25/01/2018 House of Lords

to take actions against individuals

under criminal law -- have

comprehensive powers. The honourable

gentleman from the front bench also

made that point opposite.

Baroness Tessa Jowell. Thank you

very much indeed and can I just

begin by extending my deepest

gratitude to everybody who is giving

their time to come to this debate

this afternoon and to contribute to

something that will begin to reshape

the way in which we think about the

treatment of cancer for our people

all over the world. So thank you for

that time. And I would like in doing

that to thank all those noble Lords,

friends and colleagues who have

shown me such support since I

learned that I had a brain tumour.

Today, though, is not about

politics, but about patients and the

community of carers who support

them. It is also about the NHS, but

it is not just about money but also

the power of kindness. It is also

about support for carers. It is also

about better informed judgments by

patients and doctors. And it is

about sharing access across more and

better data to develop better

treatments. Let me tell you just

briefly what happened to me. On the

24th of May last year, I was on my

way to talk, not for the first time,

about new Sure Start project in East

London. I got into a taxi but I

could not speak. I had two powerful

seizures. I was taken to hospital.

Two days later I was told that I had

a brain Schumer. A glioblastoma

multiformat. A week later the tumour

was removed by an outstanding

surgeon at the National Hospital in

Queen's Square. I then had the

standard treatment of radio and

chemotherapy. To put it in context,

across the country GMB strikes less

than 3000 people every year. It

generally has a very poor prognosis.

Less than 2% of Cancer research

funding is spent on brain tumours

and no new vital drugs have been

developed in the last 50 years. A

major factor in survival is

successful surgery. The gold

standard is to use a die to enable

the surgeon to identify the tumour

precisely. But it is only available

in about half of the brain surgery

centres in the UK. And it must, of

course, be extended to all of them.

Cancer is a tough challenge to or

health systems and particularly to

our cherished health service. We

have the worst survival rate in

western Europe, partly because

diagnosis in cancer is too slow.

Brain tumours in particular grow

very quickly and they are very hard

to spot. However, there is a good

reason for hope and it is called the

Eliminate Cancer Initiative, the ECI

for short. Its director is here with

us today, one of the greatest men in

the cancer field, with his great

colleague who is travelling with

him. Its director, Professor Ronald

D Pino from the centre in Houston is

identifying the way in which ECI is

a global mix of programme and

campaign already under way in

Australia. It is designed to be

rolled out in the next areas in UK,

the USA and China. It recognises

that no one nation can solve the

problem of GBM on its own. It is an

opportunity that belongs to the

world. ECI aims to do three main

things. The first, link patients and

doctors across the world through a

clinical trial network. Secondly,

speed up the use of active trials.

And thirdly, build a global database

to improve research and patient

care.

Usually drunk trials test only one

drug at a time. They take years and

cost a fortune to deliver. -- drug

trials. They speed up the process

and save a lot of money when we can

see these approaches to the delivery

of cancer transformed. So adaptive

trials can test many treatments at

the same time by speeding up the

process and saving the money. ECI

also has a secure cloud platform. It

sounds rather technical, but you

will very soon understand its

importance. ECI has a very important

platform where doctors can share

insight and data. Too much data is

held in silos with highly limited

access. That reduces its value. This

is now quite a new approach. Already

collaborative discussions are under

way in England. ECI will focus on

GBM because it is so tough to beat.

So, all about sharing knowledge at

every level between everyone

involved, that is what it is about.

If we achieve this, we will go a

long way to crack GBM and other

cancers. What would every cancer

patient want? First, to know that

the best, the latest science, was

being used and available for them.

Whatever in the world it was

developed, whoever began it. What

else would they want? They need to

know that they have a community

around them, supporting and caring,

being practical and kind while

doctors look at the big picture, and

we can all be a part of a human

sized picture. Seamus Heaney's last

words were, do not be afraid. I am

not afraid. I am fearful that this

new and important approach may be

put into the too difficult box. But

I also have such great hope. So many

cancer patients collaborate and

support each other every day. They

create that community of love and

determination that they find in each

other every day. All we now ask is

that doctors and health systems

learn to do the same and for us to

work together, to learn from each

other. In the end what gives a life

meaning is not only how it is lived

but how it draws to a close. I hope

that this debate will give hope to

other cancer patients like me so

that we can live well together with

cancer, not just dying of it. All of

us for longer. Thank you.

Thank you very much.

My Lords, this

is the greatest privilege and one of

the most daunting moments of my

life, to follow my noble friend with

the eloquence, the care, the

compassion and courage that she has

shown. My noble friend not by

affiliation of values, although we

share them, but my noble friend

through a lifelong friendship that

has lasted for well over 40 years.

If the House will forgive me, I want

to say a little word about Baroness

Tessa Jowell as a person. We really

got to know each other when we both

cheered our respective social

services committee and that is where

I saw to begin with her care and

compassion described so well this

afternoon. The compassion that has

overcome the challenges that she

faces and that of her family.

Yesterday on the Today Programme,

and she said it this afternoon about

the community of care, it was not

just her own courage that shone

through, it was the deep love and

affection of her family, David and

Jesse, and Matthew and of her

extended family, and the care she

displayed this afternoon reached out

because it is the caring family and

the community around those with

cancer who travelled the journey as

well. It is the love and the hope

that they give that reaches out as

well. The young mother yesterday on

the Today Programme, Sally,

displayed the search for excellence

for innovation and above all for

action that Baroness Tessa Jowell

has led us along this afternoon, the

ECI that I know absolutely nothing

about, but I will! The need to set

aside bureaucracy in terms of the

experimentation that patients who

are on this journey wish to try, to

set aside the usual processes and to

be able to share the best practice

from wherever it comes. Part of the

role of family is to enable people

to be able to sustain themselves

while they seek access to that

innovation, to that improvement, and

to know about where excellence

exists here and across the world.

Who you know is so often, too often,

the telling point when you are

seeking the best that exists in

scientific development.

What Baroness Jowell has said this

afternoon, is that should be

available whoever you know, where

ever you are, whatever axis you have

had two other people's knowledge,

the breakthroughs across the world

need to be made available as quickly

and as speedily and with as little

bureaucracy in our health service as

possible. This afternoon my noble

friend mentioned the 24th of May

last year, on the way to a sure

start programme, when she was the

first designated Public health

minister and I was education

diploma, we started the sure start

programme. We have both been on a

journey through to Cabinet, heard to

exemplify her own wonderful

networking skills in helping us to

win the then picks from London and

the implementation that shone across

the world -- to win the Olympics. Me

in all sorts of different guises,

good and bad. But that journey has

always for Tessa Jowell, Baroness

Jowell, has always been about

support and care and reaching out to

others when terrible... When

terrible terrorist acts have taken

place, to care about those families,

just as her family now care about

her. We are all privileged to be

here this afternoon and to have

heard her speak and to give us a

clarion call to pick up that cudgel

and work tirelessly to make sure

that what she seeks is carried

forward for others in the future and

that our NHS and our scientists and

our innovators and consultants can

draw down on the experience from

across the world and can remember

Tessa Jowell as we all will and we

are privileged to have heard this

afternoon.

