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House of Commons Hansard
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World Cancer Day
30 January 2019
Volume 653

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We now come to the next debate, which can continue with the benefit of unused time until 13 minutes past six.

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I beg to move,

That this House has considered World Cancer Day.

It is a pleasure to serve under your chairmanship, Sir Christopher. I am grateful to right hon. and hon. Members for being here to debate an important issue that sadly affects too many of our constituents.

This debate comes ahead of what will be the 20th World Cancer Day, which will take place on Monday 4 February. I am delighted that following a suggestion from Elaine Monro, who is a constituent of mine and a Cancer Research UK volunteer, the Palace of Westminster will mark World Cancer Day by lighting up in pink. As far as I am aware, this will be the first time that Westminster will be illuminated for World Cancer Day, so I would like to place on the record my thanks to the Speaker and the Lord Speaker for agreeing to that request.

World Cancer Day is an initiative led by the Union for International Cancer Control. Each year, the global cancer community is united in seeking to raise awareness about cancer prevention and treatment, and about the importance of Governments’ working together, tackling cancer globally. Last year’s World Cancer Day involved more than 1,000 activities in 139 countries, culminating in half a million social media mentions and over 14,000 press articles and broadcasts in 145 countries worldwide.

Cancer is a global problem. Last year, more than 18 million people worldwide were diagnosed with cancer, but the story of those patients varies hugely depending on where they were born; many countries have no access to basic treatments, such as radiotherapy. This is all about working together—a global push to tackle a global issue. As Cancer Research UK has put it:

“No single person, organisation, or country is going to beat cancer on its own. We must all work together.”

In the UK, a number of charities mark World Cancer Day through campaigns or fundraising activities. Cancer Research UK and CLIC Sargent both sell wristbands, which I am pleased that I and colleagues are wearing today, to raise funds and awareness about the day. Children with Cancer UK and the Institute of Cancer Research are also running campaigns to coincide with World Cancer Day and in previous years many other charities, including Macmillan Cancer Support, Marie Curie, Breast Cancer Now and Anthony Nolan, have also marked the day. Events are taking place across the United Kingdom, from the Scottish cancer prevention conference in Edinburgh to Cancer Research UK’s winter run in London.

I pay tribute to each and every one of those charities, their staff and volunteers; they do incredible work. They are truly a credit to our country and contribute significantly to the global effort to tackle cancer, doing hugely valuable work with global partners. Cancer Research UK is the largest independent funder of cancer research in the world and it has played a role in developing eight of the world’s top 10 cancer drugs. Can the Minister touch upon how the Government support this work and how they help the UK to continue to contribute to the global effort to tackle cancer? I know that some charities have concerns about the impact that Brexit may have on the UK’s continued contribution to this work.

There is some great work being carried out in my constituency; I shall mention a few examples. The Cancer Research UK team from Selkirk, led by Elaine Monro, has developed an official tartan scarf, which is produced in the Borders by Lochcarron and continues to sell like hot cakes, not only in Selkirk and Scotland, but throughout the United Kingdom. The Marie Curie team in the Borders, who now help patients with terminal illnesses generally, not just cancer, do some incredible work caring for people in their final days. I must not fail to mention that I will be running the London marathon in a few weeks to help raise funds to support my local Marie Curie nursing team. I hope that by raising £5,000 I shall be able to support their work in caring for people with terminal illness in my constituency.

In partnership with Macmillan, NHS Borders runs a dedicated, world-leading cancer centre at the Borders General Hospital, which pulls together specialist staff and treatments all in one location. NHS Borders is very good at meeting its cancer treatment waiting times, as well as targets for cancer screening, not least because of that Macmillan centre.

Although World Cancer Day is focused on tackling cancer globally, we are understandably focused on the UK’s record. Like most other developed nations, the UK has higher rates of cancer, but we also have quite high mortality rates—just above the average, according to the 2018 Global Cancer Observatory figures, and higher than many other developed nations. Given that the UK leads the way in vast amounts of cancer research, and that we have some of the world’s best cancer professionals and a universal health service, our mortality rates are simply too high.

Cancer continues to affect far too many people in the UK. More than 360,000 Brits are diagnosed with cancer each year, and that is expected to rise to the equivalent of one new case every minute by 2035. Every day, 12 children and young people are diagnosed with cancer, which remains the biggest killer of children by disease in the United Kingdom.

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I am grateful to my hon. Friend for his excellent speech and for securing this debate. When he mentions children’s cancer, he will be aware of a case that I have raised in Parliament and a guest that I had at Downing Street last week. Abbie Main, who sadly died on Christmas day two years ago, died of a very rare disease—sarcoma. Her legacy, through a difficult period, was to set up a charity. While great work is done by charities to raise funds for research into cancer, great work is also done by local charities such as Abbie’s Sparkle Foundation, raising money for people who have to live with cancer, to give them better facilities and better care in hospital.

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My hon. Friend makes an excellent point; I was delighted to meet Abbie’s brother at the Downing Street Burns supper last week. He has done an incredible amount of work to raise funds for Abbie’s Sparkle Foundation in memory of his sister. He is one of many examples, not only in Moray but in all our constituencies throughout the United Kingdom, of fundraising groups that are raising the profile of cancer and also raising much-needed funds to tackle it.

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I congratulate my hon. Friend on bringing this important debate to the House. Does he welcome the initiative in my constituency, run by the Maggie’s Centre in Dundee, which helps and supports many people who are suffering? We had a penguin parade in which 80 penguins were decorated across Tayside, and children through their summer holidays had to go on a penguin search. In the end, we raised £540,000 for the local Maggie’s Centre. It just shows that there are initiatives all across Scotland and the United Kingdom that are beneficial in raising as much money as possible.

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I am grateful to my hon. Friend for raising that example, which demonstrates that it is not just in large cities, but smaller communities, whether they be in Angus and Dundee, in Moray or across our county, that people are coming together to produce such great work to tackle this dreadful disease.

