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Economic and Voting Scales

6.31 pm

Sir Gerald Kaufman (Manchester, Gorton) (Lab): I wish to present a petition in the name of my constituent, Mr. Martin Burke.

The petition states:


Schools (Yorkshire)

6.34 pm

Ms Dari Taylor (Stockton, South) (Lab): I beg leave to present to the House a petition signed by 6,000 residents, the majority of whom are parents of young children, and who live in Ingleby Barwick, a residential area in my constituency. They are requesting that the Government locate the rebuilding of Egglescliffe school in the Preston Park area of Stockton-on-Tees, so that the school will serve the two communities of Ingleby Barwick and Egglescliffe, delivering excellent education to all children.

The petition states:


Roads (Cheshire)

6.35 pm

Mr. Mike Hall (Weaver Vale) (Lab): This petition relates to a road proposal being brought forward by Cheshire West and Chester local authority to link the Winnington urban village to the A556. The proposed road will pass through the Hartford part of my constituency and through a conservation area. If this had been a planning application, it would have been refused. However, because it is a road scheme, it is being permitted to go ahead. Unfortunately, the work started on Monday. This petition has been collected by the Hartford civic society and contains more than 800 names.

To the House of Commons:


20 May 2009 : Column 1607

Clatterbridge Centre for Oncology

Motion made, and Question proposed, That this House do now adjourn. —(Mr. Frank Roy.)

6.36 pm

Ben Chapman (Wirral, South) (Lab): I am delighted to have secured this debate on the Clatterbridge Centre for Oncology. It is an immensely valuable institution and a source of pride to the local community, but I fear that it is none the less under a degree of threat. My right hon. Friend the Member for Birkenhead (Mr. Field) would have liked to be here, but was unable to be. He has asked me to say that he supports my campaign to prevent moves that could damage the services provided at the CCO. My hon. Friend the Member for Wirral, West (Stephen Hesford) has been similarly supportive throughout the campaign and in this context.

Stephen Hesford (Wirral, West) (Lab): I congratulate my hon. Friend on securing this important debate. May I remind him of a meeting that we had with the Under-Secretary of State for Health, my hon. Friend the Member for Brentford and Isleworth (Ann Keen), whom I am pleased to see in her place tonight? Does he remember that that meeting was not wholly positive? Is that one of the reasons he feels the need to bring the matter before the House of Commons? May I urge him to continue his work in this regard?

Ben Chapman: I am grateful to my hon. Friend. I well remember that meeting with the Minister. Of course, she was listening then, as I hope she will do tonight to the points that we are about to make.

Max, the son of my hon. Friend the Member for Alyn and Deeside (Mark Tami), was given radiotherapy treatment at Clatterbridge prior to having a bone marrow transplant, and my hon. Friend—whom I am delighted to see here—is unstinting in his praise for the services provided there.

I want to say a few words about the history, which illustrates the CCO’s long-standing contribution to cancer services in Britain and to its locality. The centre’s roots date back over a century to the Liverpool hospital for cancer and diseases of the skin, which was established in 1862. In 1882, the hospital moved to a new site and was renamed the Radium Institute. The first Roentgen ray apparatus was purchased in 1901 and the centre gradually developed into one of the two major radiotherapy centres in the north-west of England. The centre has been at Clatterbridge since the early 1950s. It has provided chemotherapy since the 1970s, and CCO consultants were among the first to use multiple-drug chemotherapy. Today, the centre is thriving. It became a foundation trust hospital in 2006. Patient numbers are continually rising, with an average of 50 treated on each accelerator every day. Over 7,000 new patients are registered at the hospital each year.

The CCO has received significant investment in recent years and is now one of the best-equipped radiotherapy centres in Britain. Facilities include nine linear accelerators, which I am going to call “linacs”, a cobalt unit, superficial and orthovoltage X-ray machines, two simulators, two scanners, tomography simulators and so forth. The centre places great emphasis on research and development, regularly participating in national and international
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clinical trails. It employs 650 staff, most of whom live locally. Any diminution of services would thus be damaging not just to the hospital but to the community.