My Lords, there's a lot

of skulduggery in politics. Tessa

said this wasn't about party

politics but it's so much about

politics. Looking to my left and

right, I see every Labour peer I've

ever met and a large number of

Labour peer is I've never met.

LAUGHTER

Looking to my further left, I see a

memorable members of Parliament and

looking at the public gallery I've

never seen a public gallery as full

as it is today and everyone is a

friend or a member of the family of

Tessa Jowell. Tessa Jowell has done,

in the decades I've known her, but

everybody in the country wants their

politicians to do, what they want

their politicians to do is earnestly

follow noble causes and tried to

make life better for other people.

Tessa has been doing that in every

way on every day through years and

years and years. These last months

for Tessa have not been easy but

three things shine out about these

last few months. First of all the

extent to which she has touched

other people's lives, she has had

masses and masses of correspondence

from people that she has helped. One

sticks in my mind, a journalist she

met when she was Secretary of State

for something, and the journalist

was having trouble just having had a

baby and Tessa went down to a quite

far part of south London. Just to

see the journalist and give her

assistance regarding bringing up her

baby was absolutely typical of

Tessa, and she said in her speech is

that we should try to bring some

kindness into politics and that is

what she has done all along. There

is so much to go with Tessa. She's

going to make such a difference in

what happens in the world. Wembley

test of character came -- when the

test of character came for Tessa on

the 24th of May 2017, and my

goodness it came, my goodness me she

passed it.

My Lords, I would like to

congratulate the noble lady for

arranging this debate and to express

my extreme admiration for her brave

and moving speech full stop it's an

honest to be able to add praise for

all she has done and for the battle

that she and her family have fought.

And as a result of her efforts, I

believe that she will help many who

are less fortunate than her in the

future. My younger sister died of

cancer last year she was a

successful novelist with a great

capacity to make friends and an

extraordinary knowledge of culture

and languages, but she had a pain in

she did what so many women do, she

struggled on and delayed seeking

medical help with fatal

consequences. In spite of the

brilliance of the doctors, she died

within two years of her first pain.

I'm speaking today, not only to

commend the noble lady, but to

encourage everyone to seek medical

advice in such circumstances and to

endorse the government's scheme for

varying possible cancer cases to

hospital within two weeks. Since I

have a business background I want to

make a few other points, the first

is to commence pharmaceutical sector

for their many breakthroughs -- the

first is to commend the

pharmaceutical sector for the we

have an extraordinary share of Nobel

prizes in this country but we also

have great firms, like JFK, and

smaller innovative sisters --

GlaxoSmithKline. These businesses

have a real role in the task of

finding innovative solutions for

hard to tackle cancer is including

brain cancer which we are discussing

today. The second, to highlight the

role of business focused corporate

responsibility so when I was at

Tesco we traded a partnership with

Cancer Research UK called race for

life -- created. Every year we would

organise 200 300 races around

Britain, including one in Battersea

park, which I ran for every year.

They were great if spirits is --

great experiences, with people young

and old. There was always a bevy of

Baroness is to add a touch of class

and shed a few pounds and some of

you are here today. But the

important thing is that we raised a

vast amount of money for Cancer

Research UK, over 400 million in

that period and we increased the

salience of cancer research through

our TV ads and promotions and on the

back of every runner was scribbled a

message about a friend with cancer

or a friend who died with cancer, a

very emotional experience. My Lords,

in that era it was the time that

cancer recovery period is

accelerated and we were in the right

place at the right time, and I wish

the noble lady's campaign similar

success.

I also would like to thank

my noble and inspirational friend

Baroness Jowell. Very few people can

take a personal challenge and

transform it for universal good with

such courage and insight and

compassion. You are a beacon of

light to us all and I thank you from

the bottom of my heart. My remarks

are based on personal experience, my

late husband, a great friend and

tremendous admirer of Tessa, he died

of cancer in 2011, and a routine

test showed an advance and a 30%

chance of survival. Chemotherapy had

limited effect. My husband chose to

go to New York for his life-saving

operation. That was a mistake and 80

months later the tumour returned --

18 months. Then followed a second

operation which extended his life by

year but where was the accessible

database highlighting the centre of

excellence will be needed it most?

There have been precious few

advances in this area cancer since.

We must share these as much as

possible. In the UK, interestingly,

we have a resilient IT platform,

CMC, created by NHS clinicians for

end of life care in London, putting

patients experiences at the heart of

the data collection. Doctors develop

a personal health care plan which is

shared with health and social care

and emergency services. In the last

year five out of ten Souci ill

patients died in hospital in London

but for those on CMC it was less

than two out of ten with the biggest

increase able to die at home as they

wished. If we genotype every cancer

sufferer and do DNA sequencing on

their tumours as has been called

for, by adding this data to generate

a big data, we could have sets of

price list data and improve the

consultations by providing a graft

of reactions. Most oncology teams

are focused on improving survival,

pain and nausea and bone marrow

support of the main routes, but

patients with digestive system

cancers like: cancer, also suffer

terrible side-effects. Specialising

in uncovering the cause of symptoms

anchoring them, it was so essential

to Philip's quality-of-life that I

find a trial which found that nearly

all patients responded positively to

13 expensive tests based on a simple

algorithm and delivered by a trained

nurse and the result was a better

quality of life and a better

tolerance of treatment, so maybe

this could be injured used in

relevant centres without a trial.

Our marvellous NHS is overwhelmed

and struggling to make the shift to

personalised cancer care and take

advantage of global research. The

universal patient centric database

of genetic information treatment and

symptoms could be a bridge between

the tried and tested protocols we

depend upon and the personalised

medical programmes of the future.

Making sure of increased innovation

and improvement that Tessa has

called for, and maybe this could

become a programme, providing key

data for Baroness Jowell's vision of

international cooperation.

My Lords,

I joined this debate to pay tribute

to the noble Baroness Jowell for

speaking so bravely and so

powerfully on behalf of patients to

promote the need, the desperate need

for faster access, to innovative

treatment for cancer patients. I

will stop by declaring my interest,

as chief executive of the medical

research charity breast cancer now,

my Lords, we know that research has

led to huge improvements and

outcomes for cancer, especially in

breast cancer, the area I know best,

and we also know that sadly progress

has not been uniform and it has been

woefully slow for some cancer types

and this really does need to change.

