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4.28 pm

Justin Madders (Ellesmere Port and Neston) (Lab): I congratulate the hon. Member for Basildon and Billericay (Mr Baron) on securing this incredibly important debate along with the hon. Members for Bury St Edmunds (Jo Churchill) and for Bosworth (David Tredinnick). I welcome the considered way in which he set out the issues in his opening speech. He raised a series of important questions for the Minister on earlier diagnosis, the measurement of the performance of CCGs, patient experience metrics and the cancer drugs fund. Those are all important issues that are set out in the strategy. I echo his tribute to the various all-party parliamentary groups on cancer. They do an extremely good job of highlighting these issues in Parliament and we all welcome the contribution they make.

I thank my hon. Friend the Member for Alyn and Deeside (Mark Tami) for raising the important issue of blood cancer. His family experience highlights the lack of support, particularly for children, during the period beyond cancer. The strategy tries to begin to address that issue. I also thank my hon. Friend the Member for Scunthorpe (Nic Dakin) for his speech, as well as for his work as chair of the all-party group on pancreatic cancer. He quite rightly pointed out the very poor survival rates for pancreatic cancer and the difficulty of getting referrals for diagnosis from GPs.

I echo the comments made by the hon. Member for Castle Point (Rebecca Harris). She raised important issues regarding the repurposing of drugs, particularly for the treatment of brain tumours. The hon. Member for Foyle (Mark Durkan) also made valid points about how the various groups should not be seen as rivals. Indeed, they should be united behind this one strategy, the full force of which has been expressed today.

I also echo the comments made by the hon. Member for Bury St Edmunds. She pointed out that, with more than 200 different types of cancer, an overriding strategy is needed. She reminded us of the shocking statistic that about 20% of diagnoses take place in accident and emergency, which really highlights the challenge we face in making correct diagnoses. She also highlighted the policy gap in relation to off-patent drugs, which we recently discussed in the Chamber.

All Members speak on this matter from experience, which is sometimes of a very personal nature. It is the personal experience of many of those who have contributed to the strategy that we are debating that makes the document so powerful. We know that one in five people who are diagnosed with cancer feel they are treated as a set of symptoms, rather than recognised as a person. We clearly need to change that. The very moving speeches today help us to remember that behind every statistic there is a person with a family and friends.

The Opposition welcome the recommendations of the independent cancer taskforce, many of which build on proposals that the Labour party set out before the election. We hope that the strategy will be implemented in full. It has the potential to deliver improved outcomes for patients, while also delivering better value to the taxpayer. However, as several hon. Members have said, we will realise such benefits only if the recommendations are delivered in full, with front-loaded investment. I hope that the Minister will confirm that the funding required to deliver the strategy will be included in the

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comprehensive spending review next week. He may be under instructions not to pre-empt the Chancellor’s big day, in which case we hope that the mood of the House can be conveyed to the right hon. Gentleman.

There have been some positive developments on cancer drugs and screening in recent years, but our progress on cancer care has stalled to some extent. The target to treat at least 85% of cancer patients within 62 days of being urgently referred by their GP for suspected cancer has been missed in successive quarters across England for almost two years. Of the 21,629 patients who waited more than 62 days in 2014-15, 42% waited between two weeks and one month after the target date and about a quarter waited for even longer. As Cancer Research UK has pointed out, this is not just a missed target; patients are being failed when they have to wait too long for treatment.

Another concern is that, despite progress in improving some cancer survival rates over the past decade, we still lag behind the best-performing countries. As several hon. Members have mentioned, it has been estimated that up to 10,000 deaths each year in England can be attributed to lower survival rates compared with those in the best-performing countries. As hon. Members have repeatedly pointed out, diagnosis of cancer at a later stage is generally agreed to be the single most important reason for the lower survival rates in England, so it is vital that we do better not only on early diagnosis, but on prevention and awareness.

With a total of 95 recommendations, the strategy will need consistent political and financial support if it is to be implemented in full. We welcome the possibility of a national cancer advisory board, which, as the report states, would allow a mirror to be held up to the NHS on progress in implementing the strategy. No doubt the precise make-up of such a body would be a matter of detail, but we are keen to ensure that there is an independent chair, as has been mentioned, and that patients’ voices are heard on that body.

With so many individual recommendations in the report, it is impossible to do them all justice in the time available. For those unable to read the entire report, I suggest that the principles set out on page 16 are a very helpful overview of the core aims of the strategy. I do not propose to go through all 95 recommendations—we certainly do not have time to do so—but I want to talk about one or two areas.

I want to speak about the quality of life after treatment and about end-of-life care. One of the most compelling and difficult debates in which I have been involved during my short time in the House was that on the Assisted Dying (No. 2) Bill. One message that came through loud and clear in the debate was that there are massive differences in the quality of palliative care available. Evidence consistently shows that far more people diagnosed with a terminal illness would prefer to die in their own home than currently get the chance. That is not an easy conversation to have, but we must get better at it.

