Radiotherapy: Accessibility

Tim Farron Excerpts

Tuesday 18th July 2023 Westminster Hall

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

It is a pleasure to serve under your guidance this morning, Dame Maria. I pay tribute to the hon. Member for North Devon (Selaine Saxby) for leading the debate and doing so extremely well; I agree with every word she said. I also pay tribute to the hon. Member for Easington (Grahame Morris) for not just his speech, but his ongoing work in this area. He speaks with great authority and obviously with great personal experience. I also thank Professor Pat Price, who has been mentioned by both of my colleagues and leads the cancer charity Radiotherapy UK. She is a specialist who adds enormous value to our campaigns to help those in positions of influence to make wise decisions about this vital technology.

Let me start with another positive, and say a massive thank you to that small but incredibly talented workforce of maybe only 5,000 people who deliver radiotherapy in all the centres around the country, literally saving lives every single day. We are massively, massively grateful to all of them.

I apologise that there will be some repetition, but all good campaigns involve repeating one’s messages. We know that one of the most dark and terrible facts of life is that around half of us at some point in our lives will contract cancer, which means that pretty much all of us have experienced it in our families—some with remarkable and wonderful outcomes, some with tragic and incredibly sad ones. I have experienced both within mine. We know that radiotherapy is a really important tool in tackling cancer in terms of both palliative and curative treatment. As has been said, the international standard for the number of people with cancer who should receive radiotherapy is 53%; in the United Kingdom, it is only 27%. That should ring enormous alarm bells in all parts of the House and in every corner of the national health service, but I am afraid that it does not feel like that is happening. There are many reasons behind that, but one that we have already heard is that we spend only 5% of our cancer budget on radiotherapy, and the average of countries similar to ours in the western world is nearer to 10%.

Again, we have already heard—but I will restate—that in the United Kingdom we have 4.9 linear accelerators per 1 million of population. In France, there are 8.5 linear accelerators per million people. For the UK to become just average, we would need 125 additional linear accelerator machines this year, as has already been said. Put bluntly, the fact that this is quite a balkanised commissioning process is one reason why we are where we are. The lack of central commissioning means that different centres will, or will not, have sinking funds, so there is absolutely a postcode lottery. It also means that, as our survey—through the all-party parliamentary group for radiotherapy, which I am privileged to chair—discovered, 75 machines that are basically past their sell-by dates will be in use in our hospitals next year, many without a plan to replace them.

We are behind not just on the volume of technology but, as has been suggested, on the deployment of new technology, much of which was developed in this country. That makes it all the more inexcusable. For example, AI software could allow clinicians to accurately plan patient care in a few minutes rather than a few hours. Imagine the impact that would have on our workforce.

We absolutely need to invest in our workforce. We need to support them, to ensure that we boost the morale of people who are already in the service to keep them working in the service, and to bring in the perhaps 1,500 additional net posts needed to ensure that we have a properly functioning radiotherapy workforce. Alongside that, the fact that we could allow clinicians to do their planning even more accurately, in a fraction of the time, obviously makes sense because we would get even better use out of the workforce than we currently do, in terms of the hours that they put in.

We could also invest, as has already been mentioned, in surface-guided radiation therapy to reduce waiting times. Again, that was developed in the UK, but has not been deployed much here. When we have 40% of people in north Cumbria and about 30% of people in south Cumbria waiting more than two months for their first treatment—we have already heard that every four weeks of delay means that someone is 10% less likely to survive—then, surely, investing in that capacity in radiotherapy, as well as in new technology, is just a no brainer.

All of that costs peanuts—that is a Treasury term, I think—in comparison with equally worthy but vastly more expensive drug treatments. We are talking just £200 million for those 125 new linear accelerators. I am not knocking those treatments, by the way; chemotherapy and immunotherapy are vital weapons in our fight against cancer. Herceptin has saved so many lives, for example, but I have picked that drug for a reason, because the cost of Herceptin, in one year, is equivalent to two thirds of the entire radiotherapy budget.

That is understandable, because drugs do cost more than kit, but it is a reminder of how relatively straightforward this problem is to solve. For a Government that wanted to shift the dial quickly and do something of long-term value, but that would have an impact in a short period of time and would cost, relatively speaking, very little, it should be an obvious no-brainer, and it frustrates me that we are where we are.

Let us be cross-party in our self-criticism, because I can blame this Government for their inaction, and I can blame the coalition Government, and I can blame the previous Labour Government. It is 30 years of us being behind the curve here. Let all accept that we are all responsible and we will all do something about it, starting right now.

Why are we in this situation? I suspect that it is because decisions are often made when the right people are in the room. I am not knocking the pharmaceutical companies, but they have the resource to be in the room. However, when we have our radiotherapy APPG meetings, and we have clinicians from right across the country—the best people in their profession—huddled into little rooms off Westminster Hall, I realise that that is the radiotherapy industry. That is the radiotherapy “lobby”. That is it. We do not have paid specialists; the lobby is in that room. That is perhaps why radiotherapy has slipped off the radar. This is the moment in which it must go right back on to it.

The situation is even worse in rural communities. Some 3.5 million of us live in what we would refer to as radiotherapy deserts, where we are more than a 45-minute journey away from the nearest radiotherapy treatment centre. The national radiotherapy advisory group says that any trust that allows that to happen is guilty of bad practice. In my constituency, pretty much everybody lives outside that 45-minute guideline distance, and when we are looking at the travel times, they are always those from the best-case scenario—travelling at 2 o’clock in the morning, or not in the middle of the tourist season. Twenty million people visit the lakes every year; the roads get a bit clogged up from time to time. If someone is from Dent, the round trip to Preston to get their treatment will take them about two and a half hours. From Kirkby Stephen, it is two hours to Carlisle, two and a half hours to Preston. From Grasmere and Coniston, the round trips are nearer three hours.

Over my time as an MP it has been a privilege to often take my constituents to their treatment in the Rosemere cancer treatment centre in Preston. By the way, it is absolutely excellent, but just blinking miles away; it is far too far away. I remember taking a young mum—a teaching assistant—and her two young children, for her breast cancer treatment. I remember the impact it had on her, how wearying it was; and she was an otherwise fit and healthy young person. I remember taking an older woman from Kendal, some years later, also for daily treatment, and the impact that had on her and her family. It is not just that travelling those long distances is inconvenient; it is actually dangerous. Sometimes, as has already been said by the right hon. and learned Member for North East Hertfordshire (Sir Oliver Heald), it means that people will choose not to complete their treatment. It is also true—clinicians will sometimes baulk at this, but I am not criticising them—that people will not be recommended or referred for radiotherapy because it is recognised that that person will not cope with the travelling.

