Devon (Selaine Saxby), for West Lancashire (Rosie Cooper), for Rhondda (Chris Bryant), for Central Ayrshire (Dr Whitford), for Liverpool, Riverside (Kim Johnson) and for Bootle (Peter Dowd).

Our collective view is that we need urgent action to catch up with cancer. I mentioned the figures for my own area, but Macmillan estimates that across England as a whole there are a terrifying 50,000 missing diagnoses. Clinicians report that more patients are now coming through needing palliative rather than curative care—people who could have survived who are now on end-of-life pathways and are simply being treated to alleviate the pain.

[Grahame Morris (Easington) (Lab)]

That is a really important point. How do we quantify the scale of the backlog to enable us to have an action plan to address it? Specialists say that whereas the ratio is currently 50:50 in terms of the therapeutic application of radiotherapy for treatable cancers and therapeutic palliative care, last year it was 70% treatable and 30% palliative. Do we not need the release of the datasets to quantify that in an accurate way?

[Tim Farron]

I am extremely grateful to the hon. Gentleman for making a very important point. I have heard the same reports from the frontline that treatment would normally be 70:30 curative to palliative and that now it is 50:50. That is a blindingly obvious consequence of the fact that when we catch cancer, we catch it too late.

I have a request of the Department, which we have made before, including in face-to-face meetings with the Secretary of State. I want the Department of Health and Social Care team responsible to sit down with the frontline experts—we can provide them this afternoon—and go through the evidence of the backlog. There is no way of tackling the problem if the NHS management and the Department are not cognisant of it and prepared to listen to the people working their socks off in cancer units all over the United Kingdom.

I want to make another important point. Whoever was in power during this time would have been handed the same challenge and would have made many mistakes. The Government have rightly sought to control the virus so that we can protect the NHS and save lives. The lives that we seek to save are those at risk from not just covid but other illnesses, including, of course, cancer.

We as a country have stood together and defended our NHS so that it has the ability to fight cancer in the midst of a pandemic, which is what every clinician is desperate to do. The great success of this year, for which Ministers should rightly be proud, is that our NHS has not collapsed and did not fall over. Our doctors, nurses, paramedics and clinicians of every sort have saved lives, defeated the odds and kept our NHS on its feet so that it can fight cancer, and yet a failure at senior levels of NHS England and in Government to recognise the scale and nature of the cancer backlog means that people are dying today who did not need to die.

We have terminal diagnoses for cancers that could have been treatable among my constituents and yours, Ms McVey—among all our constituents. Their lives have been cut short when earlier, more urgent and more ambitious action from our leaders could have saved them. What troubles me so much is that we hear statements from some in senior management in the NHS, and from within the Department, that suggest they do not quite get the scale of the backlog problem. They freely admit that they do not know how big the backlog is. On more than one occasion, I have heard the Secretary of State seek to reassure us by saying that progress has been made on recovering the 62-day wait. If people understand what is happening, however, that does not reassure them. It does the exact opposite: it sends a shiver down their spine—it confirms the problem.

Surely Ministers know that the 62-day waiting time target for treatment does not give a complete snapshot of the situation, because it captures only patients who are already in the system. I am sorry to be brutal, but as more people die, there are fewer people in the system. The target does not take into account the tens of thousands of undiagnosed patients who may be going about their daily life completely unaware that they are living with cancer.

I fear that the Government hugely underestimate the cancer backlog, and the consequence will be thousands of unnecessary deaths and lost life years. An article last month in The BMJ estimated that there will be 60,000 lost years of life as a result. Does the Minister recognise the significant fall in people receiving cancer treatment this year compared with 2019? Like me, is she worried that this will mean there are thousands of people out there with undiagnosed cancer who have yet to come forward?

I move on now to my second point, which relates to the Chancellor’s recent comprehensive spending review, which was a pivotal opportunity to signal that the Government, the Department of Health and Social Care, the Chancellor and NHS leaders understood the need for investment in the techniques and treatment required to quickly build capacity in order to clear the cancer backlog and ensure a resilient service going forward—to build the capacity that is vitally needed if we are to make sure cancer patients are not the collateral damage of covid. Far from seizing that pivotal opportunity, the Government appear to have turned it into a missed opportunity. As far as we can tell, there is no boost to cancer treatments in the comprehensive spending review. There is no increase in capacity to catch up with cancer, and there is no plan to do what is needed to save thousands of cancer patients’ lives.

The Action Radiotherapy charity estimates that the true cancer backlog could be as high as 100,000 patients. It supports the estimate of the Chair of the Health and Social Care Committee that it would take cancer services working at over 120% pre-covid capacity two years just to catch up. Members of all political persuasions, working with clinicians and experts who are desperate to make a difference, are clear about how the Government could provide the boost required to catch up with cancer and to save thousands of lives. The answer is not to exhort our heroic frontline staff to work harder—they continue to be inspirational, straining every sinew. It is not to carry on doing what we have always done, but just doing it a little better. It requires some new thinking. It requires taking an axe to some of the internal bureaucracy that has held back some treatments, such as radiotherapy. Crucially, it requires investment, but that critical investment seems to be missing from the comprehensive spending review. That is a missed opportunity on a massive scale, and I hope it is not too late to make a change.

