Sharon Hodgson MP's report - Jul-Aug 2020 number 130
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As Shadow Minister for Public Health, Sharon responded to a Westminster Hall debate ahead of World Cancer Day 2019 on behalf of the Opposition.
You can read Sharon's speech below:
It is a pleasure to serve under your chairmanship, Sir Christopher. I start by thanking the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for securing this timely debate, and the other hon. Members for their excellent contributions: my hon. Friends the Members for High Peak (Ruth George), for Lincoln (Karen Lee) and for Coatbridge, Chryston and Bellshill (Hugh Gaffney), and the hon. Members for Strangford (Jim Shannon) for Ayr, Carrick and Cumnock (Bill Grant), and for Central Ayrshire (Dr Whitford).
World Cancer Day gives us an opportunity to come together and celebrate how far we have come in cancer diagnosis, treatment and care. It also gives us a chance to reflect on what more needs to be done to fight cancer. The Minister and I have previously worked closely together as co-chairs, as we often say in debates, on breast cancer, as I also have with the hon. Member for Central Ayrshire. That shows that all the main parties’ spokespersons are committed to working together on this issue.
Cancer is a very emotive issue, as we have heard in this debate in some passionate contributions. One in two of us will be affected by it in our lifetime. Most of us in this room will be here today because of the personal effect that cancer has had on our or our family’s lives. In the UK alone, more than 360,000 people are diagnosed with cancer every year. That figure is expected to rise to more than half a million cancer cases every year by 2035. That is equivalent to one new case every minute. That makes the Prime Minister’s commitment to diagnose three in four cancers at an early stage by 2028 all the more ambitious.
Our NHS workforce do a fantastic job every day in caring for us and our loved ones, but as we have heard, there are chronic staff shortages across the NHS. There are vacancies for 102,000 staff, including 41,000 nurses. That makes it harder and harder for them to do the jobs that they want to do. I agree with my hon. Friend the Member for Lincoln, who as a former nurse powerfully made the point about the effect that the lack of the bursary has on the situation. Cancer Research UK has also pointed to the chronic shortages in the diagnostic workforce, with over one in 10 positions unfilled nationally. This is a worrying trend, as more people are expected to be diagnosed with cancer over the years and the NHS cancer workforce are already struggling to keep up with demand.
We covered a lot of this ground with the Minister in the debate earlier this month, in which we also discussed the long-term plan. The Minister said that,
“we must ensure that we have the right staff with the appropriate skills and expertise to ensure that patients receive the best care.”—[Official Report, 8 January 2019; Vol. 652, c. 60WH.]
I agree with him. Therefore, will he tell the House when he plans to publish the workforce implementation plan and when the budget for Health Education England will be set? Patients have a right to the best possible care and it is crucial that the NHS workforce are able to provide that. That is why I believe the Minister should consider it—as he probably does—a top priority.
It will be World Cancer Day on Monday, and I am proudly wearing my wristband. We must recognise the contribution the UK in particular has made to cancer diagnosis, care and treatment around the world. For example, Cancer Research UK has played a role in developing eight of the world’s top 10 cancer drugs. More than a quarter of the clinical trials that Cancer Research UK funds involve at least one other country. Cancer Research UK’s international grand challenge scheme brings together researchers from the UK, Europe and around the world on three five-year programmes, to take on some of the toughest challenges in cancer research. Cancer is an international challenge, which is why we should all unite together against cancer.
It is not just about surviving cancer. As we have heard today, it is about living well with cancer. According to Macmillan, 70% of people with cancer are living with one or more other serious health condition, often as a result of cancer and its treatment. Similarly, a third of people who have completed their treatment in the last two years say that their emotional wellbeing is still affected. As we have heard, during and after treatment, the cost of cancer can be a major issue with regard to not just loss of earnings, but travel and transport costs, and the increasingly expensive parking charges.