Not long ago there was a bus driver in my neck of the woods who gave up work for two months and moved to Preston for his treatment, because he could afford to do so. The economic impact on people, in terms of worsening their poverty because of the distances that people have to travel, is huge. The simple fact is that because of the distance they have to travel to treatment, people do not live as long in rural areas. That is outrageous.

In 2008 we launched a campaign to bring a cancer treatment centre to Westmorland General Hospital in Kendal. We have largely succeeded. We brought chemotherapy there in 2011, there is more and more surgery, and diagnostics is arriving in the coming months. The one thing we wanted that we have not got is that radiotherapy satellite unit. I want to be clear that the Rosemere unit in Preston is fantastic. We do not want to replicate it; we want to be associated with it. That is, we want a satellite unit that is attached to the Rosemere one and operating at the hospital in Kendal—just as Rosemere itself was once a satellite to the Christie. Today, there are centres that are satellites of the Christie at Oldham, Macclesfield and Bolton, all of them doing a fantastic job and allowing people who live in those communities closer access to that important treatment.

The simple reality is that over these last few years the proposal that has been made for a radiotherapy satellite unit at the Westmorland General Hospital in Kendal has been written and proposed, and the trust has been behind it. It was eventually signed off in 2014 and then cancelled in 2016. I often point the finger at Ministers and the NHS for that failure to deliver, but I also encourage the trusts and commissioners locally not to let it drop off their agenda. It has vital importance. I often hear commissioners, local trusts in Morecambe Bay and the Lancashire hospitals teaching trusts say the right things, but it feels not sufficiently urgent—tell you what, it is urgent to my constituents. It is urgent every time that somebody gets that awful diagnosis and then realises that they have weeks and weeks of travelling and might not make it. They might not complete the journeys; that might mean that they do not survive.

Yet if we look at the demographics, our need in Cumbria is increasing. It is recognised that at the moment there is demand for 1.3 linear accelerators, just in the area that is closer to Kendal than to Preston. Sadly, cancer is a disease of ageing, at least in part; as our population ages, we know that that demand will get greater.

Here is a crucial point that I really want the Minister to take on board. The evidence is that when a satellite unit is opened, there is a greater level of demand than was predicted. Why is that? There are reasons why only 27% of people are having radiotherapy treatment when it should be 53%, and access is one of them. The APPG for radiotherapy had a forum for the satellite units a little while ago. What we gained from that was the staggering news that when a new satellite centre opens, rather than just getting the demand from the parent centre that was predicted, there is at least 20% more demand than was expected, in every single one. In some cases, the increase in demand is 50%. That is because those patients were not being referred or were choosing not to complete. If you build them, Minister, they will come, and lives will be saved. That all means that people in Kendal, Grange, Windermere, Kirkby Stephen, Appleby, Sedbergh, Ambleside, Coniston, Grasmere and the rest of our communities in rural Cumbria are facing not just longer journeys, but shorter lives. That is not acceptable.

The United Kingdom needs a radiotherapy boost across the board. It would be relatively inexpensive, and if the Government committed right now, we would see dividends and lives being saved within a matter of months. Rural communities, from Westmorland to the west country and from Northumberland to Norfolk, need it even more. For the 3 million people who live in a radiotherapy desert, as I do, investing in satellite units will make an immense difference.

We are desperate for action in Westmorland. We are desperate to see our satellite radiotherapy unit delivered at the Westmorland General Hospital in Kendal. I ask the Minister to act personally now and look at our bid for a satellite unit. If he acts and instructs commissioners to get on with the business of commissioning, I promise that our community will raise at least £2 million to help him to make that case in a partnership bid. If he commits to helping people in Westmorland to have better treatment, shorter journeys and longer lives, I will be permanently, eternally grateful.

--- Later in debate ---

[Grahame Morris]

The Minister is being generous in giving way. The debate is instructive, and I am glad he has mentioned integrated care boards. As the hon. Member for Westmorland and Lonsdale (Tim Farron) mentioned—sorry, the right hon. Gentleman.

[Tim Farron]

I am merely honourable.

[Grahame Morris]

Well, I am sure it is only a matter of time.

One of the issues has been commissioning. NHS England is responsible for commissioning without having a sensible plan to replace old machines, and there are bizarre disincentives to using the most modern machines, which require fewer visits. Furthermore, the fractionations are smaller, and the radiotherapy could be delivered in a shorter time. Bizarre commissioning arrangements and tariffs apply. Is the advent of the ICBs, with the responsibilities they hold, an important element in deciding where the new treatment centres are going to be? Will the Minister outline their role in the context of access to radiotherapy services?

[Will Quince]

I thank the hon. Gentleman for his question and will jump to the part of my speech that covers equipment, because the issue has been raised by all hon. Members during the debate.

We are absolutely focused on improving cancer treatment and supporting advances in radiotherapy using cutting-edge imagery and technology. As my hon. Friend the Member for North Devon pointed out, since 2016 we have invested £162 million in the most cutting-edge radiotherapy equipment, which is designed to replace or upgrade more than 100 radiotherapy treatment machines so that we can deliver the best possible outcomes for patients. As the hon. Member for Westmorland and Lonsdale said, NHS England is carrying out a stocktake of linear accelerator age, which will be completed in the summer. It is also working with partners to undertake a demand and capacity review, which will complete by the end of the year.

On AI specifically, we want to ensure that we have the best possible cutting-edge, innovative equipment and technologies in the NHS, so we have announced an additional £21 million of funding that will speed up the roll out of AI across the NHS. That will enable us to help to improve diagnosis and to reduce waiting times—one of our top priorities—and clinicians will be freed up to spend more time delivering frontline patient care. The point made by the hon. Member for Easington about AI and the benefits thereof is well made.

The hon. Member for Westmorland and Lonsdale has been campaigning on the issue for around a decade, or perhaps longer, and he has met several Ministers. I am yet to meet with the hon. Gentleman, and I know he was due to meet my hon. Friend the Minister for Social Care, but I am happy to honour that meeting. He recently met his local hospital trust to discuss radiotherapy being part of the new hospital programme. Ultimately, that is a matter for commissioners, but we can certainly have that conversation when we meet and try to find a way forward.

