25/01/2018

0:00:00 > 0:00:00to take actions against individuals under criminal law -- have

0:00:00 > 0:00:07comprehensive powers. The honourable gentleman from the front bench also

0:00:07 > 0:00:10made that point opposite.

0:00:46 > 0:00:53Baroness Tessa Jowell. Thank you very much indeed and can I just

0:00:53 > 0:01:03begin by extending my deepest gratitude to everybody who is giving

0:01:03 > 0:01:11their time to come to this debate this afternoon and to contribute to

0:01:11 > 0:01:16something that will begin to reshape the way in which we think about the

0:01:16 > 0:01:24treatment of cancer for our people all over the world. So thank you for

0:01:24 > 0:01:36that time. And I would like in doing that to thank all those noble Lords,

0:01:36 > 0:01:40friends and colleagues who have shown me such support since I

0:01:40 > 0:01:47learned that I had a brain tumour. Today, though, is not about

0:01:47 > 0:02:00politics, but about patients and the community of carers who support

0:02:00 > 0:02:07them. It is also about the NHS, but it is not just about money but also

0:02:07 > 0:02:17the power of kindness. It is also about support for carers. It is also

0:02:17 > 0:02:26about better informed judgments by patients and doctors. And it is

0:02:26 > 0:02:31about sharing access across more and better data to develop better

0:02:31 > 0:02:38treatments. Let me tell you just briefly what happened to me. On the

0:02:38 > 0:02:4624th of May last year, I was on my way to talk, not for the first time,

0:02:46 > 0:02:51about new Sure Start project in East London. I got into a taxi but I

0:02:51 > 0:03:02could not speak. I had two powerful seizures. I was taken to hospital.

0:03:02 > 0:03:12Two days later I was told that I had a brain Schumer. A glioblastoma

0:03:12 > 0:03:16multiformat. A week later the tumour was removed by an outstanding

0:03:16 > 0:03:23surgeon at the National Hospital in Queen's Square. I then had the

0:03:23 > 0:03:31standard treatment of radio and chemotherapy. To put it in context,

0:03:31 > 0:03:42across the country GMB strikes less than 3000 people every year. It

0:03:42 > 0:03:50generally has a very poor prognosis. Less than 2% of Cancer research

0:03:50 > 0:03:59funding is spent on brain tumours and no new vital drugs have been

0:03:59 > 0:04:09developed in the last 50 years. A major factor in survival is

0:04:09 > 0:04:17successful surgery. The gold standard is to use a die to enable

0:04:17 > 0:04:26the surgeon to identify the tumour precisely. But it is only available

0:04:26 > 0:04:37in about half of the brain surgery centres in the UK. And it must, of

0:04:37 > 0:04:45course, be extended to all of them. Cancer is a tough challenge to or

0:04:45 > 0:04:53health systems and particularly to our cherished health service. We

0:04:53 > 0:04:59have the worst survival rate in western Europe, partly because

0:04:59 > 0:05:06diagnosis in cancer is too slow. Brain tumours in particular grow

0:05:06 > 0:05:15very quickly and they are very hard to spot. However, there is a good

0:05:15 > 0:05:27reason for hope and it is called the Eliminate Cancer Initiative, the ECI

0:05:27 > 0:05:33for short. Its director is here with us today, one of the greatest men in

0:05:33 > 0:05:37the cancer field, with his great colleague who is travelling with

0:05:37 > 0:05:51him. Its director, Professor Ronald D Pino from the centre in Houston is

0:05:51 > 0:05:57identifying the way in which ECI is a global mix of programme and

0:05:57 > 0:06:04campaign already under way in Australia. It is designed to be

0:06:04 > 0:06:14rolled out in the next areas in UK, the USA and China. It recognises

0:06:14 > 0:06:23that no one nation can solve the problem of GBM on its own. It is an

0:06:23 > 0:06:30opportunity that belongs to the world. ECI aims to do three main

0:06:30 > 0:06:41things. The first, link patients and doctors across the world through a

0:06:41 > 0:06:52clinical trial network. Secondly, speed up the use of active trials.

0:06:52 > 0:06:58And thirdly, build a global database to improve research and patient

0:06:58 > 0:07:08care.

0:07:08 > 0:07:16Usually drunk trials test only one drug at a time. They take years and

0:07:16 > 0:07:26cost a fortune to deliver. -- drug trials. They speed up the process

0:07:26 > 0:07:34and save a lot of money when we can see these approaches to the delivery

0:07:34 > 0:07:43of cancer transformed. So adaptive trials can test many treatments at

0:07:43 > 0:07:52the same time by speeding up the process and saving the money. ECI

0:07:52 > 0:07:59also has a secure cloud platform. It sounds rather technical, but you

0:07:59 > 0:08:05will very soon understand its importance. ECI has a very important

0:08:05 > 0:08:15platform where doctors can share insight and data. Too much data is

0:08:15 > 0:08:25held in silos with highly limited access. That reduces its value. This

0:08:25 > 0:08:31is now quite a new approach. Already collaborative discussions are under

0:08:31 > 0:08:44way in England. ECI will focus on GBM because it is so tough to beat.

0:08:44 > 0:08:47So, all about sharing knowledge at every level between everyone

0:08:47 > 0:08:54involved, that is what it is about. If we achieve this, we will go a

0:08:54 > 0:09:05long way to crack GBM and other cancers. What would every cancer

0:09:05 > 0:09:11patient want? First, to know that the best, the latest science, was

0:09:11 > 0:09:19being used and available for them. Whatever in the world it was

0:09:19 > 0:09:27developed, whoever began it. What else would they want? They need to

0:09:27 > 0:09:33know that they have a community around them, supporting and caring,

0:09:33 > 0:09:41being practical and kind while doctors look at the big picture, and

0:09:41 > 0:09:51we can all be a part of a human sized picture. Seamus Heaney's last

0:09:51 > 0:10:09words were, do not be afraid. I am not afraid. I am fearful that this

0:10:09 > 0:10:20new and important approach may be put into the too difficult box. But

0:10:20 > 0:10:25I also have such great hope. So many cancer patients collaborate and

0:10:25 > 0:10:35support each other every day. They create that community of love and

0:10:35 > 0:10:40determination that they find in each other every day. All we now ask is

0:10:40 > 0:10:45that doctors and health systems learn to do the same and for us to

0:10:45 > 0:10:55work together, to learn from each other. In the end what gives a life

0:10:55 > 0:11:07meaning is not only how it is lived but how it draws to a close. I hope

0:11:07 > 0:11:12that this debate will give hope to other cancer patients like me so

0:11:12 > 0:11:26that we can live well together with cancer, not just dying of it. All of

0:11:26 > 0:11:35us for longer. Thank you.

0:12:41 > 0:12:51Thank you very much.My Lords, this is the greatest privilege and one of

0:12:51 > 0:12:57the most daunting moments of my life, to follow my noble friend with

0:12:57 > 0:13:01the eloquence, the care, the compassion and courage that she has

0:13:01 > 0:13:06shown. My noble friend not by affiliation of values, although we

0:13:06 > 0:13:10share them, but my noble friend through a lifelong friendship that

0:13:10 > 0:13:14has lasted for well over 40 years. If the House will forgive me, I want

0:13:14 > 0:13:23to say a little word about Baroness Tessa Jowell as a person. We really

0:13:23 > 0:13:26got to know each other when we both cheered our respective social

0:13:26 > 0:13:33services committee and that is where I saw to begin with her care and

0:13:33 > 0:13:40compassion described so well this afternoon. The compassion that has

0:13:40 > 0:13:47overcome the challenges that she faces and that of her family.

0:13:47 > 0:13:51Yesterday on the Today Programme, and she said it this afternoon about

0:13:51 > 0:13:57the community of care, it was not just her own courage that shone

0:13:57 > 0:14:06through, it was the deep love and affection of her family, David and

0:14:06 > 0:14:11Jesse, and Matthew and of her extended family, and the care she

0:14:11 > 0:14:19displayed this afternoon reached out because it is the caring family and

0:14:19 > 0:14:21the community around those with cancer who travelled the journey as

0:14:21 > 0:14:28well. It is the love and the hope that they give that reaches out as

0:14:28 > 0:14:45well. The young mother yesterday on the Today Programme, Sally,

0:14:45 > 0:14:49displayed the search for excellence for innovation and above all for

0:14:49 > 0:14:58action that Baroness Tessa Jowell has led us along this afternoon, the

0:14:58 > 0:15:06ECI that I know absolutely nothing about, but I will! The need to set

0:15:06 > 0:15:12aside bureaucracy in terms of the experimentation that patients who

0:15:12 > 0:15:18are on this journey wish to try, to set aside the usual processes and to

0:15:18 > 0:15:24be able to share the best practice from wherever it comes. Part of the

0:15:24 > 0:15:29role of family is to enable people to be able to sustain themselves

0:15:29 > 0:15:33while they seek access to that innovation, to that improvement, and

0:15:33 > 0:15:41to know about where excellence exists here and across the world.

0:15:41 > 0:15:49Who you know is so often, too often, the telling point when you are

0:15:49 > 0:15:55seeking the best that exists in scientific development.

0:15:55 > 0:15:58What Baroness Jowell has said this afternoon, is that should be

0:15:58 > 0:16:04available whoever you know, where ever you are, whatever axis you have

0:16:04 > 0:16:08had two other people's knowledge, the breakthroughs across the world

0:16:08 > 0:16:13need to be made available as quickly and as speedily and with as little

0:16:13 > 0:16:21bureaucracy in our health service as possible. This afternoon my noble

0:16:21 > 0:16:27friend mentioned the 24th of May last year, on the way to a sure

0:16:27 > 0:16:32start programme, when she was the first designated Public health

0:16:32 > 0:16:37minister and I was education diploma, we started the sure start

0:16:37 > 0:16:43programme. We have both been on a journey through to Cabinet, heard to

0:16:43 > 0:16:48exemplify her own wonderful networking skills in helping us to

0:16:48 > 0:16:52win the then picks from London and the implementation that shone across

0:16:52 > 0:16:58the world -- to win the Olympics. Me in all sorts of different guises,

0:16:58 > 0:17:09good and bad. But that journey has always for Tessa Jowell, Baroness

0:17:09 > 0:17:13Jowell, has always been about support and care and reaching out to

0:17:13 > 0:17:21others when terrible... When terrible terrorist acts have taken

0:17:21 > 0:17:24place, to care about those families, just as her family now care about

0:17:24 > 0:17:29her. We are all privileged to be here this afternoon and to have

0:17:29 > 0:17:37heard her speak and to give us a clarion call to pick up that cudgel

0:17:37 > 0:17:42and work tirelessly to make sure that what she seeks is carried

0:17:42 > 0:17:48forward for others in the future and that our NHS and our scientists and

0:17:48 > 0:17:52our innovators and consultants can draw down on the experience from