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My hon. Friend is making an excellent speech. One issue that is not often raised is that of people with cancer who have disabilities. Wendy Douglas, a constituent of mine, died of breast cancer aged just 36. She had very severe autism, and her cancer was caught too late because she was not able to communicate any symptoms or pain verbally to her family or doctors. Will my hon. Friend join me in paying tribute to Wendy’s mother Eileen, who raises money for all kinds of cancer charities, and particularly for her work trying to raise awareness of cancer in those who cannot communicate it?

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Again, I am grateful to my hon. Friend for raising a powerful case and example. I suppose the question is what would happen were it not for all these volunteers, raising huge amounts of money and raising awareness of cancer, and filling a gap that otherwise the NHS and the state would have to provide for. That is something we should not forget.

That is not to say that we have not made huge progress in tackling cancer. While diagnosis rates have risen significantly in the past decade, the number of people dying from cancer in this country is falling.

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I congratulate the hon. Gentleman on securing this important debate. On the question of diagnosis, I congratulate Leeds Teaching Hospitals and the University of Leeds; their pathology department is the first in the world, I believe, to move away from glass slides to fully digitised diagnosis, and is now working with artificial intelligence, which will improve diagnosis rates and move us forward, so that many more people can get early treatment.

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The hon. Gentleman makes an excellent point, and raises a very good example. My brother’s father-in-law sadly died a couple of weeks ago. His treatment was provided by Leeds hospital, so I know the tremendous amount of resource and expertise they have in that particular hospital.

For breast cancer in Scotland, the mortality rate was 53 per 100,000 women in 1992. That has fallen to 32 per 100,000, despite the incidence of breast cancer increasing. In short, we are much better than we used to be at both identifying and treating cancer. That is because the UK has taken the steps that World Cancer Day promotes—in particular, tackling tobacco use and obesity levels and rolling out national cancer strategies.

Big issues clearly remain; pretty much all the cancer charities I have spoken to ahead of today’s debate agree with that. We need to get better at early diagnosis, because we know how much of a difference it can make. For example, if bowel cancer is diagnosed early, nine in 10 people will survive, but with a late diagnosis, the survival rate is only one in 10.

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Does the hon. Gentleman agree that research shows that the awareness around breast cancer means that women come forward quickly, but with bowel cancer people do not? Research done in the west of Scotland showed that the biggest delay was in going to the GP. We need to get people to talk about it, be open about it and go and get help.

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I could not agree more. There is an awareness issue. Often, when people develop some symptoms that they are unsure of, they are nervous about going to the doctor. People need to be encouraged to step forward and go to their GP, to ensure that if there is an opportunity to get an early diagnosis, that is achieved, because the results are clearly much more positive if that is the case.

That is why we have early diagnosis targets across the UK, and why it is so serious that in Scotland, more than 20% of patients are waiting for longer than the six-week standard for diagnostic tests. Too many people are waiting too long for treatment. NHS boards north of the border are meant to take no more than two months to start treatment, but that target is being missed for every type of cancer. In some health boards, one in five patients did not meet that target. I am sure we have all received emails from patients who are faced with an agonising wait for treatment, knowing that they have cancer. While the missed targets are by no means unique to Scotland, I hope that we can all come together here—Scottish National party colleagues included—to call on the Scottish Government to make clear that that needs to get better.

I should also be interested to hear the Minister’s views on whether any consideration has been given to reviewing treatment target times with a view to introducing faster treatment targets for certain types of cancer. It strikes me as odd that across the UK our targets are the same for all cancers, regardless of type.

One significant reason for the time taken to diagnose and treat is problems to do with workforce. Demand for tests is only going to increase, due to a growing and ageing population, but we already do not have enough staff in a range of areas.

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Does the hon. Gentleman agree with me on the impact of no longer having nursing bursaries? When I was a nurse, I had a nursing bursary. I could not have trained without that. We really must bring back the bursary. It is all right saying, “We have all these vacancies and we are going to have all these nurses,” but if people do not train, we will not have the people to fill those vacancies.

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I am grateful to the hon. Lady for making that point. There is a range of options that we need to consider. I recently met my local NHS health board, and I meet a number of my GPs frequently. There are vacancies in all different parts of the health service, and we need to consider how we get more people in to do the jobs that we need. There is a particular challenge in my constituency—many rural communities do not have enough GPs or get enough nurses. Bursaries may be part of that. There are a range of things that we need to do, and that the Scottish Government and the UK Government can do, to address those issues.

For example, there is a 10% vacancy rate for radiology consultants across Scotland. One in five of the current workforce are expected to retire over the next five years. So, yes, there are challenges just now, but there are future challenges coming down the line.

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I congratulate the hon. Gentleman on securing the debate. He talks about access to existing treatments, but does he agree that more work has to be done on conditions for which treatment is not yet available? The late Tessa Jowell worked very hard on this issue, right up to the end of her life, trying to improve access to new treatments and to improve care for people with conditions for which there is perhaps no treatment out there. Does he agree that we should pay tribute to Tessa Jowell and continue that work?

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I absolutely agree. We need to do much more to promote awareness of those conditions. I will come on later to the availability of drugs.

The Scottish Government recognise that the high number of vacancies is a problem, but missed their target for increasing the number of nurse endoscopists by 40%. In England, nurse vacancies are similarly too high. The availability of drugs is also an issue that concerns charities and patients alike. The most high-profile example is the breast cancer drug Perjeta, which was rejected for use three times in Scotland but was finally approved just a few weeks ago. Quicker and more cost-effective access to the latest and best treatments must be a priority in future.

I know that colleagues will want to press the Minister on what the UK Government are doing to tackle cancer in England, but all these issues need to be addressed across all parts of our United Kingdom. As a Scottish MP, I am conscious that the Minister is not directly responsible for the cancer waiting times and treatments for my constituents. However, UK-wide approaches should be taken to help us tackle cancer head on, together.

