Tuesday 4 December 2018 / 10:30 AM Health / Jonathan Ashworth

Jonathan Ashworth speech at the Britain Against Cancer Conference

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Jonathan Ashworth MP, Labour’s Shadow Health and Social Care Secretary, speaking at the Britain Against Cancer Conference 2018, said:

Good Morning can I start by thanking for you for inviting me here today to offer a few remarks.

The All Party Parliamentary Group has existed now for 20 years and of course, it’s also the 70th anniversary of our National Health Service too.

So can I begin by thanking the All Party Parliamentary Group – and especially my friends Nic Dakin and Joan Walmsley – for your leadership and dedication.

This group brings together Parliamentarians, ensuring the voice of cancer patients, their loved one and those who everyday care for those with cancer is heard at the very top of the government.

This conference – the Britain Against Cancer Conference – brings together patients, carers, clinicians, charities and politicians, and has established itself as not only the largest, but most important, gathering of the cancer community in the UK.

So I’m honoured to have been invited here this morning.

But I would prefer it if we didn’t have to have this Conference every year. I would much prefer it if there was no need for All Party Parliamentary Groups because I would very much prefer it if cancer wasn’t responsible for a quarter of all deaths for women and nearly a third of deaths for men.

And the sad reality is there are 2.5 million people living with cancer in Britain today and it’s predicted to rise to 4 million by 2030. The truth is one in two people will face a cancer diagnosis in their lifetime; every two minutes someone in the UK is diagnosed with cancer.

So while we face this reality, it’s absolutely right that policymakers and influential politicians focus in on cancer, and we do all we can to ensure those with a diagnosis have the very best clinical care, that those living with cancer are provided with the very best support and that those working to cure cancer do so in the very best research environment possible.

So it is my commitment, and my pledge to you this morning, that, should I be fortunate enough to one day assume the role of the nation’s Health and Social Care Secretary, that cancer will be given the priority, resources and focus patients deserve.

This year, the NHS celebrated its 70th birthday, and NHS England has been tasked with developing a vision for the next decade of health care.

I believe it’s vital that cancer is at the heart of that vision.

Across Britain today, more people are living with cancer than ever before. And that’s a hugely positive story. People are now twice as likely to survive at least ten years after being diagnosed with cancer than they were at the start of the 1970s.

In the past 40 years or so, better screening and advances in treatment mean we have seen a huge change in what a cancer diagnosis means; it is now a moment that is frequently not life-ending, but it is always life-changing.

That presents us with many more challenges.

Challenges for a health system which already finds itself under huge strain.

We expected the Long Term Plan yesterday – disappointingly Brexit seems to totally occupy government and goodness knows where will be by the end of today so to be frank, it now wouldn’t surprise me if we didn’t see the Long Term Plan until January.

But let me offer a few thoughts on what should be contained in that plan when it’s eventually published.

We all know, that the earlier a cancer is diagnosed, the more likely it is to be treated successfully.

Yet just over half of people in England are diagnosed early in stage 1 or 2.

And early diagnosis rates vary hugely across the country, with rates as low as 46 per cent in some CCGs and up to 61 per cent in others.

Today, we’ve released some new analysis that shows the number of people on the waiting list for diagnostic testing has increased – disproportionately –  by 75% since 2010, rising to just over 944,000, with the percentage of people waiting over 6 weeks to be tested increasing, with this target consistently being breached.

Now not all of these people will be waiting for tests related to cancer, but some of these people will ultimately be given a life-changing diagnosis.

It’s clear that diagnostic services are struggling to keep up with demand, which is unacceptable when so much is at stake.

Our cancer survival rates by international comparison are shocking, and getting better at early diagnosis is absolutely key to changing that.

Indeed the Health Foundation last week said if early cancer care was improved, including early diagnosis, 10,000 lives could be saved each year. 10,000 lives, just think about that. 10,000 families spending longer with loved ones, 10,000 sons or daughters with a parent who has survived. What an extraordinary achievement that would be.

So we endorse NHS England’s focus on early diagnosis and look forward to engaging constructively with their plans. It’s an argument we have long been making. Last year in the general election we announced labour would set up a network of cancer early diagnosis centres if it wins the election to improve diagnosis rates.