As we have heard it is time to do

the really difficult stuff. Brain

tumour research must be a concern,

not for the whole cancer research

community, not least because in

addition to many patients with

primary brain tumours, thousands of

patients with breast, lung, skin and

bowel cancer will develop metastatic

brain tumours reducing their life

expectancy to single figures, so it

is an issue of enormous concern for

the whole cancer community.

My Lords, time is short and speed is

of the essence. But the system takes

its time, time to assess the

clinical evidence for and cost

effectiveness of new treatments and

then to negotiate deals with drug

companies and then to work through

the budget impact hurdles that

treatments have to overcome, but

patients need access to life-saving

treatments now and we are being left

behind other similarly wealthy

economies. So, my Lords, the system

really needs to change. Yes, I do

believe that adaptive trials offer

real flexibility that can benefit

both patients and research, but

there are challenges involved. This

type of trial and other new

approaches really are becoming more

accepted by funders and crucially

the regulators who drive the

methodology in these situations. So

this needs to be further encouraged

and there are other innovative ways

of speeding up trials that can help

as well. Yes, innovative clinical

trials are the key to faster access,

but joining up data is vital as

well. On a very practical level, my

Lords, we are bringing together

multidisciplinary teams of

researchers, expert in clinical

trials and they represent a unique

resource for UK science. I am

delighted that the latest UK

collaboration is to bring together

UK researchers in lung, breast, skin

with brain she were researchers and

this will be a great opportunity to

take forward the noble Baroness's

ideas. Finally, innovation does not

have to be expensive. When we look

at repurposed drugs, you would think

that they would get two pages

quickly but that is not so easy and

I know the noble lord the Minister

knows all about that and I look

forward to hearing more from him.

Can I congratulate the noble lady on

speaking hope for patients.

My

Lords, it is a great privilege to

speak in this debate and I would

like to begin by observing we

currently have one of the worst

cancer survival rates in Europe. The

overall ten year survival rate for

all cancers in the UK has improved

from 25% a few decades ago to 50%

today. The laudable and ambitious

scale of our cancer strategy is to

make that 75% within the next

decade, thereby not only catching up

with but surpassing international

and especially European advocates.

Cancer Research UK is currently

researching possible therapeutic

interventions, many of them

innovative, into a range of more

than 200 different types of cancer

and that is something to celebrate.

But I would suggest that three vital

conditions need to be met if those

aspirations are to be achieved.

First, as others have mentioned, is

proper funding for research as well

as for the highest quality treatment

available for all cancer patients.

This is a major challenge for an NHS

which is strapped for cash and for a

country that fate as so many

competing demands for its resources.

In the previous debate today I and

others referred to the recent report

on the Select Committee on the

long-term sustainability of the NHS

and social care. I beg your

indulgence to do so no again. I hope

this debate directly addresses this

issue. The second condition is

prioritising planning, especially of

the workforce. Health education

include's cancer workforce plan

trains talks about training 200 more

radiographers and every patient

having access to a cancer nurse

specialists by 2021. It is

encouraging but it has to be seen in

the context of a significant

shortage of staff trained to perform

tests necessary for diagnosing

cancer. There are alarming forecasts

about future vacancies. 28% of

radiographers are due to lead by

2021. NHS England will struggle to

achieve the objectives set out in

the cancer strategy unless

corrective action is taken

immediately. That includes taking

the NHS out of party politics in

order to encourage long-term plans.

The final condition is putting

patient outcomes ahead of processed

target performance. This is

essential for identifying treatments

for inclusion within the NHS, but it

also applies to the release of

funding both for early diagnosis and

support for life after treatment.

Several cancer care alliances have

had their funding delay because of

their lack of progress and some

genomic, diagnostic testing is in

danger of being withdrawn even

though that may mean thousands of

cancer patients may have to endure

what for them would be unnecessary

and debilitating chemotherapy.

My Lords, I do welcome this short

debate on innovative cancer

treatments and, like everyone else,

I am most grateful to the noble and

courageous lady, Baroness Tessa

Jowell, for securing it and I hope

its outcome will be another step

forward for cancer patients

everywhere.

My Lords, what a real

privilege it has been to hear the

noble lady, Baroness Tessa Jowell,

give such a brave and inspiring

speech. I do not know how anyone

could not be touched by her words. I

have long admired her and now more

than ever see her as an inspiration.

The spirit she demonstrated so

clearly is absolutely characteristic

of her. If I may be permitted a

personal note, I love the hat. The

noble lady makes an impassioned case

for the availability of new

experimental forms of treatment.

Cancer Research UK says we need much

more research to understand the

nature of brain tumours and they are

right. But meantime what I the

patience to do? It is true that

doctors are able to proscribe novel

treatments for individual patients

on what is known as the name to

patient basis and the noble lord's

bill of two years ago encourages

that approach. But new treatments

are specific for very small numbers

of patients and the costs are

enormous, so that brings us to the

question of funding. We cannot get

away from that. The late lamented

cancer drug fund was soon

overwhelmed by the high costs of

diagnostics and drugs. There were

advances in so-called liquid

biopsies, scanning, proton beams,

tailored molecular therapies, but

they are all extremely costly. No

amount of juggling with flexible

pricing mechanisms will find the

money needed. They I ask the noble

lord, the minister, whether the

government will take note of the

recommendations of the Select

Committee's report on the future

sustainability of the NHS for a new

method of funding involving the

hypothecated tax system based on

national insurance payments? Sorry

to be so controversial. The average

age of your lordship's house is 69,

that means that almost half of us,

or will have had, a cancer, one or

another. I have had two myself, so I

suppose statistically speaking that

saves one for another year. That

makes cancer take on an intensely

personal meaning for all of us. We

are fortunate to live in times when

so much more can be done for us than

ever before but it all comes at a

cost and unfortunately we could be

doing so much better. As we lag

behind in so many ways and in some

cases we have complicit in failures

that should not just happen. They I

finish on a point about prevention

where we may be able to save money.

We have an extremely effective way

of detecting women who are

susceptible to varying and breast

cancer and I must express my

interest is a recently retired

trustee of the charity Barbarian

Cancer. Testing for the gene that

passes on susceptibility is now

offered to close relatives. But a

relative who is not quite so close,

with say a 5% chance of being a

carrier, cannot have the test. If

you have a one in 20 chance of

carrying the gene like that would

you not go for a test costing just

£175? It is a bargain for the NHS. I

ask the noble lord whether the offer

of such a test will be made to all

at risk relatives. Finally, the

briefing I have had from Cancer

Research UK suggests our ability to

conduct vital cancer research will

be compromised after we Brexit from

the EU if we cannot ensure the

future of cross-border clinical

trials as has been spoken of

earlier. Will the government ensure

that we will be able to continue to

collaborate seamlessly with centres

in the rest of Europe after Brexit?