World Cancer Day is all about recognising that cancer knows no boundaries, and that individual Governments cannot address these challenges in isolation. That begs the question: are the UK Government and devolved Governments working as well together on this issue as they should be? For example, should we buy some drugs and equipment on a UK-wide basis? Current practice is that four separate bodies approve new drugs across the UK. While that allows different parts of the UK to make their own decisions, surely a UK-wide approach would make sense in some cases. We could make ultra-orphan drugs more affordable or use economies of scale to deliver common drugs at lower cost.

I am therefore interested in the Minister’s views on this suggestion. Have there been any discussions with the devolved Administrations about this possibility? Are health boards across the UK as good as they can be at talking to each other and sharing best practice? Representing a constituency on the border with England, I all too often see examples of that border acting as a barrier to co-operation. I certainly hope that that is not the case when it comes to cancer treatment.

I hugely welcome the extra funding coming the NHS’s way, which will of course mean an extra £2 billion a year for the Scottish Government to spend on health, if they choose. Will the Minister outline what that means for cancer treatment in England, and how much of that extra funding will be used to improve treatment and reduce cancer waiting times?

Can we do more to support families with the cost of cancer treatment? Parents spend an average £600 a month in additional expenses as a result of their child’s active cancer treatment, much of that on travel costs. Young people in my constituency often have to make a 100-mile round trip to Edinburgh for tests and treatment. Children’s cancer charity CLIC Sargent is calling for a cancer patient travel fund, as well as a review of the disability living allowance and personal independence payments, to backdate young cancer patients’ financial support to their day of diagnosis. I certainly think that these are reasonable suggestions.

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As a parent who supported a child through cancer, I know at first hand how much a child going through cancer costs and the financial strain, as well as the emotional and physical strain, on parents and families. Universal credit does not take account of the cost of cancer; both parents often have to give up work to support one child in hospital and other children at home or at school. Does the hon. Gentleman agree that that is absolutely crippling for those families?

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I am grateful to the hon. Lady for sharing her experience. This all needs to be looked at. As I said, DLA and PIP should at the very least be backdated to the date of diagnosis. Additional support, particularly for parents like those in my constituency who have to travel such long distances to access treatment, should be factored into the calculation of how much they might be entitled to. We need to ensure that the system at least recognises those extra financial pressures.

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I utterly agree with the hon. Member for High Peak (Ruth George) on financial support. Macmillan Cancer Support estimates that having cancer costs £570 a month, which is very difficult for some families. Will the hon. Gentleman suggest to the Minister that removing the expensive parking charges at hospitals in England would make a little difference? At the moment, a parent being stuck in hospital for eight hours and then paying through the nose for parking adds insult to injury.

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I am grateful for that point. I am certainly aware of constituents, including hospital staff, facing huge penalties from the health board for parking at Borders General Hospital, because of the limited parking spaces—that is a consequence of the hospital’s parking arrangements. There are lots of dynamics, but Scotland has just as many issues as England.

It is great to see so many colleagues present today. I am pleased that Parliament will mark World Cancer Day in such a public and clear way on Monday. We have made great strides in treating cancer in recent years, thanks in no small part to the work of charities, researchers and health professionals across every part of our United Kingdom. World Cancer Day is an opportunity for us all to come together to make a strong commitment to continue the fight against this dreadful disease.

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As I mentioned earlier, I have personal experience of cancer, both as a parent and a child; my mother died of breast cancer when I was five years old. From a very young age I have seen the impact of cancer on families. I have also seen treatments improve over the decades, from the time that my mother was suffering and had what appeared to me, at that young age, to be fairly rudimentary treatments, to what are now much more sophisticated treatments, which are available to children and adults in centres of excellence such as the Christie Hospital in Manchester.

The support has also evolved greatly. I pay tribute not only to the very brave people going through cancer, and their families who support them, but to amazing organisations such as Mummy’s Star, a national charity set up in my constituency to support families with children whose parent is dying or has died of cancer. It does amazing work counselling children and helping them through the process of treatment and grief, and often bereavement as well.

I also pay tribute to our hospices. Blythe House Hospice in my constituency has a brilliant “Breast Friends” group, which I have visited and spoken to. They are very brave survivors of cancer, often two or possibly even three times over. The support they get from the local hospice and community really helps them to keep going through the emotionally and physically gruelling trauma of cancer treatment.

We have very particular concerns in High Peak. At the end of last year, just after Breast Cancer Awareness Month, breast services for patients in North Derbyshire were withdrawn from our local hospital. As that is our nearest hospital, it was incredibly traumatic for patients and families, who were faced with possibly very long distances to travel for treatment. It is extremely difficult to drive and no public transport is available. That is exceedingly worrying for them, on top of the worry and trauma of their diagnosis and treatment.

Services were also withdrawn from gastroenterology patients in Macclesfield Hospital in north Derbyshire—our other nearby hospital. On both occasions, that was due to staffing shortages; there are 42,000 vacancies for registered nurses. I urge the Minister to look at the amount of investment that is going in to support not just the nurses, but the radiotherapists and radiologists who are so important in cancer diagnosis and care.

Early diagnosis is important for people’s outcomes. We do not want to see any more people than have to going through treatment, and we certainly do not want them to find out about their cancer at a late stage, when it is much more difficult for them to recover and when the prognosis is much worse.

I echo the comments of the hon. Member for Central Ayrshire (Dr Whitford) about the costs of cancer. Again, universal credit is an extremely complicated system for people—not just the parents of children with cancer but cancer sufferers themselves—to go through. It took six hours at a computer for one young man, Neil, who is cited by Macmillan Cancer Support, to complete the claim form for universal credit while suffering from the treatment for a brain tumour. We are putting cancer patients through an absolutely sub-human system when they should already have as much support as possible.

I ask the Minister to speak to colleagues in the Department for Work and Pensions about the strain and lack of support available to parents of children with cancer or to cancer sufferers in claiming universal credit. At the moment, almost one in five patients with cancer struggles to pay their bills, which should not be the case for people who need to put all their efforts and energy into getting well.