I have supported Macmillan’s Cost of Cancer campaign for over 10 years now. It is sad that we still need to debate and discuss this, but it is still a major issue. The issue of parking could be very easily solved. The cost of cancer also includes access to benefits, as we heard from my hon. Friends the Members for High Peak and for Lincoln. That can also be solved easily by some joined-up action across Government. That is why, when thinking about cancer, we must not forget about after-care, advice and support, especially when it comes to further symptoms that could become secondary cancer. In this regard, I believe that it is vitally important that GPs are aware of all symptoms of secondary cancer, so that it can be picked up as soon as possible.
Finally, in this World Cancer Day debate, I want to pay tribute to all the NHS cancer workforce for all the hard work they do, day in, day out. Whether diagnosing, treating, caring or advising, they do a difficult, but fantastic job, which we are all very grateful for. I also pay tribute to the scientists and researchers who discover the groundbreaking new treatments and information. Finally, I thank the campaigners and volunteers. We cannot beat cancer alone, which is why we must all come together to do so. As always, I look forward to working with the Minister to do just that.
Sharon Hodgson MP's report - Mar-Apr 2017 number 94
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Sharon Hodgson MP's report - Feb-Mar 2017 number 93
Read Sharon Hodgson MP's report - News from Westminster - Feb-Mar 2017 number 93
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In her capacity as Shadow Minister for Public Health, Sharon responded to a Backbench Business Debate on Breast Cancer Drugs, specifically the drug, Kadcyla and other drugs used for treatment of breast cancer.
Image copyright BBC Parliament 2017
You can read Sharon's speech here: Breast Cancer Drugs Backbench Business Debate 26.01.17
Speech pasted below:
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
I thank my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) for securing this debate, following the very sad news that her friend Samantha Heath, who had been receiving this life-extending treatment, had heard from NICE that it was being taken away from her. I am pleased that she was able to secure this important debate through the Backbench Business Committee.
I also thank all colleagues who have attended the debate and made excellent speeches, sharing with us their experiences and thoughts, including the hon. Members for Milton Keynes South (Iain Stewart), for Portsmouth South (Mrs Drummond), for Louth and Horncastle (Victoria Atkins) and for Wycombe (Mr Baker), my hon. Friends the Members for Torfaen (Nick Thomas-Symonds) and for Wythenshawe and Sale East (Mike Kane) and the hon. Member for Linlithgow and East Falkirk (Martyn Day), who spoke for the SNP. I am sure that the Minister has been given lots to think about, and I look forward to her response shortly. I also thank Breast Cancer Now for its work campaigning on this matter, along with Breast Cancer Care for its continued dedication and its support and advocacy for individuals with secondary breast cancer.
In my contribution, I will first briefly establish the documented and perceived benefits of Kadcyla, and then, building on that, discuss the broader issues around the provision of off-patent drugs, before moving on to present the problems with determining the funding of a drug based principally on its cost-effectiveness as judged by NICE.
Kadcyla’s continued funding through the cancer drugs fund in 2015 was a great success for patients and patient advocates. At the time, the value of the drug was recognised and the concession was made that, despite its high cost, its positive impact was worth the funding it needed. Yet just over a year later, the alterations to the cancer drugs fund have prevented the future funding of this drug, along with, potentially, that of a number of other secondary breast cancer drugs such as palbociclib and Perjeta—I hope that I pronounced those correctly—as it moves towards becoming a funding mechanism for under-researched but innovative drugs with cost and value as a principal driver, and away from its original principle, which was to finance drugs that were too expensive to be recommended by NICE but proved effective in treating cancer patients.
We can all agree that patients have benefited significantly since the introduction of the cancer drugs fund, but the progress that has been made in recent years in improving access to cancer drugs is now at risk. That is unsurprising, given the cash-strapped state of the national health service—we have discussed that in the House recently in the past few weeks—which faces pressures to provide these costly drugs that are developed by large pharmaceutical companies, and is forced to consider costs rather than clinical need. I hope that the Minister will tell us whether those concerns have been assessed, and how she plans to address them. We have heard a number of good suggestions today about how funding may be redirected.
