James Duddridge (Rochford and Southend, East) (Con): First, I congratulate the new hon. Member for Dunfermline and West Fife (Willie Rennie), who said that this is a bewildering place initially. I must admit, as one who continues to consider himself a new Member, that it is bewildering still. I spoke to my Whip only a few minutes ago, and he bewildered me further. However, I understand that I have a few minutes to make some comments on the important matter of cancer, having already written off my career.
My predecessor, Sir Teddy Taylor, introduced an Adjournment debate in February 2002 on the subject of cancer care in south Essex, supported by my good friend and colleague my hon. Friend the Member for Southend, West (Mr. Amess) and by my hon. Friends the Members for Castle Point (Bob Spink) and for Rayleigh (Mr. Francois), who spoke earlier on the issue that I want to raise: the size of the cancer networks.
Some three or four years ago, when my predecessor raised the issue, he was very concerned that cancer networks had to involve a population of more than 1 million. In south Essex, the population is only about 700,000 and we were to be merged with neighbouring areas. The cancer tsar, Mike Richards, came down, had a look and said that although we have a small population, the number of operations is largeindeed, as large, if not larger, than that of some cancer networks with more than 1 million people.
In addition, south Essex is quite densely populated, but does not have good traffic infrastructure. It would be particularly difficult for patients to get out of the existing south Essex area for care. Like many Members, I have close family who have experienced cancer: my grandmother in her later years had breast cancer and received excellent care from Macmillan Cancer Relief.
Mr. Greg Hands (Hammersmith and Fulham) (Con):
On the subject of Macmillan Cancer Relief, does my hon. Friend share my concern that nursing specialists in the Hammersmith hospitals NHS trust have been threatened with a move to general ward work from
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specialist oncology and palliative care, and that one of the two Macmillan counsellors is under threat of redundancy? All of that is due to a large NHS deficit.
James Duddridge: I thank my hon. Friend for raising that point. I am horrified that that is the casemy grandmother received excellent careand I believe that Macmillan Cancer Relief's head office is in his constituency.
It is important that south Essex keeps its cancer network. It is like "Groundhog Day" in that the Southend Echo, my local newspaper, ran a "hands off our cancer centre" campaign at the time when Sir Teddy Taylor raised the issue, and is now running a "save our cancer centre" campaign. The cancer network believes that it is the right size and does not believe that the cancer centre should be merged, although admittedly it has a number of other reasons. The consultation on the south Essex cancer care centre ends on 13 March, and I and several of my parliamentary neighbours will present quite a large petition signed by a number of constituents.
To my mind, it is bizarre that we are told locally that this is just a small, structural, management change, and that only a small number of people will be affected this time roundas few as 20 or 30. We are deeply concerned, however, that once we are merged into a larger area including Anglia, more intermediate care cancer services, as well as specialist care, will be moved further and further away. Increasingly, with bad transport infrastructure, that journey will be two hours plus. While that might be acceptable for a one-off appointment, it is not acceptable in cases of cancer with many repeat appointments.
South Essex also faces a problem with the number of consultations. The strategic health authority has assured me that it will consult again if some other cancer services are moved elsewhere within an expanded network. Consultations always seem to be short, however. My hon. Friend the Member for Rayleigh is co-ordinating a consultation on the police that has been rushed through. On health services alone, six consultation processes, which kicked off in December, will end in the next few weeks. There is a degree of consultation overload.
If the local cancer network wants to remain as it is, and if local people who have been either writing to the Southend Echo or signing our petitions at pharmacists and doctors' surgeries say overwhelmingly that they do not want a merger, with the long distances involved, will the Minister assure us that we will be able to say to the local strategic health authority that, having gone through the consultation, people overwhelmingly want the network to remain as it is? My grandmother was in Bristol, not Southend. Her quality of life was appalling in her final years, despite the services provided by Macmillan Cancer Relief, and I fear what her quality of life would have been if she had had to travel for two hours every day.