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It is a pleasure to serve under your chairmanship, Sir Christopher. I thank my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for securing this important debate.

It is staggering that about 4,600 women and more than 20 men in Scotland are diagnosed with breast cancer each year. Sadly, few people, particularly males, realise that men can also be affected. My researcher was diagnosed with breast cancer nearly 16 years ago and remains eternally grateful for the care and support she received from the national health service. Her paternal grandmother and great-aunt were of a different, less fortunate generation and lost their lives to breast cancer shortly after diagnosis, although a delay in seeking assistance was undoubtedly a factor in their demise.

Regrettably, previous generations were often reticent to seek assistance, perhaps due to a lack of knowledge or embarrassment. Encouraging openness and interaction, as World Cancer Day does, and media campaigns from the national health service and various cancer charities are vital if we are to empower people through education and advocacy, including peer support, to improve their quality of life and life expectancy following a cancer diagnosis.

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I welcome the mention of embarrassment. Does the hon. Gentleman not think that we have a particular job to do with men to get beyond the embarrassment of talking about bowels, bowel motions and other bodily functions? If people cannot talk about it with their families, they will struggle to talk about it with a GP.

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I totally agree; I am of the embarrassed generation. It is challenging for males—I concede that it is men in particular—to go to the general practitioner, but we need to educate them about making that first contact and being conscious of the risk. It is particularly my generation; the generation following are a bit less self-conscious and more eager to go to the GP, where they will find that help.

As a member of the Select Committee on Science and Technology, I have become acutely aware of the importance and benefits of research. In 2014, the city of Glasgow, not far from my constituency, hosted the European breast cancer conference. Such conferences bring together experts in their respective fields to share knowledge and experience for the benefit of patients and to consider preventive measures for the future such as developments in immunotherapy that harness the body’s immune system to target cancer cells. As I understand it, such developments may be able to complement, if not replace, radiotherapy and chemotherapy, the side effects of which many breast cancer patients find more challenging than the cancer itself.

Treatment has very much improved, recognising the importance of body image in an era when the media often seek to portray the perfect person. The charity Breast Cancer Care stages regular fashion shows in which those who take to the catwalk have themselves been cancer patients. The male and female models, resplendent in their latest outfits, send a very clear message that they have beaten or are robustly fighting cancer.

Tamoxifen, a common medication for breast cancer treatment, is now just one of a range of drugs available to patients. It was heartening to learn of the Scottish Medicines Consortium’s decision to approve the life-extending drug Perjeta for routine use in treating secondary breast cancer on Scotland’s national health service. Compared with existing treatments, the drug apparently has the potential to offer valuable time to those with incurable HER2-positive secondary breast cancer.

Nowadays, cancer is treated by multi-disciplinary teams that include GPs, surgeons, oncologists, radiographers, radiologists and clinical nurse specialists. It is crucial that we have appropriate succession planning so that we can replace those vital experts as they reach retirement age or change career for whatever reason. It is quite concerning that 20% of breast radiologists in Scotland are predicted to retire before 2025, according to the charity Breast Cancer Now. We need to get the wheels in motion to replace those very important individuals.

Cancer is a challenge to our society. It changes people’s lives in different ways, and sadly some go on to develop lymphoedema. However, collectively we can meet that challenge. Some countries have a lesser incidence, so it may be prudent, as an aspect of self-help, to reflect on diet and lifestyle choices in the UK that may have a bearing on development or outcomes. The potential effects of obesity, cigarettes and alcohol need to be seriously addressed. That apart, we need to focus on the future needs of the researchers and medical professionals to protect the population who are at risk of cancer.

Finally, my constituents and I thank the national health service professionals, the volunteer drivers, the penguins of Dundee, the marathon runners from the borders and the charities. They all make the challenge of living and dealing with cancer that wee bit easier.

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It is a pleasure to serve under your chairmanship, Sir Christopher. I will keep my speech fairly brief. I speak as an ex-nurse who worked in gynaecology outpatient clinics every Tuesday morning and as a mum whose daughter died of breast cancer at just 35. She was not overweight and she did not smoke—sometimes it is just the luck of the draw, sadly.

I will make a few short points, but the most important is that although we talk about a lot of issues related to cancer, we need to consider the people—the patients with families and lives. It is not just a disease in the abstract; it affects people. That should make us determined that, austerity or no austerity, those people should get the very best treatment possible.

We must ensure that we have the best screenings processes, because everybody knows that early detection means more positive outcomes. We need to put an end to people not being called for mammograms or waiting 12 weeks for the result of a smear test, as they do where I live—surely we can do better than that. If people have a positive diagnosis, treatment must be prompt. There should be no geographical inequalities in access to care or to a clinical nurse specialist, whether for the psychological or physical manifestations of disease.

That level of treatment should be there and everybody should be able to access it, but that is just not happening. I work with a lot of cancer groups because of my experience, and it really is not equal out there. As for surgery—fancy going into hospital and having the surgery cancelled! That is what happened to a constituent of mine. It is stressful enough going in, never mind having it cancelled and then having to go back. I spoke to another constituent recently who could not access a particular drug. People just should not have those battles; the disease is enough of a battle in itself.

If a patient is lucky enough to be successfully treated, it is vital that they can access regular follow-ups as necessary. I am a patron of Westminster Health Forum and we had a day last summer when we looked at cancer treatment in the round. One of the things we talked about was having Skype sessions instead of cancer patients having to trail all the way to a hospital and sit around. Because there are not enough nurses or doctors—I speak from experience—appointments are often an hour or an hour and a half behind. People spend hours and hours sitting around when they could have had a Skype session. That is not for every patient, but some can do it. It is about looking at what is most appropriate for that patient.