I was pleased that the report acknowledges the clear link between cancer and poor mental health. Around 10% of patients with cancer will develop serious depression, and around half of all patients have some unmet need six months after treatment has concluded. Proposals to improve detection of mental health issues and to integrate better the various treatments are to be welcomed, and will hopefully lead to better patient outcomes.

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However, the strategy goes well beyond that and, as we have heard, it recognises that support for patients post-treatment in terms of lifestyle, finances and work must be hugely improved. Secondary cancer is also a huge problem, and we must ensure that care after cancer is just as good as treatment of it. I am glad that the Secretary of State has committed to the development of a quality of life metric. Improvements to the system must ensure that how well people are living is just as important as how long they live for.

Too many people are left to fend for themselves in a complicated, bureaucratic maze, while having to cope with unmet physical, emotional and financial needs—my hon. Friend the Member for Alyn and Deeside set out starkly some of the challenges that individual patients have to deal with. Nobody should have to go without help after suffering the hardship of cancer treatment, and we hope it will be possible to ensure that everybody with cancer has access to a recovery package by 2020.

In the short term, steps can be taken to make life easier. Macmillan Cancer Support has calculated that the financial impact of a cancer diagnosis makes someone on average £575 a month worse off. That is why proposals in the Welfare Reform and Work Bill to take away £30 a week in unemployment support allowance from those with cancer who are placed in the work-related activity group seem at odds with what is set out in the strategy. We need joined-up thinking not just across the health service, but across the Government and the whole of society. The report estimates that by 2030 the number of people in work who will be affected by cancer is set to increase by 1 million, and although there is statutory protection under the Equality Act 2010, in reality someone is 1.4 times more likely to be unemployed if they have cancer.

The greater role that wider society can play is set out clearly in the report, which calls for

“a radical upgrade in prevention and public health.”

If we are to make this strategy work, we must consider forming a new tobacco control strategy, and a national obesity strategy that goes beyond the responsibility deal, which is largely limited to reducing the prevalence of obesity in children. The strategy is right to include an ambition to reduce the prevalence of overall adult smoking to less than 13% by 2020. It is not difficult to imagine that current measures will do much to make that happen, and I am pleased that the report includes a recommendation that the NHS should work with the Government to deliver and implement a new tobacco control strategy within the next 12 months.

This is a matter of equality. We all know about the diverse life expectancy figures in different parts of the country, and about how a difference of just a few miles can mean huge gaps in life expectancy. There would be around 20,000 fewer deaths per year across all cancers if socioeconomically deprived groups had the same incidence rates as the least deprived. Smoking plays a large part in that, and more than half of the inequity in overall life expectancy between different social classes can be at least partially attributed to higher smoking rates among the less well-off.

My hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) deserves praise for her marathon effort to ban smoking in cars with children, and such measures will further deter smoking and encourage people to give

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up. However, even before that strategy has found its feet, it has been undermined by another huge cut to the public health grant for local councils, which will almost certainly mean that smoking cessation services are slashed.

If we are to take the Government seriously on public health, and if this strategy is to work, it must be supported fully. In-year cuts to public health funds go wholly against the strategy, and are contrary to any strategy that seeks a sustainable health service moving forward. As many experts have said, these cuts will end up costing more than they save. They are a political choice, and we should send a strong message to the Chancellor that they should not go ahead.

The introduction of the cancer drugs fund has been a positive development, and it delivered important benefits to patients over the course of the last Parliament, which we welcome. However, 19 treatments were cut from the cancer drugs fund at the beginning of the year, and another 18 went this month. Charities estimate that more than 5,500 patients a year will now be denied access to these life-extending treatments. Will the Minister tell the House whether he supports the removal of those treatments, and, crucially, what support will now be given to the thousands of patients who will miss out on the drugs in the future? I appreciate that this is not an easy situation, but it seems particularly cruel to give people hope and then to take it away.

I want to mention the need for renewed focus on treatments other than drugs. Before the election, Labour promised to create a new cancer treatment fund to look at all treatments available. Surgery and radiotherapy are responsible for nine in 10 cases where cancer is cured. The taskforce concluded that in a number of areas access to treatments such as radiotherapy are not at the level they should be. About half of all radiotherapy machines are reaching the end of their useful lives. We need to upgrade them so we can deliver safer care. We should also enable the more widespread use of modern radiotherapy techniques. Some 38% of cancer patients in England currently have radiotherapy as part of their treatment, but evidence from abroad suggests that this should be closer to 50%. We need to understand why there is this difference and to work towards correcting it.

I have touched on only a few parts of the strategy, and I hope there is recognition that there are wider challenges beyond the strategy itself. Where the Government are clearly working towards the aims of the cancer strategy, they will have our support. I would therefore like to ask the Minister what steps the Department will be taking to ensure that comprehensive implementation plans are laid out for the strategy as a whole by 31 March 2016.

Many Members will have lost someone close to them as a result of cancer. We owe it to everyone affected by this terrible disease to implement and support in full the recommendations set out in the strategy, so we can take further steps towards finally beating cancer.

