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Rev. Martin Smyth (Belfast, South): The hon. Gentleman spoke about traditional research, and mentioned the fact that tributes were paid abroad to the research that was taking place in this country. May I press him and encourage him in his campaign to get more money into that research, bearing in mind the fact that at least £25 million will be needed in Northern Ireland alone--in an excellent department under Professor Johnston--and that that need is replicated all over the United Kingdom?
Dr. Clark: The hon. Gentleman is right. At the end of my few remarks I shall discuss the need for more money. We recognise in our report the excellent work that is being done in Belfast, and Northern Ireland in general. We took evidence from people from the Province, and one of our last witness sessions--one of our larger sessions--gave us the opportunity to hear people who were recovering from cancer, who had travelled from Northern Ireland to tell us about the excellence of the service there.
Not only was it right that the organisations that we visited abroad should pay tribute to cancer research in this country, but that we as a Committee paid tribute to the cancer professionals, the cancer charities and all those associated with cancer care in this country. We are grateful for the willing help that we have obtained in preparing our report--from the Committee's own advisers, from the 30 witnesses who came to see us and from the host of institutions that we visited, in Northern Ireland and elsewhere. We received 106 written submissions, all of which were carefully scrutinised, and all of which were very valuable in helping us to prepare our report.
I mentioned that we had one witness session at the end to which we invited 20 witnesses, some of whom came from Northern Ireland to tell us of their experience of cancer. We lifted that idea from what we saw when we visited the United States Congress, where we attended a session at which members of the public were invited to speak for no more than five minutes to present their views on an issue. We held a similar session in this Parliament, at which we heard 20 witnesses in two hours. Each person was allowed five minutes to express their point of view. They came along with some trepidation, never having given evidence to a Select Committee. We received them in as friendly a way as we could and listened to their points of view, which we have taken into account in our report.
I commend to other Select Committees the idea of holding a witness session that members of the public may apply to attend to give evidence. Twenty are selected and can present their individual, and sometimes lonely, point of view to a Select Committee of the House.
It was right to call our report "A Fresh Look". There have been changes to the way in which the services are delivered. A national cancer director has been appointed, and the two largest cancer research charities are now willing to work together.
What was it, then, that triggered our report? Many factors did so, some of which I have mentioned. Comparisons have been draw between the mortality and survival rates in this country and those in other parts of the world, especially north America and Europe. It is difficult to draw definitive comparisons, but we found that some of our mortality and survival rates were not as good as they could be compared with those in other countries in the developed western world, particularly in north America. Although the survival rates for cancers overall have steadily improved in this country, there has been little or no improvement in the survival rates for cancers of the lung or the prostate.
Our report is comprehensive, as is the Government response, dated November 2000. Many issues were highlighted and discussed in our report, and other members of the Select Committee present this afternoon will wish to raise many others. I shall, therefore, quickly confine myself to dealing with three topics in the report--epidemiological and public health research issues; Government funding, as I promised the hon. Member for Belfast, South (Rev. Martin Smyth); and the national cancer research institute.
On epidemiology, cancer registration is an invaluable tool in the fight against cancer, yet the organisation of records is haphazard--probably because of historical accident, rather than by design--and needs to be improved if we are to get the most of our those records, which can be valuable in fighting cancer. If we are to fight cancer effectively, it is always helpful to know where, in which age group and in relation to which type of life style cancers occur. The Government are aware that data collection may be hindered by the Data Protection Act 1998.
In our report, we recommended:
- The Government should introduce legislation to make registration of cancer a legal requirement, both to ensure completeness of the cancer registry data and to ensure access to those data for legitimate purposes.
On Government funding, in the United Kingdom, for every pound spent by the Government, £2 is spent by charities. However, in north America, for every pound spent by charities, £2 is spent by Government. In the United Kingdom, because of the public's generosity to cancer charities, it is possible that the Government have, to some extent, been let off the hook. That is no longer acceptable. The Government should view public giving not as an excuse to minimise their own contribution, but as showing the public's earnest determination to improve the situation. The Government should recognise the fact that the public want to improve the situation, and match--and preferably double--charitable giving.