We must ensure that patient experience surveys are completed so that we know what is happening to patients and can collate that and act on it. If the disease progresses, we must ensure psychological support and medical treatment are as good as they can be. There should not be variations in end of life care. There are not enough nurses in our NHS. We have nurses in hospitals at the end of life, and we have nurses in out-patient clinics. They are a vital part of the treatment. We have lots of vacancies and apprenticeships are not being taken up at the rate that was hoped for. We need nursing bursaries back. It is not just me and Labour politicians who are saying that; the Royal College of Nursing is saying that, too. We need more nurses and more radiologists, and to get that we need bursaries.

Patients should not have to struggle with the benefits system. My hon. Friend the Member for High Peak (Ruth George) talked about filling out a form. I remember the film “I, Daniel Blake” was shown recently and a very thoughtless person—a senior politician—put something on social media saying, “It is just a film, you know.” Actually, it is what people are going through. What was said was shameful, and I do not think any apology was ever forthcoming.

Recently, I had a constituent whose husband died of cancer. He should have been on a very high level of benefits at the end, but his benefits were messed up. She tried to claim them after his death because she had to borrow money to bury him. My office fought and fought for several weeks, and we got that backdated money, but if we had not done that, she would have not got it. She would still be paying money back for that funeral, and that is shameful.

As politicians, I think we have the best of intentions, and I mean everyone in every party, but it is important that those intentions and words are matched by effective actions that ensure that people get the treatment they deserve.

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First, I congratulate the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) on securing the debate and giving us all an opportunity to participate. This issue is very close to my heart. My father battled and had the victory over cancer three times during his lifetime, but watching him and my mother go through it was incredibly tough. My dad survived those three times due to the clinical and surgical skills of the doctor, the care of the nurses, who were excellent, and, as a man of faith, the prayers of God’s people. That is the experience of so many people throughout my constituency and throughout the UK.

Cancer is no man’s respecter and the reality is that in our lifetime one out of two of us in this place will have an experience of it. I was in touch with CLIC Sargent—indeed, it was in touch with all of us. It is a wonderful charity that is very active in my constituency and I am happy to support it. It gave me the following figures, which are simply heartbreaking. Some 4,450 children and young people under 25 are diagnosed with cancer every year. That is 12 children and young people every day. Those are extremely worrying figures. Around four in five children and young people survive cancer for five years or more, yet cancer remains the disease that is the biggest killer of children and young people in the UK aged from one to 24 years old.

Cancer impacts on young people and parents’ mental health. Undergoing cancer treatment is challenging, isolating and deeply personal. Young people’s ability to cope is often seriously affected by the emotional pressures and the mental health impact of a diagnosis and months of treatment. CLIC Sargent’s 2017 “Hidden costs” report found that 79% of young people felt cancer had a serious impact on their emotional wellbeing. During their cancer treatment, 70% of young people experience depression, 83% experience loneliness, 90% experience anxiety and 42% experience panic attacks. More than half of parents—63%—say they experience depression during their child’s treatment. It affects not only the child, but the family and the parents. More than a third of parents experience panic attacks and 84% experience loneliness.

I stand with CLIC Sargent, Macmillan, Marie Curie and all the other charities that are too numerous to mention, but which do great work. They are asking the Government to improve support for young cancer patients and their parents by making changes to the way benefits such as PIPs and DLA are accessed. The stories that I have heard from others in the Chamber, in my constituency and elsewhere, and in the news are disgraceful. I know that the Minister is not responsible for the DWP, but he does, I believe, have compassion and a heart, and hopefully he will pass these issues on to the Minister who is responsible. I have written to that Minister about these matters as well.

Not only do I need to see change; the system needs to see change. As treatment starts immediately and often takes place a long way from home, the costs start building up from day one. There must be a review of access to DLA and personal independence payments for young cancer patients, so that they can get their financial support backdated from the day of diagnosis. It is so important to have that financial support in place, because that worries the parents, the families, and everyone else at a time when they need that support most desperately.

Following the Prime Minister’s announcement in April 2018 of the establishment of a children’s funeral fund in England, I ask the Minister to further clarify when that fund will be introduced. Again, that is not his responsibility, but perhaps he can ask that question of the Minister who is responsible. Furthermore, will the Minister provide an update on what the Government are doing to ensure that parental bereavement leave, which would give all employed parents a right to two weeks’ leave if they lose a child, is ready to be introduced in 2020?

I will quickly mention the importance of partnerships between universities and businesses to develop cures for cancer and other diseases: Queen’s University Belfast does that extremely well, and that partnership works. I will also mention that I had the opportunity to speak with Bowel Cancer UK the other day. Every year in Northern Ireland, 1,100 people are diagnosed with bowel cancer and 400 people die. By 2035, 332,000 more lives could be lost to that disease in the UK. There are some things that Bowel Cancer UK has asked for, but I will not go into those in the time I have left.

These topics are heartbreaking, but they need to be addressed. I ask the Minister for a response, either in this place or in writing, on how changes are going to be made to support the families of children with cancer throughout the UK. How can we make these impossible, dark, soul-wrenching things a little bit better? We can make them better by using common sense, and using funding in appropriate ways to provide support as and when it is needed, lightening the load in the only way that we can. That will not take away the pain of watching a child go through this, or losing a child, but it will take away pressure that should not exist in the first place.

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Thank you for calling me to speak in this debate, Sir Christopher, and I congratulate the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) on having secured it. World Cancer Day reminds us all that although much progress has been made, there are still many challenges to be tackled in improving treatment, support and outcomes for individuals with cancer.

Today, the importance of World Cancer Day could not be greater. Macmillan Cancer Support estimates that 2.5 million people in the UK are currently living with cancer, and about another 360,000 people will be diagnosed with cancer this year, with nearly 1,000 diagnosed every day. Those people are our colleagues, neighbours, friends and family: everyone will have their own experience of a loved one who has been taken from them because of this dreadful illness. Tomorrow, I will be attending the funeral of my brother-in-law, Jimmy Boyle, who was taken from us by cancer. He was a loving husband to my sister Mary Jo and a fantastic father to my niece Lorna. Both spent the last six months caring for and looking after Jimmy, and both know that he will be in peaceful rest, free from pain, and will never stop loving them.