0:17:52 > 0:17:57across the world and can remember Tessa Jowell as we all will and we

0:17:57 > 0:18:07are privileged to have heard this afternoon.My Lords, there's a lot

0:18:07 > 0:18:15of skulduggery in politics. Tessa said this wasn't about party

0:18:15 > 0:18:23politics but it's so much about politics. Looking to my left and

0:18:23 > 0:18:28right, I see every Labour peer I've ever met and a large number of

0:18:28 > 0:18:34Labour peer is I've never met. LAUGHTER

0:18:34 > 0:18:40Looking to my further left, I see a memorable members of Parliament and

0:18:40 > 0:18:43looking at the public gallery I've never seen a public gallery as full

0:18:43 > 0:18:50as it is today and everyone is a friend or a member of the family of

0:18:50 > 0:18:58Tessa Jowell. Tessa Jowell has done, in the decades I've known her, but

0:18:58 > 0:19:04everybody in the country wants their politicians to do, what they want

0:19:04 > 0:19:11their politicians to do is earnestly follow noble causes and tried to

0:19:11 > 0:19:17make life better for other people. Tessa has been doing that in every

0:19:17 > 0:19:26way on every day through years and years and years. These last months

0:19:26 > 0:19:34for Tessa have not been easy but three things shine out about these

0:19:34 > 0:19:40last few months. First of all the extent to which she has touched

0:19:40 > 0:19:47other people's lives, she has had masses and masses of correspondence

0:19:47 > 0:19:56from people that she has helped. One sticks in my mind, a journalist she

0:19:56 > 0:19:58met when she was Secretary of State for something, and the journalist

0:19:58 > 0:20:06was having trouble just having had a baby and Tessa went down to a quite

0:20:06 > 0:20:16far part of south London. Just to see the journalist and give her

0:20:16 > 0:20:24assistance regarding bringing up her baby was absolutely typical of

0:20:24 > 0:20:28Tessa, and she said in her speech is that we should try to bring some

0:20:28 > 0:20:35kindness into politics and that is what she has done all along. There

0:20:35 > 0:20:42is so much to go with Tessa. She's going to make such a difference in

0:20:42 > 0:20:50what happens in the world. Wembley test of character came -- when the

0:20:50 > 0:20:54test of character came for Tessa on the 24th of May 2017, and my

0:20:54 > 0:21:07goodness it came, my goodness me she passed it.My Lords, I would like to

0:21:07 > 0:21:10congratulate the noble lady for arranging this debate and to express

0:21:10 > 0:21:14my extreme admiration for her brave and moving speech full stop it's an

0:21:14 > 0:21:22honest to be able to add praise for all she has done and for the battle

0:21:22 > 0:21:27that she and her family have fought. And as a result of her efforts, I

0:21:27 > 0:21:32believe that she will help many who are less fortunate than her in the

0:21:32 > 0:21:39future. My younger sister died of cancer last year she was a

0:21:39 > 0:21:43successful novelist with a great capacity to make friends and an

0:21:43 > 0:21:47extraordinary knowledge of culture and languages, but she had a pain in

0:21:47 > 0:21:53she did what so many women do, she struggled on and delayed seeking

0:21:53 > 0:21:56medical help with fatal consequences. In spite of the

0:21:56 > 0:22:03brilliance of the doctors, she died within two years of her first pain.

0:22:03 > 0:22:11I'm speaking today, not only to commend the noble lady, but to

0:22:11 > 0:22:15encourage everyone to seek medical advice in such circumstances and to

0:22:15 > 0:22:18endorse the government's scheme for varying possible cancer cases to

0:22:18 > 0:22:24hospital within two weeks. Since I have a business background I want to

0:22:24 > 0:22:28make a few other points, the first is to commence pharmaceutical sector

0:22:28 > 0:22:33for their many breakthroughs -- the first is to commend the

0:22:33 > 0:22:38pharmaceutical sector for the we have an extraordinary share of Nobel

0:22:38 > 0:22:42prizes in this country but we also have great firms, like JFK, and

0:22:42 > 0:22:56smaller innovative sisters -- GlaxoSmithKline. These businesses

0:22:56 > 0:23:01have a real role in the task of finding innovative solutions for

0:23:01 > 0:23:06hard to tackle cancer is including brain cancer which we are discussing

0:23:06 > 0:23:14today. The second, to highlight the role of business focused corporate

0:23:14 > 0:23:17responsibility so when I was at Tesco we traded a partnership with

0:23:17 > 0:23:23Cancer Research UK called race for life -- created. Every year we would

0:23:23 > 0:23:31organise 200 300 races around Britain, including one in Battersea

0:23:31 > 0:23:38park, which I ran for every year. They were great if spirits is --

0:23:38 > 0:23:47great experiences, with people young and old. There was always a bevy of

0:23:47 > 0:23:50Baroness is to add a touch of class and shed a few pounds and some of

0:23:50 > 0:23:57you are here today. But the important thing is that we raised a

0:23:57 > 0:24:01vast amount of money for Cancer Research UK, over 400 million in

0:24:01 > 0:24:08that period and we increased the salience of cancer research through

0:24:08 > 0:24:12our TV ads and promotions and on the back of every runner was scribbled a

0:24:12 > 0:24:19message about a friend with cancer or a friend who died with cancer, a

0:24:19 > 0:24:26very emotional experience. My Lords, in that era it was the time that

0:24:26 > 0:24:30cancer recovery period is accelerated and we were in the right

0:24:30 > 0:24:34place at the right time, and I wish the noble lady's campaign similar

0:24:34 > 0:24:44success.I also would like to thank my noble and inspirational friend

0:24:44 > 0:24:50Baroness Jowell. Very few people can take a personal challenge and

0:24:50 > 0:24:52transform it for universal good with such courage and insight and

0:24:52 > 0:25:00compassion. You are a beacon of light to us all and I thank you from

0:25:00 > 0:25:05the bottom of my heart. My remarks are based on personal experience, my

0:25:05 > 0:25:13late husband, a great friend and tremendous admirer of Tessa, he died

0:25:13 > 0:25:21of cancer in 2011, and a routine test showed an advance and a 30%

0:25:21 > 0:25:29chance of survival. Chemotherapy had limited effect. My husband chose to

0:25:29 > 0:25:35go to New York for his life-saving operation. That was a mistake and 80

0:25:35 > 0:25:51months later the tumour returned -- 18 months. Then followed a second

0:25:51 > 0:25:56operation which extended his life by year but where was the accessible

0:25:56 > 0:25:59database highlighting the centre of excellence will be needed it most?

0:25:59 > 0:26:09There have been precious few advances in this area cancer since.

0:26:09 > 0:26:17We must share these as much as possible. In the UK, interestingly,

0:26:17 > 0:26:25we have a resilient IT platform, CMC, created by NHS clinicians for

0:26:25 > 0:26:29end of life care in London, putting patients experiences at the heart of

0:26:29 > 0:26:33the data collection. Doctors develop a personal health care plan which is

0:26:33 > 0:26:40shared with health and social care and emergency services. In the last

0:26:40 > 0:26:45year five out of ten Souci ill patients died in hospital in London

0:26:45 > 0:26:49but for those on CMC it was less than two out of ten with the biggest

0:26:49 > 0:26:55increase able to die at home as they wished. If we genotype every cancer

0:26:55 > 0:27:04sufferer and do DNA sequencing on their tumours as has been called

0:27:04 > 0:27:10for, by adding this data to generate a big data, we could have sets of

0:27:10 > 0:27:16price list data and improve the consultations by providing a graft

0:27:16 > 0:27:22of reactions. Most oncology teams are focused on improving survival,

0:27:22 > 0:27:27pain and nausea and bone marrow support of the main routes, but

0:27:27 > 0:27:39patients with digestive system cancers like: cancer, also suffer

0:27:39 > 0:27:46terrible side-effects. Specialising in uncovering the cause of symptoms

0:27:46 > 0:27:51anchoring them, it was so essential to Philip's quality-of-life that I

0:27:51 > 0:27:56find a trial which found that nearly all patients responded positively to

0:27:56 > 0:28:0613 expensive tests based on a simple algorithm and delivered by a trained

0:28:06 > 0:28:09nurse and the result was a better quality of life and a better

0:28:09 > 0:28:11tolerance of treatment, so maybe this could be injured used in

0:28:11 > 0:28:17relevant centres without a trial. Our marvellous NHS is overwhelmed

0:28:17 > 0:28:21and struggling to make the shift to personalised cancer care and take

0:28:21 > 0:28:27advantage of global research. The universal patient centric database

0:28:27 > 0:28:30of genetic information treatment and symptoms could be a bridge between

0:28:30 > 0:28:35the tried and tested protocols we depend upon and the personalised

0:28:35 > 0:28:39medical programmes of the future. Making sure of increased innovation

0:28:39 > 0:28:47and improvement that Tessa has called for, and maybe this could

0:28:47 > 0:28:53become a programme, providing key data for Baroness Jowell's vision of

0:28:53 > 0:29:00international cooperation.My Lords, I joined this debate to pay tribute

0:29:00 > 0:29:05to the noble Baroness Jowell for speaking so bravely and so

0:29:05 > 0:29:12powerfully on behalf of patients to promote the need, the desperate need

0:29:12 > 0:29:16for faster access, to innovative treatment for cancer patients. I

0:29:16 > 0:29:22will stop by declaring my interest, as chief executive of the medical

0:29:22 > 0:29:28research charity breast cancer now, my Lords, we know that research has

0:29:28 > 0:29:33led to huge improvements and outcomes for cancer, especially in

0:29:33 > 0:29:38breast cancer, the area I know best, and we also know that sadly progress

0:29:38 > 0:29:44has not been uniform and it has been woefully slow for some cancer types

0:29:44 > 0:29:50and this really does need to change. As we have heard it is time to do

0:29:50 > 0:29:57the really difficult stuff. Brain tumour research must be a concern,

0:29:57 > 0:30:01not for the whole cancer research community, not least because in

0:30:01 > 0:30:09addition to many patients with primary brain tumours, thousands of

0:30:09 > 0:30:13patients with breast, lung, skin and bowel cancer will develop metastatic

0:30:13 > 0:30:19brain tumours reducing their life expectancy to single figures, so it

0:30:19 > 0:30:30is an issue of enormous concern for the whole cancer community.