In addition to the CCO’s importance locally and to patients, it is recognised at national level as an outstanding NHS foundation trust. The Healthcare Commission rated it as excellent for quality and use of resources; and Monitor awarded the CCO green for governance and the provision of mandatory services, and gave it 5—the highest possible mark—for financial viability. It is in excellent financial shape.

The quality of the treatment provided is matched by the service delivery record. There is no waiting time for chemotherapy at the CCO, with 66 per cent. delivered in outreach clinics—the highest rate in the country. That is important for the comfort and convenience of patients.

Mr. Peter Kilfoyle (Liverpool, Walton) (Lab): I know what a redoubtable defender and advocate my hon. Friend is of Clatterbridge hospital and the fine services it provides. That is to his credit, but will he say a little more about the plans for outreach across other hospitals in the region? I know that both he and I support that outreach in order to ensure that the excellent services currently provided get to a wider audience.

Ben Chapman: I am grateful, as ever, to my hon. Friend, who takes a considerable and continuing interest in this subject. I will of course deal with the issue he raises as I develop my speech.

Despite the CCO’s impressive record in the provision of services and its importance locally and nationally, its future is to a degree under threat. The crux of the issue is that the Merseyside and Cheshire Cancer Network has put forward proposals for two satellite sites with linacs used in radiotherapy treatment. One satellite at Aintree, to be run as a CCO operation, has been agreed and no one contests that it will make an important contribution to providing accessible services for those living in and around Liverpool. However, I am not sure that the case has been made—my hon. Friend may well disagree with me on this point—for a second satellite at the Royal Liverpool hospital, only 5 miles from Aintree. Let me say a little more about this.

What are the reasons put forward in favour of these proposals? I am told that the two satellites are necessary to

It is assumed that the establishment of a second satellite only 5 miles from the first will inevitably improve cancer outcomes in Liverpool and satisfy unmet demand. Clinical opinion at the CCO, however, states that patients from the region, and particularly in Liverpool, already receive the best treatments available and that the outcomes following diagnosis are similar to the national rate. In fact, the cancer reform strategy and the north-west cancer plan both argue that late diagnosis is the major contributing factor to poor cancer survival rates. There is no evidence to suggest that providing more non-surgical oncology services in a given area—in this case, in Liverpool city centre—would have a direct impact on survival rates. Improved screening programmes and public awareness campaigns are considered more likely to make a difference.

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A related argument presented in favour of a second satellite at the Royal is that Clatterbridge is too far away for patients in Liverpool and that more non-surgical oncology services, over and above those planned for Aintree, are necessary to improve access. I am not wholly convinced that cancer services cannot be accessed within a reasonable travel period by people in Liverpool, or more generally in the Cheshire and Merseyside area that the CCO covers. The cancer reform strategy recommends that travel times to services should not exceed 45 minutes, and 92 per cent. of CCO patients travel by car, ambulance or taxi and are able to obtain their treatments within that time—and in many cases more quickly. When the Aintree site is fully functioning, times will be even shorter.

I want to emphasise that I accept the need for some non-surgical oncology services to be provided at a satellite in Liverpool. Along with the CCO and others involved, I very much support the establishment of the site at Aintree, which the CCO will provide. However, in that light, it is very difficult to see why we need a second site only five miles away. Projections suggest that the Aintree site will provide enough linacs to meet demand until 2017, so the second satellite will lead to overcapacity. Resources, which are always finite, will be hard pressed in the current economic climate; and it seems to me that overcapacity in Liverpool across the two sites will inevitably lead to a reduction of services at the CCO.

Furthermore, even if it could be proved that there is a need for additional linacs beyond those already provided at the CCO and at the Aintree satellite, that would not necessarily provide an argument for the establishment of a second site. Surely it would be logical and cost-effective to increase the number of linacs at Aintree. I am told that the site could incorporate that, and it would prevent the expenditure involved in building another site.

All this must be seen in the context of wider proposals for relocating the CCO to Liverpool, which are outlined in the Baker review. There is now general agreement that such a move, which would cost approximately £150 million, is inconceivable in the current economic climate, and it has been put on the back burner for at least the next five years. However, the chairman of Cheshire and Merseyside strategic health authority has confirmed that it is the “direction of travel” towards 2020.