My Lords, I start by paying tribute

to the noble Baroness, Lady jowl,

for calling such an important

debate. She shows the and courage in

confronting her own illness that has

characterised her approach

throughout her inspiring career in

public life. It is typical that she

now, passion and energy undimmed, is

still fighting to ensure that

everyone receives the best care.

Cancer is one of the most feared

words in the English language, it is

the number one cause of untimely

deaths in Britain. Cancer has

touched all our lives and we should

fully support anyone who wants to

try and innovative drug or

treatment. When confronted with

dreadful words such as malignant,

inoperable, advanced, surely any

alternative that offers hope is

better than none? There is another

important reason to allow patients

to take the risk, quite simply there

will be no cure for cancer and less

patients can receive them. Many

cancer patients talk of the

wonderful care they receive from the

NHS, but this should not blind us as

others have pointed out to the fact

that of the top 30 countries that

offer universal access to health

care, the UK is in the bottom third

in terms of cancer survival. First,

we fail to invest sufficiently in

the early diagnosis of cancer. If

caught early the chances of cure and

survival are dramatically improved.

In some states in the USA, there has

been a concerted effort to catch

lung cancer with scanning and

keyhole surgery. Secondly, the

government needs to transform a

culture in the NHS which can be

resistant to innovation. When a

patient is handed a terminal

diagnosis and only standard

treatments that do not work, the

patient dies, and so does any chance

of

finding a cure. We need to ensure

that our remarkable NHS staff are

developed and empowered to act

quickly with the innovations that

become available both in the UK and

overseas. Thirdly, there needs to be

a broader argument about the reform

and funding of the NHS. My

honourable and good friend who has

been cured of cancer twice rightly

praises the outstanding treatment he

received from the NHS. He has

proposed the NHS should be given its

own stand-alone funding stream

perhaps through hypothecated

national insurance funding

contributions. The debate is long

overdue. To quote Dylan Thomas, most

patients when confronted with

terminal cancer and the possibility

of dying do not want to go gentle

into that good night. They want to

focus on staying alive and take the

risk of adaptive trials. They should

be able to rage against the dying

light and keep their hopes alive.

My

Lords, I would like to join others

in thanking Tessa Jowell for

bringing forward this debate today.

As a politician in the other plays

she would dare to tread where others

would not even think of. I was

pleased that the early start scheme

was mentioned because that really is

a legacy given to this country that

has helped young children. I think

we are privileged today, not only to

have this debate, but to have

Baroness Tessa Jowell introduce it,

her idea, and speak from her

personal experience. I need to

declare an interest. I am a trustee

of the University College hospitals

foundation trust and I was on the

group that initiated and started

what is now the Macmillan Cancer

Centre just near the hospital.

It took a look -- lot of fun racing

but we have now got the hospital and

we have got the machine coming, but

not until 2020 -- a lot of fund

raising. And that is going to help.

At the moment, since 2008, 400 of

our young children have had to go

abroad to have treatment for cancer

because we have not had the

facilities in this country. And yet

we are very good at making

breakthroughs. The research and

innovation and all the rest of it,

so what goes wrong between them that

and actually touching the individual

that needs help? When we started

that scheme the statistics were one

in three of us would suffer cancer

in our lives and I gather that has

now gone down to one in two. It

really is a national challenge for

us and as has already been said, it

is not an easy one, it's quite

difficult. My Lords, at the moment

we are trying to raise almost

peanuts, three quarters of £1

million to buy a phototherapy,

photodynamic therapy machine, and

with lung cancer 60% of people who

have pre-diagnosis cancer lesions in

the lung, 60% of those go on to have

cancer which is difficult in many

cases and impossible to deal with.

So we are trying to raise the money

to do that and it is right that we

should try and raise money because

it is not just about national health

service money, it is about somehow

bringing together everything that we

can to fight what is the scourge, it

really is the scourge of the world

today, not just in Britain, it is an

international situation. Somehow we

have got to get the research of the

clinicians and all the profession

together to make sure that we can

deliver what the noble lady has

said. Her arguments are unanswerable

and there has to be a response and I

do hope the minister when he does

doesn't just give a list of what the

government are doing now, we want to

know what you are going to do to

respond to this very important

matter.

My Lords, less common and

rare cancers account for over half

of all cancers but each is a small

individual market and so under

researched for the weather it is

brain or others, like in my sister

's case, they suffer a chronic lack

of investment, and I congratulate

Baroness Jowell for bringing these

important issues to the house, and

for her bravery. It is the cradle to

grave records inside the NHS, we are

uniquely placed to supply the

insights of what works and what

doesn't, and this large-scale

real-world information could

revolutionise care and research

especially health economic

evaluation, yet researchers can't

get access, let me explain with some

examples. The brain tumour charity

has been trying to unlock the state

of their patients, 97% of whom want

their data to be used for research

and they have issued consent but

they have been met with official

obstruction at every turn. NHS

digital once 100,000 a year, Public

Health England once 378 and our and

for information that would be over a

year out of date -- an hour. The

same challenges faced those

developing cures and in a recent

survey over 80% of UK biochemist

places have set access to insights

was near impossible given current

processes and policy and that they

are forced abroad. We want to see

the NHS improved patients lives and

we are all aware that there is no

infinite money tree for which to pay

for such innovation and we need

timely and accurate information

based on real-world insights from

within the NHS on what works and

what doesn't. It is important to

stress decision-makers and

researchers do not generally need

access to patient level data, they

need anxious to privacy concerning

statistical insights such as is

treatment at a or be more effective.

This excess to be done more

routinely through statistics but

they are almost unknown in the NHS

which employs armies of human aloes

instead. We must get the policy

right -- human analysts instead. It

does not require primary legislation

but it does require joined up

thinking across health and business

and research and careful management

of various internal vested

interests. The creation of health

data research UK provides a unique

opportunity to drive such alignment

and therefore can I ask the minister

to commit to using life science

sector deal to make this happen. Can

he confirmed the routine measurement

of care outcomes in the NHS is his

top priority and can he clarify who

will be in charge of coordinating

and finding delivery for this

critical crosscutting agenda. My

Lords it has been a huge privilege

to partake in lady Tessa Jowell's

debate.

It discusses Rihanna

occasions like this on debates to

congratulate

it is customary on occasions like

this to congratulate the move but I

don't think that fully encapsulates

the bravery of Baroness Jowell

today. I've apply to talk about

prostate cancer, the first thing --

I would like to talk about prostate

cancer, and the first thing you are

told when you have this diagnosis,

that more people die of it than with

it, that it is manageable, but

regardless you have been diagnosed.