0:30:30 > 0:30:39My Lords, time is short and speed is of the essence. But the system takes

0:30:39 > 0:30:44its time, time to assess the clinical evidence for and cost

0:30:44 > 0:30:48effectiveness of new treatments and then to negotiate deals with drug

0:30:48 > 0:30:52companies and then to work through the budget impact hurdles that

0:30:52 > 0:30:59treatments have to overcome, but patients need access to life-saving

0:30:59 > 0:31:02treatments now and we are being left behind other similarly wealthy

0:31:02 > 0:31:10economies. So, my Lords, the system really needs to change. Yes, I do

0:31:10 > 0:31:15believe that adaptive trials offer real flexibility that can benefit

0:31:15 > 0:31:20both patients and research, but there are challenges involved. This

0:31:20 > 0:31:25type of trial and other new approaches really are becoming more

0:31:25 > 0:31:29accepted by funders and crucially the regulators who drive the

0:31:29 > 0:31:34methodology in these situations. So this needs to be further encouraged

0:31:34 > 0:31:38and there are other innovative ways of speeding up trials that can help

0:31:38 > 0:31:44as well. Yes, innovative clinical trials are the key to faster access,

0:31:44 > 0:31:52but joining up data is vital as well. On a very practical level, my

0:31:52 > 0:31:56Lords, we are bringing together multidisciplinary teams of

0:31:56 > 0:32:01researchers, expert in clinical trials and they represent a unique

0:32:01 > 0:32:04resource for UK science. I am delighted that the latest UK

0:32:04 > 0:32:10collaboration is to bring together UK researchers in lung, breast, skin

0:32:10 > 0:32:16with brain she were researchers and this will be a great opportunity to

0:32:16 > 0:32:21take forward the noble Baroness's ideas. Finally, innovation does not

0:32:21 > 0:32:27have to be expensive. When we look at repurposed drugs, you would think

0:32:27 > 0:32:31that they would get two pages quickly but that is not so easy and

0:32:31 > 0:32:35I know the noble lord the Minister knows all about that and I look

0:32:35 > 0:32:41forward to hearing more from him. Can I congratulate the noble lady on

0:32:41 > 0:32:48speaking hope for patients.My Lords, it is a great privilege to

0:32:48 > 0:32:54speak in this debate and I would like to begin by observing we

0:32:54 > 0:33:00currently have one of the worst cancer survival rates in Europe. The

0:33:00 > 0:33:04overall ten year survival rate for all cancers in the UK has improved

0:33:04 > 0:33:11from 25% a few decades ago to 50% today. The laudable and ambitious

0:33:11 > 0:33:16scale of our cancer strategy is to make that 75% within the next

0:33:16 > 0:33:20decade, thereby not only catching up with but surpassing international

0:33:20 > 0:33:30and especially European advocates. Cancer Research UK is currently

0:33:30 > 0:33:33researching possible therapeutic interventions, many of them

0:33:33 > 0:33:36innovative, into a range of more than 200 different types of cancer

0:33:36 > 0:33:44and that is something to celebrate. But I would suggest that three vital

0:33:44 > 0:33:52conditions need to be met if those aspirations are to be achieved.

0:33:52 > 0:33:57First, as others have mentioned, is proper funding for research as well

0:33:57 > 0:34:02as for the highest quality treatment available for all cancer patients.

0:34:02 > 0:34:07This is a major challenge for an NHS which is strapped for cash and for a

0:34:07 > 0:34:12country that fate as so many competing demands for its resources.

0:34:12 > 0:34:18In the previous debate today I and others referred to the recent report

0:34:18 > 0:34:21on the Select Committee on the long-term sustainability of the NHS

0:34:21 > 0:34:28and social care. I beg your indulgence to do so no again. I hope

0:34:28 > 0:34:35this debate directly addresses this issue. The second condition is

0:34:35 > 0:34:41prioritising planning, especially of the workforce. Health education

0:34:41 > 0:34:47include's cancer workforce plan trains talks about training 200 more

0:34:47 > 0:34:50radiographers and every patient having access to a cancer nurse

0:34:50 > 0:34:55specialists by 2021. It is encouraging but it has to be seen in

0:34:55 > 0:35:00the context of a significant shortage of staff trained to perform

0:35:00 > 0:35:08tests necessary for diagnosing cancer. There are alarming forecasts

0:35:08 > 0:35:12about future vacancies. 28% of radiographers are due to lead by

0:35:12 > 0:35:202021. NHS England will struggle to achieve the objectives set out in

0:35:20 > 0:35:24the cancer strategy unless corrective action is taken

0:35:24 > 0:35:30immediately. That includes taking the NHS out of party politics in

0:35:30 > 0:35:36order to encourage long-term plans. The final condition is putting

0:35:36 > 0:35:42patient outcomes ahead of processed target performance. This is

0:35:42 > 0:35:45essential for identifying treatments for inclusion within the NHS, but it

0:35:45 > 0:35:50also applies to the release of funding both for early diagnosis and

0:35:50 > 0:35:55support for life after treatment. Several cancer care alliances have

0:35:55 > 0:36:03had their funding delay because of their lack of progress and some

0:36:03 > 0:36:06genomic, diagnostic testing is in danger of being withdrawn even

0:36:06 > 0:36:09though that may mean thousands of cancer patients may have to endure

0:36:09 > 0:36:24what for them would be unnecessary and debilitating chemotherapy.

0:36:28 > 0:36:34My Lords, I do welcome this short debate on innovative cancer

0:36:34 > 0:36:37treatments and, like everyone else, I am most grateful to the noble and

0:36:37 > 0:36:43courageous lady, Baroness Tessa Jowell, for securing it and I hope

0:36:43 > 0:36:46its outcome will be another step forward for cancer patients

0:36:46 > 0:36:52everywhere.My Lords, what a real privilege it has been to hear the

0:36:52 > 0:36:58noble lady, Baroness Tessa Jowell, give such a brave and inspiring

0:36:58 > 0:37:06speech. I do not know how anyone could not be touched by her words. I

0:37:06 > 0:37:13have long admired her and now more than ever see her as an inspiration.

0:37:13 > 0:37:17The spirit she demonstrated so clearly is absolutely characteristic

0:37:17 > 0:37:27of her. If I may be permitted a personal note, I love the hat. The

0:37:27 > 0:37:30noble lady makes an impassioned case for the availability of new

0:37:30 > 0:37:37experimental forms of treatment. Cancer Research UK says we need much

0:37:37 > 0:37:44more research to understand the nature of brain tumours and they are

0:37:44 > 0:37:48right. But meantime what I the patience to do? It is true that

0:37:48 > 0:37:52doctors are able to proscribe novel treatments for individual patients

0:37:52 > 0:38:00on what is known as the name to patient basis and the noble lord's

0:38:00 > 0:38:05bill of two years ago encourages that approach. But new treatments

0:38:05 > 0:38:08are specific for very small numbers of patients and the costs are

0:38:08 > 0:38:13enormous, so that brings us to the question of funding. We cannot get

0:38:13 > 0:38:16away from that. The late lamented cancer drug fund was soon

0:38:16 > 0:38:22overwhelmed by the high costs of diagnostics and drugs. There were

0:38:22 > 0:38:27advances in so-called liquid biopsies, scanning, proton beams,

0:38:27 > 0:38:33tailored molecular therapies, but they are all extremely costly. No

0:38:33 > 0:38:38amount of juggling with flexible pricing mechanisms will find the

0:38:38 > 0:38:43money needed. They I ask the noble lord, the minister, whether the

0:38:43 > 0:38:47government will take note of the recommendations of the Select

0:38:47 > 0:38:52Committee's report on the future sustainability of the NHS for a new

0:38:52 > 0:38:55method of funding involving the hypothecated tax system based on

0:38:55 > 0:39:01national insurance payments? Sorry to be so controversial. The average

0:39:01 > 0:39:07age of your lordship's house is 69, that means that almost half of us,

0:39:07 > 0:39:15or will have had, a cancer, one or another. I have had two myself, so I

0:39:15 > 0:39:21suppose statistically speaking that saves one for another year. That

0:39:21 > 0:39:26makes cancer take on an intensely personal meaning for all of us. We

0:39:26 > 0:39:29are fortunate to live in times when so much more can be done for us than

0:39:29 > 0:39:34ever before but it all comes at a cost and unfortunately we could be

0:39:34 > 0:39:39doing so much better. As we lag behind in so many ways and in some

0:39:39 > 0:39:43cases we have complicit in failures that should not just happen. They I

0:39:43 > 0:39:48finish on a point about prevention where we may be able to save money.

0:39:48 > 0:39:53We have an extremely effective way of detecting women who are

0:39:53 > 0:39:55susceptible to varying and breast cancer and I must express my

0:39:55 > 0:40:03interest is a recently retired trustee of the charity Barbarian

0:40:03 > 0:40:09Cancer. Testing for the gene that passes on susceptibility is now

0:40:09 > 0:40:16offered to close relatives. But a relative who is not quite so close,

0:40:16 > 0:40:20with say a 5% chance of being a carrier, cannot have the test. If

0:40:20 > 0:40:24you have a one in 20 chance of carrying the gene like that would

0:40:24 > 0:40:31you not go for a test costing just £175? It is a bargain for the NHS. I

0:40:31 > 0:40:35ask the noble lord whether the offer of such a test will be made to all

0:40:35 > 0:40:42at risk relatives. Finally, the briefing I have had from Cancer

0:40:42 > 0:40:46Research UK suggests our ability to conduct vital cancer research will

0:40:46 > 0:40:51be compromised after we Brexit from the EU if we cannot ensure the

0:40:51 > 0:40:55future of cross-border clinical trials as has been spoken of

0:40:55 > 0:40:59earlier. Will the government ensure that we will be able to continue to

0:40:59 > 0:41:07collaborate seamlessly with centres in the rest of Europe after Brexit?

