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Cancer Outcomes: Tees Valley

Volume 726: debated on Monday 16 January 2023

Motion made, and Question proposed, That this House do now adjourn.—(Scott Mann.)

I would like to open my remarks tonight by paying tribute to the late Professor Stephen Bonner, whose obituary features in The Times today. Professor Bonner delivered marvellous service to the people of Teesside in his various roles delivering critical care at James Cook University Hospital, including the major expansion in the number of our intensive care and high dependency beds and his astonishing success in making James Cook the best place for junior doctors and student nurses to train in intensive care in 2016. It is entirely fitting that in a debate on health services in the Tees Valley we should recognise his enormous contribution to our lives locally. So many of my constituents have reason to be grateful to him. Professor Bonner’s obituary tragically relates:

“With their sons growing up, Bonner and his wife planned for a gradual retirement, but just as he was about to put the plan into action he received a diagnosis of inoperable bowel cancer. Bonner had spent decades improving the system, but the bowel screening test that would have diagnosed the cancer early…had been cancelled during the pandemic.”

That brings me squarely back to the subject of this debate and the particular importance of cancer screening, because ultimately that is at the heart of making sure we improve cancer care nationally as well as locally on Teesside.

A cancer diagnosis is news none of us ever wants to receive, but the reality is that someone in the UK does every 90 seconds. One in two of us will be diagnosed with cancer at some point in our lives. Even those of us not directly affected will undoubtedly have family members and friends who are. Some of the most emotional conversations I have had with constituents have been about the struggles faced by loved ones supporting relatives in their final weeks.

The scale of the challenge posed by cancer is particularly acute in the Tees Valley. The north-east of England has the highest age standardised cancer rate of any English region for both men and women. The incidence rate for female patients is 15% higher than in London, which is the region with the lowest incidence. The difference for male patients who experience higher incidence rates overall is more than 8% higher than the best performing region. The Tees Valley’s industrial heritage is, I am afraid, yielding a grim harvest. There are particular challenges with regard to historic exposure to environmental carcinogens resulting in higher rates of lung cancer and myeloma in particular.

My home area is now at the forefront of progress on much of what is good about the Government’s levelling-up programme under the leadership of Ben Houchen, but the legacy issues persist from our very challenging economic past and the deep deprivation our area continues to suffer from. Smoking and obesity rates are higher than the national average. That context at the very least contributes to Middlesbrough being ranked 140th out of 150 local authorities for premature cancer deaths by Public Health England.

The good news is that thanks to research, many more people are either beating cancer or living much longer with cancer. Macmillan estimates that in 2020, 3 million people across the UK were living with cancer. That is forecast to rise to some 5.3 million by 2040. Median cancer survival has improved hugely as a result of advances in diagnosis and treatment, but there is a lot further to go. We ought to pay tribute at this point to the fantastic effort of those individuals and community groups who are touched by this horrible disease and have decided to make a positive difference to the challenge they have faced. I refer here to Guisborough-raised jockey Bob Champion, who has done a huge amount through the Bob Champion Cancer Trust. He has raised some £12 million over the last 30 years.

On a smaller and more local scale, I pay particular tribute to Claire Starsmore and the amazing East Cleveland Pink Ladies, who have raised £131,000 for Cancer Research UK over the past decade in memory of their much-loved friend Jacqui Hampton. The annual Pink Ball is one of the highlights of the East Cleveland social calendar—I am very much looking forward to attending the 10th version in November, which is firmly in my diary. That kind of event makes the cancer fight very personal and very tangible.

I am pleased that another Tees MP is so engaged with the subject. I join the right hon. Gentleman in paying tribute to Professor Bonner for all his work for people in my constituency as well as in his own.

The right hon. Gentleman has already recognised the importance of the early diagnosis of cancer and other diseases to tackling health inequalities in his constituency and mine. Will he join me in congratulating North Tees and Hartlepool NHS Foundation Trust and Stockton-on-Tees Borough Council on their joint campaign over many years to secure a diagnostic centre for our new-look town centre, which was confirmed by the Minister earlier today?

The hon. Gentleman is absolutely right: this is a subject that crosses party boundaries and constituency boundaries. The contribution of everyone who has fought to ensure that we deliver the best possible cancer care across Teesside is undoubtedly to be applauded. I look forward to hearing the Minister’s remarks about what the Government’s pioneering work to deliver community diagnostic centres will bring to the Tees valley.

I referred a moment ago to the Pink Ball. On the same note, I pay tribute to Councillor Craig Holmes of Skelton West in my constituency, who has raised thousands of pounds for cancer charities through events including the annual Minersfest, an extraordinary music festival in East Cleveland, at which you would always be welcome, Mr Deputy Speaker. Such efforts are incredible tributes—in this case, a tribute to Craig’s mum Alison, who sadly lost her battle with cancer in 2013—and bring huge enjoyment to thousands of local people.