The point I want to highlight today,

the process of getting diagnosed, of

being aware is something that men in

particular are not very good at.

There's many men in this house who

are currently suffering from

prostate cancer. We don't go to the

doctor frequently enough and we are

not used to being prodded and probed

in the way that ladies are.

LAUGHTER

We don't like the idea the test, and

the truth has to be said, that there

is nothing much to the test and

those who don't like it, they are

scaredy-cat, and the once you do

like it, they are easily pleased. --

the ones who do like it. The

treatment I received, and support we

have enjoyed from the general in

Edinburgh since 2014, has been

exemplary. What I am concerned

about, far too many men are unaware

of the signs of the condition. Many

take hypertension drugs which result

in us getting... This nocturnal is

could be cancer related. There are a

few things I would like to see

consider, that a far greater public

awareness campaign of the symptoms

of prostate cancer and that a more

proactive approach taken by GPs when

they are prescribing drugs which

have diuretic side-effects. Far too

many men become aware the

significance of the symptoms when it

is getting late or sadly too late

and when the treatment of the

condition is a great deal more

expensive and on occasions but I'm

puzzled, and certainly not always

successful -- and on occasions I'm

puzzled. Once again I thank you for

raising the issue in the manner you

have done today, this is not a

matter for party dispute, this is a

social concern for a medical problem

which is still intractable, and we

are not going to solve it tomorrow,

but if we can solve more lives more

quickly and make those whose lives

who can't be saved that much more

comfortable, then I think we will be

fulfilling a very useful function

and offer a great deal of support to

the families that are so afflicted.

May I thank the noble Baroness

Jowell for initiating this debate

and to say it is a privilege to take

part and to thank her for her

passionate and moving and very brave

speech. But also today to support

all cancer patients who wish to have

the opportunity to be involved in

clinical trials as adaptive clinical

trials are a promising way to

develop new treatment by offering

those patients multiple

opportunities to test. Life

expectancy has significantly

improved but unfortunately in some

selected cancer sites early

intervention is more difficult, or

example as we have heard, brain

cancer and pancreatic has which my

late husband suffered from. -- for

example. Those numbers have

struggled to move and as we all know

cancer touches everyone. Today's

debate brings to attention the

innovative new cancer treatment and

how this can offer life changing

treatment. The NHS is working with

the life science sector to improve

accountability and transparency in

the take-up of innovation with the

support of NICE, and that has got to

be welcomed. We welcome the

contributions from companies in the

UK in the life science sector, many

small and medium-sized companies,

and I'm pleased that financial

support has been given with the help

of the new £6 million government

scheme together with providing £34

million over four years to encourage

and support those innovators to

develop world leading digital

solutions. A good supportive

research environment is needed in

the UK to make sure that the best

research can be carried out

ultimately to speed up the

development of pioneering treatments

with accelerating access to new

medicines and benefiting from

working with international

collaboration on clinical trials.

That must continue. Flexible pricing

mechanisms such as outcome based

pricing would result in quicker

decisions about approvals with price

based on drug value for the NHS and

also more emphasis must be placed on

the genomic revolution to eliminate

the one size fits all approach to

cancer treatment and to welcome the

NHS England step to create a

genomics medicine service in closing

the gap and to make sure of

equitable access to molecular

diagnosis and testing for all

patients across England. Importantly

to have good sharing data is

paramount. The cancer diagnosis is

frightening and distressing and

confusing and as I said it touches

everyone whether it be a loved one a

friend or Kholi, so with a need to

shift the emphasis towards

prevention -- or colleagues.

Together with a strong media

campaign, this must lead to

increased longevity. Finally, cancer

patients are focused on staying

alive as long as possible so it is

important patients are free to take

more risks. I thank the noble

Baroness Jowell for her brave speech

and I have to say it is about hope

for everyone, for all patients, and

to improve the campaign, cancer

campaign, and to improve outcomes.

I

want to thank my noble friend

Baroness Jowell for an extraordinary

speech, with passion and compassion

and hope. I had the privilege of

following her as a minister at the

Department of Health and what a

formidable reputation she had as our

first public health minister. What a

legacy she left, many of today's

public health programmes which are

taken for granted, she established

in those first two crucial years. I

don't know if she knows, I've not

quite forgiven her for her other big

decision at Richmond house, to get

rid of chocolate biscuits. And bring

in other things instead. There are

certain ministers who had a secret

cachet of those biscuits not far

from where she is sitting and that

is why the noble Lord Hutton became

very popular during meetings in his

own ministerial room.

LAUGHTER

Baroness Jowell has raised a huge

question about access for NHS

patients to innovative treatment and

in a sense it is the great paradox

of health in this country. We have

the NHS which we are enormously

proud of and it is still very well

regarded internationally. We have

incredible strong life sciences

sector, over £60 billion of

turnover, over 200,000 high-quality

jobs, and we have one of the

strongest pharmaceutical industries

in the world, 25% of all global

medicines developed in the UK. And

then as as has been said, we have

the great paradox, it is a British

problem, we have this great

development, great invention, but we

are slow to adopt and the experience

of my noble friend and so many other

patients in the NHS is of the same.

If you look at other countries, like

Germany and France, we can see that

their patients have much more access

to innovative treatments than we do.

When the noble Baroness was a

minister, she discussed this with

NICE who were set up to deal with

this British problem, and it was

captivated it would take 15 years

for a new treatment to be adopted

generally in the health service. And

here we are, 20 years later, we

still face a huge problem of

innovation adoption. It is true the

government has adopted the

accelerated access new and we also

have the life sciences strategy post

Brexit. But I think we have to do

much more. The minister will know it

is not just finance, it is also

attitude. We have got to do better

in the NHS to adopt the huge

innovation that so often takes place

in this country.

Like Lord Blunkett

I have known the noble ladies

Baroness Jowell for over 40 years --

noble lady. We met as young women

trying to make our way in the Labour

Party and to change the world. I

never dreamt that we would end up as

ministerial colleagues at the

Department of Health or two decades

later, as fellow members of the

house today. But what doesn't

surprise me is that my very dear

friend has shown unfathomable

fortitude and determination in her

current illness or that her injury

commitment of the public good has

led her to scrutinise the care we

provide to those who have cancer

especially object cancers like her

own and to campaign for improvements

in that care. I believe that UK has

to Mendis opportunities to make

progress cash tremendous. --

tremendous. Even given the

formidable challenges that these

cancers provide and the development

and evaluation of effective

treatments, but if we are to make

that progress across the spectrum of

prevention detection, treatment and

cures, we have got to collaborate

internationally and I hope the

minister will have some words to say

about that. And we have to explore

it all the resources we have and

that includes the NHS and its

scientific gold mine of information

which my noble friend has already

referred to. That is one resource.