0:41:07 > 0:41:13My Lords, I start by paying tribute to the noble Baroness, Lady jowl,

0:41:13 > 0:41:18for calling such an important debate. She shows the and courage in

0:41:18 > 0:41:22confronting her own illness that has characterised her approach

0:41:22 > 0:41:28throughout her inspiring career in public life. It is typical that she

0:41:28 > 0:41:32now, passion and energy undimmed, is still fighting to ensure that

0:41:32 > 0:41:36everyone receives the best care. Cancer is one of the most feared

0:41:36 > 0:41:42words in the English language, it is the number one cause of untimely

0:41:42 > 0:41:46deaths in Britain. Cancer has touched all our lives and we should

0:41:46 > 0:41:49fully support anyone who wants to try and innovative drug or

0:41:49 > 0:41:55treatment. When confronted with dreadful words such as malignant,

0:41:55 > 0:41:59inoperable, advanced, surely any alternative that offers hope is

0:41:59 > 0:42:03better than none? There is another important reason to allow patients

0:42:03 > 0:42:07to take the risk, quite simply there will be no cure for cancer and less

0:42:07 > 0:42:13patients can receive them. Many cancer patients talk of the

0:42:13 > 0:42:17wonderful care they receive from the NHS, but this should not blind us as

0:42:17 > 0:42:22others have pointed out to the fact that of the top 30 countries that

0:42:22 > 0:42:26offer universal access to health care, the UK is in the bottom third

0:42:26 > 0:42:34in terms of cancer survival. First, we fail to invest sufficiently in

0:42:34 > 0:42:39the early diagnosis of cancer. If caught early the chances of cure and

0:42:39 > 0:42:43survival are dramatically improved. In some states in the USA, there has

0:42:43 > 0:42:49been a concerted effort to catch lung cancer with scanning and

0:42:49 > 0:42:52keyhole surgery. Secondly, the government needs to transform a

0:42:52 > 0:42:57culture in the NHS which can be resistant to innovation. When a

0:42:57 > 0:42:59patient is handed a terminal diagnosis and only standard

0:42:59 > 0:43:05treatments that do not work, the patient dies, and so does any chance

0:43:05 > 0:43:15of

0:43:15 > 0:43:17finding a cure. We need to ensure that our remarkable NHS staff are

0:43:17 > 0:43:19developed and empowered to act quickly with the innovations that

0:43:19 > 0:43:22become available both in the UK and overseas. Thirdly, there needs to be

0:43:22 > 0:43:24a broader argument about the reform and funding of the NHS. My

0:43:24 > 0:43:30honourable and good friend who has been cured of cancer twice rightly

0:43:30 > 0:43:35praises the outstanding treatment he received from the NHS. He has

0:43:35 > 0:43:38proposed the NHS should be given its own stand-alone funding stream

0:43:38 > 0:43:42perhaps through hypothecated national insurance funding

0:43:42 > 0:43:49contributions. The debate is long overdue. To quote Dylan Thomas, most

0:43:49 > 0:43:52patients when confronted with terminal cancer and the possibility

0:43:52 > 0:43:58of dying do not want to go gentle into that good night. They want to

0:43:58 > 0:44:01focus on staying alive and take the risk of adaptive trials. They should

0:44:01 > 0:44:13be able to rage against the dying light and keep their hopes alive.My

0:44:13 > 0:44:21Lords, I would like to join others in thanking Tessa Jowell for

0:44:21 > 0:44:30bringing forward this debate today. As a politician in the other plays

0:44:30 > 0:44:35she would dare to tread where others would not even think of. I was

0:44:35 > 0:44:39pleased that the early start scheme was mentioned because that really is

0:44:39 > 0:44:45a legacy given to this country that has helped young children. I think

0:44:45 > 0:44:49we are privileged today, not only to have this debate, but to have

0:44:49 > 0:44:56Baroness Tessa Jowell introduce it, her idea, and speak from her

0:44:56 > 0:45:01personal experience. I need to declare an interest. I am a trustee

0:45:01 > 0:45:05of the University College hospitals foundation trust and I was on the

0:45:05 > 0:45:11group that initiated and started what is now the Macmillan Cancer

0:45:11 > 0:45:14Centre just near the hospital.

0:45:14 > 0:45:23It took a look -- lot of fun racing but we have now got the hospital and

0:45:23 > 0:45:28we have got the machine coming, but not until 2020 -- a lot of fund

0:45:28 > 0:45:40raising. And that is going to help. At the moment, since 2008, 400 of

0:45:40 > 0:45:44our young children have had to go abroad to have treatment for cancer

0:45:44 > 0:45:48because we have not had the facilities in this country. And yet

0:45:48 > 0:45:52we are very good at making breakthroughs. The research and

0:45:52 > 0:45:57innovation and all the rest of it, so what goes wrong between them that

0:45:57 > 0:46:03and actually touching the individual that needs help? When we started

0:46:03 > 0:46:09that scheme the statistics were one in three of us would suffer cancer

0:46:09 > 0:46:17in our lives and I gather that has now gone down to one in two. It

0:46:17 > 0:46:24really is a national challenge for us and as has already been said, it

0:46:24 > 0:46:28is not an easy one, it's quite difficult. My Lords, at the moment

0:46:28 > 0:46:35we are trying to raise almost peanuts, three quarters of £1

0:46:35 > 0:46:41million to buy a phototherapy, photodynamic therapy machine, and

0:46:41 > 0:46:49with lung cancer 60% of people who have pre-diagnosis cancer lesions in

0:46:49 > 0:46:55the lung, 60% of those go on to have cancer which is difficult in many

0:46:55 > 0:47:00cases and impossible to deal with. So we are trying to raise the money

0:47:00 > 0:47:06to do that and it is right that we should try and raise money because

0:47:06 > 0:47:10it is not just about national health service money, it is about somehow

0:47:10 > 0:47:17bringing together everything that we can to fight what is the scourge, it

0:47:17 > 0:47:23really is the scourge of the world today, not just in Britain, it is an

0:47:23 > 0:47:28international situation. Somehow we have got to get the research of the

0:47:28 > 0:47:33clinicians and all the profession together to make sure that we can

0:47:33 > 0:47:39deliver what the noble lady has said. Her arguments are unanswerable

0:47:39 > 0:47:44and there has to be a response and I do hope the minister when he does

0:47:44 > 0:47:47doesn't just give a list of what the government are doing now, we want to

0:47:47 > 0:47:50know what you are going to do to respond to this very important

0:47:50 > 0:47:57matter.My Lords, less common and rare cancers account for over half

0:47:57 > 0:48:02of all cancers but each is a small individual market and so under

0:48:02 > 0:48:10researched for the weather it is brain or others, like in my sister

0:48:10 > 0:48:20's case, they suffer a chronic lack of investment, and I congratulate

0:48:20 > 0:48:23Baroness Jowell for bringing these important issues to the house, and

0:48:23 > 0:48:32for her bravery. It is the cradle to grave records inside the NHS, we are

0:48:32 > 0:48:35uniquely placed to supply the insights of what works and what

0:48:35 > 0:48:40doesn't, and this large-scale real-world information could

0:48:40 > 0:48:45revolutionise care and research especially health economic

0:48:45 > 0:48:49evaluation, yet researchers can't get access, let me explain with some

0:48:49 > 0:48:56examples. The brain tumour charity has been trying to unlock the state

0:48:56 > 0:49:02of their patients, 97% of whom want their data to be used for research

0:49:02 > 0:49:05and they have issued consent but they have been met with official

0:49:05 > 0:49:11obstruction at every turn. NHS digital once 100,000 a year, Public

0:49:11 > 0:49:17Health England once 378 and our and for information that would be over a

0:49:17 > 0:49:23year out of date -- an hour. The same challenges faced those

0:49:23 > 0:49:36developing cures and in a recent survey over 80% of UK biochemist

0:49:36 > 0:49:39places have set access to insights was near impossible given current

0:49:39 > 0:49:43processes and policy and that they are forced abroad. We want to see

0:49:43 > 0:49:50the NHS improved patients lives and we are all aware that there is no

0:49:50 > 0:49:54infinite money tree for which to pay for such innovation and we need

0:49:54 > 0:49:58timely and accurate information based on real-world insights from

0:49:58 > 0:50:04within the NHS on what works and what doesn't. It is important to

0:50:04 > 0:50:08stress decision-makers and researchers do not generally need

0:50:08 > 0:50:12access to patient level data, they need anxious to privacy concerning

0:50:12 > 0:50:21statistical insights such as is treatment at a or be more effective.

0:50:21 > 0:50:26This excess to be done more routinely through statistics but

0:50:26 > 0:50:29they are almost unknown in the NHS which employs armies of human aloes

0:50:29 > 0:50:39instead. We must get the policy right -- human analysts instead. It

0:50:39 > 0:50:42does not require primary legislation but it does require joined up

0:50:42 > 0:50:46thinking across health and business and research and careful management

0:50:46 > 0:50:52of various internal vested interests. The creation of health

0:50:52 > 0:50:56data research UK provides a unique opportunity to drive such alignment

0:50:56 > 0:50:59and therefore can I ask the minister to commit to using life science

0:50:59 > 0:51:04sector deal to make this happen. Can he confirmed the routine measurement

0:51:04 > 0:51:10of care outcomes in the NHS is his top priority and can he clarify who

0:51:10 > 0:51:13will be in charge of coordinating and finding delivery for this

0:51:13 > 0:51:18critical crosscutting agenda. My Lords it has been a huge privilege

0:51:18 > 0:51:27to partake in lady Tessa Jowell's debate.It discusses Rihanna

0:51:27 > 0:51:29occasions like this on debates to congratulate

0:51:33 > 0:51:38it is customary on occasions like this to congratulate the move but I

0:51:38 > 0:51:43don't think that fully encapsulates the bravery of Baroness Jowell

0:51:43 > 0:51:50today. I've apply to talk about prostate cancer, the first thing --

0:51:50 > 0:51:54I would like to talk about prostate cancer, and the first thing you are

0:51:54 > 0:52:00told when you have this diagnosis, that more people die of it than with

0:52:00 > 0:52:05it, that it is manageable, but regardless you have been diagnosed.

0:52:05 > 0:52:10The point I want to highlight today, the process of getting diagnosed, of

0:52:10 > 0:52:18being aware is something that men in particular are not very good at.

0:52:18 > 0:52:24There's many men in this house who are currently suffering from

0:52:24 > 0:52:29prostate cancer. We don't go to the doctor frequently enough and we are

0:52:29 > 0:52:37not used to being prodded and probed in the way that ladies are.LAUGHTER

0:52:37 > 0:52:41We don't like the idea the test, and the truth has to be said, that there

0:52:41 > 0:52:52is nothing much to the test and those who don't like it, they are

0:52:52 > 0:52:55scaredy-cat, and the once you do like it, they are easily pleased. --

0:52:55 > 0:53:02the ones who do like it. The treatment I received, and support we

0:53:02 > 0:53:07have enjoyed from the general in Edinburgh since 2014, has been

0:53:07 > 0:53:15exemplary. What I am concerned about, far too many men are unaware

0:53:15 > 0:53:21of the signs of the condition. Many take hypertension drugs which result

0:53:21 > 0:53:35in us getting... This nocturnal is could be cancer related. There are a

0:53:35 > 0:53:40few things I would like to see consider, that a far greater public

0:53:40 > 0:53:44awareness campaign of the symptoms of prostate cancer and that a more

0:53:44 > 0:53:50proactive approach taken by GPs when they are prescribing drugs which

0:53:50 > 0:53:56have diuretic side-effects. Far too many men become aware the

0:53:56 > 0:54:02significance of the symptoms when it is getting late or sadly too late

0:54:02 > 0:54:06and when the treatment of the condition is a great deal more

0:54:06 > 0:54:12expensive and on occasions but I'm puzzled, and certainly not always

0:54:12 > 0:54:20successful -- and on occasions I'm puzzled. Once again I thank you for

0:54:20 > 0:54:23raising the issue in the manner you have done today, this is not a

0:54:23 > 0:54:27matter for party dispute, this is a social concern for a medical problem

0:54:27 > 0:54:32which is still intractable, and we are not going to solve it tomorrow,