A number of hon. Members raised the issue of the workforce. The hon. Member for Strangford (Jim Shannon) is no longer in his place, but he laboured this point, and rightly so. We have made good progress in growing the cancer workforce. The annual growth rate of the workforce remains steady at between 3% and 4%, but we need to go further. As of February, there were 33,174 full-time equivalent staff in the cancer workforce. In trusts, that is an increase of more than 11,300 since February 2010. Specifically, the number of therapeutic radiography staff grew by 17.4% between 2016 and 2021. As has been referenced, we published our long-term workforce plan, which sets out actions that are backed by £2.4 billion of Government funding up to 2028-29, a couple of weeks ago.

On travel, the travel that a patient needs to undertake is dependent on the type of treatment they need. Decisions about treatment locations are made on a case-by-case basis. As hon. Members have pointed out, specialised services are not available in every local hospital, in part because they have to be delivered by specialist teams of health professionals with the necessary skills and experience and access to the necessary equipment and medicines. Patient-specific requirements are based on what each individual can cope with and are discussed between the patient and clinician.

The Government are, of course, striving wherever possible to reduce any necessity to travel unreasonable distances, which is why our priority continues to be to bolster the specialist workforce and ensure ever-expanding coverage of equipment. That includes by investing in new radiotherapy machines, but the responsibility for investing in that equipment sits with local systems—the ICBs, which I suspect we will discuss in greater detail when we meet. I hear the case that has been made about equality and rurality. We can address some of those issues and work with integrated care boards so that they see the benefits to patients and to outcomes, as well as the cost savings, if we get it right.

We are supporting providers to accelerate the delivery of stereotactic ablative body radiotherapy for targeted cancers, thereby lowering the risk of damage to normal cells. Specialised commissioners have allocated £12 million to support providers to deliver SABR.

[Tim Farron]

The Minister has given a comprehensive response to us all. On the issue of SABR, would he look in particular at the point made by the hon. Member for Easington (Grahame Morris) about commissioning arrangements and the perverse incentives that lead to some cancer treatment centres effectively being paid more for using lesser treatment than they would be for more efficient, less invasive, less frequent but more powerful SABR technology and other similar advanced forms of treatment? It would save an awful lot of money and still do a better job.

[Will Quince]

In short, the answer is yes. There are perverse incentives that exist across Government, and the NHS is no exception. Wherever we identify them, we have to work to drive them out of the system. We have a tendency, unfortunately, to focus on processes and procedures. I want all trusts—I would like us to do this across Government—to focus more on outcomes than on processes. Perhaps when we meet the hon. Gentleman could set out that exact challenge in more detail, because I would be glad to look at it in detail.

Dame Maria, I am conscious that I have gone on for longer than I should have; you have been very generous. I again thank my hon. Friend the Member for North Devon for bringing this matter to the attention of the House, and I thank all hon. Members for their contributions on this hugely important subject. I hope I can assure my hon. Friend and Members from all parties that with the investments we have made and the innovations the NHS has adopted, and the innovations to come, we will continue to improve access to radiotherapy throughout the country. I look forward to meeting the hon. Members present, alongside NHS England, to see what is within the art of the possible in this space. I look forward to working with parliamentary colleagues throughout the House to bring about the improved cancer outcomes that we all want to see.

Oral Answers to Questions

Tim Farron Excerpts

Tuesday 11th July 2023 Commons Chamber

[Steve Barclay]

Not only do I agree, but I have been with my hon. Friend to see this scheme at first hand. He has championed the scheme vociferously and helped to secure that investment for his constituents. I look forward to working with him to ensure it is delivered as quickly as possible.

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

Plans to remove overnight primary care clinicians from Westmorland General Hospital three nights a week are a massive risk to our community and mean that, overnight, people will be reliant on Barrow or Penrith for an out-of-hours doctor. Will the Secretary of State instruct the ICB to intervene to protect people in South Lakeland from this massive reduction in the quality and accessibility of services?

[Steve Barclay]

Some of us remember when the Lib Dems were for greater localism. One of the things we are looking at is how to empower commissioners, on a place-based basis, to make decisions on where best to place services. We need to move more services into the community upstream, to address the frail elderly before they get to hospital and to have more community services. I am happy to look at the specific issue the hon. Gentleman raises, but I would have thought the Lib Dems would support the general trend of empowering integrated commissioning systems to make place-based decisions.

Hospice Services: Support

Tim Farron Excerpts

Wednesday 14th June 2023 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Ms Nokes. I pay tribute to the hon. Member for Eastleigh (Paul Holmes) for securing this important debate.

St Mary’s Hospice at Ulverston, St John’s Hospice at Lancaster and the Eden Valley Hospice at Carlisle provide tender, professional and specialist care for people with life-limiting conditions and their loved ones—something we are so grateful for. They prove that life has dignity from beginning to end. Hospitals, however marvellous they are, do not have the resources to replicate the care that is provided by hospices.

The costs of running a hospice have gone through the roof in recent times. Val Stangoe, the chief executive of St Mary’s, one of our three local hospices, said to me:

“The recent settlement by the NHS Lancashire South Cumbria ICB of 0.0%”—

as pointed out by the hon. Member for Lancaster and Fleetwood (Cat Smith)—

“has left our hospices in a state of financial deficit, with potential loss of hospice beds and services.”

She went on:

“Your local hospices”—

our hospices—

“are now operating on a deficit budget, have received the lowest settlements in England. The proposed 0.0% uplift equates to almost 10% in cuts, significantly impacting delivery of services. This stands in contrast to other regions, where hospices have received an average uplift of 2.7%”—

which is not enough. She continued:

“The disproportionate treatment faced by hospices in Lancashire South Cumbria is unfair and must be addressed.”

My fundamental ask of the Minister is this: will she directly involve herself in that situation to stop our hospices in Cumbria suffering? I have been asking the Government for months to come up with a scheme to help hospices that are struggling with their energy costs, which have gone up three times in recent months. There are lots of promises and no action.

There is a cost to meeting the NHS pay settlement. There is a cost to ensuring that hospices are paid properly so that they can pay their staff, keep them, and recruit them in the first place, and so that they can pay their energy bills. But the cost of not doing that is far greater, not only in terms of the health damage and people’s pain and suffering, but for the hospitals that have to pick up the pieces when hospices are not able to meet people’s needs.

[Caroline Nokes (in the Chair)]

Because one speaker has dropped out, I am going to increase the time limit back to three minutes.