There is much more that we need to do to reduce the average of 460 deaths per day from cancer in the United Kingdom. One of the strongest predictors of cancer outcomes is how early a diagnosis is made and treatment is started. It is estimated that for every week earlier that the treatment of cancer commences, the chance of five-year survival increases by at least 1.5%, so it makes a material difference.

May I share in the warm words of tribute to Professor Bonner from the right hon. Gentleman, my constituency neighbour? Like me, he is very much aware of the superb, world-class work that goes on at the James Cook University Hospital’s oncology department. It has six linear accelerators with a lifespan of about 10 years, but half of them are now reaching the end of their natural life, and as they break down they are becoming less efficient. Does he share my plea to the Department of Health and Social Care and the Treasury to ensure that the necessary funding is made available to the James Cook University Hospital and the trust to carry on their vital, life-saving work for our constituents across Teesside and beyond?

I echo what the hon. Gentleman says about the importance of ensuring that our equipment is absolutely the best it can be. I had the privilege of seeing the new equipment at the James Cook’s interventional radiology department before Christmas, which was incredibly impressive. The hon. Gentleman is absolutely right that such investment is vital to ensuring that once treatment commences, people can get the best possible care.

The right hon. Gentleman is being staggeringly generous in giving way; it is noted and appreciated. The technology is important, but what is also important is where it is. I echo the call for linear accelerators to be up-to-date so that radiotherapy treatment is as up-to-date as possible. That is incredibly important, but the National Radiotherapy Advisory Group also says that nobody who needs radiotherapy should have to travel for more than 45 minutes to get it. Areas a little more rural than Middlesbrough may face lengthy journeys; there is nobody at all in Westmorland who lives within 45 minutes of our nearest radiotherapy centre. Does the right hon. Gentleman agree that having satellite units, with linear accelerators placed away from the main centre—for us, that would be in Kendal—would be one way of ensuring that people in more remote and rural communities get the treatment they need so that their life can be longer?

The hon. Gentleman is absolutely right. Representing East Cleveland as I do, I have some insight into the challenges of distance in rural areas. Bringing care to people to the greatest extent possible and commensurate with the challenges is vital, particularly for things like screening.

That leads me neatly to a point raised by Mr Jonathan Ferguson, the consultant lung surgeon at the James Cook University Hospital in Middlesbrough and clinical cancer lead for South Tees Hospitals NHS Foundation Trust. He has done much to bring to my attention the fantastic work that is already going on in the Tees Valley to increase early diagnoses. Much of that work is clearly led by him, although he is far too modest to say so. Jonathan is a linchpin of our local healthcare system, and a hugely impressive consultant. In the light of the impact of covid, this progress is more vital than ever. Macmillan estimated that by March last year there were still at least 37,000 fewer cancer diagnoses than expected as a result of the disruption caused by the pandemic. It is clearly vital for us to address that.

Over the last 12 months, Mr Ferguson has been the driving force for the new targeted lung health check programme in the Tees Valley. That region-wide service is now up and running, identifying curable cancers that would otherwise have been undetected for longer through effective collaboration between local NHS teams and an independent-sector diagnostic specialist. This approach has identified a curable cancer every two days, which is fantastic, through scanners operating 12 hours a day, seven days a week, from mobile units—a subject raised by the hon. Member for Westmorland and Lonsdale (Tim Farron)—in supermarket car parks, with the facility operating at a 97% occupancy rate, which is wonderful. The facility is staffed and appointments are managed by the independent partner, with target patients identified through NHS records and an initial telephone questionnaire.

This enables our brilliant local NHS teams to focus on treating patients and tackling the backlogs, which we know will allow them to deliver great results. The superb clinicians at the James Cook University Hospital have an excellent track record of innovating to improve patient care, with recent initiatives including the Macmillan-supported thoracic surgery community nursing programme, which won the Nursing Times award for the best surgical nursing team. It has reduced both the length of hospital stays and readmission rates for patients following thoracic surgery. Many of those are, of course, lung cancer patients.

It is exciting to hear the proposals for a new Tees Valley diagnostic hub in Stockton, which I think the Minister will say more about in her speech—I look forward to that. It was originally not expected to welcome patients until 2025, but it has been fast-tracked and is now expected to open much sooner. Mr Ferguson believes passionately that opening the hub this year would

“save more lives on Teesside than I have throughout my surgical career”,

so we should all welcome it warmly, given the practical difference it will make on the ground.

I know it is a mission of this Government to ensure that we address health disparities, and there is probably nowhere in England where a greater difference can be made than on Teesside. I am joined tonight by my hon. Friends the Members for Stockton South (Matt Vickers), for Redcar (Jacob Young) and for Sedgefield (Paul Howell), and we are all very grateful for the action that the Government have taken.