0:54:32 > 0:54:36but if we can solve more lives more quickly and make those whose lives

0:54:36 > 0:54:41who can't be saved that much more comfortable, then I think we will be

0:54:41 > 0:54:47fulfilling a very useful function and offer a great deal of support to

0:54:47 > 0:54:56the families that are so afflicted. May I thank the noble Baroness

0:54:56 > 0:54:59Jowell for initiating this debate and to say it is a privilege to take

0:54:59 > 0:55:03part and to thank her for her passionate and moving and very brave

0:55:03 > 0:55:09speech. But also today to support all cancer patients who wish to have

0:55:09 > 0:55:16the opportunity to be involved in clinical trials as adaptive clinical

0:55:16 > 0:55:19trials are a promising way to develop new treatment by offering

0:55:19 > 0:55:25those patients multiple opportunities to test. Life

0:55:25 > 0:55:29expectancy has significantly improved but unfortunately in some

0:55:29 > 0:55:32selected cancer sites early intervention is more difficult, or

0:55:32 > 0:55:37example as we have heard, brain cancer and pancreatic has which my

0:55:37 > 0:55:44late husband suffered from. -- for example. Those numbers have

0:55:44 > 0:55:48struggled to move and as we all know cancer touches everyone. Today's

0:55:48 > 0:55:52debate brings to attention the innovative new cancer treatment and

0:55:52 > 0:55:59how this can offer life changing treatment. The NHS is working with

0:55:59 > 0:56:04the life science sector to improve accountability and transparency in

0:56:04 > 0:56:11the take-up of innovation with the support of NICE, and that has got to

0:56:11 > 0:56:16be welcomed. We welcome the contributions from companies in the

0:56:16 > 0:56:21UK in the life science sector, many small and medium-sized companies,

0:56:21 > 0:56:24and I'm pleased that financial support has been given with the help

0:56:24 > 0:56:29of the new £6 million government scheme together with providing £34

0:56:29 > 0:56:32million over four years to encourage and support those innovators to

0:56:32 > 0:56:38develop world leading digital solutions. A good supportive

0:56:38 > 0:56:41research environment is needed in the UK to make sure that the best

0:56:41 > 0:56:44research can be carried out ultimately to speed up the

0:56:44 > 0:56:48development of pioneering treatments with accelerating access to new

0:56:48 > 0:56:53medicines and benefiting from working with international

0:56:53 > 0:56:59collaboration on clinical trials. That must continue. Flexible pricing

0:56:59 > 0:57:02mechanisms such as outcome based pricing would result in quicker

0:57:02 > 0:57:10decisions about approvals with price based on drug value for the NHS and

0:57:10 > 0:57:15also more emphasis must be placed on the genomic revolution to eliminate

0:57:15 > 0:57:18the one size fits all approach to cancer treatment and to welcome the

0:57:18 > 0:57:25NHS England step to create a genomics medicine service in closing

0:57:25 > 0:57:29the gap and to make sure of equitable access to molecular

0:57:29 > 0:57:35diagnosis and testing for all patients across England. Importantly

0:57:35 > 0:57:43to have good sharing data is paramount. The cancer diagnosis is

0:57:43 > 0:57:47frightening and distressing and confusing and as I said it touches

0:57:47 > 0:57:52everyone whether it be a loved one a friend or Kholi, so with a need to

0:57:52 > 0:57:59shift the emphasis towards prevention -- or colleagues.

0:57:59 > 0:58:02Together with a strong media campaign, this must lead to

0:58:02 > 0:58:08increased longevity. Finally, cancer patients are focused on staying

0:58:08 > 0:58:12alive as long as possible so it is important patients are free to take

0:58:12 > 0:58:17more risks. I thank the noble Baroness Jowell for her brave speech

0:58:17 > 0:58:23and I have to say it is about hope for everyone, for all patients, and

0:58:23 > 0:58:30to improve the campaign, cancer campaign, and to improve outcomes.I

0:58:30 > 0:58:34want to thank my noble friend Baroness Jowell for an extraordinary

0:58:34 > 0:58:39speech, with passion and compassion and hope. I had the privilege of

0:58:39 > 0:58:44following her as a minister at the Department of Health and what a

0:58:44 > 0:58:48formidable reputation she had as our first public health minister. What a

0:58:48 > 0:58:52legacy she left, many of today's public health programmes which are

0:58:52 > 0:58:59taken for granted, she established in those first two crucial years. I

0:58:59 > 0:59:03don't know if she knows, I've not quite forgiven her for her other big

0:59:03 > 0:59:10decision at Richmond house, to get rid of chocolate biscuits. And bring

0:59:10 > 0:59:20in other things instead. There are certain ministers who had a secret

0:59:20 > 0:59:23cachet of those biscuits not far from where she is sitting and that

0:59:23 > 0:59:28is why the noble Lord Hutton became very popular during meetings in his

0:59:28 > 0:59:35own ministerial room.LAUGHTER Baroness Jowell has raised a huge

0:59:35 > 0:59:40question about access for NHS patients to innovative treatment and

0:59:40 > 0:59:47in a sense it is the great paradox of health in this country. We have

0:59:47 > 0:59:52the NHS which we are enormously proud of and it is still very well

0:59:52 > 0:59:58regarded internationally. We have incredible strong life sciences

0:59:58 > 1:00:05sector, over £60 billion of turnover, over 200,000 high-quality

1:00:05 > 1:00:08jobs, and we have one of the strongest pharmaceutical industries

1:00:08 > 1:00:18in the world, 25% of all global medicines developed in the UK. And

1:00:18 > 1:00:25then as as has been said, we have the great paradox, it is a British

1:00:25 > 1:00:29problem, we have this great development, great invention, but we

1:00:29 > 1:00:36are slow to adopt and the experience of my noble friend and so many other

1:00:36 > 1:00:43patients in the NHS is of the same. If you look at other countries, like

1:00:43 > 1:00:48Germany and France, we can see that their patients have much more access

1:00:48 > 1:01:01to innovative treatments than we do. When the noble Baroness was a

1:01:01 > 1:01:04minister, she discussed this with NICE who were set up to deal with

1:01:04 > 1:01:09this British problem, and it was captivated it would take 15 years

1:01:09 > 1:01:14for a new treatment to be adopted generally in the health service. And

1:01:14 > 1:01:19here we are, 20 years later, we still face a huge problem of

1:01:19 > 1:01:26innovation adoption. It is true the government has adopted the

1:01:26 > 1:01:30accelerated access new and we also have the life sciences strategy post

1:01:30 > 1:01:39Brexit. But I think we have to do much more. The minister will know it

1:01:39 > 1:01:51is not just finance, it is also attitude. We have got to do better

1:01:51 > 1:01:58in the NHS to adopt the huge innovation that so often takes place

1:01:58 > 1:02:06in this country.Like Lord Blunkett I have known the noble ladies

1:02:06 > 1:02:14Baroness Jowell for over 40 years -- noble lady. We met as young women

1:02:14 > 1:02:18trying to make our way in the Labour Party and to change the world. I

1:02:18 > 1:02:21never dreamt that we would end up as ministerial colleagues at the

1:02:21 > 1:02:27Department of Health or two decades later, as fellow members of the

1:02:27 > 1:02:33house today. But what doesn't surprise me is that my very dear

1:02:33 > 1:02:38friend has shown unfathomable fortitude and determination in her

1:02:38 > 1:02:46current illness or that her injury commitment of the public good has

1:02:46 > 1:02:48led her to scrutinise the care we provide to those who have cancer

1:02:48 > 1:02:53especially object cancers like her own and to campaign for improvements

1:02:53 > 1:02:59in that care. I believe that UK has to Mendis opportunities to make

1:02:59 > 1:03:11progress cash tremendous. -- tremendous. Even given the

1:03:11 > 1:03:16formidable challenges that these cancers provide and the development

1:03:16 > 1:03:19and evaluation of effective treatments, but if we are to make

1:03:19 > 1:03:27that progress across the spectrum of prevention detection, treatment and

1:03:27 > 1:03:30cures, we have got to collaborate internationally and I hope the

1:03:30 > 1:03:37minister will have some words to say about that. And we have to explore

1:03:37 > 1:03:44it all the resources we have and that includes the NHS and its

1:03:44 > 1:03:49scientific gold mine of information which my noble friend has already

1:03:49 > 1:04:02referred to. That is one resource. Another is the Cambridge biochemist.

1:04:02 > 1:04:10At the campus, we have world leading research institutes including

1:04:10 > 1:04:15molecular biology and Cancer Research UK and the welcome

1:04:15 > 1:04:23Institute just down the road. We have great NHS hospitals,

1:04:23 > 1:04:27Addenbrooke's, for example, and we have leading international

1:04:27 > 1:04:34pharmaceutical companies including AstraZeneca and GS K and we have the

1:04:34 > 1:04:38University of Cambridge itself. The opportunities if these players can

1:04:38 > 1:04:44collaborate effectively is enormous. There are exciting plans led by

1:04:44 > 1:04:48Professor Richard Gilbertson who is a world leading expert in brain

1:04:48 > 1:04:54cancers in children to build on the already impressive results, for

1:04:54 > 1:04:59example in breast cancer, by creating a ground-breaking Institute

1:04:59 > 1:05:04for early detection and for a new cancer research Hospital bringing

1:05:04 > 1:05:09patients speedy access to the latest research and treatments. I hope that

1:05:09 > 1:05:13the Department of Health will see this not as another simple NHS

1:05:13 > 1:05:18building project but as a real opportunity within the context of

1:05:18 > 1:05:25the life sciences strategy.

1:05:25 > 1:05:29The noble Baroness, Baroness Jay, cannot be here today and she asked

1:05:29 > 1:05:33me to say how sad she was to miss this opportunity and to pay some

1:05:33 > 1:05:40words of tribute to the noble bonus Tessa Jowell. I think she would feel

1:05:40 > 1:05:49that the House has perhaps done her proud in paying that tribute. I

1:05:49 > 1:05:52started off by saying that 40 years ago Tesla wanted to change the

1:05:52 > 1:06:00world. I think the debate today illustrates very clearly that her

1:06:00 > 1:06:05determination to do so is undiminished.My Lords, I would like

1:06:05 > 1:06:10to thank my noble friend and very good friend Tessa Jowell who I have

1:06:10 > 1:06:16been friends with for over 40 years from our days at Camden Council and

1:06:16 > 1:06:20many other campaigns for her did become a parliamentarian and so on.