That bothers me. I challenge the fundamental assumption that the primary centre for non-surgical oncology services in the region should necessarily be in Liverpool. The existing Clatterbridge location is liked by patients, it ain’t broke, it is a pleasant environment and, as I have said, it makes an important contribution to the local community. To move it would involve unnecessary and unwise expenditure, and in my view the idea has no obvious merit. Furthermore, proposals to move the centre seem to reflect a city-centric point of view. In fact, the CCO serves Cheshire and Merseyside and, as we have just heard, part of north Wales—Alyn and Deesside—and in that sense it is centrally located.

The case that the Royal is a desirable location for these services rests on two central arguments. The first is that it would allow cancer services to be in close physical proximity to acute facilities. Although I see the merits of that argument, it does not necessarily provide a reason for the centre to be moved to Liverpool. The CCO is about 15 minutes’ drive from Arrowe Park
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Hospital. It is also developing its own high-dependency unit to support patients who become acutely ill during their treatment at the centre.

Secondly, it has been argued that the Royal location has advantages in terms of its academic links. However, the first satellite is to be built on the campus of the University Hospitals Aintree NHS Foundation Trust, which enjoys the same status as the Royal in terms of well-established academic links with Liverpool university. It seems to me that there is some confusion between academic status and proximity to the university itself. Moreover, the CCO is committed to developing its academic links and research. I am not convinced that the case for relocation at the Royal has been fully demonstrated either by the arguments about its acute facilities or by those about its academic links.

As I have said, for the time being there are no clear plans for a full-scale relocation, but I fear that, in the short term, the creation of a second satellite may constitute a piecemeal development, which the Cancer Network, the Royal and PCTs hope will eventually lead to the establishment of a cancer centre at the Royal. The second satellite was originally suggested in the context of relocation of the whole centre, in the light of the Baker report. It does not make sense on its own merits. However, the Cancer Network and PCTs preferred to push on regardless, apparently on the primary basis that if the money was available, why not?

This raises important question about how decisions are made about cancer services in the region. I am deeply concerned that PCTs, which have the power to determine the expenditure of large amounts of money—for instance, on the establishment of the proposed satellites—are, in my experience, only notionally accountable and often, I am afraid, profligate. They have not consulted me or other local Members of Parliament—or as far as I am aware, others—about the current round of proposals. If the PCTs are only notionally accountable, the Cancer Network is wholly unaccountable. Although it can only make recommendations rather than decisions, the PCTs do not appear to have probed its proposals sufficiently before endorsing them.

There is a clear need for cancer services in the region to be viewed on a strategic basis. Resources must be allocated and services located in a logical and transparent way, based on an assessment of the current and future needs of all local people and on expert advice.

I have described the CCO as a centre of excellence, and as such it is worth protecting for a number of reasons. It houses an impressive concentration of services and expertise, and continues to develop, improve and carry out research. As such, it is in a strong position to attract investment. In the current economic climate, funding will of course be scarce. Public money must be used even more wisely and cautiously than usual. If services are salami-sliced away from Clatterbridge with no clear plan, and cancer services in Merseyside are spread across multiple sites, no one institution in the area will draw the substantial funding that will be required in future years. Furthermore, if services are gradually moved from Clatterbridge, eroding the critical mass, the centre may well suffer a loss of confidence. It will fail to attract the best qualified staff, and it may start to decline.

20 May 2009 : Column 1611

I suspect that the Minister will reply to me on the basis of drafts provided by the strategic health authority and the Cancer Network. However, in none of the correspondence that I have received from either of those organisations is there any evidence that they have taken account of the views of the CCO, or, indeed, of the concerns expressed by me and my hon. Friend the Member for Wirral, West. Can the Minister assure me that she will take account of them in her response, and may I tell her that although what is proposed is euphemistically presented merely as a long-term “direction of travel”, in my view it is a wrong direction for which the case remains unproven and the costs very large?

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