When we are looking at our future options, we should bear in mind that the more we can do with the private sector as well to increase our capacity, the better. Through what he has been doing with his supermarket car park screening, Mr Ferguson has shown the value of such partnerships in unlocking extra capacity. I urge the Government to look at all the options to ensure that we can get the maximum number of people through the system, receiving the care that they need through all parts of our healthcare system.

Coupled with last week’s exciting announcement about the cancer vaccines trial partnership between the Department of Health and Social Care and BioNTech—which could allow eligible patients in England early access to revolutionary personalised mRNA therapies through trials as soon as next autumn—are the Government’s significant steps to give cancer patients improved chances of survival, and to give families and friends more precious time to spend together. I know that colleagues on both sides of the House will join me in welcoming those efforts, which will make an enormous difference to our constituents.

This is a practical and tangible debate on an issue that touches nearly every family at some point. I would be grateful if the Minister could tell us what the Government are doing to ensure that cancer outcomes across Teesside continue to improve in the way that has been so encouraging to us all so far.

Let me begin by thanking my right hon. Friend the Member for Middlesbrough South and East Cleveland (Mr Clarke) for securing this debate. He has been working hard to make sure that his constituents get faster diagnosis and better treatment for cancer. He mentioned working together with his constituents on the clinical side, doing tremendous work to lead efforts to diagnose and care for people in his area, as well as fundraising. I heard him mention the Pink Ball, which sounds tremendous. I pass on many congratulations to all those involved and commend them for their work.

As my right hon. Friend said, many people are affected by cancer, whether due to a diagnosis themselves or somebody they are close to. Many people have therefore lived through that difficult experience of waiting to hear whether they will be diagnosed with cancer, or have the all-clear after being referred for testing. For patients with cancer, it is quite simple: faster diagnosis saves lives. That is why this Government are helping the NHS recover and transform health services in the aftermath of the pandemic, with a particular focus on the earlier diagnosis of cancer.

I will talk a little about what we are doing nationally, but I will focus on my right hon. Friend’s constituency. He mentioned the high prevalence of cancer in his constituency and the wider Tees Valley. To give a sense of the scale, in 2020, there were just under 4,000 cancer diagnoses in the Tees Valley, so that gives a sense of the number of people who could benefit from faster diagnosis, which we know can improve outcomes. There is more that we can and should do to prevent people, both nationally and in the Tees Valley, from developing cancer in the first place, such as policies that help people maintain a healthy weight and lifestyle and stop smoking, and promoting the uptake of the HPV vaccine, particularly in groups where coverage is lower.

The Minister mentioned my magic word—smoking. Could she give us some indication of when the Government will bring forward the tobacco control plan? She recognises, as I do, that in the most deprived inner-city communities the incidence of smoking is higher and lung cancer is higher as a result. I would be interested to know what plans she has to bring that forward.

The hon. Gentleman is absolutely right to pick up on what I said about the importance of supporting people to stop smoking, but for the sake of this Adjournment debate I will focus on responding to my right hon. Friend’s speech, particularly looking at cancer diagnostic services.

We want to level up diagnostic services for cancer around the country so that people with symptoms of potential cancer can receive an accurate diagnosis and begin treatment as quickly as possible. That is part of our ambition to reduce health disparities in more deprived areas, such as some areas in my right hon. Friend’s constituency, and to improve early-stage cancer diagnosis rates for all. A key part of improving early diagnoses is ensuring that people come forward when they suspect that they have cancer.

Sadly but understandably, during the pandemic we saw the number of urgent referrals for cancer fall, but it is positive that in the North East and North Cumbria integrated care board over 13,000 patients had their first consultation appointment following an urgent GP referral in November last year. That is an 18% increase from November 2020 during the pandemic, and nearly a 20% increase on the figures for November 2019 prior to the pandemic. That indicates that in the Tees Valley, as we are seeing across the country, people are coming forward to be diagnosed or discover that they have the all-clear from cancer, which is the case for most people.

In a moment I will talk about our innovative new community diagnostic centre programme, but first I want to highlight some of the other things we are doing to improve the early diagnosis of cancer. One important innovation is introducing the serious non-specific cancer pathway, which Tees Valley has successfully implemented. This means that GPs can refer patients into the service when there are possible symptoms of potential cancer, or someone has a gut feeling that something is not right. That is especially important for patients who do not fit specific pathway referral criteria but whose symptoms are more generic.

In addition, Tees Valley has initiated a programme of targeted lung health checks aimed at people aged between 55 and 74. My right hon. Friend referred to that and the impact that it is having. It is anticipated that the programme will result in around 530 diagnoses of lung cancer over the next four years. In deprived areas of Middlesbrough, Hartlepool and Darlington, clinicians are taking part in a trial to assess the benefit of the new GRAIL test that looks for signs of cancer in a sample of blood. This is hugely exciting as it can identify cancer where no symptoms are even present, allowing for earlier diagnosis.