We need more investment in general practice too, which is why we would significantly increase the overall proportion of NHS spending on primary care.

And because we have some of the lowest levels per head of CT scanners and MRI scanners in the OECD and many hospital trusts are reliant on old equipment – the NHS is using at least 46 MRI scanners and 45 CT scanners over ten years old – we would as part of our £10 billion infrastructure fund invest to ensure we have the best equipment for the future too.

But the Long Term Plan, to command any credibility, must offer a realistic solution to staffing across the NHS.

We know we have chronic staff shortages across the NHS with vacancies for 102,000 staff including over 40,000 nurses.

We have heard of Trusts publicly exploring whether to close chemotherapy units because of a lack of specialist nurses.

In the Cancer Patient Experience Survey, 7 per cent of cancer patients said there were rarely or never enough nurses, to care for them properly. And of course, there is huge variation across the country – with some areas where more than 15 per cent of patients said their cancer care was understaffed.

Cancer Research UK has pointed to chronic shortages in the diagnostic workforce, with over 1 in 10 positions unfilled nationally at a time when demand is growing – for example by 2020 we’ll need to carry out at least 750,000 more endoscopies every year.

The Royal College of Radiologists has warned of a shortage of cancer doctors, with 5 per cent of clinical oncologist posts vacant during the course of last year, up from a 3 per cent vacancy rate in 2015.

And the future is challenging too. Nearly six in ten consultant breast radiologists will retire by 2025, while 13 per cent of posts are now unfilled.

But with growing numbers of people living with cancer, often with other long-term conditions, a credible, worked out strategy to support and recruit the cancer workforce for the future has to be at the heart of the Long Term Plan. In fact, I would go as far as to say alongside the Ten Year Long Term Plan we need a Ten Year Staffing Plan as well.

Such a plan should begin with fully funding the NHS, including better resourcing training and education. We need to make the NHS the most attractive employer in the country, offering staff opportunities for training, clear advancement and development.

And financial burdens shouldn’t be a barrier to joining the NHS so we would reinstate the training bursary so we can recruit the nurses we need for the future.

I am so proud that our NHS has such an immense international workforce and always has done so we would also guarantee continued recruitment internationally, valuing both the clinical workforce and non-clinical workforce too.

Just as early diagnosis, and a credible plan for workforce, is key to improving cancer outcomes so is a greater emphasis on prevention too – especially when we know 40 per cent of cancers are caused by behavioural, lifestyle and environmental factors.

Tackling the wider social determinants of ill health is absolutely central to my vision of an NHS and healthcare of the future.

Because when the NHS was founded 70 years ago, yes, it was about the relief of chronic pain and the assault on infectious disease. But it was also about something more fundamental: equality.

And yet 70 years later, health inequalities are wide and widening, with life expectancy even going backwards in some of the poorest parts of the country.

We shouldn’t settle for that.

So the next Labour government will have a specific overarching target to tackle health inequalities.

And that means going further and faster to tackle the causes of some of the biggest risk factors for cancer such as obesity, smoking and excessive alcohol consumption.

So we would, for example, take radical action to tackle the childhood obesity crisis.

This is so urgent when obesity rates among year 6 children have hit a record high.

We would ensure proper labelling on food packaging, we would ban the advertising of food high in fat, sugar and salt on family TV before 9pm and would support schools to take up initiatives like the daily mile.

And rather than cutting public health budgets that support people to give up smoking, or get help with drink problems, we would fully fund public health budgets.

Last week we revealed new analysis which exposed the devastating public health cuts per head of population.

For example between 2013/14 and 2016/17, budgets for stop smoking services & interventions were slashed to just £2.09 per head- a 36 per cent cut. Sexual health promotion, prevention and advice services have received a 29 per cent cut per head- down to just £1.23.

These cuts will continue, with planned expenditure between 2017/18 and 2018/19 set to involve a further 22 per cent cut to stop smoking services, leaving expenditure at just £1.92 per head in 2018/19.

I just can’t see how a credible Long Term plan for tackling cancer can be taken seriously, while at the same time endorsing these reductions in local public health services.