This Saturday, I will be attending a teenage cancer fundraiser with my other nieces, Eva and Lia, who along with their friends wanted to do something for teenagers who are living with cancer. It is my family’s experience and those of families across the country that motivate all of us in this House to campaign for better support for those living with cancer, or living with someone who has cancer. I am sure that other Members have been contacted in the days leading up to this debate, be it by those living with cancer, their loved ones, or charities fighting on their behalf. It is staggering to me that when a person is undergoing cancer treatment, as mentioned earlier, the average cost to their family is £600 a month. The idea that people undergoing treatment and their families should face such a financial burden at a time of emotional and personal distress is shocking, and we have heard from hon. Members about universal credit.

The UK, Welsh and Scottish Governments could and should do more to provide financial support for these families. Young lives Vs Cancer has proposed that a young cancer patient travel fund should be established to help families with the cost of transport to and from treatment, as other Members have already mentioned. That is a great idea that is worth exploring and indeed we should look at reducing the cost of travel for treatment.

We should also look at improving the public transport links to our hospitals. My local bus and rail services are at their worst level. That is another debate. In my own area of North Lanarkshire, Breast Cancer Now estimates that around 120 local women develop breast cancer every year and it is expected that there will be a 27% increase in breast cancer diagnoses in Scotland by 2027. Yet Breast Cancer Now suggests that 20% of Scotland’s cancer radiologists will have retired by 2025.

So I call on the Scottish Government and NHS Scotland to ensure that we recruit the next generation of radiologists, so that women can access the service they need. Whether we are considering breast cancer or other types of cancer, we must ensure that the NHS is properly funded and staffed, and capable of improving the treatment, care and positive outcomes that those who are living with cancer deserve. That matters not just in Scotland; it matters here as well, and across the whole of the UK.

I conclude by paying tribute to my local Maggie’s Centre, the Lanarkshire Beatson and of course St Andrew’s Hospice, which cared for my brother-in-law, Jimmy, for their care and support, and the services that they provide for those living with cancer, their families and their friends, and I urge everyone in this House to show their support for World Cancer Day.

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It is great to have this debate on the 20th World Cancer Day and I, too, congratulate the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont)—we need shorter constituency names—on securing it.

Obviously, it is very clear in my record and from my previous speeches that I have been a breast cancer surgeon for over 30 years. When I graduated in the 1980s, the survival rate from breast cancer at five years was approximately 53%; we are now in the high 80s and approaching 90%. However, breast cancer is not just about survival. In those days, treatment was incredibly destructive. Women lost their breasts through mastectomy and had very harsh radiotherapy, the side effects of which were awful, and there was very little in the way of other forms of treatment.

Now, we practice much less destructive surgery; we have computed tomography-planned radiotherapy; and our drugs are designed and developed, such as the immunotherapy that the hon. Member for Coatbridge, Chryston and Bellshill (Hugh Gaffney) mentioned. So the treatment has moved on, the survival rate has moved on and the impact on patients has moved on.

Critical to that movement, as is said over and over, is early diagnosis; that is the importance of screening. However, what we are seeing in many screening programmes, particularly in breast cancer screening programmes, is a gradual fall-off. So it is important that we encourage people to attend the screening that they are suitable for, whether that is cervical screening or breast cancer screening, or—as I say—people putting poo in the post once they reach that age, examining themselves, and not being embarrassed to go and see a doctor.

We have raised this issue in previous discussions, but we are lucky enough in Scotland that bowel screening—the poo in the post programme—starts at 50, and because the endoscopy that results from a positive test does not just treat cancer but gives us the opportunity to remove a polyp, the incidence of bowel cancer in men in Scotland has fallen by 18%. So bowel cancer screening is not just finding cancer early; it is a chance to prevent the cancer from developing. The Government said last August that they would also move to that earlier screening age instead of 60, and I would be grateful to know from the Minister roughly when that change will happen.

However, what challenges screening, as Members have already talked about, is workforce. Radiology is not just an issue in Scotland; radiology is an issue right across the UK. I am co-chair of the all-party parliamentary group on breast cancer and our report last year—“A Mixed Picture”—showed very clearly that as three radiologists retire, they are likely to be replaced by only two.

The other group is endoscopers. If we are running screening, and if screening in England is going to start earlier, that will generate more endoscopies. The NHS is not buildings and machines; it is people. That is a challenge for all of us and I have to say that unfortunately I think Brexit will make workforce more difficult as we go forward.

The number of cancers increases as we get older, as does the complexity of treatment. We are discovering new drugs by design, genetics and cell biology rather than just by accident, as many drugs in the past were found. We have to turn that around. We talk about access to a new drug that might be £100,000 a treatment, but how much cheaper to try to prevent the cancer in the first place? Most members of the public know that smoking is the No. 1 cause, but smoking has been going down, particularly since the smoking ban in the mid-2000s. In fact, lung cancer incidence in men is down by just over 17%. That means 17% of men not getting lung cancer, not having a big operation and not dying from it. There is absolutely no treatment that will achieve that.

What many people do not know is that obesity is the second commonest cause. We have discussed things such as childhood obesity strategies, and the need for a watershed on advertising, high-quality school meals and active transport, so it is easier for people to maintain a healthy weight and to remain fit. We live in an obesogenic society; it is really hard for people to resist things when they are bombarded from every direction. Low-quality carbohydrate food is still much cheaper than fresh vegetables and protein. That always means people are slanted in the wrong direction.

Alcohol is also a cause of cancer. I am proud that, after five years of being dragged through the courts, the Scottish Government have managed to introduce minimum unit pricing, particularly to tackle white ciders—the really poor-quality alcohol at the lower end of the spectrum.

To tackle cancer, the best strategy is to prevent it. That requires a health-in-all-policies approach right across every Department and Government. As well as preventing cancer, that would prevent many of the chronic illnesses that cause debility in older life. As well as preventing cancer, it would prevent other suffering; we would improve the quality of life of our senior citizens. That is something we should all aspire to.