Another is the Cambridge biochemist.

At the campus, we have world leading

research institutes including

molecular biology and Cancer

Research UK and the welcome

Institute just down the road. We

have great NHS hospitals,

Addenbrooke's, for example, and we

have leading international

pharmaceutical companies including

AstraZeneca and GS K and we have the

University of Cambridge itself. The

opportunities if these players can

collaborate effectively is enormous.

There are exciting plans led by

Professor Richard Gilbertson who is

a world leading expert in brain

cancers in children to build on the

already impressive results, for

example in breast cancer, by

creating a ground-breaking Institute

for early detection and for a new

cancer research Hospital bringing

patients speedy access to the latest

research and treatments. I hope that

the Department of Health will see

this not as another simple NHS

building project but as a real

opportunity within the context of

the life sciences strategy.

The noble Baroness, Baroness Jay,

cannot be here today and she asked

me to say how sad she was to miss

this opportunity and to pay some

words of tribute to the noble bonus

Tessa Jowell. I think she would feel

that the House has perhaps done her

proud in paying that tribute. I

started off by saying that 40 years

ago Tesla wanted to change the

world. I think the debate today

illustrates very clearly that her

determination to do so is

undiminished.

My Lords, I would like

to thank my noble friend and very

good friend Tessa Jowell who I have

been friends with for over 40 years

from our days at Camden Council and

many other campaigns for her did

become a parliamentarian and so on.

I find today are very important

debate. It is an important debate

for the evaluation of cancer

treatments. Britain has a

first-class reputation for research

but we do not always manage to get

the treatment to patients as early

as we should. A number of citizens

from around the world want to come

to Britain because they know we have

a good reputation for research and

treatment of cancer and it has to go

further. Furthermore, there must be

more sharing of research and data in

Britain and around the world. This

can save time and lives. Travelling

for patients with cancer is tiring

and dangerous and that is why we

must have places of excellence in

cities so people can get them. I

would also like to thank and realism

for her great work that she is doing

and who I work with closely in the

eve Appeal. It raises awareness and

funds research into five kine are

logical cancers. It was set up to

save women's lives by funding

ground-breaking research focused on

developing effective methods of risk

protection. Early detection and

developing screening for women only

cancers. It is vital that the health

service continues to fund screening

and screening must be more

available. This will save many lives

and also detect cancer earlier in

the same way as my noble friend

topped about prostate cancer. Women

must also not be afraid to go for

these tests. I would like to thank

Vanessa Elliott, a consultant at St

George 's Hospital, and Sarah

Rudman, a consultant at Guy 's and

Saint Thomas's who were very helpful

to me about this debate, thinking I

would have hours to speak. I told

them it was three minutes. They were

very helpful. I hope we will have a

campaign where I can talk about much

more. The charities that have

contacted us have explained how

serious and important it is that

cancer is dealt with as quickly as

possible. There are lots of

imperfections in clinical trial

design and the processes could be

improved. They try to have good

working relationships in order to

involve the trial design and process

at the earliest opportunity is. My

Lords, they hope that focusing on

design will lead to a drug license.

Most of the time the pharmaceutical

industry and the clinicians are not

always aligned. Although the drug

development process is still chunky,

traditionally most trials will still

progress through phase one, two and

three, which is expensive in terms

of finance, nursing and doctors'

time and importantly patients'

effort. It is also time-consuming

and may result in patients waiting

too long for new treatments. We must

make sure that when there are new

treatments there is availability for

people to experiment with these

treatments. In recent years more

innovative drug trials have been

used to reduce time for drug trial

development processes. It is really

important for patients to also have

equitable access to an early phase

of clinical trials. These trial

units are often only found in large

cancer centres and not all patients

have access to them. My Lords, it is

well enough for patients who have

exhausted conventional treatments

and tumour specific trials may want

to access unlicensed drugs.

My first experience of watching her

was taking on the Chancellor Gordon

Brown to squeeze the Olympic budget

out of, which was as close as you

could get to a combat sport, so none

of us who know or are in the least

surprised that she should see her

own cancer challenge as an

opportunity to help other people.

Tessa, thank you for shining a very

bright light on the subject, and I'm

delighted to work with you again. I

topped mostly about science, because

I believe we are not a pivotal

moment in cancer research. That's

why for the past year have been very

involved with Cancer Research UK.

Really trying to help them think

through how to raise all the money

we need privately to capture the

enormous opportunity which is

presented by the spectacular

advances in science and technology.

Improvements in the ability to

harvest our immune system and

treatments. Our ability to visualise

what's going on inside tumours. Then

you can apply all the new technology

we've built. This was when I say

things like AI, the planning and

machine learning and your Lord and

we know what were talking about. It

means you can generate and analyse

massive amounts of data, which is

hugely helpful for a bit patient

trials around the world. So quite

simply, I think the call of Cancer

Research UK and this is what was

thinking about is how to exploit

these specific developments and this

has been mentioned a couple of times

before, but basically to improve the

ten year survival outcomes from two

out of four people to three out of

four people. A nice simple call. To

accomplish this there are three

particular areas of focus that I'd

like to bring to your attention this

afternoon. The first one, and be

freely talked about this already,

but Cancer Research UK will devote

much more money and meaningfully

shift focus to hard to treat cancers

like brain tumours, as well as long,

pancreatic, which killed my father,

and cancers of the oesophagus.

Research in these areas compared to

the bowel and breast cancer has been

very low. The second key area of

work is what she was called

personalised medicine. Doctors need

to be armed with a detailed readout

of the molecular faults of the

tumour and the need to be armed with

the new generation of drugs at

precisely targets them, so no more

hit and miss and wait and see. An

enormous amount is happening in this

around the world. I think I've

picked out these comments before.

That great new treatments, smart

clinical trials. There is a big

opportunity to get those properly

coordinated, so we can get the most

out of them, because the current

approach is much too fragmented. The

final bit of work is revolutionary,

and it is what most captures the

changes in science we need to

exploit, what we're calling the

grand challenges. These are very big

research grants and they are aimed

at simply solving the biggest

problems, the one that will change

people's wives, and they're doing it

by bringing people together,

bringing the best sign Victor Allen

from around the world and from

across different disciplines and

forging together to attack the big

problems. I am very optimistic that

that will produce world is outcomes.

Changing Our aim is to raise all the

money for this privately, conveying

to potential donors at the

opportunity, because of the science

revolution is huge and it is now, so

give us your money. And I apologise

for practising my but she, but we

need to work on it. My request to my

noble friend is not for money, but

simply to help preserve the

competitiveness of the UK's research

environment. I it with one thing,

which is first, after we leave the

EU, it is really essential that our

future immigration system allows us

to attract, recruit and retain the

global scientific talent at all

levels regardless of nationality.