However, the waiting list for diagnostic tests in England currently stands at over 1.59 million patients, with around 26% of those patients waiting more than six weeks. In the North East and Yorkshire region, the waiting list for diagnostic tests has over 200,000 patients, with just over 20% of those waiting more than six weeks. These are figures that we very much want to improve because, as I have said, earlier diagnosis can mean better outcomes. We want to get to the point where 95% of patients needing a diagnostic test receive it within six weeks by March 2025. Equally, early-stage cancer diagnosis is a key ambition of the NHS long-term plan, which aims to ensure that 75% of cancers are identified at stage 1 or stage 2.

What the Minister says about the waiting time for diagnostics is very troubling. What is even more troubling is that in my part of Cumbria 43% of people who have had a diagnosis of cancer are now waiting more than two months for their first treatment. In North Cumbria and Northumberland, the figure is 62%. Can she say what she is going to do to speed up treatment for those people who have had a diagnosis of cancer?

Yes of course. More people coming through for referral for cancer diagnosis and increased early rates of diagnosis feed through into us needing to increase the rates of treatment. The NHS is treating more people for cancer, but of course this is taking time because of the increased levels of referrals. We are working very hard to do this.

I want to return to talking particularly about cancer diagnosis and what we are doing to do that earlier, and specifically about the community diagnostic centres that are being rolled out across the country supported by £2.3 billion of capital investment. Local health systems can bid for a share of that funding when they make the case for community need and clinical value, and I am delighted to say that 89 community diagnostic centres are currently operational across the country. Hard-working NHS staff have so far delivered more than 2.7 million additional checks at these centres. Specifically in the Tees Valley, I know that my right hon. Friend has been working with his local NHS to support its proposal for a new diagnostic centre in Stockton-on-Tees, and I can update him with the good news that this new site has been approved, with a planned opening date of December 2023.

Can I thank the Government for this fantastic investment in my part of the town? It will save lives. Also, importantly, can I thank the Government for challenging us locally to deliver it more quickly so that we can save more lives more quickly and make a bigger difference to the community? Thank you very much. We are going to do our best.

It is good to be able to talk about good news. As my hon. Friend says, his area is not only getting a community diagnostic centre but getting it quicker because the timeframe for doing it has been brought forward. That is tremendous, and I look forward to his area achieving that later this year. It is great that we have been able to announce the date when it will open.

The new Castlegate site for the Tees Valley community diagnostic centre is planned for construction on the Castlegate shopping centre site as part of the local regeneration project. There are excellent transport links, which means that it will be accessible to the whole community. It is important to make these places accessible in order to get people to come forward for testing and screening. This will be the latest addition to the 14 existing community diagnostic centres in the North East and Yorkshire region and the four hub-and-spoke sites in the Tees Valley area, which have so far delivered over 250,000 tests.

I want to respond to the other comments from my right hon. Friend the Member for Middlesbrough South and East Cleveland, who also raised the important role that the independent sector has to play in meeting the needs of patients. Last month, my right hon. Friends the Prime Minister and the Secretary of State for Health and Social Care launched the elective recovery taskforce, bringing together academics and healthcare experts to advise the Government on how best to unlock capacity in the independent sector to reduce waiting times. The independent sector is also helping us directly to tackle the diagnostic backlog, providing additional capacity in underserved communities and forming productive partnerships with the NHS to run community diagnostic centres.

The hon. Member for Westmorland and Lonsdale (Tim Farron) asked about effective treatment, and I am pleased to say that the NHS has treated a record number of people for cancer in the last year, with more than 321,000 people receiving their first cancer treatment between December 2021 and November 2022, which is up by more than 10,000, or 3%, on the same period pre-pandemic. Within the North East and North Cumbria ICB, 1,690 patients started their first treatment for cancer in November 2022. The number has recovered following the pandemic—the equivalent figure for November 2019 is 1,652.

The NHS continues to offer cutting-edge treatments, including newly developed drugs and radiotherapy. Just a week or so ago, my right hon. Friend the Secretary of State signed a memorandum of understanding with BioNTech to bring innovative vaccine research to England, with the potential to transform outcomes for early-stage and late-stage cancer patients.

I thank my right hon. Friend the Member for Middlesbrough South and East Cleveland for raising this important issue and for his continued commitment to improving cancer care in the north-east and Tees valley region. I encourage him to continue his excellent work with his local NHS system, and I look forward to continuing to work with him and the NHS as we meet the challenge of reducing diagnostic waiting times and improving cancer outcomes.

Question put and agreed to.

House adjourned.