1:06:20 > 1:06:27I find today are very important debate. It is an important debate

1:06:27 > 1:06:32for the evaluation of cancer treatments. Britain has a

1:06:32 > 1:06:35first-class reputation for research but we do not always manage to get

1:06:35 > 1:06:40the treatment to patients as early as we should. A number of citizens

1:06:40 > 1:06:44from around the world want to come to Britain because they know we have

1:06:44 > 1:06:48a good reputation for research and treatment of cancer and it has to go

1:06:48 > 1:06:53further. Furthermore, there must be more sharing of research and data in

1:06:53 > 1:07:00Britain and around the world. This can save time and lives. Travelling

1:07:00 > 1:07:04for patients with cancer is tiring and dangerous and that is why we

1:07:04 > 1:07:09must have places of excellence in cities so people can get them. I

1:07:09 > 1:07:15would also like to thank and realism for her great work that she is doing

1:07:15 > 1:07:19and who I work with closely in the eve Appeal. It raises awareness and

1:07:19 > 1:07:31funds research into five kine are logical cancers. It was set up to

1:07:31 > 1:07:36save women's lives by funding ground-breaking research focused on

1:07:36 > 1:07:41developing effective methods of risk protection. Early detection and

1:07:41 > 1:07:47developing screening for women only cancers. It is vital that the health

1:07:47 > 1:07:50service continues to fund screening and screening must be more

1:07:50 > 1:07:56available. This will save many lives and also detect cancer earlier in

1:07:56 > 1:08:00the same way as my noble friend topped about prostate cancer. Women

1:08:00 > 1:08:07must also not be afraid to go for these tests. I would like to thank

1:08:07 > 1:08:13Vanessa Elliott, a consultant at St George 's Hospital, and Sarah

1:08:13 > 1:08:18Rudman, a consultant at Guy 's and Saint Thomas's who were very helpful

1:08:18 > 1:08:22to me about this debate, thinking I would have hours to speak. I told

1:08:22 > 1:08:30them it was three minutes. They were very helpful. I hope we will have a

1:08:30 > 1:08:36campaign where I can talk about much more. The charities that have

1:08:36 > 1:08:40contacted us have explained how serious and important it is that

1:08:40 > 1:08:45cancer is dealt with as quickly as possible. There are lots of

1:08:45 > 1:08:49imperfections in clinical trial design and the processes could be

1:08:49 > 1:08:57improved. They try to have good working relationships in order to

1:08:57 > 1:09:02involve the trial design and process at the earliest opportunity is. My

1:09:02 > 1:09:06Lords, they hope that focusing on design will lead to a drug license.

1:09:06 > 1:09:11Most of the time the pharmaceutical industry and the clinicians are not

1:09:11 > 1:09:17always aligned. Although the drug development process is still chunky,

1:09:17 > 1:09:24traditionally most trials will still progress through phase one, two and

1:09:24 > 1:09:29three, which is expensive in terms of finance, nursing and doctors'

1:09:29 > 1:09:34time and importantly patients' effort. It is also time-consuming

1:09:34 > 1:09:38and may result in patients waiting too long for new treatments. We must

1:09:38 > 1:09:46make sure that when there are new treatments there is availability for

1:09:46 > 1:09:50people to experiment with these treatments. In recent years more

1:09:50 > 1:09:55innovative drug trials have been used to reduce time for drug trial

1:09:55 > 1:10:01development processes. It is really important for patients to also have

1:10:01 > 1:10:08equitable access to an early phase of clinical trials. These trial

1:10:08 > 1:10:13units are often only found in large cancer centres and not all patients

1:10:13 > 1:10:18have access to them. My Lords, it is well enough for patients who have

1:10:18 > 1:10:23exhausted conventional treatments and tumour specific trials may want

1:10:23 > 1:10:42to access unlicensed drugs.

1:10:42 > 1:10:46My first experience of watching her was taking on the Chancellor Gordon

1:10:46 > 1:10:50Brown to squeeze the Olympic budget out of, which was as close as you

1:10:50 > 1:10:56could get to a combat sport, so none of us who know or are in the least

1:10:56 > 1:11:02surprised that she should see her own cancer challenge as an

1:11:02 > 1:11:09opportunity to help other people. Tessa, thank you for shining a very

1:11:09 > 1:11:15bright light on the subject, and I'm delighted to work with you again. I

1:11:15 > 1:11:20topped mostly about science, because I believe we are not a pivotal

1:11:20 > 1:11:24moment in cancer research. That's why for the past year have been very

1:11:24 > 1:11:29involved with Cancer Research UK. Really trying to help them think

1:11:29 > 1:11:34through how to raise all the money we need privately to capture the

1:11:34 > 1:11:37enormous opportunity which is presented by the spectacular

1:11:37 > 1:11:47advances in science and technology. Improvements in the ability to

1:11:47 > 1:11:51harvest our immune system and treatments. Our ability to visualise

1:11:51 > 1:11:55what's going on inside tumours. Then you can apply all the new technology

1:11:55 > 1:12:02we've built. This was when I say things like AI, the planning and

1:12:02 > 1:12:09machine learning and your Lord and we know what were talking about. It

1:12:09 > 1:12:12means you can generate and analyse massive amounts of data, which is

1:12:12 > 1:12:18hugely helpful for a bit patient trials around the world. So quite

1:12:18 > 1:12:23simply, I think the call of Cancer Research UK and this is what was

1:12:23 > 1:12:29thinking about is how to exploit these specific developments and this

1:12:29 > 1:12:34has been mentioned a couple of times before, but basically to improve the

1:12:34 > 1:12:37ten year survival outcomes from two out of four people to three out of

1:12:37 > 1:12:44four people. A nice simple call. To accomplish this there are three

1:12:44 > 1:12:47particular areas of focus that I'd like to bring to your attention this

1:12:47 > 1:12:57afternoon. The first one, and be freely talked about this already,

1:12:57 > 1:13:00but Cancer Research UK will devote much more money and meaningfully

1:13:00 > 1:13:06shift focus to hard to treat cancers like brain tumours, as well as long,

1:13:06 > 1:13:14pancreatic, which killed my father, and cancers of the oesophagus.

1:13:14 > 1:13:17Research in these areas compared to the bowel and breast cancer has been

1:13:17 > 1:13:26very low. The second key area of work is what she was called

1:13:26 > 1:13:29personalised medicine. Doctors need to be armed with a detailed readout

1:13:29 > 1:13:36of the molecular faults of the tumour and the need to be armed with

1:13:36 > 1:13:40the new generation of drugs at precisely targets them, so no more

1:13:40 > 1:13:44hit and miss and wait and see. An enormous amount is happening in this

1:13:44 > 1:13:49around the world. I think I've picked out these comments before.

1:13:49 > 1:13:52That great new treatments, smart clinical trials. There is a big

1:13:52 > 1:13:58opportunity to get those properly coordinated, so we can get the most

1:13:58 > 1:14:01out of them, because the current approach is much too fragmented. The

1:14:01 > 1:14:08final bit of work is revolutionary, and it is what most captures the

1:14:08 > 1:14:15changes in science we need to exploit, what we're calling the

1:14:15 > 1:14:18grand challenges. These are very big research grants and they are aimed

1:14:18 > 1:14:22at simply solving the biggest problems, the one that will change

1:14:22 > 1:14:25people's wives, and they're doing it by bringing people together,

1:14:25 > 1:14:29bringing the best sign Victor Allen from around the world and from

1:14:29 > 1:14:32across different disciplines and forging together to attack the big

1:14:32 > 1:14:40problems. I am very optimistic that that will produce world is outcomes.

1:14:40 > 1:14:46Changing Our aim is to raise all the money for this privately, conveying

1:14:46 > 1:14:49to potential donors at the opportunity, because of the science

1:14:49 > 1:14:54revolution is huge and it is now, so give us your money. And I apologise

1:14:54 > 1:15:01for practising my but she, but we need to work on it. My request to my

1:15:01 > 1:15:07noble friend is not for money, but simply to help preserve the

1:15:07 > 1:15:12competitiveness of the UK's research environment. I it with one thing,

1:15:12 > 1:15:17which is first, after we leave the EU, it is really essential that our

1:15:17 > 1:15:23future immigration system allows us to attract, recruit and retain the

1:15:23 > 1:15:29global scientific talent at all levels regardless of nationality.

1:15:29 > 1:15:34Thank you once again to the local lady, my dear friend attempt Tessa

1:15:34 > 1:15:41for shining a light and long may she continue.This has been a magical

1:15:41 > 1:15:47debate. I can't remember anything quite like it. In all my time in

1:15:47 > 1:15:51this house. I do believe it will have a profound effect. I would like

1:15:51 > 1:15:58to express my great admiration for my honourable friend Baroness

1:15:58 > 1:16:02Jowell, for her steely determination, her compassion and

1:16:02 > 1:16:07humanity for other people. This debate, I think, will be seen in

1:16:07 > 1:16:15many different countries. My Lords, quite a few years ago, the

1:16:15 > 1:16:20celebrated American biologist Stephen Jay Gould was diagnosed with

1:16:20 > 1:16:25mesothelioma, which is cancer derived from contact with asbestos.

1:16:25 > 1:16:31Doctors told him that he only had eight months to live, that's what he

1:16:31 > 1:16:35thought they told him, because this was the average survival period. He

1:16:35 > 1:16:41looked at this and what matters about an average is not just the

1:16:41 > 1:16:47average, but the spiral of possibilities. And he was a

1:16:47 > 1:16:51statistician who understood. He made this famous quote, he said, I am an

1:16:51 > 1:16:58optimist who tends to see the doughnut rather than the whole. He

1:16:58 > 1:17:01studied the evidence on survival rates and he did so in a careful and

1:17:01 > 1:17:06sophisticated way. This is his conclusion, I quote from what he

1:17:06 > 1:17:12wrote. Those with positive attitudes, with the strong will, and

1:17:12 > 1:17:17a purposeful living, with a commitment to struggle and not just

1:17:17 > 1:17:22a passive acceptance of anything doctors may say, tend to live

1:17:22 > 1:17:29longer. While Stephen Jay Gould lived to 22 years after his

1:17:29 > 1:17:34diagnosis, admittedly this was the supreme force of his will and his

1:17:34 > 1:17:43knowledge ability, but it shows you that you must interrogate any

1:17:43 > 1:17:50diagnosis that is made. This is really crucial. Moreover, his fame

1:17:50 > 1:17:54brought mesothelioma is a bit out of the shadows, when it languished for

1:17:54 > 1:18:00so long, because it was a bit like the tobacco industry, there was a

1:18:00 > 1:18:09lot of industry resistance. In the concluding part of what I have two

1:18:09 > 1:18:13say, Mike Lawrie was a bit stalled and by the previous speaker, because

1:18:13 > 1:18:20I would like to say I think we are on the threshold of some of the

1:18:20 > 1:18:24greatest revelations ever made in medicine and these are coming very

1:18:24 > 1:18:30quickly, though, very fast. Why? Because of the algorithmic powers of

1:18:30 > 1:18:35computers, because of the fact that doctors and medical researchers can

1:18:35 > 1:18:39share their research instantaneously across the world, which was never

1:18:39 > 1:18:48possible before the digital age. And because of advances link to this in

1:18:48 > 1:18:54genomics and genetics. So there is enormous hope. For example, myeloid

1:18:54 > 1:19:00leukaemia, which was thought to be incurable, now is quite different,

1:19:00 > 1:19:03because of these research breakthroughs. The main question to

1:19:03 > 1:19:07be asked of the noble lord the minister is the one that inspired

1:19:07 > 1:19:13the debate. Will these breakthroughs be confined to the privileged few?