Thank you once again to the local

lady, my dear friend attempt Tessa

for shining a light and long may she

continue.

This has been a magical

debate. I can't remember anything

quite like it. In all my time in

this house. I do believe it will

have a profound effect. I would like

to express my great admiration for

my honourable friend Baroness

Jowell, for her steely

determination, her compassion and

humanity for other people. This

debate, I think, will be seen in

many different countries. My Lords,

quite a few years ago, the

celebrated American biologist

Stephen Jay Gould was diagnosed with

mesothelioma, which is cancer

derived from contact with asbestos.

Doctors told him that he only had

eight months to live, that's what he

thought they told him, because this

was the average survival period. He

looked at this and what matters

about an average is not just the

average, but the spiral of

possibilities. And he was a

statistician who understood. He made

this famous quote, he said, I am an

optimist who tends to see the

doughnut rather than the whole. He

studied the evidence on survival

rates and he did so in a careful and

sophisticated way. This is his

conclusion, I quote from what he

wrote. Those with positive

attitudes, with the strong will, and

a purposeful living, with a

commitment to struggle and not just

a passive acceptance of anything

doctors may say, tend to live

longer. While Stephen Jay Gould

lived to 22 years after his

diagnosis, admittedly this was the

supreme force of his will and his

knowledge ability, but it shows you

that you must interrogate any

diagnosis that is made. This is

really crucial. Moreover, his fame

brought mesothelioma is a bit out of

the shadows, when it languished for

so long, because it was a bit like

the tobacco industry, there was a

lot of industry resistance. In the

concluding part of what I have two

say, Mike Lawrie was a bit stalled

and by the previous speaker, because

I would like to say I think we are

on the threshold of some of the

greatest revelations ever made in

medicine and these are coming very

quickly, though, very fast. Why?

Because of the algorithmic powers of

computers, because of the fact that

doctors and medical researchers can

share their research instantaneously

across the world, which was never

possible before the digital age. And

because of advances link to this in

genomics and genetics. So there is

enormous hope. For example, myeloid

leukaemia, which was thought to be

incurable, now is quite different,

because of these research

breakthroughs. The main question to

be asked of the noble lord the

minister is the one that inspired

the debate. Will these breakthroughs

be confined to the privileged few?

The NHS is in the middle of a

horrible crisis. There are problems

of the changing demographic

structure of our society that lies

behind this. Will the Minister say

forcefully that those kinds of

cancer, like brain cancer or

mesothelioma, that are relatively

rare, will not suffer as a result of

the situation in our health service,

and that he will take measures to

ensure this?

This has been eight

unique, living and effective debate

and I am proud to be allowed to

support the demands of the noble and

courageous Baroness Jowell. In my

three minutes, I want to focus on

two of her demands, early diagnosis

and patient rights. Public health

England says diagnosing cancer early

is one of the most important ways to

improve cancer survival, and we know

that those patients who have their

cancers diagnosed as an emergency

have over outcomes. That is why new

screening and diagnostic methods

must be made available quickly. I am

standing here because of screening

and I say to the Lord Sternberg, I

have had two as well, perhaps we

should start a club. It shows for we

have come. Screening doesn't merely

diagnose disease, but can addict

risk of disease by identifying gene

mutations. Genomics screening can

contribute to decisions by

predicting how the tumour will

respond to chemotherapy. This can

avoid chemotherapy for those

patients who will not benefit from

it. Diagnoses of colorectal cancer

through the National bowel screening

programme remains under 10%. This

effect of early diagnostic tool is

not being used widely enough. This

is because the screening is not

being offered or is it because

people are not returning the

samples? What is the government

doing to improve these figures? I

agree with that noble Baroness

Jowell that patients should have a

great deal more say in their risk

they are prepared to take and

adaptive trials should be allowed,

where they could help. I will not

repeat many of the examples, cancer

related examples we have heard

today. I would like to give your

Lordships a non-cancer example of

where the system is preventing a

patient receiving medicines which

have already been shown to work. To

illustrate that the problems she has

identified is whiter than cancer. A

small boy who I will call A has rare

and serious epilepsy. He was treated

at great expense to the NHS with

powerful drugs to stop its vets, or

both of them were not even mice and

produced on children. His condition

did not improve and the doctors

admitted the drugs could damage is

vital organs and shorten his life.

His parents heard of a similar case

in Holland, where the child was

being successfully treated with

cannabis -based medicines, which

were licensed there. Child A has now

been receiving cannabis treatment in

Holland with tremendous success. His

doctor he is convinced of the safety

and efficacy of these medicines

which are not licensed here, but is

frightened to treat him with them,

because he is afraid the GMC will

strike him off. The family can no

longer afford to remain in The Hague

armour but the Home Office tells me

it will not grant a special licence

for this treatment in the UK. This

child could die of its vets. His

parents would agree in a heartbeat

that he should receive these

medicines here. They know the risk

is small and the benefits huge. They

should have the right to make that

decision for their child's, just as

the cancer patients mentioned by

Baroness Jowell should have the

right to make the decision about

risks and about their own treatment.

So what is the noble Lord Minister

going to do about that?

The

beginning of this debate, it became

completely clear we are dealing with

one of those extraordinary

parliamentary moments and anyway, I

have a much easier job than the

noble Lord the Minister. My

sympathies with him in answering

this debate. Are any of us surprised

that my noble friend tempted turned

round when she was diagnosed with

what she called this bloody shimmer

with her usual courage to try and

improve the outcomes of all people

with cancer? Are we surprised that

she did this? No, we're not. Because

this is a woman who is the first

public health minister promoted

tobacco control wheel motor it for

granted. She faced outrage from the

tobacco industry and their friends

and many backbench Labour MPs. Pubs

and clubs would go out of business

people were not to drink in the smog

created by cigarettes. How many

lives have been saved already as the

results of her determination to do

the right thing? The label nanny was

continued because of sure start, of

course. Her determination letter to

take on the Prime Minister and all

comers to convince us that the

Olympics should come to London,

could come to London and then when

they did so, to cure to make sure we

all had a great time in 2012. The

reason I'm reminding the house of

these matters is not only because of

my admiration for my friend tempted,

I'm reminding the house that in the

face of opposition and scepticism,

my noble friend will win through.

She has proved to be correct at time

and time again. I say to the noble

Lord and the government that they

had better believe this noble lady

and take what she is telling us very

seriously indeed. Indeed, from the

relatively modest demand to the more

innovative, adapting clinical trial

testing, multiple treatments against

the standard that would speed up the

introduction of new drugs, as well

as enabling existing ones to be

repurposed, links to the platform to

share data across the world. My

noble friend is saying this is a

demanding new paradigms, but the

prize is surely worth the struggle.

