Minutes of a meeting of the All Party Parliamentary Group on Pancreatic Cancer

18th June 2013

Minutes

Welcome and introduction – Eric Ollerenshaw MP

APPG Secretary Eric Ollerenshaw MP opened the meeting, welcoming Parliamentary Under Secretary of State for Public Health Anna Soubry MP to the APPG’s meeting. He noted that Soubry had been invited to address the APPG about the Government’s work on pancreatic cancer. He also welcomed attendees from Parliament, patients and relatives of those with pancreatic cancer, the pancreatic cancer charities, and other guests.

Ollerenshaw briefly outlined Soubry’s background, noting her election in 2010 as Member of Parliament for Broxtowe, her subsequent appointment as Parliamentary Private Secretary to the former Health Minister Simon Burns MP, before being appointed as a junior health minister herself in the September 2012 reshuffle.

He noted Soubry is responsible for a broad range of areas, including for “preventing avoidable mortality, saving lives”, adding this was of particular importance for pancreatic cancer, which has seen five-year survival rates remaining at a very low rate for the past 40 years.

Speech from Public Health Minister, Anna Soubry

Anna Soubry thanked the APPG’s officers for inviting her, and also thanked Nic Dakin MP and Eric Ollerenshaw MP for attending a recent meeting to discuss pancreatic cancer. She introduced herself as a journalist and barrister by background before entering Parliament. She mentioned that, in her current role, she has responsibility for all cancers.

Soubry discussed the significant changes to the health system following the Health and Social Care Act 2012, noting the new responsibilities of NHS England, which she called a very important part of the new NHS landscape.

She added her delight at the APPG’s inquiry into pancreatic cancer, arguing that APPGs can achieve a lot of good, with MPs and peers working on a cross-party basis across the political divide. She welcomed the production of reports by APPGs which were based on evidence with strong conclusions – adding she would support the inquiry’s final report accordingly. She added that the APPG should work to involve the NHS in Wales, Scotland and Northern Ireland.

Soubry noted that under the new health service arrangements, the Secretary of State remained the “steward” of the health service and is responsible for issuing an annual Mandate to NHS England. She mentioned a difficulty the Government is facing in determining the right balance in the Mandate between particular conditions, and added that Health Secretary Jeremy Hunt is focusing on mortality rates – arguing the NHS should improve its performance.

Soubry recognised that pancreatic cancer has particularly poor mortality rates and poor performance in a number of measures. She recognised the late diagnosis of pancreatic cancer, and added that the outcomes for patients with pancreatic cancer were “not where they should be”. She suggested that there are lessons to be learnt from other countries’ outcomes, and noted the Health Secretary has asked officials to look at this.

Soubry noted the incidence rate of pancreatic cancer adding in around 80% of cases the individual was aged 60 and over. She mentioned the importance of research into pancreatic cancer, highlighting some lifestyle causes of pancreatic cancer including smoking. She also discussed the importance of diet.

Soubry concluded by stating the Department of Health knows there is a big problem, shown by the poor statistics. She described pancreatic cancer as “damned difficult” to diagnose. She also drew attention to the Government’s “Be Clear on Cancer” campaign, with its focus on unexplained symptoms.

Questions

Anna Soubry took questions from a range of audience members.

• Clara Mackay (Pancreatic Cancer UK), asked a question regarding variations in survival rates and asked if the Minister would support including pancreatic cancer in the international cancer benchmarking programme.

Soubry responded that she could not make such a commitment immediately but would take it away to discuss with officials, agreeing that there are a range of countries which have better performance than the UK.

• Baroness Morgan of Drefelin drew attention to the inquiry, mentioning that a number of GPs have given evidence that they would find it useful to be able to refer patients directly for CT scans. She noted that several GPs had also said they did not feel confident that if they themselves asked for patients to receive a scan, it would necessarily happen.

Soubry responded that under the Government’s health reforms, clinical commissioning groups have the opportunity to do a lot of “free thinking”. She pointed to new approaches in Leicestershire in Nottingham which were showing effective ways of collaborating in tackling conditions such as diabetes. She added that she has great faith in the new system, noting that CCGs can have a lead GP for certain conditions such as cancer – with this person developing the relationship with the local foundation trust. She suggested they could then argue for direct access to scans, adding this was also an issue she had heard raised in relation to brain cancer.

• Ali Stunt (Pancreatic Cancer Action) asked if there should be an audit of pancreatic cancer in
England and Wales, noting the audit which had taken place in Scotland.

Soubry responded that she thought that it could be something for the APPG to consider looking at either itself or by approaching NHS England. She noted the benefits of a healthy rivalry in terms of performance that could exist between the NHS in England and the NHS in Scotland.

• Lord Aberdare asked how the new landscape of the NHS will help deal with poor outcomes across the UK. He noted that pancreatic cancer required specialist treatment which is best done by areas working together.

Soubry drew attention to Health Secretary Jeremy Hunt’s interest in distributing data, pointing to many types of data being published, including public health data, and reiterating her earlier point regarding the benefits of healthy rivalry. She pointed to the roles of Health and
Wellbeing Boards, who can look at local statistics and engage locally including with the foundation trust and clinical commissioning group. She noted that CCGs can work across areas, noting parallels with reforms to the treatment of stroke in London. She noted however that often politicians find it difficult to support local hospital closures despite them leading to better health outcomes.

• A couple noted the death of their daughter from pancreatic cancer aged 29. They argued for effective GP education, saying that GPs need to understand pancreatic cancer better and have greater awareness.

Soubry noted that the public expects GPs to know everything, adding it was perhaps “too much”. She pointed to the role of CCGs in working together and argued that there was no culture of loss of professional pride in the barristry profession which prevented people from admitting that they did not know the answer. She said if CCGs are working properly then GPs will speak to colleagues. Turning to early diagnosis, she noted one charity which had run an awareness campaign had found that awareness had not just been raised amongst members of the public but also amongst GPs, who had benefited from information on how to diagnose the condition. She noted this was an excellent example of the good work done by medical charities.

• Stella Kyriazis (Tories for Older People) raised the impact of obesity and smoking on pancreatic cancer, and noted that increases in obesity amongst young children could lead to a fall in the average age of pancreatic cancer patients.

Soubry noted the presence of lifestyle factors, but noted that it was very difficult for the Government to work on this area because of inevitable allegations about a “nanny state”. She said the Government puts a great deal of emphasis on childhood obesity, noting stronger support from the public in working to tackle obesity amongst children. She pointed to advice from experts in obesity to focus on diet. She also agreed with a question from another audience member who noted that not all who die from pancreatic cancer are overweight, unhealthy, or smokers.

• Ali Stunt (Pancreatic Cancer Action) noted that there was very little known about pancreatic cancer, and that there are low levels of research funding.

Soubry responded that she had raised this issue previously, and that an issue was that researchers were not coming forward with research projects. She said that if people come up with good research projects then there will be funding.

• Clara Mackay (Pancreatic Cancer UK) suggested that there could be incentives for researchers to focus on pancreatic cancer.

Soubry noted that sometimes there was a need for a “magic” moment to act as a trigger for greater public awareness, pointing to Jade Goody who had cervical cancer.

In closing, Eric Ollerenshaw MP thanked Anna Soubry for her time, her speech and taking questions. He also thanked attendees for their support of the APPG on Pancreatic Cancer.

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