1:19:13 > 1:19:20The NHS is in the middle of a horrible crisis. There are problems

1:19:20 > 1:19:23of the changing demographic structure of our society that lies

1:19:23 > 1:19:31behind this. Will the Minister say forcefully that those kinds of

1:19:31 > 1:19:36cancer, like brain cancer or mesothelioma, that are relatively

1:19:36 > 1:19:44rare, will not suffer as a result of the situation in our health service,

1:19:44 > 1:19:53and that he will take measures to ensure this?This has been eight

1:19:53 > 1:19:57unique, living and effective debate and I am proud to be allowed to

1:19:57 > 1:20:05support the demands of the noble and courageous Baroness Jowell. In my

1:20:05 > 1:20:10three minutes, I want to focus on two of her demands, early diagnosis

1:20:10 > 1:20:14and patient rights. Public health England says diagnosing cancer early

1:20:14 > 1:20:19is one of the most important ways to improve cancer survival, and we know

1:20:19 > 1:20:23that those patients who have their cancers diagnosed as an emergency

1:20:23 > 1:20:29have over outcomes. That is why new screening and diagnostic methods

1:20:29 > 1:20:33must be made available quickly. I am standing here because of screening

1:20:33 > 1:20:41and I say to the Lord Sternberg, I have had two as well, perhaps we

1:20:41 > 1:20:45should start a club. It shows for we have come. Screening doesn't merely

1:20:45 > 1:20:54diagnose disease, but can addict risk of disease by identifying gene

1:20:54 > 1:20:58mutations. Genomics screening can contribute to decisions by

1:20:58 > 1:21:02predicting how the tumour will respond to chemotherapy. This can

1:21:02 > 1:21:04avoid chemotherapy for those patients who will not benefit from

1:21:04 > 1:21:11it. Diagnoses of colorectal cancer through the National bowel screening

1:21:11 > 1:21:17programme remains under 10%. This effect of early diagnostic tool is

1:21:17 > 1:21:22not being used widely enough. This is because the screening is not

1:21:22 > 1:21:25being offered or is it because people are not returning the

1:21:25 > 1:21:30samples? What is the government doing to improve these figures? I

1:21:30 > 1:21:36agree with that noble Baroness Jowell that patients should have a

1:21:36 > 1:21:40great deal more say in their risk they are prepared to take and

1:21:40 > 1:21:45adaptive trials should be allowed, where they could help. I will not

1:21:45 > 1:21:50repeat many of the examples, cancer related examples we have heard

1:21:50 > 1:21:54today. I would like to give your Lordships a non-cancer example of

1:21:54 > 1:21:57where the system is preventing a patient receiving medicines which

1:21:57 > 1:22:03have already been shown to work. To illustrate that the problems she has

1:22:03 > 1:22:14identified is whiter than cancer. A small boy who I will call A has rare

1:22:14 > 1:22:17and serious epilepsy. He was treated at great expense to the NHS with

1:22:17 > 1:22:23powerful drugs to stop its vets, or both of them were not even mice and

1:22:23 > 1:22:26produced on children. His condition did not improve and the doctors

1:22:26 > 1:22:31admitted the drugs could damage is vital organs and shorten his life.

1:22:31 > 1:22:36His parents heard of a similar case in Holland, where the child was

1:22:36 > 1:22:39being successfully treated with cannabis -based medicines, which

1:22:39 > 1:22:44were licensed there. Child A has now been receiving cannabis treatment in

1:22:44 > 1:22:49Holland with tremendous success. His doctor he is convinced of the safety

1:22:49 > 1:22:53and efficacy of these medicines which are not licensed here, but is

1:22:53 > 1:22:57frightened to treat him with them, because he is afraid the GMC will

1:22:57 > 1:23:01strike him off. The family can no longer afford to remain in The Hague

1:23:01 > 1:23:06armour but the Home Office tells me it will not grant a special licence

1:23:06 > 1:23:10for this treatment in the UK. This child could die of its vets. His

1:23:10 > 1:23:18parents would agree in a heartbeat that he should receive these

1:23:18 > 1:23:21medicines here. They know the risk is small and the benefits huge. They

1:23:21 > 1:23:26should have the right to make that decision for their child's, just as

1:23:26 > 1:23:30the cancer patients mentioned by Baroness Jowell should have the

1:23:30 > 1:23:34right to make the decision about risks and about their own treatment.

1:23:34 > 1:23:42So what is the noble Lord Minister going to do about that?The

1:23:42 > 1:23:48beginning of this debate, it became completely clear we are dealing with

1:23:48 > 1:23:52one of those extraordinary parliamentary moments and anyway, I

1:23:52 > 1:23:57have a much easier job than the noble Lord the Minister. My

1:23:57 > 1:24:02sympathies with him in answering this debate. Are any of us surprised

1:24:02 > 1:24:07that my noble friend tempted turned round when she was diagnosed with

1:24:07 > 1:24:11what she called this bloody shimmer with her usual courage to try and

1:24:11 > 1:24:14improve the outcomes of all people with cancer? Are we surprised that

1:24:14 > 1:24:21she did this? No, we're not. Because this is a woman who is the first

1:24:21 > 1:24:25public health minister promoted tobacco control wheel motor it for

1:24:25 > 1:24:32granted. She faced outrage from the tobacco industry and their friends

1:24:32 > 1:24:38and many backbench Labour MPs. Pubs and clubs would go out of business

1:24:38 > 1:24:49people were not to drink in the smog created by cigarettes. How many

1:24:49 > 1:24:52lives have been saved already as the results of her determination to do

1:24:52 > 1:25:02the right thing? The label nanny was continued because of sure start, of

1:25:02 > 1:25:05course. Her determination letter to take on the Prime Minister and all

1:25:05 > 1:25:08comers to convince us that the Olympics should come to London,

1:25:08 > 1:25:14could come to London and then when they did so, to cure to make sure we

1:25:14 > 1:25:20all had a great time in 2012. The reason I'm reminding the house of

1:25:20 > 1:25:27these matters is not only because of my admiration for my friend tempted,

1:25:27 > 1:25:32I'm reminding the house that in the face of opposition and scepticism,

1:25:32 > 1:25:40my noble friend will win through. She has proved to be correct at time

1:25:40 > 1:25:44and time again. I say to the noble Lord and the government that they

1:25:44 > 1:25:47had better believe this noble lady and take what she is telling us very

1:25:47 > 1:26:02seriously indeed. Indeed, from the relatively modest demand to the more

1:26:02 > 1:26:05innovative, adapting clinical trial testing, multiple treatments against

1:26:05 > 1:26:09the standard that would speed up the introduction of new drugs, as well

1:26:09 > 1:26:13as enabling existing ones to be repurposed, links to the platform to

1:26:13 > 1:26:20share data across the world. My noble friend is saying this is a

1:26:20 > 1:26:23demanding new paradigms, but the prize is surely worth the struggle.

1:26:23 > 1:26:28I think the government and all of us should follow her example and not be

1:26:28 > 1:26:40afraid to commit to making this happen.Can I begin in joining all

1:26:40 > 1:26:44members of this house in paying fulsome tribute to the noble lady,

1:26:44 > 1:26:47not just for securing this debate today, but for the extraordinary

1:26:47 > 1:26:53character she is showing in leading it. It has been a rich and very

1:26:53 > 1:26:58moving discussion and as the noble Lord Blunkett, it's extremely

1:26:58 > 1:27:02daunting to follow the noble lady to try and do justice to the requests

1:27:02 > 1:27:06and of the speech that she has given. It is also a privilege to be

1:27:06 > 1:27:09able to do that on behalf of the government. I would also like to

1:27:09 > 1:27:13praise the noble lady for the determination she is showing in

1:27:13 > 1:27:16raising the profile of issues around cancer treatment during the course

1:27:16 > 1:27:20of her own illness. I think it's fair to say she has inspired us all

1:27:20 > 1:27:28and many can cancer sufferers as well. But I suppose we should expect

1:27:28 > 1:27:31nothing less from the woman who brought us the most wonderful

1:27:31 > 1:27:36Olympic Games and Paralympic games in 2012. I thank Baroness Thornton

1:27:36 > 1:27:40for her speech and I've done everything I can in my response to

1:27:40 > 1:27:45address the questions she has asked as she will forgive me if there are

1:27:45 > 1:27:50any statements to pick up on afterwards. As we have heard today,

1:27:50 > 1:27:55every story about cancer is a personal one. But behind the numbers

1:27:55 > 1:28:02by some very stark figures. Behind those stories, lie stark numbers. As

1:28:02 > 1:28:06our population ages and the prevalence of cancer rises, one in

1:28:06 > 1:28:10two of us will get cancer at some stage in our life. The question is

1:28:10 > 1:28:14not so much about how we stop that happening, but how we can diagnose

1:28:14 > 1:28:18and treat it more quickly and effectively, so that it moves from

1:28:18 > 1:28:22being a life-threatening disease to one that can be managed throughout a

1:28:22 > 1:28:26normal and happy lifetime. Must be honest in saying we're not there

1:28:26 > 1:28:30yet. Historically we have lagged behind the best performing countries

1:28:30 > 1:28:35in Europe and catching up with those standards has been the focus of

1:28:35 > 1:28:38successive governments including this one. There is good news, things

1:28:38 > 1:28:44are getting better. In the last eight years, various actions mean

1:28:44 > 1:28:48there are 7000 people alive who wouldn't have been otherwise. The

1:28:48 > 1:28:52benefits of the treatments are spread unevenly. Survival rates were

1:28:52 > 1:28:57certain cancers are stubbornly low. Testicular cancer has been

1:28:57 > 1:29:02transformed into a nearly curable disease, but for other cancers, we

1:29:02 > 1:29:07have heard about cancer of the oesophagus, pancreas, lung and liver

1:29:07 > 1:29:12and brain cancers, very little progress has been made. There is

1:29:12 > 1:29:18much still to do and we do need to do better. The first step towards

1:29:18 > 1:29:21achieving the world-class cancer outcomes we all want to see and

1:29:21 > 1:29:25which NHS patients rightly expect is to have a pun on the planet is

1:29:25 > 1:29:31backed by the counter community. At plan was provided three years ago by

1:29:31 > 1:29:34the independent cancer task force which provided a cancer strategy

1:29:34 > 1:29:39aimed at saving 30,000 lives by 2020. It was truly a landmark

1:29:39 > 1:29:43moment. The government, as indeed any government would have, adopted

1:29:43 > 1:29:49the recommendations of the strategy. It starts of course with prevention.