Despite problems with the local bus and train service, people in Southend can still get to Southend hospital relatively easily, and they would be grateful for an assurance that if all the parties in the consultation call for no change, there will be no change. Let us not go through all of this again in three yearswhen I hope
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that I will still be the MPif the issue arises once more. My predecessor seemed to have dealt with it. Sadly, that is not the case. I seek the Minister's reassurance.
Mr. Stephen O'Brien (Eddisbury) (Con): First, let me associate myself and my right hon. and hon. Friends with the Secretary of State's generous remarks about Gregor MacKay, whose memorial event is taking place today. We all pay great tribute to the work that he did for us as a colleague, and indeed to his many friendships across the political divide. We pay equal tribute to Linda Smith. We have been debating a terrible disease that afflicts so manythat, indeed, afflicts almost everyone in the country, at least indirectly, in our minds. That applies particularly to someone who was so public, so much loved, and such a wonderful comedienne.
I congratulate the hon. Member for Dunfermline and West Fife (Willie Rennie) on an extremely good maiden speech. As the last Conservative by-election winnersome years agoI am glad to be able to congratulate the most recent Liberal Democrat by-election winner. I met many of my future colleagues on the streets of my constituency: 200 Labour Members. As it happens, the debate in which I made my maiden speech was very well attended, although I hasten to say that that was nothing to do with me. At least 400 Members present who had worked their socks off to try to ensure that I did not arrive here had to listen to my speech. I therefore had considerable sympathy with the hon. Gentleman when he described his experience. I also thought that he spoke very movingly about the experience of stepping into the shoes of a much-respected Member, Rachel Squire, who sadly succumbed to the brain tumour that she had borne so bravely. That is particularly sad in the context of today's debate. In many respects it is a highly appropriate debateand it is for another day for us to make any points about a Scottish Member seeking to involve himself in a debate that relates only to England.
Mr. O'Brien: Given that the hon. Gentleman, who is the Secretary of State's Parliamentary Private Secretary, is the only other Scottish Member who has been present for most of the debate, it is a shame that he has made his presence felt from a sedentary position.
The hon. Member for Dunfermline and West Fife gave us a wonderful and engaging tour of his constituency. I am sure that his constituents look forward to his serving them with all his energy and enthusiasm. I fear that he will have to rely on the Official Report to ensure that his most notable and, I predict, his most challenging constituent, the Chancellor of the Exchequerwho, for some reason, was not present for his speechrecognises what a marvellous new Member of Parliament he has.
I am glad that the Secretary of State congratulated the Opposition on making this vital subject a priority for their precious time. The debate has been characterised by the concern, care and expertise brought to it by all who have had an opportunity to speak on behalf of their constituents. I am aware that tributes in the House often sound ritual, but I know that I am joined by my right
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hon. and hon. Friends, and indeed by Members throughout the House, in thanking the countless people in the NHS and beyond it who work tirelessly for and with those affected by cancer.
My hon. Friend the Member for Billericay (Mr. Baron) made an excellent and constructive opening speech. I could not help being rather amused by the Secretary of State's slight discomfort over having to take the politics out of the NHS, but we were serious about wanting to debate the future of cancer services as a high priority. We heard from many Members on both sides of the House. The hon. Member for Northavon (Steve Webb) talked about the possibility of securing much lower provider costs for the NHS. That is, of course, an important subject, but I was particularly interested in what he had to say about the herceptin issue. For the sake of brevity, I will give the source for everything that he said about it. It can be found in column 1062 of the 8 December edition of the Official Report, set out wonderfully by my hon. Friend the Member for South Cambridgeshire (Mr. Lansley). He is obviously grateful that it has been read into the record again.
In a celebration of a local investment to which he wished to draw attention, the right hon. Member for Oxford, East (Mr. Smith) mentioned tariffs that have recently been imposed in a most incompetent manner. I think he found it difficult to refrain from mentioning that. However, he rightly highlighted the uncertainty that that is causing and the quick resolution that is required to clarify the matter. He asked whether the serious deficit in the Oxford Radcliffe Hospitals NHS Trust should be spread among others. He seemed to be shifting the debate as well as shifting the deficit, rather than dealing with the fundamental issue, which is vital to so many of the issues that we face in the NHS.