--- Later in debate ---

[Helen Whately]

As the hon. Member mentioned earlier, we have indeed met and spoken about the hospice to which she refers. I have also met with several other hon. Members. I am grateful to them for coming to me to talk about the specific difficult situations faced by some of the hospices serving their communities.

That brings me to exactly what I was coming to talk about: the financial pressures on hospices, which have been a strong theme of the debate. I know very well, not just from this debate but from conversations with hospices, about the financial challenges that hospices are facing. In fact, financial challenges are being faced by many organisations that provide care in our communities, whether NHS organisations or care homes, as the hon. Member for Leicester West (Liz Kendall) mentioned. In particular, there are the extra pressures of energy costs—such organisations often use substantial amounts of energy—and the higher costs of staff pay. We know that many hospices pay their staff in alignment with the NHS agenda for change pay scales.

An additional difficult context for hospices at the moment is fundraising. That was clearly hard during the pandemic, but since then many households have been affected by the higher cost of living and therefore have found it harder to contribute to fundraising efforts in their communities, including those organised by hospices. I know how hard that context is for our hospices.

On energy costs, many hospices have been able to benefit from the Government’s energy bill relief scheme, which ran to 31 March. Eligible organisations, including hospices, will continue to get baseline discount support for gas and electricity bills under the energy bills discount scheme, which is running from 1 April 2023 to 31 March 2024. In addition, last year NHS England released £1.5 billion of extra funding to integrated care boards in recognition of the extra costs arising from inflation in the services they commission. ICBs have been responsible for distributing that funding according to local need, including to palliative and end of life care providers in our communities, whether they are NHS organisations or hospices.

[Tim Farron]

Of course, ICBs are not elected, but the Minister is. She heard what the hon. Member for Lancaster and Fleetwood (Cat Smith) and I had to say about the 0% increase that the Lancashire and South Cumbria ICB has granted—or not granted—our hospices. Will she directly get involved in that to fix it so we do not have to have the 10% cuts that St Mary’s Hospice thinks we will have to deliver?

Oral Answers to Questions

Tim Farron Excerpts

Tuesday 6th June 2023 Commons Chamber

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

There was a net loss of 577 full-time equivalent GPs last year. A contributing factor in rural communities was the Government’s decision a few years ago to remove the minimum practice income guarantee, making it unsustainable for small surgeries—and many rural surgeries are necessarily small—to survive. Will the Minister consider whether it is time to reintroduce a strategic small surgeries fund, to allow smaller rural surgeries in communities such as mine to survive and thrive?

[Neil O’Brien]

The funding formula already takes account of rurality. I hear the hon. Gentleman’s argument, but it is worth noting that our GPs are doing more than ever before. In the year to April there were nearly 10% more appointments than before the pandemic, or 20 more appointments in every GP practice per working day. GPs are working incredibly hard, as well as putting in extra staff, and I pay tribute to them for the sheer amount of work they are doing.

NHS Dentists: South-West England

Tim Farron Excerpts

Wednesday 24th May 2023 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Ms Elliot. I congratulate the hon. Member for West Dorset (Chris Loder) on securing an important debate and opening it very well. Access to NHS dentistry is becoming harder across the country, but, as we can sense from the contributions we have heard, especially so in rural communities such as those in Cornwall, Devon, Somerset, and Dorset, as well as in areas such as my own, in Cumbria.

Rural communities struggle more than others with access to dentistry because of pressures such as high housing costs and lower working-age populations, which mean there is a smaller dental workforce. Access to dental care in rural communities is also worse because we are dealing with sparsely populated areas and fewer economies of scale are available for the surgeries in question. There is the additional and crucial matter of the physical distances that people have to travel to receive treatment. Last week, I did a quick search and found that for a family in Coniston in my community the nearest available NHS dental place was in Hexham in Northumberland, which is a 160-mile round trip.

Every month it seems that we lose another NHS dental practice. I am sure that is the case for Members in every part of the country—from the contributions so far, especially in the south-west. I have recently lost a surgery in my community that saw 5,800 patients lose their NHS status overnight. The private plan that those patients were offered to replace those places would have cost a family of four £1,000 a year just to stay registered and on the books. With increasing prices, such as the rise in mortgage costs, rental costs, fuel duty and food—the cost of just living in any respect—how is that acceptable or affordable, given that that family, like everybody here, have already paid for their NHS dentistry through taxes?

People across our country have paid for a service, as my hon. Friend the Member for Tiverton and Honiton (Richard Foord) said, that the Government have not delivered. It is about not just the financial costs to families if they have to go private when an NHS dental service is no longer available but the physical pain, the anxiety and the sense of guilt, for parents, that their child is not seeing a dentist because they cannot afford to send them because NHS dentistry is not available. My hon. Friend the Member for Bath (Wera Hobhouse) talked about oral cancers and the fact that many dentists are the first to spot them and provide life-saving treatment.

For what it is worth, I do not blame the dentists, because I speak to so many of them. They are as angry as the rest of us, for many reasons. First, the Government take the public’s money but do not pass it on to the dentists. There is not enough money in the system, as the hon. Member for South Dorset (Richard Drax) wisely pointed out. That is true nationally, but it is also true surgery by surgery. Dentists tell me that it is often the case that the Government’s funding per unit of dental activity may be less than what a patient paid over the counter for their treatment. Dentists and patients, then, are both being ripped off.

A unit of dental activity payment, at the most basic level, could net perhaps £20 or £30 for a single examination. Diligent dentists seeking to do a good job might do three of those in an hour. Let us do the maths—that funding is not enough to pay to keep the lights and heating on, pay the rent and pay for staff salaries and materials. Many dentists feel that treating patients at a good standard therefore costs them and their practice more money, and that they have to subsidise the NHS. There are incentives to cut corners, to be on a treadmill, to rush through more patients and to do a job that the dentists themselves feel professionally dissatisfied with. As we have heard, good dentists who are committed to the NHS find that they cannot afford to stay, so they leave and it breaks their heart. That leaves thousands of our constituents without access to adequate, affordable dental care, which leads to more expensive, painful and damaging emergency hospital dental care further down the line.

There are many things that we can do as local MPs. I have written to my local surgeries to encourage them to take advantage of things that the integrated care system has offered to bring some back to the NHS, but unless there is radical reform of the system, good dentists will leave the NHS and thousands on thousands of our constituents will not be able to access the dental care that they have already paid for through their taxes for themselves and their children.