In paragraph 102 and 103 on page 16 of their response, the Government give an encouraging reply. They say:
- The UK Government expenditure on cancer research is inevitably a smaller proportion of total expenditure from all sources than in many countries where a tradition of popular support for cancer research is less evident.
Nonetheless, the Government accepts the Committee's basic premise, and supports the case for increased investment in order to redress years of under-funding, to make the most of exciting new opportunities.
The day before the press conference on our report, the Government announced an extra £200 million for cancer research. I am sure that, in winding up the debate, the Minister will recap on all the initiatives that the Government have undertaken and all the new money that they plan to make available.
Finally, we proposed a national cancer research institute to co-ordinate cancer research in the United Kingdom and cancer research funding. On 27 September 2000 the Government responded positively with the announcement in the NHS cancer plan of their intention to come forward with definitive proposals for such a research institute, broadly along the lines that we had proposed. Page 20, paragraph 117 of the Government reply 117 sets that out. We are grateful to the Government for that response and look forward to seeing the benefits of implementing those proposals in due course.
Although we are debating cancer from our adversarial positions in this House, cancer is not a political topic. It is a human problem of national and, indeed, international importance and dimensions. The alleviation of suffering, the treatment of patients and the cures for the disease are also national and international responsibilities. We on the Science and Technology Select Committee have tried to present a fair, comprehensive and helpful report. The Government's response was appreciative and encouraging. I believe that the Government are ready to acknowledge that there is still a lot to do, and we wish them well in their endeavours.
2.6 pm
Dr. Ashok Kumar (Middlesbrough, South and Cleveland, East): As a member of the Science and Technology Committee I start by paying tribute to our Chairman, who co-ordinated the work and ensured that we all behaved cordially and made significant progress. My hon. Friend the Member for Norwich, North (Dr. Gibson) was the prime mover and the idea was his brainchild. We should, therefore, record, that the agenda was set by him.
As the hon. Member for Rayleigh (Dr. Clark) said, the debate is essential and we need a fresh look at cancer research in the United Kingdom. I agree that what the Government have done and the Secretary of State's announcements have given a boost to cancer treatment. That boost fits perfectly with the national plan for the NHS. The NHS is the greatest achievement of Labour Members. We recognise that the health plan fits in with the Government's programme for the 21st century.
As the hon. Gentleman said, cancer is one of the great scourges of our time. It is a disease that knows no boundaries--boundaries of country, class, gender or race. The prevalence of cancer means that one person in four will at some time be diagnosed as suffering from a cancerous condition and a third of all those here will die from that condition.
As anyone who has had a close family relative with cancer knows, the sheer malignancy can infect the entire household emotionally. I know that only too well myself
as my aunt died from breast cancer in 1983. In a close-knit, Asian family where ties of affinity are great, it hit me hard personally and caused a lot of pain and heartache. I saw at first hand what a deadly disease cancer was. My aunt was only 52. She was effectively robbed of her young life. She was a happy, lively woman and I adored her. She faced this dreadful disease with dignity and courage. She was given all the support of her doctors, nurses and hospital staff and, of course, of her family--her nearest and dearest.The challenge that we face is to eradicate the conditions that help to foster cancer. Society can then begin to make positive steps towards the better treatment and analysis of the cancers that still occur.
At this point, I want to highlight some of the Committee's findings and to place them in the context of the work being carried out on cancer research, treatment and prevention, from which my constituents could benefit. The report makes 38 good recommendations. I want to focus on only a few of them, specifically those in paragraphs 119 and 143 of the report, relating to the need for patient involvement and the need to spread cancer research across the United Kingdom in a new network of centres of excellence.