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It is a pleasure to serve under your chairmanship, Sir Christopher. I start by thanking the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for securing this timely debate, and the other hon. Members for their excellent contributions: my hon. Friends the Members for High Peak (Ruth George), for Lincoln (Karen Lee) and for Coatbridge, Chryston and Bellshill (Hugh Gaffney), and the hon. Members for Strangford (Jim Shannon) for Ayr, Carrick and Cumnock (Bill Grant), and for Central Ayrshire (Dr Whitford).

World Cancer Day gives us an opportunity to come together and celebrate how far we have come in cancer diagnosis, treatment and care. It also gives us a chance to reflect on what more needs to be done to fight cancer. The Minister and I have previously worked closely together as co-chairs, as we often say in debates, on breast cancer, as I also have with the hon. Member for Central Ayrshire. That shows that all the main parties’ spokespersons are committed to working together on this issue.

Cancer is a very emotive issue, as we have heard in this debate in some passionate contributions. One in two of us will be affected by it in our lifetime. Most of us in this room will be here today because of the personal effect that cancer has had on our or our family’s lives. In the UK alone, more than 360,000 people are diagnosed with cancer every year. That figure is expected to rise to more than half a million cancer cases every year by 2035. That is equivalent to one new case every minute. That makes the Prime Minister’s commitment to diagnose three in four cancers at an early stage by 2028 all the more ambitious.

Our NHS workforce do a fantastic job every day in caring for us and our loved ones, but as we have heard, there are chronic staff shortages across the NHS. There are vacancies for 102,000 staff, including 41,000 nurses. That makes it harder and harder for them to do the jobs that they want to do. I agree with my hon. Friend the Member for Lincoln, who as a former nurse powerfully made the point about the effect that the lack of the bursary has on the situation. Cancer Research UK has also pointed to the chronic shortages in the diagnostic workforce, with over one in 10 positions unfilled nationally. This is a worrying trend, as more people are expected to be diagnosed with cancer over the years and the NHS cancer workforce are already struggling to keep up with demand.

We covered a lot of this ground with the Minister in the debate earlier this month, in which we also discussed the long-term plan. The Minister said that,

“we must ensure that we have the right staff with the appropriate skills and expertise to ensure that patients receive the best care.”—[Official Report, 8 January 2019; Vol. 652, c. 60WH.]

I agree with him. Therefore, will he tell the House when he plans to publish the workforce implementation plan and when the budget for Health Education England will be set? Patients have a right to the best possible care and it is crucial that the NHS workforce are able to provide that. That is why I believe the Minister should consider it—as he probably does—a top priority.

It will be World Cancer Day on Monday, and I am proudly wearing my wristband. We must recognise the contribution the UK in particular has made to cancer diagnosis, care and treatment around the world. For example, Cancer Research UK has played a role in developing eight of the world’s top 10 cancer drugs. More than a quarter of the clinical trials that Cancer Research UK funds involve at least one other country. Cancer Research UK’s international grand challenge scheme brings together researchers from the UK, Europe and around the world on three five-year programmes, to take on some of the toughest challenges in cancer research. Cancer is an international challenge, which is why we should all unite together against cancer.

It is not just about surviving cancer. As we have heard today, it is about living well with cancer. According to Macmillan, 70% of people with cancer are living with one or more other serious health condition, often as a result of cancer and its treatment. Similarly, a third of people who have completed their treatment in the last two years say that their emotional wellbeing is still affected. As we have heard, during and after treatment, the cost of cancer can be a major issue with regard to not just loss of earnings, but travel and transport costs, and the increasingly expensive parking charges.

I have supported Macmillan’s Cost of Cancer campaign for over 10 years now. It is sad that we still need to debate and discuss this, but it is still a major issue. The issue of parking could be very easily solved. The cost of cancer also includes access to benefits, as we heard from my hon. Friends the Members for High Peak and for Lincoln. That can also be solved easily by some joined-up action across Government. That is why, when thinking about cancer, we must not forget about after-care, advice and support, especially when it comes to further symptoms that could become secondary cancer. In this regard, I believe that it is vitally important that GPs are aware of all symptoms of secondary cancer, so that it can be picked up as soon as possible.

Finally, in this World Cancer Day debate, I want to pay tribute to all the NHS cancer workforce for all the hard work they do, day in, day out. Whether diagnosing, treating, caring or advising, they do a difficult, but fantastic job, which we are all very grateful for. I also pay tribute to the scientists and researchers who discover the groundbreaking new treatments and information. Finally, I thank the campaigners and volunteers. We cannot beat cancer alone, which is why we must all come together to do so. As always, I look forward to working with the Minister to do just that.

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As ever, time is short, so I cannot answer everyone’s questions, but that is the nature of Westminster Hall. It is nice to see you in the Chair, Sir Christopher.

It is an honour, as always, as the Cancer Minister, to respond to these debates. As the shadow Minister said, we have been here before many times. The three Front Benchers are consistent and other hon. Members move around us. This time I congratulate my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont) on securing the debate and on lighting up Parliament pink next Monday. It will be my wife’s birthday, so she will enjoy that. I look forward to seeing my hon. Friend for the event on the Terrace.

The title of the debate, World Cancer Day, suggests two things to me—the fact that cancer is recognised as important enough to have its own world day, and the fact that it transcends every international border and, tragically, affects everybody, regardless of their standing, their age and the wealth they accumulate. It touches everybody, including those of us here in the Chamber. I offer my condolences to the hon. Member for Coatbridge, Chryston and Bellshill (Hugh Gaffney) and his family. I hope that tomorrow goes well, and I am sure they will honour his late brother-in-law. I wish the hon. Gentleman well.