Oral Answers

Tim Farron Excerpts

Tuesday 25th April 2023 Commons Chamber

[Helen Whately]

My hon. Friend makes a really important point about the very important work that hospices do in our communities, and I fully support hospices as a sector. The funding for hospices generally comes through the NHS and the local integrated care boards that commission the services they provide, as well as, of course, from their own fundraising efforts. I am speaking to NHS England about the support it provides to hospices, because I am very keen to make sure that they get the support that they need.

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

T8. I have in my hands the draft business case for a satellite radiotherapy unit at the Westmorland General Hospital in Kendal. If it is approved and commissioned, residents in my community who have cancer will no longer have to travel two, three or four-hour round trips every day to get lifesaving treatment; they will be able to get it closer to home. Will Ministers meet me and the clinical specialists who helped draft the business case, so that we can make it come to fruition?

[Helen Whately]

Yes, I am very happy to meet the hon. Member.

Cancer Care

Tim Farron Excerpts

Tuesday 14th March 2023 Westminster Hall

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

It is an honour to serve under your guidance today, Mr Paisley, and to follow the hon. Member for Bootle (Peter Dowd), who made some important points, for which I thank him. I express massive congratulations to the hon. Member for West Bromwich East (Nicola Richards) not just on securing an important debate, but on making an excellent speech. I commiserate, console and offer my condolences to her on the loss of her mother. I also lost my mum to cancer. The hon. Lady is a bit younger than I am, so I assume we lost our mums at about the same age.

My mum, Dr Susan Farron—she would like me to mention her title, I am sure—passed away from ovarian cancer 19 years ago. Although we are here to represent our constituents and do what is right, whether we are personally affected or not, there is an element of honouring our mothers in what we seek to do today. I am sure the hon. Lady’s mother would be massively proud of her, not just for what she has done today.

This is a huge issue. It is said that half of us will get cancer at some point in our lives, and 100% will be affected by it in one way or another. We deal at the moment with terrifying waiting times for cancer treatment. They are not quite as awful as they were a month or so ago. The Minister may say that, and we will grab some positives where they exist, but they are still deeply troubling.

In my constituency, in south Cumbria, 27% of people with cancer are not being seen within two months of being diagnosed. Someone who has cancer and has been told they have this dangerous thing within them that is potentially going to kill them then waits for two months for treatment. In north Cumbria, 44% of people diagnosed with cancer are waiting more than two months for their first intervention. What terror does that spark in an individual with cancer and all their loved ones? What frustration does that lead to within the clinical community, who desperately want to care for those people? To add substance to that terror, we know that on average—although there is no average cancer—for every four weeks that treatment is delayed, there is a 10% reduction in life expectancy. That is disastrous and massively worrying for everybody who faces that challenge.

Covid has played a part, with its massive impact on our health service. People perhaps did not come forward with symptoms during the pandemic as soon as they might have done. I have many disagreements with the Government about how they handled the pandemic, but it is important to say that, if they had not locked down, the situation would have been far, far worse. Let us remember that many of the pressures that we face are because we sought to protect the NHS to save lives, and we did just that. However, the waiting times are unacceptable. They are explicable but not excusable.

I want to focus my remarks on radiotherapy. I chair the all-party parliamentary group on radiotherapy. One reason for doing that is that I recognise that radiotherapy is one of an important range of tools that can be used to treat, and often cure, that terrible disease of cancer. Across the world, in countries with similar levels of GDP to ours, such as other European countries, Australia and New Zealand, there is an average international target that 53% of patients living with cancer should receive radiotherapy. In the UK, the proportion is 27%. One reason is the lack of investment from Governments of all colours represented in this room. I will point the finger at this Government for not taking the action they need to now, but I could point the finger inwards at the coalition Government and the Labour Government. We have collectively neglected this situation, I am afraid.

Only 27% of people with cancer who should or could receive radiotherapy are getting it. For a clue as to why that is the case, let us look at Australia, where the five-year survival rates for lung cancer are a third better than those in the UK. Australia spends around 10% or 11% of its cancer budget on radiotherapy; in the UK, we spend just 5%.

[Peter Dowd]

I am pleased that the hon. Gentleman raised that. Radiotherapy UK provided some figures indicating that

“by the end of 2024 there will be 74 out of date machines in the NHS,”

and that

“by 2025 it will be 90.”

Does he agree that that is a pretty grim statistic?

[Tim Farron]

It is, and in a moment, I will come on to how we might tackle that. It is a real problem, and not all of it is down to money—some of it is down to where and how the money is spent.

The all-party parliamentary group on radiotherapy has been working with the charity Radiotherapy UK, which the hon. Gentleman rightly referred to. We have been delighted with the coverage that we have received recently through the Daily Express, which has run a campaign alongside us calling for a £1 billion boost in radiotherapy. The Minister can read all about it not just in the Express, but in the manifesto put together by the all-party group, which details that.

To put it bluntly, in the run-up to the Budget this week, we know that the Chancellor has something like £30 billion more to spend than he thought because of underspend on energy support and an increase in tax revenues, not least because of people spending more money on goods due to inflation, and therefore spending more VAT. The Government therefore have that windfall to play with. I am asking for one thirtieth of that to be spent on radiotherapy, so that we can save thousands and thousands of lives.

What would we spend that money on? We would spend it on new kit. Not all of that would need to be new money; it could just be money that is spent more wisely. As the hon. Member for Bootle alluded to, part of the problem is that we have ancient kit. He mentioned the 74 machines—linear accelerators—that will be out of date by the end of next year. Why do we have so many out-of-date linear accelerators and other bits of radiotherapy kit? It is largely because the funding for those machines is feast and famine, and because it is devolved to 42 different specialist commissioners, when we actually need a central, national, well-funded rolling programme to replace and update linear accelerators. It is not rocket science—though it is science—and the Government could do that without spending an absolute fortune.

I want to ask the Minister again about the issue regarding tariffs. Many of our cancer centres are using second-division kit, to put it crudely. The tariff for using a second-division piece of kit means that centres can be paid for the 30 fractions a person might need to deal with their cancer, whereas with a first-division piece of kit, it might take only four, five or six trips to treat someone. Centres are paid per fraction, so there are perverse incentives whereby trusts are more likely to be rewarded if they use poorer kit more often than better kit less often. That has been fixed in part, but not for every cancer, not for every machine and not for every unit. That needs to be dealt with, and again, it could be done freely.