I think the government and all of us

should follow her example and not be

afraid to commit to making this

happen.

Can I begin in joining all

members of this house in paying

fulsome tribute to the noble lady,

not just for securing this debate

today, but for the extraordinary

character she is showing in leading

it. It has been a rich and very

moving discussion and as the noble

Lord Blunkett, it's extremely

daunting to follow the noble lady to

try and do justice to the requests

and of the speech that she has

given. It is also a privilege to be

able to do that on behalf of the

government. I would also like to

praise the noble lady for the

determination she is showing in

raising the profile of issues around

cancer treatment during the course

of her own illness. I think it's

fair to say she has inspired us all

and many can cancer sufferers as

well. But I suppose we should expect

nothing less from the woman who

brought us the most wonderful

Olympic Games and Paralympic games

in 2012. I thank Baroness Thornton

for her speech and I've done

everything I can in my response to

address the questions she has asked

as she will forgive me if there are

any statements to pick up on

afterwards. As we have heard today,

every story about cancer is a

personal one. But behind the numbers

by some very stark figures. Behind

those stories, lie stark numbers. As

our population ages and the

prevalence of cancer rises, one in

two of us will get cancer at some

stage in our life. The question is

not so much about how we stop that

happening, but how we can diagnose

and treat it more quickly and

effectively, so that it moves from

being a life-threatening disease to

one that can be managed throughout a

normal and happy lifetime. Must be

honest in saying we're not there

yet. Historically we have lagged

behind the best performing countries

in Europe and catching up with those

standards has been the focus of

successive governments including

this one. There is good news, things

are getting better. In the last

eight years, various actions mean

there are 7000 people alive who

wouldn't have been otherwise. The

benefits of the treatments are

spread unevenly. Survival rates were

certain cancers are stubbornly low.

Testicular cancer has been

transformed into a nearly curable

disease, but for other cancers, we

have heard about cancer of the

oesophagus, pancreas, lung and liver

and brain cancers, very little

progress has been made. There is

much still to do and we do need to

do better. The first step towards

achieving the world-class cancer

outcomes we all want to see and

which NHS patients rightly expect is

to have a pun on the planet is

backed by the counter community. At

plan was provided three years ago by

the independent cancer task force

which provided a cancer strategy

aimed at saving 30,000 lives by

2020. It was truly a landmark

moment. The government, as indeed

any government would have, adopted

the recommendations of the strategy.

It starts of course with prevention.

And we've heard about the vigour

with which the noble lady put shoot

public health intervention when she

was a health minister. Smoking and

obesity remain the biggest

preventable risk factors for cancer

and that's why there has been last

year a childhood obesity strategy

and tobacco control plan. They are

making progress on smoking and

smoking rates are coming down for

every age group, but we do have a

long way to go to tackle the obesity

epidemic, which we have not yet

done. Or courage is needed, I fear.

Early diagnosis is critical, and

that our new early diagnosis

standards, including a 20 D

standard. But we all know it's not

just about standards, it's about

bringing the best diagnostic tools

and therapies into the NHS more

quickly.

There are exciting discoveries, one

by John Hopkins University. We want

our NHS to bring on these

innovations and I am hopeful our

accelerated pathway, and the team

meets next week, we'll look at these

technologies and provide

opportunities to come into the NHS

up to double Vo years quicker.

-- up to four. At the centre of

every experience is a human being.

With all the emotional and physical

needs that attend. It is right to

expect every patient is treated with

compassion and dignity.

The National Cancer patient survey

showed more cancer patients are

experiencing positive care which is

welcome. I want to use this

opportunity to pay tribute to the

amazing staff who deliver care, but

to our range of charities and

voluntary organisations, including

Macmillan, Cancer Research UK UK,

who provide outstanding support to

people with and recovering from

cancer.

For all patients, the onus is not

what defines them, life goes on.

As well as challenges. And making

sure life can go on as close to

normal is essential.

Standards of care are high but there

is variation which is why there is a

plan to create a package therefore

every patient from the moment they

are diagnosed.

Where the Government can make a

difference is in providing the

necessary investment and I would

like to highlight important areas

but avoid the list ministers can

slip into, where that investment is

making an impact for cancer

patients.

Elsewhere the noble lady has spoken

about the surgery required to treat

her cancer which can be highly

invasive and debilitating. There is

a major investment in radiotherapy

equipment including new proton beam

centres and it is hoped that will

bring benefits to 6000 brain tumour

patients every year who will get

access to less invasive surgery.

She asked about the availability of

a key senescent die, -- fluorescent

dye, which helps surgeons to see

malignant tissue. We have spoken to

NHS England and they have committed

to working with surgery centres to

drive national uptake.

I would also like to highlight

another innovation and change which

has been a big investment in

infrastructure through 20 biomedical

research centres in England. I did

visit one of those last year at UCL

Hospital where I met some wonderful

and brave cancer patients among some

of the first in the world to trial

these therapies. I understand the

importance of giving patients a

choice to take risk when the prize

is extra months of life. These

centres are now recruiting or have

set up 700 trials. I am sorry the

noble lady was not able to find one

in this country she was able to

access for her particular form of

cancer. Our determination is British

cancer patients should not have to

travel abroad to be part of trials

or access the treatment they need.

Before closing, I would like to

address a number of issues. I agree

more investment is needed in

research for brain cancer, that is a

specific objective of the working

group. I can confirm that group will

deliver its report next Wednesday

and one of the actions will be a

highlight lettuce to encourage

researchers to submit applications

for funding in brain Cancer Research

UK and I would hope some of the

interesting research ideas and

projects will look at that

opportunity so we get more funding

into this important area.

The noble lady spoked about adaptive

trials, I can report they form a

growing proportion of the clinical

research networks portfolio. We need

to be more radical and she has

provided a specific suggestion. I

would be delighted to meet the

director of the Astute and am

thrilled he is here to hear the

debate.

-- Institute. There is a lack of new

brain cancer drugs. We have been in

touch with NICE and informed there

are drugs in development

specifically. NICE have committed to

publishing draft guidance on these

drugs, and drugs will be funded from

the point of licensing bringing

forward the opportunity to use them

by many months. The noble lady spoke

about the importance of data and

access. I couldn't agree more. One

of the wonderful things about our

NHS is it it's here for us all of

the time, and one of the quirks in

how it was set up is it has an

unrivalled data on patients and

their medical experiences and

journeys which is invaluable to

research. We haven't got policy

right always. All brought the public

with us about the benefits of

sharing data. But there are key

decisions coming up so we can access

and create that dataset for research

purposes. I welcome the opportunity

to engage with the noble lady to win

the argument with the public about

sharing data for the benefit of one

another and --. There have been many