1:29:49 > 1:29:55And we've heard about the vigour with which the noble lady put shoot

1:29:55 > 1:29:59public health intervention when she was a health minister. Smoking and

1:29:59 > 1:30:02obesity remain the biggest preventable risk factors for cancer

1:30:02 > 1:30:09and that's why there has been last year a childhood obesity strategy

1:30:09 > 1:30:12and tobacco control plan. They are making progress on smoking and

1:30:12 > 1:30:16smoking rates are coming down for every age group, but we do have a

1:30:16 > 1:30:21long way to go to tackle the obesity epidemic, which we have not yet

1:30:21 > 1:30:27done. Or courage is needed, I fear. Early diagnosis is critical, and

1:30:27 > 1:30:34that our new early diagnosis standards, including a 20 D

1:30:34 > 1:30:36standard. But we all know it's not just about standards, it's about

1:30:36 > 1:30:40bringing the best diagnostic tools and therapies into the NHS more

1:30:40 > 1:30:46quickly.

1:30:46 > 1:30:54There are exciting discoveries, one by John Hopkins University. We want

1:30:54 > 1:30:57our NHS to bring on these innovations and I am hopeful our

1:30:57 > 1:31:05accelerated pathway, and the team meets next week, we'll look at these

1:31:05 > 1:31:09technologies and provide opportunities to come into the NHS

1:31:09 > 1:31:21up to double Vo years quicker. -- up to four. At the centre of

1:31:21 > 1:31:25every experience is a human being. With all the emotional and physical

1:31:25 > 1:31:32needs that attend. It is right to expect every patient is treated with

1:31:32 > 1:31:35compassion and dignity. The National Cancer patient survey

1:31:35 > 1:31:39showed more cancer patients are experiencing positive care which is

1:31:39 > 1:31:45welcome. I want to use this opportunity to pay tribute to the

1:31:45 > 1:31:50amazing staff who deliver care, but to our range of charities and

1:31:50 > 1:31:59voluntary organisations, including Macmillan, Cancer Research UK UK,

1:31:59 > 1:32:03who provide outstanding support to people with and recovering from

1:32:03 > 1:32:07cancer. For all patients, the onus is not

1:32:07 > 1:32:17what defines them, life goes on. As well as challenges. And making

1:32:17 > 1:32:22sure life can go on as close to normal is essential.

1:32:22 > 1:32:26Standards of care are high but there is variation which is why there is a

1:32:26 > 1:32:31plan to create a package therefore every patient from the moment they

1:32:31 > 1:32:35are diagnosed. Where the Government can make a

1:32:35 > 1:32:38difference is in providing the necessary investment and I would

1:32:38 > 1:32:46like to highlight important areas but avoid the list ministers can

1:32:46 > 1:32:49slip into, where that investment is making an impact for cancer

1:32:49 > 1:32:56patients. Elsewhere the noble lady has spoken

1:32:56 > 1:33:01about the surgery required to treat her cancer which can be highly

1:33:01 > 1:33:07invasive and debilitating. There is a major investment in radiotherapy

1:33:07 > 1:33:14equipment including new proton beam centres and it is hoped that will

1:33:14 > 1:33:21bring benefits to 6000 brain tumour patients every year who will get

1:33:21 > 1:33:25access to less invasive surgery. She asked about the availability of

1:33:25 > 1:33:35a key senescent die, -- fluorescent dye, which helps surgeons to see

1:33:35 > 1:33:40malignant tissue. We have spoken to NHS England and they have committed

1:33:40 > 1:33:47to working with surgery centres to drive national uptake.

1:33:47 > 1:33:55I would also like to highlight another innovation and change which

1:33:55 > 1:34:00has been a big investment in infrastructure through 20 biomedical

1:34:00 > 1:34:06research centres in England. I did visit one of those last year at UCL

1:34:06 > 1:34:12Hospital where I met some wonderful and brave cancer patients among some

1:34:12 > 1:34:19of the first in the world to trial these therapies. I understand the

1:34:19 > 1:34:24importance of giving patients a choice to take risk when the prize

1:34:24 > 1:34:31is extra months of life. These centres are now recruiting or have

1:34:31 > 1:34:37set up 700 trials. I am sorry the noble lady was not able to find one

1:34:37 > 1:34:42in this country she was able to access for her particular form of

1:34:42 > 1:34:48cancer. Our determination is British cancer patients should not have to

1:34:48 > 1:34:55travel abroad to be part of trials or access the treatment they need.

1:34:55 > 1:35:07Before closing, I would like to address a number of issues. I agree

1:35:07 > 1:35:12more investment is needed in research for brain cancer, that is a

1:35:12 > 1:35:20specific objective of the working group. I can confirm that group will

1:35:20 > 1:35:25deliver its report next Wednesday and one of the actions will be a

1:35:25 > 1:35:32highlight lettuce to encourage researchers to submit applications

1:35:32 > 1:35:39for funding in brain Cancer Research UK and I would hope some of the

1:35:39 > 1:35:42interesting research ideas and projects will look at that

1:35:42 > 1:35:45opportunity so we get more funding into this important area.

1:35:45 > 1:35:52The noble lady spoked about adaptive trials, I can report they form a

1:35:52 > 1:36:00growing proportion of the clinical research networks portfolio. We need

1:36:00 > 1:36:04to be more radical and she has provided a specific suggestion. I

1:36:04 > 1:36:09would be delighted to meet the director of the Astute and am

1:36:09 > 1:36:15thrilled he is here to hear the debate.

1:36:15 > 1:36:20-- Institute. There is a lack of new brain cancer drugs. We have been in

1:36:20 > 1:36:28touch with NICE and informed there are drugs in development

1:36:28 > 1:36:34specifically. NICE have committed to publishing draft guidance on these

1:36:34 > 1:36:40drugs, and drugs will be funded from the point of licensing bringing

1:36:40 > 1:36:47forward the opportunity to use them by many months. The noble lady spoke

1:36:47 > 1:36:53about the importance of data and access. I couldn't agree more. One

1:36:53 > 1:36:57of the wonderful things about our NHS is it it's here for us all of

1:36:57 > 1:37:05the time, and one of the quirks in how it was set up is it has an

1:37:05 > 1:37:10unrivalled data on patients and their medical experiences and

1:37:10 > 1:37:14journeys which is invaluable to research. We haven't got policy

1:37:14 > 1:37:20right always. All brought the public with us about the benefits of

1:37:20 > 1:37:25sharing data. But there are key decisions coming up so we can access

1:37:25 > 1:37:30and create that dataset for research purposes. I welcome the opportunity

1:37:30 > 1:37:35to engage with the noble lady to win the argument with the public about

1:37:35 > 1:37:43sharing data for the benefit of one another and --. There have been many

1:37:43 > 1:37:48questions, I hope you will forgive me for not trying to answer all of

1:37:48 > 1:37:52them in the interests of time. I will write to any I have answered

1:37:52 > 1:38:00specifically. Firstly, genomic medicine has been mentioned in

1:38:00 > 1:38:03combination with artificial intelligence and machine learning.

1:38:03 > 1:38:10We have a set of 5000 whole cancer genome sequences, the biggest in the

1:38:10 > 1:38:15world. Think of the numbers getting cancer every year. We need to do

1:38:15 > 1:38:20much better. There are big ambitions here. I hope to make some real

1:38:20 > 1:38:26progress in something ambitious. Several have asked about the

1:38:26 > 1:38:30sustainability report perhaps not showing the department in its best

1:38:30 > 1:38:35light in how late it has been. It will be published very soon.

1:38:35 > 1:38:40The issue of taxation has been raised, I hope you will forgive me

1:38:40 > 1:38:47if I say that is above my pay grade. They may have noticed the Secretary

1:38:47 > 1:38:51of State has been here throughout the whole debate listening intently.

1:38:51 > 1:39:02I am looking to him! As I know he will be making the case across

1:39:02 > 1:39:05Government. Finally, I have been minister for

1:39:05 > 1:39:11long enough to note that you can't have a debate that Brexit. Let us

1:39:11 > 1:39:15make it quick and positive, clinical trials have been mentioned but we

1:39:15 > 1:39:20should mention regulation. Our intention is to have a new form of

1:39:20 > 1:39:24creating the same partnership we have now not just for the good of

1:39:24 > 1:39:30patients here but across the EU, that is our intention, that is the

1:39:30 > 1:39:31right thing to do.

1:39:35 > 1:39:40My thoughts, to close, I would like to talk about a word that the noble

1:39:40 > 1:39:45Baroness focused on at the end of her speech, that word is hope. It

1:39:45 > 1:39:50happens to be the name of my youngest daughter.

1:39:50 > 1:39:55The NHS symbolises many noble ideas, reassurance, compassion, service to

1:39:55 > 1:40:01others. More than anything, it provides hope of a better life and

1:40:01 > 1:40:06more years enjoyed, not just for themselves but those they hold dear,

1:40:06 > 1:40:09hope for a better today and tomorrow.

1:40:09 > 1:40:15What the noble lady has done is offer hope, her courage in leading

1:40:15 > 1:40:20this debate with her fertile mind making suggestions to improve cancer

1:40:20 > 1:40:24care, she raises our sites and demands collectively we work harder

1:40:24 > 1:40:27to offer hope to people affected by the terrible disease she suffers

1:40:27 > 1:40:32with such dignity. It is the right challenge and one I am prepared to

1:40:32 > 1:40:38accept on behalf of the Government. I promised her our efforts will not

1:40:38 > 1:40:41waver until the scourge of cats are no longer robs us of the ones we

1:40:41 > 1:40:47love. -- scourge of cancer.

1:40:47 > 1:40:57Can I just thank the Minister very much indeed for a really inspiring

1:40:57 > 1:41:03and excellent summary to our discussion and obviously I would

1:41:03 > 1:41:12like to thank everybody else who has considered and taken part in

1:41:12 > 1:41:18discussion today. I feel that we have made real progress forward, it

1:41:18 > 1:41:25happens very rarely in this sort of way, and I am absolutely delighted

1:41:25 > 1:41:32and grateful to everybody from, for the opportunities that they have

1:41:32 > 1:41:41contributed and the support that you as Minister will continue to have,

1:41:41 > 1:41:56and the Secretary of State will keep his... I always have problems with

1:41:56 > 1:42:03my... With keeping everything, and he will know exactly what I am

1:42:03 > 1:42:13talking about!

1:42:14 > 1:42:15Now, we look forward to

1:42:17 > 1:42:27APPLAUSE

1:42:41 > 1:42:49My Lords, I beg to move that we adjourn the House.

1:42:49 > 1:42:51My Lords, let the House now adjourn.