4.41 pm

The Parliamentary Under-Secretary of State for Health (Ben Gummer): It is a great pleasure to respond to the excellent speeches that have formed this interesting and remarkably well-informed debate. I echo the thanks given by the shadow Minister and others to my hon.

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Friends the Members for Basildon and Billericay (Mr Baron), for Bury St Edmunds (Jo Churchill) and for Bosworth (David Tredinnick) for securing the debate in such a timely manner. I do not think that even they would have anticipated it coinciding with today’s launch of the consultation.

The debate touches on the lives not only of everyone in this House but of everyone in the country. The frustrating regularity of cancer diagnosis—in the past week, two of my friends have had a cancer diagnosis confirmed—is shared by Members and by people watching this debate across the country. That is why this is such an important and salient issue for all our constituents. I am therefore very grateful to hon. Members for both speaking on this matter and for bringing it to the attention of the House.

At the start of my speech, it is worth reflecting that we are able to speak about this issue from a position of celebrating the success of the past few years. There have been quantum leaps in the treatment, diagnosis and survival rates of cancer. More than half of people receiving a cancer diagnosis now live 10 years or more, a remarkable statistic that would scarcely have been believed 20 or 30 years ago. The fact that we are able to speak frankly about this at all, with the very personal speeches hon. Members have given today, marks the end of the dangerous taboo surrounding talking about cancer. Happily, we are now able to replicate that fight in relation to mental health and end-of-life care. The work done by cancer charities over many years, to talk about cancer and to make it a live issue in the public imagination, is now reflected in other important areas of care.

Mr Baron: The Minister is absolutely right to say that we have made great strides, and the Government are to be congratulated on playing their full part in that, but may I gently remind him that as we have made great strides, other countries have also made great strides? The debate is largely about the fact that we are still well behind European averages on survival rates. The first year survival rate in this country is 69%, whereas in Sweden it is 81%. That apparently small difference accounts for about 10,000 lives a year in this country being needlessly lost because we diagnose too late. I am sure the Minister will agree that there is still a lot to improve on.

Ben Gummer: I could not agree more with my hon. Friend. I was not trying to offer mere bromides. Indeed, I was about to say that although we perform well in many clinical areas, we perform badly on cancer compared with other countries. We have made significant progress over the past few years, but we are still not where we should be: at the top of the pack. There are many reasons for that, some of which we understand and some of which we do not, but it behoves us all to do something about it, which is why the taskforce was set up. In that regard, I add my thanks to Harpal Kumar and the many people who contributed to the taskforce’s conclusions.

I am speaking to an expert audience here—I am conscious that almost everyone who has spoken has considerably greater expertise in this area than I do—so I will not rehearse the history of the taskforce or its recommendations. Importantly, there is now a consensus about what needs to happen. Various things have to happen if we are to deliver on the aims of the taskforce.

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Mark Tami: Does the Minister agree we should be talking about people living with cancer and the associated issues? A lot of people talk about “a cure” as if everything goes back to how it was before the diagnosis.

Ben Gummer: We should indeed. I found the hon. Gentleman’s remarks extremely interesting; I learned a lot from them.

I want to answer hon. Members’ questions as well as I can, although I am conscious that I am answering them on behalf of the public health Minister, who has responsibility for cancer and has considerable expertise in this area. She is sorry she cannot be here. My hon. Friend the Member for Basildon and Billericay (Mr Baron) asked some salient questions. The first was: when will the taskforce conclusions be implemented? He will know that the new national director for cancer has just been appointed, and I met her yesterday. As he knows, she is an immensely impressive women, having run one of the foremost cancer institutes in the world, and she is aware that one of her initial tasks is rapidly to set out an implementation plan. In doing that, I know she will want to speak to the all-party group on cancer as soon as she develops her plans in order to keep its members abreast of developments and to hear their views about the pace of implementation. I will ensure that officials write to Members with any further details about implementation.

My hon. Friend asked about the CCG scorecards. I understand the nervousness—I detected it in his voice—about the complex measurements and the dashboard being translated into apparently simple measurements in the scorecard. I want to give him some reassurance. The scorecards used for hospitals are immensely complex and have behind them a huge amount of data that are then distilled into simple scorings, the point of which is to provide clear accountability and transparency to patients and people living in CCG areas, who, at the moment, have no grip, because we do not give them any, on how well a CCG is performing. The expert panel looking at the operation of the scorecards will be out for consultation next month and will report back before the scorecards are put in place in April. I know it will listen carefully to his comments about one-year survival rates and the detail of how the scorecards are put together, but I am clear that the oncological experts on the panel will not want to undermine the work done on the various metrics and the dashboard.

My hon. Friend spoke with eloquence about genomics. It is of course true that the reason we are able to make increasingly rapid progress is that cancer is a genetic disease, and genetics and genomics are the great new frontier in medical innovation. In a sense, therefore, dealing with cancer and drugs for cancer will be the tip of the spear when it comes to developing all new drugs in the decades ahead. It is very exciting, but presents massive challenges to funded healthcare systems around the world. It is in trying to find a way of affording the new drugs that are coming online, but also releasing the unique possibilities that the NHS offers, that we think we are in such a strong position to offer opportunities both to those wanting to research cancer from an academic point of view and to those businesses and companies doing so in order to develop drugs.