Mary Glindon (North Tyneside) (Lab)
Is not the situation made all the more poignant by the fact that since 2001, the incidence of breast cancer has been rising by 9% every year?
That is a very good point. It may be that more and more people are coming forward and being diagnosed, but, as my hon. Friend says, this will clearly become more of an issue, not less of an issue, in the years to come.
As we have heard today, it is estimated that Kadcyla benefits 1,200 women every year in England alone, and that on average it can increase the length of a woman’s life by six months, although reports suggest that in the case of some women that can stretch into years. Even if it is measured in months, however, the extra time is surely priceless to the women and families involved. I speak from personal experience, as I lost my mother-in-law to secondary breast cancer 20 years ago this year, when my children were very small. I know that she fought for every extra week and day in the end, and that she would have given anything for an extra six months to spend with her grandchildren. We all wanted that little bit longer for her. For all those 1,200 women, that extra time is time with their families. It means seeing their children reach perhaps one more milestone, starting school or university, getting married, or even giving them a grandchild. What is the cost of such moments, such memories, which are so precious and which help families so much with what, ultimately and inevitably, will follow?
The hon. Lady has made a powerful point. In the case of the most aggressive cancers, the period between diagnosis and death can be very short. As the hon. Lady says, any extension of life enabling women to celebrate family events, or anything else, is incredibly important, and we should not lose sight of that.
I agree. What price can be put on those precious months?
Thangam Debbonaire (Bristol West) (Lab)
I have some investment in this. My own experience of breast cancer treatment over the last two years has left me passionate about the issue of prevention and early diagnosis. Will my hon. Friend join me in not just thanking the breast cancer charities—as she has already done—but calling on all Members to spread the word among all the women they know that they must learn how to examine their breasts? I learnt how to do it from a comic sketch in a television programme: that is how I diagnosed my lump. I want everyone to learn how to do it, and also to learn what they can do to help prevent breast cancer, because, although there is no magic prevention method, there are ways of reducing the risk.
Although we have not so far touched on prevention or early diagnosis, they are vital issues. We have discussed them in the House on many occasions, but they can never be discussed too often, and I am grateful to my hon. Friend for raising them. Let me add that I am happy every day to see her back in this place, and doing so well.
What also stands out with Kadcyla is the reduced side effects, as we have heard, as opposed to alternative breast cancer treatments, the side effects of which can include the inducement of osteoporosis and an increased risk of blood clots. As some colleagues will, sadly, know first-hand or through experiences of family and friends or constituents, the side effects of some cancer treatments can be truly awful, and in some cases are daunting enough to prevent the acceptance of further treatment entirely. It is a common perception that women make the decision to end their treatment much earlier than planned, despite it prolonging their life sometimes. That is because they feel the suffering they are enduring as a result of the treatment is not worth the additional life it is providing to them, because it is all about the quality of that life.
Research conducted by Genentech in the United States on the side effects of Kadcyla found that less than 5% of women taking the treatment suffered any hair loss. Through my work as co-chair of the all-party group on breast cancer, I know that hair loss can be a highly traumatic experience for women undergoing cancer treatment and is one of the most discussed side effects of cancer treatment in general. Given that in this debate we are discussing the treatment of secondary breast cancer, which is ultimately a terminal disease, the best outcome we can offer through treatment is both the extension of life and the preservation of the quality of life enjoyed pre-diagnosis. Therefore, because Kadcyla causes fewer side effects, it represents a treatment that can effectively achieve not only an extension of life, but the preservation of some of that quality of life enjoyed by these women pre-diagnosis. So I look forward to hearing from the Minister about what she is doing to ensure women will benefit from this vital treatment in the future.