We talked about the workforce. The radiotherapy workforce is really small—about 6,400 individuals. There are 30% fewer entrants coming into the sector than there are places available, which has an impact on the morale of the people already working there. We are losing people as a consequence. Retention is becoming a problem because recruitment is such a problem. People feel under such weight. With such a small workforce, it would not involve an awful lot of effort to significantly increase that. We need to invest in training to bring clinical oncologists and clinical radiologists into the profession, and also to alleviate the pressure that staff are under now by supporting new admin staff up-front, which could be done very quickly, to allow people currently in the profession to be able to concentrate more on their frontline duties, rather than on admin.

I will make a final remark regarding radiotherapy, which is about access. Among the reasons why only 27% of people with cancer are getting radiotherapy in England—as opposed to the 53% who really should—is that many people, particularly in my community, are just too far away from the treatment. In our communities, the majority of patients using our nearest radiotherapy centre are making two or three-hour round trips every single day. The national radiotherapy advisory group says that it is bad practice for people to have to travel more than 45 minutes for treatment—never mind three-hour round trips every day for 30 days. As a consequence, some people do not get referred for treatment at all, or may even make the choice themselves not to finish that treatment. There is no doubt that that is having an impact on survival rates.

We have built a strong case, in our community, for a radiotherapy satellite unit from the Rosemere unit in Preston—our nearest unit—to be deployed at the Westmorland General Hospital in Kendal. A solid clinical and business case was put for that, and I would be grateful if the Minister might agree to meet with me, even for just 15 minutes, to review that and consider the extent to which the Department might be able get behind it and other satellite units around the country that could cut waiting times and save lives.

There are no silver bullets to many problems that we face in this place, but this is quite close to being one. For a relatively small amount of money, the UK Government could do something that would save lives, and do so quickly. I encourage them to do so.

--- Later in debate ---

[Helen Whately]

I will come on to talk about radiotherapy, but I can say to the hon. Gentleman here and now that I will indeed look into what has happened to the response to that letter.

However, I will start by talking about the waiting times, recovery from the pandemic and reduction of the pandemic backlog. Our elective recovery plan included the ambitious target to return the number of people waiting for more than 62 days for an urgent cancer referral back to pre-pandemic levels by this month. Since the publication of that recovery plan, the NHS has seen enormously high demand for cancer checks. More than 2.8 million people were seen in the 12 months to January 2023—up by 19% compared with the same period before the pandemic. The return in demand, with people coming forward for cancer checks, is very positive after the falls we saw in the pandemic.

When giving evidence to the Health and Social Care Committee last week, Dame Cally Palmer, NHS England’s national cancer director, said that

“we are not going to meet the pre-pandemic target by the end of March, simply because of those record levels of demand.”

That is already in the public domain. However, I assure hon. Members that we are working closely with NHS England to reduce the time people are waiting to receive a diagnosis, or an all-clear, and to start treatment, and we are making progress on that. The latest published figures show that the 62-day cancer backlog for the week ending 26 February stood at just over 22,000, which is a fall of 35% since its peak in the pandemic. However, that is 22,000 people too many who have had to wait 62 days, and many of them will have had to deal with the anxiety of waiting for a diagnosis or an all-clear, which is why we are working so hard on this issue with NHS England.

As I said, it is good that more people have come forward for cancer checks but, in response, we must increase our capacity to diagnose and treat cancer. That is one reason why we have been investing in community diagnostic centres, and we have more than 93 centres open and operational. That is why the NHS is rolling out what we call fit tests to speed up diagnosis for people who may have, for instance, bowel cancer. That is why the NHS is rolling out teledermatology to speed up diagnosis for people who may have skin cancer, and speeding up access to MRI scans for people who might have prostate cancer. Those are the three types of cancer with the most people waiting for a diagnosis or an all-clear or, if they have a diagnosis, to start treatment, and I am determined to reduce those waits.

When I meet charities and clinicians, the one message I consistently hear is how important early diagnosis is for improving patient outcomes and care, and that was something my hon. Friend the Member for West Bromwich East referred to. She talked about the ambition in our long-term plan to be diagnosing 75% of cancers at stages 1 or 2 by 2028. As part of achieving that, we are extending targeted lung health checks, with more than double the number of community lung truck sites. The targeted lung health checks programme had diagnosed 1,625 lung cancers by the end of December 2022, with 76% of those diagnosed at an earlier stage.

To help people get a cancer diagnosis or an all-clear more quickly, since November GPs have been able to directly order diagnostic tests such as CT scans, ultrasounds or brain MRIs for patients with concerning symptoms who fall outside the National Institute for Health and Care Excellence’s guideline threshold for urgent referral. Alongside that, community pharmacists in pilot areas are helping to spot signs of cancer in people who might not have noticed symptoms or realised their significance, and we continue to see non-specific symptom pathways rolled out. As of December 2022, more than 100 are live across the 21 cancer alliances.

To encourage people to contact their GP if they notice, or are worried about, symptoms that could be cancer, NHS England has run the “Help Us, Help You” campaign, which seeks to address the barriers deterring patients from accessing the NHS if they are concerned they might have cancer. In March and June 2022, we saw a 1,600% increase in the number of visits to the NHS website’s cancer symptoms landing page, so the campaign had a huge impact on the number of people looking to see whether they might have cancer symptoms. NHS England is in the process of planning “Help Us, Help You” activity for 2023-24, to make sure we continue the momentum and continue to encourage people to come forward if they have worrying symptoms of something that might be cancer.

However, we all know that diagnosis is just the first step on a patient’s journey, so we are also taking steps to improve cancer outcomes by rolling out innovative new treatments, such as the potentially life-saving drug pembrolizumab for one of the most aggressive forms of breast cancer, and mobocertinib to treat a specific form of lung cancer. The National Institute for Health and Care Excellence has made positive recommendations in all 18 of its appraisals of breast cancer medicines since March 2018, and those medicines are now available to NHS patients. NICE is also able to make recommendations to the cancer drugs fund, which has benefited more than 88,000 patients, with 102 medicines receiving funding for treating 241 different cancers.

My hon. Friend the Member for West Bromwich East mentioned radiotherapy equipment, as did the hon. Members for Westmorland and Lonsdale and for Bootle (Peter Dowd). Since 2016, more than £160 million has been invested in radiotherapy equipment so that every radiotherapy provider has access to modern, cutting-edge radiotherapy equipment. That investment enabled the replacement or upgrade of around 100 radiotherapy treatment machines and in some cases the roll-out of new techniques, such as stereotactic ablative radiotherapy. On top of that, £260 million has been invested in establishing two services to deliver proton beam therapy in London and Manchester.