The point of saying that is that the cancer drugs fund, which many Members referred to in their speeches, will necessarily have to change in response to the significant

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changes of the last few years. To the shadow Minister’s point about the cancer drugs fund, I would gently say that it was an innovation personally promoted by the Prime Minister in 2010. He has made a personal commitment to it, so all Members should take solace from the fact that he will be watching carefully how the fund develops. It has risen from a few hundred million pounds to over £1.2 billion. That demonstrates a commitment that was not present before the cancer drugs fund was invented. Its size is such that it now makes up a considerable part of the overall drugs spending of the NHS.

I hope hon. Members will take comfort from the fact that the consultation announced today by NHS England aims to build on the success of the cancer drugs fund, to incorporate the new structures that need to come about as a result of the significant changes in genomic research over the last five years and to align the general research, licensing and funding of drugs through NICE with the principles of the cancer drugs fund, so that we have a far more integrated system in future. I would encourage all hon. Members present to contribute to the consultation on the cancer drugs fund and thereby help to inform the second stage of its existence, when that comes about—I imagine at some point next year.

David Tredinnick: I may be pre-empting what my hon. Friend is about to say, but on the point about widening the scope of drugs, which he has alluded to, will he take note of the remarks about broadening the scope of patient choice and the range of therapies available, and perhaps using Professional Standards Authority-regulated professionals rather more?

Ben Gummer: I will, and I was about to move on to my hon. Friend’s remarks. He made a similar point—that great progress had been made but there was still much to be done. He spoke with eloquence and detail about complementary treatments, in which I have absolutely no expertise—I shall have to disappoint him on that. I know that he has written to me about the regulation of herbal medicines. I have today spoken to the Minister for Life Sciences, and I know that my hon. Friend will be receiving a full response about the various issues he has raised.

In response to my hon. Friend’s points about complementary treatments, I would say that it is very important when spending taxpayers’ money on cancer treatments that there is a solid evidence base for what we do. However, his point is well made—that the entire person needs to be taken into account when considering treatment. That can also involve people living with cancer, not just the treatment of it.

It was very nice to hear the hon. Member for Alyn and Deeside (Mark Tami) speak. It was also good to hear him speak from a personal point of view—it was good of him to share his sorrow regarding his son. On the stem cell transplantation issue that he raised, I can tell him that the recovery package as part of the taskforce’s recommendations that the Government have already moved on will apply to blood cancer patients who have undergone stem cell transplantation. The Government are very supportive of the work by the Anthony Nolan trust and other charities, but I will make sure that the hon. Gentleman gets a fuller response on the specific issues that he raised, so he can be satisfied that we have taken into account the particular difficulties and challenges facing those who have undergone stem cell transplantation.

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It was a great pleasure to hear from the hon. Member for Scunthorpe (Nic Dakin). I have a particular affection for him, not only because he helped me on the way through King’s Cross the other day, but because he spoke just before me in my maiden speech—we made ours at the same time. This is a good point at which to reflect that the Member who spoke after me was the former right hon. Member for Oldham West and Royton, who is much missed in this place.

The hon. Member for Scunthorpe brought to our attention the issue of rare cancers—specifically pancreatic and blood cancers. I would like to reassure him about research. He will know that Cancer Research UK has looked specifically at the rare cancers and has prioritised work in the areas where it feels additional research funding and effort need to go, which include blood and pancreatic cancers—and, indeed, brain cancers, which my hon. Friend the Member for Castle Point (Rebecca Harris) mentioned. The hon. Member for Scunthorpe also raised the issue of GP imaging capacity, and I would like to reassure him that, as part of the ACE programme—Accelerate, Co-ordinate, Evaluate—by NHS England, imaging will be expanded within primary care. I hope that I will be able to write to him with further details.

I thank my hon. Friend the Member for Castle Point for her fascinating speech and for bringing to our attention the very sad story of her constituent Danny Green. Her point about a national register for off-label drugs was well made, and I know it is an issue that the Under-Secretary of State for Life Sciences, my hon. Friend the Member for Mid Norfolk (George Freeman), is looking at actively. My hon. Friend the Member for Castle Point made a point about research,. She will be aware that it is always difficult to try to divvy up research funding, but I will make sure that her point is reflected back to my hon. Friend the Under-Secretary.

My hon. Friend the Member for Bury St Edmunds (Jo Churchill) made some very good points about joined-up care. It is certainly the case that we need to see such care across the NHS.

The hon. Member for Foyle (Mark Durkan) spoke about the cancer drugs fund, and made an interesting point about a UK-wide set of arrangements. I shall certainly pass on his comments to the Minister responsible for cancer. He also spoke about molecular diagnostics, and I would like to reassure him that, in England at least, we will significantly roll out molecular diagnostics as a result of our acceptance of the principles of the taskforce recommendations.