I will now move on to how we can better support off-patent drugs, especially for breast cancer. Drug patents typically last for 20 years—although sometimes only 10 years—and at the end of that patent there is very little incentive for the drugs to be licensed for use in another indication. These drugs are still clinically effective in many cases and can be a low-cost effective treatment, but currently the NHS has no method for making them routinely available.
Bisphosphonates are one such example of an off-patent drug that is not being made universally available to patients, despite evidence showing its effectiveness. It is estimated that, if given to the entire eligible population, this drug could prevent one in 10 breast cancer deaths. It is therefore concerning that research conducted by the UK Breast Cancer Group found that only 24% of breast cancer clinicians were offering bisphosphonates to patients. Solving this issue therefore provides an opportunity to improve breast cancer survival rates, and it is something that I hope the Minister will consider carefully.
I want to finish by discussing the cost-effectiveness of drugs. Currently NICE measures cost-effectiveness using quality-adjusted life years—QALY—and one QALY is equal to one year of life in perfect health. As I am sure colleagues will agree, it is almost impossible to objectively measure someone’s quality of life, and there are questions surrounding the morality of attempting to do so, as raised in NICE’s “Social value judgements” paper on the moral evaluation of drugs.
As is so often the case in these debates, a clear cause of the problem lies with how NICE approves drugs. At the last general election, Labour proposed a top-to-bottom reform of NICE, ensuring that drug acceptance and funding is determined solely by clinical need, not with cost or value considerations. This debate shows there is clearly a need to re-address these issues.
As I have already mentioned, Kadcyla patients tend to experience considerably fewer side effects, and this can potentially have a positive impact on their ability to enjoy a higher quality of life post-diagnosis. Because of practicality and cost implications, it is almost impossible for NICE to comprehensively and effectively measure this exact quality of life. However, what we can say, without a doubt, is that these individuals would suffer a lower quality of life without Kadcyla, and this, I believe, deserves more attention and value in the process of drug approval and funding.
The current funding of drugs is becoming based on the cost-effectiveness of a drug, rather than the clinical need, yet, as this debate has shown, it should not be the final deciding factor as it disregards very personal reasons for many people who rely upon drug treatments. Kadcyla has benefited many women during their time living with a terminal disease, and has now been pulled, devastatingly, out of their reach.
It is the Minister who has the levers of power to address the problems in the system which is letting these women down. Members from across this Chamber have eloquently made their case to the Minister. I hope she has listened—I am sure she has—and will give these women and their families some reassurances today.
Sharon Hodgson MP's report - Jan 2017 number 91
Read Sharon Hodgson MP's report - News from Westminster - Jan 2017 number 91
Sharon has supported the call by the APPG on Cancer – of which she is a member – to address cancer survival rates in the UK, which are amongst the worst in Europe.
It is estimated that by 2020, almost half of the UK population will receive a cancer diagnosis during their lifetime.
Over the past year the percentage of people in England surviving at least one year from their initial cancer diagnosis has risen from 69.3% to 70.2%. However, this is still well behind comparable international rates – in Sweden, for example, one-year cancer survival is around 82%.
At the event, Sharon was presented with the cancer survival rates for Sunderland Clinical Commissioning Group which showed that 69% of local people with cancer will live for a year after diagnosis. This is lower than the national one-year survival rate for England of 70%.
Speaking at the event, Sharon said:
“During my time as a local Member of Parliament, I have worked hard on addressing cancer-related issues. This has included being chair of the Ovarian Cancer APPG and Co-Chair of the Breast Cancer APPG.
“One-year cancer survival rates have increased in Sunderland over the past few years, however, they still remain slightly below the national average. I have worked closely with Sunderland’s Clinical Commissioning Group on this matter, and will continue to do so in the coming years.
“All cancer patients deserve to be diagnosed as soon as possible to help address the costs to our NHS but also the cost to human life when diagnosis is too late to save a person’s life, that is why I will continue to work hard on this matter for my local constituents.”