Research is being carried out into the causes and the nature of cancer and can be fertilised by other research being carried out in related fields, notably the work being carried out on the human genome project. Research into drug discovery and design is also taking place, as is translational research that seeks to transfer the findings of interdisciplinary teams of scientific workers into treatment regimes. Such work is based on clinical trials and their evaluation. Research is also being carried out into improving patients' quality of life. It is crucial that such work is seen as cross-disciplinary and cross-frontier, and that everyone involved, in whatever sector, is able to appreciate how his or her work can be seen to contribute to the over-arching cause: the eradication and overcoming of cancer.
There are many strands to the research work. The Medical Research Council, in giving evidence to the Committee, stated that such strands
- can be pursued and shared simultaneously.
Specialists working in those fields must, likewise, pay heed to the work of those dedicated people who manage national and local cancer charities. Charities fund much research work at local and national levels, as the hon. Member for Rayleigh mentioned. All those engaged in research must be conscious of the efforts of people working at the sharp end of the treatment process: the consultant oncologists, the nursing staff, professionals allied to medicine, radiographers and voluntary workers from the various cancer relief groups.
Those involved in research must, above all, have empathy with cancer sufferers and patients, who have a role in combating the disease by volunteering for clinical trials and by playing a full role in supporting research
work carried out in their locality. One of the Committee's most far-reaching recommendations is in paragraph 119, which is that
- all Government-supported cancer research committees include patients' representatives as full members and that the Government provides resources to ensure proper training and support for patients' representatives.
This call for resources is little more than cancer sufferers and their families deserve. The Committee showed, on the evidence of cross-comparisons, that Government support for advanced research into cancer is low compared with that available in other advanced nations. We come out particularly badly when compared to the United States. Indeed, as paragraph 145 of the report points out, the two UK centres that we visited--Belfast city hospital and the Beatson oncology centre in Glasgow--receive better funding from the US National Cancer Institute than they do from our own Government. That should not be tolerated.
The siting of centres of excellence should be tied to existing facilities, such as new large hospitals and universities with records of excellence in medical research and training, and to areas where there are specific incidence of cancer. My area of Teesside should be considered. It has hospitals and university expertise at the university of Teesside and the university of Durham's Teesside campus, which is located in Stockton. The simple reason why such a centre should be situated there is that we are unfortunate in having one of the highest incidence of cancer in the country.
Specialists from the South Cleveland hospital, which is managed by the South Tees acute hospitals NHS trust and is the cancer centre for Teesside, told me that they support, from a local perspective, the sentiments of many of the report's conclusions. Oncologists in particular are optimistic. Mr. Peter Dunlop, the clinical director of radiotherapy and oncology, and a cancer specialist at the hospital, told me:
- Research and development and education are vital elements involved in running an effective cancer service . . . Stimulate and advance local academic and research training activity and you will get quality outcomes for patients . . . Many of these recommendations for enhancing the UK cancer research resource base in the UK are fully supported.
- I still believe that difficulties lie ahead. Recruitment of specialist staff will be needed across many disciplines, particularly those suffering the worst workforce planning blight ever . . . We are still short of nurses, we have difficulty in recruiting therapy radiographers, medical physics and technical staff, whilst other specialisms such as clinical oncology . . . are entering a barren period.
It is not only consultants who welcome aspects of the report. Another local leading cancer fighter, Dr. Pat Keane, director of the local Cancer Care Alliance at Middlesbrough general hospital, told me:
- We would welcome the opportunity to increase our contribution in cancer research, both locally and nationally, to the proposals outlined within the report . . . Unfortunately the Teesside area has some of the highest incidence of deaths from cancer, particularly for lung . . . cancer, in the U.K . . . We are very keen to increase resources to support local clinical staff in matching their excellent clinical work with a higher involvement in both clinical trials and ongoing research associated with the quality of life of people with cancer.
I believe that this is an excellent report, though I am bound to say that because I was involved in it. It points out a way forward for the radical overhaul and improvement of UK research centres. I know that the Minister will respond positively and I look forward to a day when many more announcements will be made on the back of the work that we have done.
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