Finally, the hon. Member for Ellesmere Port and Neston (Justin Madders), the shadow Minister, rightly

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made some points about public health strategy. It is, of course, difficult to make sure that we balance the books, while keeping to our manifesto pledges. His points about tobacco and obesity were well made, and I know that the Government will be coming forward with obesity plans in short order.

With no more time available to me, I would like to thank Members for their full, excellent and expert contributions to this fascinating debate. I hope that the Government have shown the kind of progress and commitment to this important area that they are so keen to see.

Madam Deputy Speaker (Natascha Engel): That leaves one minute for John Baron to conclude the debate.

4.59 pm

Mr Baron: That is very kind and generous, Madam Deputy Speaker.

I would like to thank all who contributed today—it proves how much expertise has been brought to bear in such a well-informed debate from all sides. I would like to thank the Minister once again for stepping into the cancer Minister’s shoes and for answering our questions. I am sure he will want to answer some further questions in writing. I would like to thank him, too, for taking on board the importance that the whole cancer community attaches to the one-year cancer survival rates as a means of promoting earlier diagnosis. I thank him for that.

I leave the Minister and the House with just one thought. There are not many areas of Government policy that could save 10,000 lives a year if we raised our game on earlier diagnosis. We need a policy that will match the best internationally. We have that capability in our hands: let us hope that we seize the opportunity.

Question put and agreed to.


That this House notes the findings of the independent cancer taskforce published in July 2015; and calls on the Government to publish an action plan on implementing the new cancer strategy.

Business without Debate

business of the house


That, in respect of the Northern Ireland (Welfare Reform) Bill, notices of Amendments, new Clauses and new Schedules to be moved in Committee may be accepted by the Clerks at the Table before the Bill has been read a second time.—(Jackie Doyle-Price.)

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Mesothelioma Compensation (Military Veterans)

Motion made, and Question proposed, That this House do now adjourn.—(Jackie Doyle-Price.)

5 pm

David Mackintosh (Northampton South) (Con): Thank you, Madam Deputy Speaker, for giving me an opportunity to speak about mesothelioma compensation for military veterans. I am pleased that it follows such an important debate on the wider cancer strategy. I also thank the members of the public who have taken the time to come and watch our proceedings from the Gallery, and who signed the petition. It is encouraging to see such strong public support for change, and I am glad that I have the chance today to bring this issue further into the spotlight. I pay tribute to other Members who have raised the issue, including my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch), who has done so much work on it in the past.

Before I speak about the specific case of my constituent and the problems he faces, let me explain what we are talking about today. Most people who are suffering as a result of exposure to asbestos have been compensated thanks to the Mesothelioma Act 2014, which was passed during the last Parliament and which allows those who were diagnosed with mesothelioma on or after 25 July 2012 to apply for compensation. However, when Parliament reviewed the Act in July 2013, Lord James of Blackheath noted that although civilians suffering from mesothelioma would benefit from it, naval personnel with asbestos-related illnesses would be left behind in terms of financial reparations.

Given its association with asbestos, mesothelioma usually affects individuals who have worked in professions such as carpentry or construction, but it has also afflicted a large number of veterans, particularly naval personnel who worked as engineers in the boiler rooms of ships, and it is on that specific aspect that I intend to focus.

Service personnel and veterans are unable to sue for injuries and illnesses sustained before the introduction of the Crown Proceedings (Armed Forces) Act 1987. The only avenue of redress open to veterans with mesothelioma is the war pension scheme, which awards regular payments for life. It is difficult for the scheme to accommodate serious long-term illnesses, as it cannot award large lump sums to those recently diagnosed with terminal conditions. As a result, although service-related mesothelioma attracts a 100% war disablement pension, veterans who are single, divorced or widowed stand to receive considerably less compensation than their civilian counterparts.

For example, whereas a 63-year-old civilian claimant would be awarded about £180,000 in compensation under the Government’s diffuse mesothelioma scheme, a veteran of the same age who lived for one year would receive just £32,000 under the war pension scheme. In fact, many veterans would receive even less. That is at odds with the armed forces covenant, which states that members of our armed forces community should experience no disadvantage as a result of their service, and it is an unfortunate anomaly in the system. I am sure other Members will agree with me when I say that I do not believe the House intended to cause such discrimination

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against military veterans, but that is the situation that confronts us today. I certainly commend the Government for all their work on the armed forces covenant.

Michael Ellis (Northampton North) (Con): I congratulate my hon. Friend and constituency neighbour on securing the debate. Does he agree that military veterans are among the very best in our society, and that, far from being prejudiced in any way by their military service, they should be rewarded? When an ailment has resulted from their service, should not the Government do everything they can to ensure that they are adequately compensated?

David Mackintosh: I thank my hon. Friend and neighbour for raising that point. I do agree. I will talk later about my constituent. I think that Members will agree that he served our country admirably and went over and above what was asked of him.

I was talking about the armed forces covenant. I congratulate the Government on everything that has been done so far. Clearly, there is more to do. The covenant has enshrined two underlying principles in law. Members of the armed forces community should face

“no disadvantage compared to other citizens in the provision of public and commercial services”


“special consideration is appropriate in some cases, especially for those who have given the most such as the injured or the bereaved”.