The hon. Member for Lincoln (Karen Lee) always speaks with great passion in cancer debates. She is another one of the consistencies in such debates—it is always nice to see her. She talked about the screening review. She was not here on Monday, when we had a very big debate on cervical cancer. There was a Petitions Committee debate initiated by a young lady who died of cervical cancer at the age of 31, leaving four very young children. It was a heartbreaking story, and all her friends were in the Gallery. There was obviously a lot of talk about cervical cancer and the screening age for it. As I said in that debate, Sir Mike Richards is doing a big piece of work for the Department on screening programmes, including for cervical and breast cancer. I am optimistic about what the review will bring, and I know the hon. Lady will take great interest in that report.

The hon. Lady mentioned the national cancer patient experience survey. As she knows, I agree that it is very important, because we need to know what patients are saying. She will therefore be pleased that I decided to give that a permanent opt-out from the new Data Guardian rules, to ensure that that can continue and that the data can be good. She also mentioned technology and Skype interactions, and I know that she will be pleased that technology is one of the three priorities of the new Secretary of State, and that it is at the centre of the long-term plan. She is right to say that words should be followed by action—indeed, that is why the 10-year plan for the NHS has been produced and there will be £20.5 billion a year of extra investment for the NHS in England.

As always, the hon. Member for Central Ayrshire (Dr Whitford) spoke from great experience and raised many good points, which I shall not repeat. She is right to say that smoking is still the biggest preventable killer in our United Kingdom. We must and will do better, and we have a very ambitious tobacco control plan in England. We had an interesting ten-minute rule Bill in the House yesterday on smoking in NHS properties in England, which provoked an interesting debate. The Bill was promoted by the hon. Member for Batley and Spen (Tracy Brabin).

The hon. Member for Central Ayrshire asked about bowel cancer screening at 50. I cannot give a firm commitment on timescales for lowering the age to 50, but the NHS long-term plan makes it clear that we are committed to doing so as soon as practically possible, which is the key phrase—it has to be practically possible. NHS England and Public Health England, for which I am responsible, are working hard on that. They know I am on their case about it, and I hope to be able to confirm a start date very shortly. I am following it incredibly closely and will say more as soon as I can—I know that she will be watching like a hawk.

The hon. Member for High Peak (Ruth George) and my shadow, the hon. Member for Washington and Sunderland West (Mrs Hodgson), talked about the workforce. As I have said many times, the NHS is nothing without the 1.3 million staff who patients depend on day in, day out. With the right workforce in place, we can deliver the long-term plan. In December 2017, Health Education England published the first ever cancer workforce plan, in which we set out our ambitious plans to expand the capacity and skills of the NHS cancer workforce. That was a welcome first step, and the Secretary of State has now commissioned Baroness Dido Harding—she is working closely with Sir David Behan, formerly of the Care Quality Commission—to lead a number of programmes to engage with the key NHS interests and develop a detailed workforce implementation plan. In March they will present initial recommendations to the Department and Secretary of State, who will then consider the detailed proposals to grow the workforce rapidly as we move towards the big spending review.

The sponsor of the debate, my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk, raised many great points. He asked about the health boards that they have north of the border, and about those boards’ collaboration with the 19 cancer alliances that we have in England. My cancer alliance is down in Wessex—I should not think that they have an awful lot of interaction. He raises a good point, and I am always up for more collaboration—the hon. Member for Strangford (Jim Shannon) often raises that subject with me, certainly in the absence of an Executive at Stormont. He knows that the offer is always there. In answer to my hon. Friend’s question on health boards, to be honest, there is not much interaction between them and the cancer alliances at that level, but I would say there is significant collaboration at the clinical level, particularly on research. The original bowel cancer screening trial was based at sites in England and Scotland. Indeed, the chair of the UK National Screening Committee, Professor Bob Steele, is based at the University of Dundee. There was therefore a lot of clinical interaction, but maybe not enough practical interaction. I am happy to explore ways to make that happen.

The hon. Gentleman mentioned research, and I think that our record is clear: we are, and want to remain, a world leader in cancer research. That is made clear in the long-term plan. The National Institute for Health Research spent £137 million on cancer research in 2016-17, and the largest research investment in a disease area was in cancer.

The hon. Member for Rutherglen and Hamilton West (Ged Killen), who is no longer in his place, made the point about the late Baroness Jowell and her work on brain tumours. Her great legacy there is to stimulate the research community to come forward with decent research proposals that we can back. We heard the same in last week’s debate on the treatment of ME: it is not for Ministers in the Department of Health and Social Care to decide what research projects will and will not happen. The projects have to come from the research community, and they have to be good to be backed by the NIHR. That is the same for cancer as it is for every area.

How much of the extra NHS funding will be used to tackle cancer? The funding breakdown for the long-term plan is still being finalised, but the plan has significant ambition for England around the 75% stage 1 to early diagnosis standard. I am very proud of that. We have already put £600 million into the 19 cancer alliances in England, and there will be more. They are very much our delivery mechanism and, as I said, I would be very keen to see any interaction between those two across the border—especially on behalf of those who represent seats close to the border.

Many other points were made—those around PIP and DLA were well made—and I know that CLIC met the Minister for Disabled People, my hon. Friend the Member for Truro and Falmouth (Sarah Newton). She, too, will take notice of all the points made in the debate.

I wish to give my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk 60 seconds to sum up, so I will conclude. We have made great strides in cancer in the past 20 years, and we have the best survival rate ever. On research, diagnostics, treatment and, ultimately, survival rates, however, there is so much more to do. Anyone who knows me or listens to me when I respond to such debates knows that I certainly do not lack ambition in this area, nor is there an ounce of complacency in me.

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I am grateful to all Members who contributed to the debate. I am struck, as ever, by how many of us have had friends, families or people in our community—as well as people through casework—affected so personally by this terrible illness. I am also grateful for the Minister’s comments. I make a final plug for 4 February, the coming Monday, which is World Cancer Day. If people are able to join the team from Cancer Research and others on the Terrace at about 5.30 pm on Monday, they will see the Palace of Westminster lit in pink to mark that important day.

Question put and agreed to.

Resolved,

That this House has considered World Cancer Day.

Sitting adjourned.