I have to say that there has been a collective gasp of disbelief across the oncology and radiotherapy sector, as it appears—unless we are all mistaken—that there is not even an explicit mention of radiotherapy in the spending review, never mind of the investment in it. Radiotherapy is covid-safe and is required by over 50% of cancer patients. It already plays a significant role in 40% of cancer cures and is able, where clinically appropriate, to substitute for chemotherapy and surgery at times when they are deemed not to be appropriate because of the fact that we are in a pandemic. It is hugely cost-effective: it cures patients for as little as £5,000 to £7,000 apiece.

The reality is that radiotherapy has huge untapped potential to do even more to clear the backlog. For many reasons, however, it has been actively restricted and held back for years. Although radiotherapy treats 50% of cancer patients, it receives just 5% of the annual cancer budget—something for which recent Governments of all parties must share the blame. That is why the UK is massively behind on technology that could empower the workforce to do more. Pre-pandemic it was estimated that as many as 24,000 patients were missing access to radiotherapy treatment each year. It is worse now.

Faced with the current crisis, the radiotherapy community came together to put together a transformation plan for consideration at the comprehensive spending review. The six-point plan would deliver a super-boost to cancer services to clear the backlog, with innovative technology and digital solutions to deploy linear accelerators at the many covid-clean hospital sites in England, such as the Westmorland General Hospital in my constituency, that are perfectly suited to adding satellite capacity to their main cancer units while protecting patients and clinicians from covid infection risk. The plan would also see an immediate boost in precision radiotherapy at existing cancer units, upgrading linear accelerators to perform curative treatment over shorter periods. However, on our reading of the spending review, that appears to have been totally ignored. In fact, as far as we can tell, there is no clear plan of investment in cancer treatment capacity at all.

While the investment in diagnostic machines over 10 years is truly welcomed by all of us here, it is not enough. According to Freedom of Information Act requests carried out by the Radiotherapy4Life campaign, more than half of NHS trusts are using radiotherapy machines that are more than 10 years old. To replace only the machines that deliver diagnostics, or radiology, and not those that actually cure people—the radiotherapy machines—is a baffling decision, to me and, more importantly, the experts. Patients and the public will be shocked to learn that immediate solutions presented by expert professionals to the covid-induced cancer crisis are being overlooked.

Every week that we delay giving an immediate boost to cancer services—capacity, diagnostics and treatments —we increase the risk of losing cancer patients needlessly. Recent data shows that for every four weeks of delay in starting treatment there is as much as a 10% increase in deaths. Some departments report a 20% drop in the number of patients classified as curable, leading to downgrading to palliative treatment instead. Patients—our constituents, families and friends—are being told that their cancer now cannot be cured and that their treatment will be palliative instead. Yet the decision to catch up urgently with cancer has been either delayed or ignored. We will pay a huge cost for missing out on the chance to correct things at the spending review. That is why I hope it is not too late to do so. The public inquiry, when it happens, will reveal the situation. The cost of the understandable litigation by patients and families who have been failed will be needlessly huge.

We first wrote to the Secretary of State about the growing crisis in April, and we have not stopped warning of the devastating impact that there will be on the lives of cancer patients. Three hundred and seventy-five thousand people have signed the Catch Up With Cancer petition and have hundreds of patients shared their heartbreaking stories. Experts are saying that there will be as many as 35,000 unnecessary deaths and, as I have said, 60,000 life years lost to cancer because of the impact of the covid crisis. Cancer survival rates have been pushed back to where they were more than a decade ago.

I know that the Minister cares. She is a good person seeking to do a good job. I hope that she will forgive me for being direct today, but thousands of people could have their lives lengthened or saved, and their families could be spared unspeakable grief, if we acted urgently to catch up with cancer. I conclude by repeating my plea in the strongest possible terms. Will the Minister meet me and, most importantly, the expert clinicians who advise the Catch Up With Cancer campaign, in the next few days so that we can turn the tide on the crisis?

[Esther McVey (in the Chair)]

Just for the ease of colleagues, I will say that I am looking to call the Front-Bench speakers at 10.30 am, so divide the time among yourselves.

--- Later in debate ---

[Tim Farron]

The hon. Members for Warrington South (Andy Carter), for Gower (Tonia Antoniazzi), for Easington (Grahame Morris), for Strangford (Jim Shannon), for Angus (Dave Doogan) and for Nottingham South (Alex Norris), and indeed the Minister, all made excellent points, and I am extremely grateful. I thank the Minister for what she said and for agreeing to meet us this side of the recess. To be specific, we are after a meeting with her, of course, and departmental finance officials so that we can revisit the investment decision—that decision is problematic—and have our experts meet hers to get to the bottom of the data. We need to see the datasets so that we can explore the extent to which there is an urgent crisis—we are certain that there is one.

Finally, the Minister talked about the importance of diagnosis. The Government are making progress on diagnostics. Of course, in the NHS long-term plan, we see the desire to find more cancers earlier so that we can treat them. If we find more cancers early, however, we will have more people to treat. That is why the radiotherapy investment that we have called for is essential, not just now but in the long term.

Motion lapsed (Standing Order No. 10(6)).

[Esther McVey (in the Chair)]

I will suspend the sitting for two minutes so that hon. Members can exit safely and the next lot can come in safely.