On the workforce, from 2016 to 2021, the number of therapeutic radiotherapy staff grew by more than 17%, and the number of clinical oncologists by more than 24%. From 2021, there has also been an uplift in the number of entry-level places available, with 108 in clinical oncology, up from an average of around 60 per year in previous years.

I want to pick up on the claim that only 27% of cancer patients are treated with radiotherapy. That claim is outdated and incorrect, as it includes radiotherapy only as part of a patient’s primary treatment for cancer and does not capture a substantial proportion of patients who receive radiotherapy as a subsequent treatment. Also, I am told that the data is from 2013-14, so that is also out of date. NHS England has assured me—I have looked into this—that those who need radiotherapy treatment can access it.

[Tim Farron]

Will the hon. Lady give way?

[Helen Whately]

If the hon. Gentleman will allow me, I want to move on to the major conditions strategy, which my hon. Friend the Member for West Bromwich East mentioned as well. I want to talk about going beyond the immediate action we are taking here and now to improve people’s access to cancer diagnosis and treatment and about what we are doing looking further ahead.

In January, we announced that we will publish a major conditions strategy, which will tackle the conditions that contribute most to morbidity and mortality across the population in England, one of which is cancer. Many people now experience major conditions as part of a wider set of illnesses or needs, known as multi-morbidity. A 2020 academic study of cancer patients in England found that most had at least one co-morbidity and nearly one in two had multiple co-morbidities, so many people with cancer also have another long-term condition. We want to support individuals by diagnosing them earlier, helping conditions to be better managed and improving the overall co-ordination of treatment and care for those who have cancer and other major conditions.

The strategy will draw on the previous work on cancer, and hon. Members mentioned the long-term plan on that. It includes more than 5,000 submissions that were provided as part of our call for evidence last year. I can assure hon. Members that we will continue to work closely with stakeholders, the public and the NHS, including those involved in cancer care, in the coming weeks and months as we work up the details of that strategy. We will look at the health of people at all stages of life and, in reference to the point my hon. Friend the Member for West Bromwich East made on health disparities, focus on the geographical differences in health that contribute to variations in health outcomes.

[Tim Farron]

Will the hon. Lady give way?

[Helen Whately]

I just want to spend a little time on research, and I am conscious of the clock ticking.

[Tim Farron]

She mentioned a couple of points about the figures.

[Helen Whately]

If the hon. Gentleman will allow me to proceed, I want to talk briefly about the third priority—research—which is so important to improving cancer outcomes.

The Department of Health and Social Care invests £1 billion a year in health and care research through the National Institute for Health and Care Research. The NIHR spent almost £100 million on cancer research in 2021-22. I should also say that, among other charities, Cancer Research UK makes a huge contribution to funding research. Thanks to the generosity of the British public, it spent £388 million in 2021 on research activity.

There is a huge amount of research for us to be excited about. For example, the NHS-Galleri trial looks for markers in blood to identify signs of more than 50 cancers, and a vaccine taskforce-style approach is being taken to invest over £22 million in cancer research as part of the life sciences cancer mission. A memorandum of understanding that the Secretary of State for Health and Social Care signed with BioNTech SE will aim to deliver 10,000 doses of personalised therapies to UK patients by 2030.

As another example, just last week I visited Imperial College London. I saw some truly exciting research that could help us to diagnose pancreatic cancer and other upper gastrointestinal cancers early through a relatively simple breath test. It is in its early stages, but it could make a huge difference for cancers such as pancreatic cancer, which can be so hard to diagnose early.

Before I close, I will mention the hospital that my hon. Friend the Member for West Bromwich East talked about. The exciting rebuild of the Midland Metropolitan University Hospital, as part of our new hospital programme, will bring together urgent care centres from three hospitals across the region into one state-of-the-art site, providing services to 500,000 people. As my hon. Friend said, construction has already commenced, and the hospital should be completed and open for patients in 2024.

The hospital will introduce a new model of care, which means that out-patient clinics, day case surgery and routine diagnostics will be provided from the Sandwell and City Hospital sites, while maternity services, emergency care, general surgery and medical wards will all be based at the Midland Metropolitan University Hospital. The new hospital will be a centre of excellence for clinical care and research. The new therapeutic model of care will encourage patients to maintain mobility and independence during a hospital stay. I spend a lot of time looking at the downside of people having long stays in hospital. Maintaining independence and mobility is an important thing for us to try to achieve. I share my hon. Friend’s excitement about the forthcoming opening of the new hospital.

To conclude, I once again thank my hon. Friend for raising this issue. Improving cancer care is a priority for the Government, and I assure her and other hon. Members that we will continue to work hard to beat this terrible disease.

NHS Workforce Expansion

Tim Farron Excerpts

Tuesday 28th February 2023 Commons Chamber

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. Unless the NHS has the staff it needs, patients will not get the timely care they deserve. It really is as simple as that. We have a plan; the Government do not, and they are very welcome to take ours.

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

The shadow Secretary of State is making a very good speech. On the issue of cancer, around half of cancer patients need radiotherapy, but barely a quarter get it. One reason is that the workforce in radiotherapy is small— 6,400 people. At the moment, the number of posts vacant in radiotherapy centres is 30% higher than the number of new graduates leaving college and coming into the professions that make up that workforce. We also found in the Radiotherapy UK survey that 80% of the workforce in radiotherapy centres reported that either they or a colleague had considered leaving. Does he think that the cancer workforce is essential to a cancer plan that will actually save lives?

[Wes Streeting]

The hon. Gentleman is absolutely right, and I have been following his work and that of the all-party parliamentary group on radiotherapy in this area, because he raises issues that ought to be taken very seriously. I was very grateful to my hon. Friend the Member for Easington (Grahame Morris) for coming to meet me about these challenges in particular. Of course, this has to be at the heart of a serious plan to improve cancer outcomes.

There is no doubt but that Labour’s workforce plan—supported by the NHS, supported by the professions, supported by so many members of the public—would make a difference. In fact, our inboxes have been filling with people welcoming the plan. It was a particular surprise to me to see one piece of fan mail that said:

“Despite my obvious political allegiances it would be remiss of me not mention the fact that Labour has pledged to double the number of medical school places and recruit additional health visitors and district nurses.”