As leader of Northampton Borough Council, I signed the Northampton armed forces community covenant in 2013 further to embed those commitments in my local community. I am pleased that that has been taken up by so many other local authorities around the country.

I move on now to the case of my constituent Mr Fred Minall, a veteran who is affected by this. He first raised the issue with me when he was diagnosed a few months ago. Mr Minall is a naval veteran who is suffering from mesothelioma as a result of exposure he received while on active duty between 1957 and 1965 with the Royal Navy. When Fred came to see me to tell me about the problems he was facing, I was very moved. I was also shocked that an anomaly in the system had put him in this position, and concerned that there may be many other veterans such as Fred who are suffering from mesothelioma but who are not receiving the support available to other sufferers outside the military.

Bob Stewart (Beckenham) (Con): Does my hon. Friend have any idea how many naval veterans in total may have mesothelioma now? How many people are we talking about?

David Mackintosh: I am grateful to my hon. and gallant Friend for raising that matter. I will talk about that later, but the Royal British Legion estimates that about 2,500 British naval veterans will be affected.

Mr Minall was not able to make it to the Chamber today to watch the debate, as he is undergoing chemotherapy. I know that he is watching at home and that he is pleased that we are able to debate this subject in greater detail and ensure that the issue, which affects a lot of people around the country, receives the attention it deserves. Fred has asked me to say on his behalf:

“Mesothelioma sufferers have little time left, and so we entrust Parliament to make a wise and fair decision, backdating any awards agreed today to the same date as if discrimination had

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been avoided in the 1987 Act. Why should these brave men and women endure discrimination, just when they learn they will die, due to events so long ago, during their dedicated service to Queen and Country? They should be aided and rewarded, not penalised.”

It is hard to disagree.

Mesothelioma is an extremely aggressive form of terminal cancer that is usually caused by exposure to asbestos and affects the pleura of the lungs. The disease can take decades to materialise but, once diagnosed, most sufferers die within one or two years. According to research from the Royal British Legion, with which I have been working closely on the issue over the past months, it is projected that just over 2,500 British naval veterans are likely to die from mesothelioma between 2013 and 2047. There is currently no cure for mesothelioma, which means that it is even more crucial that we are able to help our constituents by doing all we can now.

What can the Government do to help constituents such as Fred overcome the hardship they face? The Royal British Legion has suggested that the Government should offer military veterans the choice between receiving a lump sum compensation payment that is comparable to the sums awarded under the diffuse mesothelioma payment scheme and a traditional war disablement pension. Veterans with mesothelioma should be allowed to choose the form that their compensation takes. We recognise that, for veterans who live for some time, or have a spouse or partner, that should be their choice. The traditional war disablement pension may work out more generous than the lump sums awarded by the diffuse mesothelioma payment scheme. I have already mentioned the armed forces covenant principle that those who are bereaved should, where appropriate, be eligible for special consideration. As such, I would not wish any changes in policy to come at the expense of that arrangement.

We should place great importance on the health and well-being of our veterans and I believe wholeheartedly that they should be treated fairly. I am pleased to hear that the Government are committed to ensuring that those who serve in the armed forces and their families, regular or reserve, past and present, are treated with dignity and receive the care and support they deserve, but this is an anomaly that we need to look at.

I am pleased that the armed forces covenant is enshrined in law so that our forces’ families face no disadvantage compared with other citizens in the provision of public and commercial services. I look forward to hearing the views of hon. Members from across the House, and also to hearing the update my hon. and gallant Friend the Minister is able to provide to me, my constituent and other hon. Members’ constituents who are unfortunate enough to find themselves in this most difficult situation.

5.3 pm

Kirsten Oswald (East Renfrewshire) (SNP): It is a pleasure to follow the hon. Member for Northampton South (David Mackintosh), and I thank him for allowing me to speak in this debate, which he secured, as this is an issue that causes me great concern, as it clearly does him. I completely agree that the case of Mr Minall perfectly illustrates the need for us to have this debate, and to have it now; unfortunately, people such as his constituent do not have the time for us to waste.

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I must also applaud the Royal British Legion, whose campaign in this area calling on the Government to find fairer ways of compensating veterans suffering from this devastating condition, has been very effective. Like the hon. Gentleman, I am aware of many positive developments in the way in which veterans are dealt with across the UK. There have been a number of debates in recent months in this House where this has been usefully discussed.

In Scotland we have a newly appointed veterans commissioner, effective local veterans champions such as those the hon. Gentleman mentioned, innovative housing projects and links with many excellent charities. However, in the UK context, it is none the less true that the issue of mesothelioma represents a gap in our approach to veterans, and one that I sincerely hope we can address.

The hon. Gentleman has already told us what a terrible disease mesothelioma is. There are few things more difficult to deal with for sufferers and their families than the kind of body-blow that a diagnosis of mesothelioma brings. Rectifying this unfair treatment will not make anyone suffering from this disease any better, but it might improve their quality of life during the time they have left, and it might mean that they and their families have significantly less financial anxiety than they may at present.

