Let me start by congratulating Stuart Andrew on securing this important and well-attended debate. Every Member who spoke made an effective and moving speech. However, the speech that stands out for me is that of my hon. Friend Fiona Mactaggart. We have already heard that ovarian cancer is a very serious
condition and that it is the fifth most common cancer among UK women. Members have also set out the relatively low survival rates for ovarian cancer—they are around 40% compared with 79% for breast cancer. That is largely due to the fact that three out of four women are diagnosed late, once the cancer has spread. It is worth repeating that survival rates could be as high as 90% if the cancer were diagnosed at an early stage. In Hackney, in east London, the five-year ovarian cancer survival rate is only 35%, which is significantly below average.
Despite the evidence relating to lack of awareness, the rates of late diagnosis, and the delays in diagnosis admissions by A & E, there is still no Department of Health-led activity to improve awareness of symptoms among women and GPs. That is despite the Government’s commitment to save 5,000 lives a year from cancer by 2014. I welcome the new National Institute for Health and Clinical Excellence guidance on symptoms and the increased access to diagnostics that was announced in the cancer strategy, which mean that there will be new opportunities to improve early diagnosis. But unless women know when to visit their GP, unless the symptoms of ovarian cancer become as well known among ordinary women as the symptoms of breast cancer are, and unless GPs know how to consider ovarian cancer, rates of late diagnosis and levels of delay will not improve.
We have already heard, but it is worth repeating, that there is no national outcome measure for ovarian cancer; there are only such measures for breast, lung and bowel cancer. That is already impacting on the ability of PCTs and cancer networks to undertake awareness work about ovarian cancer, as funding for awareness work is being channelled to breast, lung and bowel cancer. That will potentially lead to a worsening of the situation, because it means in practice that there will be a decline in activity.
The quality standard for ovarian cancer will be one of the first of the new suite of quality standards to be introduced by NICE to inform local commissioners, but as yet it is not clear how the standard can be used effectively. Can the Minister tell us whether the Department of Health is considering introducing a national outcome measure for ovarian cancer? Can he also say how the Department will ensure that the quality standard is used effectively?
The Minister will be aware that the first findings of the international cancer benchmarking study—a study led by the Department of Health—showed that in the UK late diagnosis is thought to be a key driver of survival rates, which are poor compared to those in other countries in the study. However, ovarian cancer is the only cancer type in the study not to have had remedial action taken to improve awareness.
The Minister will forgive me when I say that under the last Government we saw substantial investment in cancer services and consequently outcomes improved; for instance, the survival rate for breast cancer rose from 50% to more than 80%. In the case of ovarian cancer, although the figures are not necessarily much better than they were when Tim Farron faced the issues in relation to his mother, the survival rate has in fact doubled in the past 30 years. The commitment shown by the last Labour Government meant that in excess of 1,000 more women per year in England and
Wales are now surviving ovarian cancer. However, the UK survival rate for ovarian cancer is still among the lowest in Europe, at 36%. If we achieve the average European survival rate, we will save 500 lives per year.
All of us, including the Minister, know that two major trials are currently taking place: the first is for women in the general population; and the second is for women with a strong family history of ovarian cancer. The former trial will report in 2015 and the latter trial in 2012. However, it is not at all certain that the findings of those trials will result in a national screening programme. Perhaps the Minister can tell the House what the Government’s position is on that issue.
Cancer Research UK tells me that it is concerned that the Health and Social Care Bill, which is currently being debated in another place, risks fragmenting responsibility for the early diagnosis of cancer between Public Health England, local authorities and the NHS. Cancer Research UK’s proposal for guarding against fragmentation is that local authorities and clinical commissioning groups should be jointly incentivised to prioritise early diagnosis, including shared indicators in the public health and NHS outcomes frameworks. That process should be supported by shared budgets, to ensure joint responsibility for delivering improvements in awareness and early diagnosis of cancer. In other words, Cancer Research UK is concerned that policies and responsibilities around early diagnosis will fall through the cracks. How will the Minister respond to that proposal by Cancer Research UK?
The Minister will be aware that, earlier this year, at the 12th international forum of the Helene Harris Memorial Trust, which was originated and facilitated by Ovarian Cancer Action, 50 of the world’s leading researchers and clinicians in ovarian cancer came together to discuss the future for ovarian cancer research. Out of those discussions came nine key actions: improving recognition that “ovarian cancer” is a general term; better targeting of clinical trials; identifying patients at increased genetic risk; developing new approaches to identify targets for treatment; ensuring that both the tumour and the tumour micro-environment are treated; better understanding of relapses of treatment-resistant ovarian cancer; setting up international collaboration to enable tissue samples to be shared and analysed in research; developing better experimental models; and ensuring that clinical trials include measures of quality of life and symptom benefit. Ovarian Cancer Action believes that those nine actions would not only help to improve the quality of life and ovarian cancer survival rates for women in the UK, but help to position the UK as an international leader in the fight against this deadly disease. Is the Minister aware of those recommendations and what is his response to them?
My hon. Friend Kevin Brennan made the point that, in the sometimes humdrum routine of the life of a junior Minister, there is occasionally a genuine opportunity to make a difference. Having listened to the informed, personal and passionate contributions of colleagues and other hon. Members this morning, I hope that the Minister will go away from this debate determined to move ahead—on the very strong basis of what the last Labour Government did and what his Government have done up to now—and actually make a difference in relation to ovarian cancer.