So I’m asking the Secretary of State to commit to reversing these cuts in the upcoming Long Term Plan.

Our commitment to the prevention agenda means we strongly support a ‘Health in All Policies approach’ and there is no better place to start than by prioritising children’s health.

For me improving the health and well-being of every child and young person will be my guiding mission because as Nelson Mandela said “there can be no keener revelation of a society’s soul than the way in which its treats its children.”

Every year across the UK around 4,450 children and young people under 25 are diagnosed with cancer.

Every day 12 children and young people are diagnosed with cancer.

Though cancer among children and young people is rare, 0-24 is the age group with greatest increase in cancer incidence rates since the early 1990s.

And it remains the biggest killer of children and young people by disease in the UK.

As a father of two little healthy girls, I can’t even begin to imagine the toll, the anguish that a diagnosis of cancer on your own child must mean for you.

I can’t imagine the worry, confusion and perhaps terror that a child with a cancer diagnosis must experience.

The emotional burden on children and their families that diagnosis brings must be heart-breaking.

So I’m determined that children and young people with cancer are given the very best possible care and support throughout diagnosis, treatment and recovery.

As well as investment in diagnosis and treatment that I’ve mentioned, the voice of children and young people must be heard and acted upon which is why a Labour Government will ensure that under 16s are included in the Cancer Patient Experience Survey.

But we need better mental health and emotional wellbeing support for children with cancer and their families too.

Research from CLIC Sargent found that 79 per cent of young people felt cancer had a serious impact on their emotional wellbeing, 70 per cent of young people experienced depression during their cancer treatment, 83 per cent experienced loneliness and 90 per cent of young people experienced anxiety during their cancer treatment.

Of course, parents are affected too, with more than half of parents saying they experienced depression during their child’s treatment

So it’s my commitment that every child or young person, along with their parents or carers, will be offered the support with their emotional wellbeing and mental health throughout diagnosis, treatment and beyond.

To help ease social isolation and loneliness when in hospital, we want to see every hospital offering free, high-quality WiFi that is accessible to all wards and all patients.

And because when your child is facing cancer you shouldn’t have to worry about train tickets or petrol to travel to specialist treatment, a Labour government would cover the costs of travel for treatment by establishing a Young Cancer Patient Travel Fund.

We stand on the cusp of some extraordinary advances in treatment and care that were probably just the stuff of dreams twenty years ago when the All Party Group was founded.

We have an opportunity to ensure the response to cancer becomes much more personalised.

The progress in research and knowledge is exciting and transformative such as the amazing immunotherapy advances I heard about from Professor Kevin Harrington at the Institute of Cancer Research last week.

Or the brilliant work in cancer genetics and precision medicine I learnt about at the Leicester Cancer Research Centre at the University of Leicester recently too.

Our research and science community will always have my commitment and backing as Health and Social Care Secretary.

And just as treatment becomes more personalised care, pathways should too.

It’s not just children who suffer the emotional and mental health impact of cancer.

People are living longer with cancer or its consequences.

It’s not about a one-off battle or fight.

The trauma of cancer doesn’t end when treatment ends; there are other barriers, other burdens whether emotional or physical. For example, it’s not unusual to experience depression or anxiety after treatment.

Alongside prioritising treatment we must prioritise the overall care needs, wellbeing needs and mental health needs of individuals as well.

That means building a Holistic Needs Assessment into the care pathway to offer every single cancer patient the personalised care plan they deserve.

And if that means making broader changes to the health system as well we shouldn’t shy away from them.

Because whether its prevention, diagnosis, treatment or future support we need services that are better co-ordinated, better integrated, better planned at a local level in what has become an increasingly, and I believe unnecessarily wasteful fragmented landscape. Today I’m inviting you to contribute to our consultation on how we simplify and better integrate services putting the patients are the heart of the system.

Macmillan’s Lynda Thomas writing in the New Statesman recently said

“As well as adding more years to life, we need to add life to those years. A cancer system that prioritises living well with cancer as well as living longer is the very least that cancer patients deserve.”

I couldn’t agree more.

It’s my commitment too.

Working together, I hope we can make it a reality.