It goes on to say that it

“is something I very much hope the government also adopts on the basis that smart governments always nick the best ideas of their opponents.”

Well, what luck that this particular fan of Labour’s policy joined the Government just two weeks after he sent the email. It is, of course, the Chancellor of the Exchequer, who I must say I thought was an excellent Chair of the Health Committee. It is almost as if he had learned from all his mistakes when he was the Secretary of State for Health.

This is Lent, a period for atonement and a time for forgiveness, so I make this pledge today: if the Chancellor realises the errors of his ways and comes to this House to double the number of medical school places in the Budget and adopt Labour’s NHS expansion to deliver the biggest expansion of the NHS workforce in history, I will cheer him on from the Opposition Front Bench during the Budget. I will cheer him on—

Urgent and Emergency Care Recovery Plan

Tim Farron Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

My right hon. and learned Friend has been key to securing the funding. He has assiduously lobbied me and ministerial colleagues to make a powerful case on behalf of his constituents, and I think he should be proud of the outcome, which reflects his and his parliamentary colleagues’ work on this issue. He is right; indeed, the case he made was around how this frees up capacity in the system, which will result in much better care for patients in Swindon.

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

There is nothing in this plan to address the fact that thousands of people are now turning up at A&E as a direct result of being unable to get regular access to an NHS dentist. Last week, another Cumbrian dental practice, in Grange-over-Sands, wrote to all of its 5,800 patients, as it had been forced to quit the NHS too. There is now not a single NHS dental place available anywhere in Cumbria. What will the Secretary of State do to fix an NHS dentistry crisis that leaves a family of four having to cough up an extra £1,000 a year during a cost of living crisis to get access to dental care that they have already paid for through their taxes?

[Steve Barclay]

I have addressed that point, in that we are bringing forward the third component of our three plans. I spoke earlier about the elective recovery plan; today’s announcement is on the urgent and emergency care recovery plan; and the third element will be the primary care recovery plan. Of course, alongside the work we are doing on dentistry it is also about access to services, both dentistry and A&E. That comes together in things such as the 111 service and how we review that, as well as the NHS app. It is about looking at how we better manage demand at the front door, and the demand for dentistry is not only through NHS dentistry but often manifests itself through a lot of patients coming forward for dentistry at A&E.

Sudden Unexplained Death in Childhood

Tim Farron Excerpts

Tuesday 17th January 2023 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Twigg, and a pleasure to follow the right hon. Member for Spelthorne (Kwasi Kwarteng), who made a very moving and thoughtful speech. I especially congratulate him on securing this really important debate.

SUDC is an unimaginable tragedy to strike any family. We are here because people in our communities have reached out to us to share their experiences with us. I know we all feel that it is a huge responsibility and an honour to share their experiences.

I spoke last night and previously to my constituent Charlotte and her husband Andy regarding their little son Wilfred, who was two years and 10 months old when he died a little over a year ago. Charlotte and Andy refer to Wilfred as a

“vibrant, energetic little boy who had a vivacious and fearless lust for life.”

She goes on to say:

“The shock that reverberates into every aspect of your life when your child dies unexpectedly and suddenly is unimaginable”.

Unimaginable it is to those of us who have not personally experienced that tragedy. As I seek to honour Wilfred, perhaps the best thing that I can do is speak briefly about actions that could spare other families from experiencing the grief and tragedy with which Wilfred’s family continue to live.

The challenges are what to do with the evidence and what to do about the lack of evidence. Those are the two things that it would be good to consider. Let me first turn to what to do about the evidence. Wilfred passed away at two years and 10 months. At 10 months old, he suffered his first febrile seizure. He was never referred for further investigations to ascertain the cause or to ascertain whether a febrile seizure could lead to anything more dangerous. Wilfred had his sixth febrile seizure, which led to a cardiac arrest, and he passed away just a few days later.

Research by the US branch of the charity Sudden Unexplained Deaths in Childhood shows that roughly a third of sudden unexplained child deaths happen to children with a history of febrile seizures. So they are not totally unexplained, are they? At least some of them are not. However, febrile seizures are mostly not treated as serious or potentially serious. Most NHS trusts do not have a pathway to deal with children who have suffered a febrile seizure, and that surely must be addressed urgently. Febrile seizures must be seen as a red flag that all NHS providers should be aware of, and they should be equipped to act accordingly.

I want also to refer to something that tends to affect not very young children, but young people who are still minors: deaths caused by undiagnosed heart conditions. In particular, I want to refer to the work of CRY—Cardiac Risk in the Young—which does tremendous work in screening young people, particularly those who have any kind of family history but even those who do not, to see whether there is a potential risk. Thousands of people have been assessed by Cardiac Risk in the Young, which is a wonderful charity that works across the north-west and further—indeed, it has done sessions in Kendal. I encourage the Minister to look into how we can screen young people, particularly if there is any family history, to ensure that we do not lose them to undiagnosed heart conditions.

That is what to do with the evidence. What do we do about the lack of evidence? Simply, for the children we lose to sudden unexplained death, it is indeed totally unexplained: there are no clues. We ask collectively today that the Government prioritise scientific research into sudden unexplained deaths among children, potential causes and modifiable risk factors. We also ask that the Government and the NHS prioritise medical education to increase awareness.

[Andy Slaughter (Hammersmith) (Lab)]

I agree with what the hon. Gentleman said. I am here because a constituent told me about the tragic death of her two-year-old nephew in 2021. I am educating myself, with the help of SUDC UK, but it is difficult because there is so little debate, publicity and awareness. I hope that this well-attended debate will mean that research and education is forthcoming. It is a very rare but absolutely devastating condition.

[Tim Farron]

I agree with the hon. Gentleman.

In memory of Wilfred, in honouring his family, and as we remember all those who have tragically died and we seek to support their loved ones, we ask that the Government take practical steps to help us to tackle the horror of sudden unexplained deaths among children.

I spoke to another family—I will not name them—who talked about the loss of their child not so long ago. The mother said to me:

“It clouds everything you do, feel and breathe. I hate that it happened to him and not me. I will never not be able to see him in A&E, thinking this can’t be happening, he is healthy, and I left him a couple of hours ago absolutely fine.”

There is a reason why it is such an uncomfortable issue, but it is important to grasp uncomfortable issues, not only in honour of the memory of Wilfred and everybody else who has passed away and to honour their families, but to prevent any other families from going through the same thing in future.