The hon. Member for Norwich, North (Dr. Gibson), the chairman of the all-party group on cancer, as ever gave us an enthusiastic tour d'horizon of leading-edge scientific progress in this country. He advanced a wonderful argument for the success of our competitiveness internationally, intellectually and scientifically and then suggested that we get rid of competition. That was an interesting circular argument, which all of us will enjoy pondering once the Official Report is out.
We heard movingly from my hon. Friend the Member for North Wiltshire (Mr. Gray), who gave his personal testimony, particularly in the light of the difficult and dreadful experience that his wife has been through. I was very pleased, as I am sure all hon. Members were on both sides of the House, to hear that she has been given a clean bill of health and continues to receive the follow-on treatment. He made the important point, which we have sought to emphasise, that it is to the benefit of patients and to the subject as a whole that we take great care not to make it deliberately a party political issue when we look at the opportunities to improve outcomes for cancer survival and treatment.
We also heard from my hon. Friend the Member for Rochford and Southend, East (James Duddridge). Apart from the slightly interesting start, when he called his Whip bewildering, which struck me as instant career death, he spoke powerfully and made a cogent case on
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behalf of himself and my hon. Friends the Members for Southend, West (Mr. Amess), for Castle Point (Bob Spink) and for Rayleigh (Mr. Francois) about the cancer network, and what the appropriate size is for the South Essex cancer care centre, considering local conditions. I hope that people at both national and local decision-making levels have taken due account of that strong and well-made case.
We also heard from the hon. Member for Gateshead, East and Washington, West (Mrs. Hodgson)that is certainly one of the most confusing constituency titles, with half of each city in it. She said that she spent some time deciding what to specialise in. I felt that she spoke sensitively about her experience as a result of the breast cancer of her friend. The House was helped by hearing of that experience.
Looking at the future, we have to be clear where things stand today. As my hon. Friend the Member for Billericay said in relation to cancer care services, the present situation is unacceptable. There has been investment and continuing improvements, the Organisation for Economic Co-operation and Development has confirmed that the trend was already well established before this Government took over nine years ago, buthere is the big butafter nine years, survival rates are still among the worst in Europe, and significant inequalities of outcome persist in the UK. According to the Public Accounts Committee report, those inequalities are widening, not narrowing.
As we have heard today, difficulties have arisen following the Government's efforts to focus targets on reducing waiting timesthe front end of the patient pathway. That has led to neglect of later treatment. We face a serious issue: once a patient is on the pathway, the pipeline of time is extending. There is a serious issue in respect of how to deal with the problem involving radiographers.
It was interesting to note that the future of cancer services is threatened because of the NHS's ballooning deficits. Will the Minister answer the excellent question from the hon. and learned Member for Redcar (Vera Baird) and confirm that there is no diminution or delay regarding the announcement from the Minister of State, Department of Health, the hon. Member for Doncaster, Central (Ms Winterton), as recently as August last year of a £37.5 million bowel cancer screening programme, which was confirmed just 30 days ago? Will she confirm that it will be up and running in April with five centres, not just one, as is being hinted as part of the financial cuts?
In addition to issues such as waiting times, the size of the work force, the new requirements for benchmarking and the exchange of informationso that clinicians, who are best placed to make such judgments, can draw on the very best of existing practicethere is another big issue that we need to concentrate on. The Secretary of State has had some time in which to deal with the herceptin issue. On the question of the announcement that she made in October, even if she is arguing that she did not say that she would end the postcode lottery for early-stage breast cancer and that there was no change, therefore, in her Department's policy, one is still left with the following question. Why on earth did she make the statement that she made in October, unless it was made on the ground of cost?
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We were determined to raise today on the Floor of the House the future of cancer care services, because it is a priority. Such services need not merely to be maintained: the trends need to be enhanced, given the debilitating effect that cancer has on so many people in this country. At the moment, the opportunities to enhance the services available are being missed.