It is perfectly reasonable to expect anyone in this situation to feel disappointed, because they are being treated less well than their civilian counterparts. That is no way to support our service personnel, and I do hope that we can hear some positive words from the Minister on that.

It is clear that thousands of people who served in the armed services prior to 1987 have been exposed to asbestos while under military orders and have subsequently been diagnosed with mesothelioma. They are suffering from this disease because of the job they did in our armed forces, but clearly at present they are not entitled to the full compensation that others are.

We have heard that around 2,500 ex-service personnel are affected in this way, and every one of them has served this country and has the right to expect to be compensated fairly. Veterans lose out very significantly when compared with civilians in the same position. These civilians may be eligible for up to £180,000 in compensation, but the ex-service personnel may be eligible for only £31,000.

In 2008 the Labour Government published the Command Paper “The Nation’s commitment: cross-government support to our armed forces, their families and veterans”. It stated:

“The essential starting point is that those who serve must not be disadvantaged by virtue of what they do.”

More recently Prime Minster David Cameron has said:

“Our Armed Forces Bill will ensure Parliament holds the Government to account on the central principle of the covenant that military personnel will not suffer any disadvantage as a result of their work”—

and, of course, they should not be disadvantaged. It is not right morally, and it is not fair, but clearly some ex-service personnel are being disadvantaged. This is a breach of the military covenant that we hear so many fine words about.

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The military covenant commits the Government to removing this disadvantage. This situation is most certainly a disadvantage at a most difficult time in people’s lives. We need to deal with it, and do so quickly. Let us back up our words with action. The Royal British Legion summarises the situation perfectly when it says it is

“unfair and has to change”.

As the hon. Member for Northampton South told us, in 2014 the Government set up a scheme to pay compensation to civilians, which is very welcome. However, like the hon. Gentleman, I would like to note that a word of caution about the issue of veterans was already being stated when the Mesothelioma Act was being reviewed in July 2013, but so far that issue has not been resolved. It is our duty to deal with this now, before more ex-service personnel have their final months blighted by financial worry and inequity.

I also note that the independent medical expert group for the new armed forces compensation scheme expresses the view that the war pension scheme is unable properly to recognise the impact of asbestos-related cancer. As we have heard, the Royal British Legion suggests that veterans diagnosed with mesothelioma should be able to choose between receiving a traditional war disablement pension and a lump-sum compensation payment broadly similar to that awarded under the new Government scheme. That would quite reasonably allow ex-service personnel to take account of their particular health and family situation and decide which route was the more appropriate.

The Royal British Legion is clearly not a lone voice in this regard. It has support among Members on both sides of the House, as evidenced by a recent early-day motion, and from Seafarers UK, the Royal Navy & Royal Marines Charity, Poppyscotland and many other organisations. I note that, at a meeting of the Central Advisory Committee on Pensions and Compensation in June this year, the Minister committed to looking at this issue and said that he understood the urgency involved. I am pleased about that, because it is an acknowledgement of the importance of the issue. However, having read a transcript of a debate in this place in February—some 10 months ago—I note that a commitment was also made at that time to look into this matter urgently. It was also noted in that debate that nothing had happened following a previous commitment to deal urgently with the matter five months before that. I therefore have some anxiety about how urgently this is being dealt with, and I hope that the Minister will be able to allay my concerns.

Veterans who develop mesothelioma from working with asbestos while in the Navy can be left tens of thousands of pounds worse off than their civilian counterparts. This is unfair; it is a clear breach of the military covenant and a completely unacceptable way to treat terminally ill veterans. I agree with the Minster that the matter should be dealt with urgently, and I hope that we will hear something today about positive progress and about how we can move this forward.

5.16 pm

The Parliamentary Under-Secretary of State for Defence (Mark Lancaster): I start, of course, by congratulating my hon. Friend the Member for Northampton South (David Mackintosh) on securing this debate to discuss

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compensation for our military veterans who have been diagnosed with mesothelioma. I recognise that mesothelioma is a devastating disease that changes the lives not only of the people who are diagnosed but of those who care about them—their families and loved ones. I recognise that this is an important subject to hon. Members across the House and that it is something we all feel strongly about, as evidenced by the correspondence I have received, as well as by the recent letter from the Defence Committee and the early-day motion that some hon. Members have signed. This is also a subject that is close to the hearts of our constituents.

I would like to pay tribute to all those who have taken the time to contribute to the discussions on this subject, some of whom I have engaged with, including the Royal British Legion. I welcome the statement read out by my hon. Friend concerning his constituent, Mr Fred Minall, who I understand has been diagnosed with mesothelioma as a result of his service in the Royal Navy during the 1950s and ’60s. This was something I was very sorry to learn of. Let me reassure all hon. Members that I recognise the need to act swiftly and that I am extremely sympathetic to this cause. I can assure them that I am minded to find a solution, and have been working with my officials to do so, and crucially to do so quickly.

I would like to pay tribute to all our armed forces—those still serving and those who have served. This is particularly relevant at this time of year, as we remember their commitment and sacrifice in serving this country. We owe them all a debt of profound gratitude. This Government and I, as Minister for Veterans, are committed to doing all we can to honour that debt of gratitude. That is why we have put the armed forces covenant, which represents the moral obligation we owe to those who serve or have served, at the heart of our national life and enshrined its principles in law.

Our commitment to doing the very best we can for our veterans is genuine and unswerving. However, it is a commitment that we need to frame within the context of fairness and reality. Mesothelioma is a cancer caused by exposure to asbestos, and 40 years or more can often pass before it manifests itself and an individual is diagnosed, tragically with a short life expectancy thereafter. That is why it is so important to ensure that we get the support right for those who are affected by the disease.

Bob Stewart: Will the Minister give me his reassurance that modern-day sailors are not threatened when they are working in boiler rooms today? We have some pretty old ships, and they might still have asbestos on them.

Mark Lancaster: Indeed, and I will move on in a moment to the action that the Royal Navy has taken. If my hon. Friend will bear with me, I will come to that shortly.

In the light of what I was describing, I want to explain the support that is currently in place for our armed forces veterans who are diagnosed with mesothelioma. Asbestos was identified as causing mesothelioma in the 1960s. At that time, certain types of service in the Royal Navy were identified as particularly increasing the risk of exposure for armed forces personnel. When this was identified the Ministry of Defence started to address the matter quickly. By the early 1960s, the Royal Navy had already introduced new insulation materials on ships and on shore, as well as providing respiratory

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protection for those personnel who were most highly exposed. That was extended to all personnel who were classified as “at risk” in the following years, and by 1973 the risk of asbestos exposure for members of the Royal Navy was very low. It was not until 1987, however, that the Control of Asbestos at Work Regulations were introduced by legislation. As I have indicated, most of the cases of exposure to asbestos were between the 1950s and the 1970s. Under current arrangements, those armed forces veterans who are diagnosed with mesothelioma are able to claim compensation under the war pensions scheme—this applies to service before 6 April 2005.

The war pensions scheme allows an individual to claim the maximum war disablement pension, supplementary allowances and, in many cases, automatic entitlement by an eligible dependant to a war widow’s or widower’s pension. The Mesothelioma Act 2014 enabled the establishment of the diffuse mesothelioma payment scheme. This pays a one-off lump sum to an individual who is diagnosed. That legislation is aimed at those individuals where there is no existing employer to sue. As an enduring employer, the Ministry of Defence has provided for veterans who are diagnosed for a significant period before this through the war pensions scheme. Under the war pensions scheme, claims are settled quickly, so that the early payment of compensation can begin and claimants can be assured that their dependants will be provided for after their death.

It is important, however, that we consider how veterans are treated under the Act. The matter for consideration here is whether the current arrangements for veterans continue to meet the needs for which they were designed. I would again like to thank the Royal British Legion and those who have contributed to the discussion on compensation for veterans who are diagnosed with mesothelioma in the light of the Act—I welcome their engagement. I acknowledge the argument they are making that the Ministry of Defence should offer veterans with mesothelioma the option of a lump sum in compensation which is broadly comparable to that awarded under the Act. During the last Central Advisory Committee on Pensions and Compensation meeting in June, to which the hon. Member for East Renfrewshire (Kirsten Oswald) referred, ex-service organisations were updated on our consideration of this issue. Let me outline what steps we have taken so far.

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Ministry of Defence Ministers commissioned advice from the Independent Medical Expert Group to look at mesothelioma and the awards paid through the war pensions scheme. I want to take a moment to explain some of the observations of the group. It advised that mesothelioma is unique in some respects and considered how awards were made under the war pensions scheme. The group commented that the regular income stream structure of the war pensions scheme addressed the needs of those whose civilian employability was compromised. It observed that the very poor prognosis for the majority of individuals diagnosed with mesothelioma meant that this structure offered only limited benefit in life to the sufferer—I realise that that is a crucial point. However, unlike industrial injuries disablement benefit, the war pensions scheme maintains support to eligible dependants after the pensioner’s death through payments of tax-free dependants’ benefits. While this generosity has been acknowledged, I recognise that the Royal British Legion has raised the position of single, widowed or divorced claimants, and although I am unable to offer a final solution to the House today, I can confirm to hon. Members that I am reviewing the provision that is currently available. I intend to make an announcement regarding the matter of lump sum payments very shortly.

As hon. Members will recognise, this is a complex matter that has required detailed consideration, and close consultation and engagement with colleagues across Whitehall. However, I hope to be in a position to make an announcement as soon as possible. To that end, I hope to update the charities at the forthcoming central advisory committee meeting next month.

In conclusion, I wish to again thank my hon. Friend the Member for Northampton South for calling for this debate on what I recognise is an emotive subject. Let me emphasise again that we place great importance on the health and wellbeing of our veterans and are absolutely committed to treating them fairly. As my officials continue to consider the details of this complex matter, I intend to remain fully engaged, but please rest assured that I am dedicated to bringing this matter to a swift conclusion.

Question put and agreed to.

5.25 pm

House adjourned.