The event launched
Macmillan’s campaign to make cancer a top priority in the upcoming general election.
The chair of the event, Ciaran Devane, Chief Executive of
MacmillanCancer Support, began by saying it was ‘not good enough’ for the UK to be at the bottom in terms of national cancer statistics across Europe. He said it wasn’t acceptable for the UK to be aiming for average statistics compared with other European countries when we could be the best.
Mr Devane said that 2 million people in the UK had cancer in 2010 and that it was predicted to increase to 4 million by 2030, therefore the system needs to change to cope with this increase.
He said that with the general election exactly one year away,
Macmillanaims to make sure that the political parties prioritise cancer care in their manifestos and that
Macmillanhas started conversations with all three main parties. Ahead of the general election
Macmillanwill be calling on all three parties to commit to:
• deliver cancer outcomes that match the best in Europe
• ensure all cancer patients are treated with the highest levels of dignity and respect and that staff are supported to do this
• ensure everyone at the end of life is given free social care to support them to spend their final weeks and days in the place of their choosing.
He was also keen that people affected by cancer who are at the end of their life have ‘as good a death as possible’ and that where people wish they have the choice to die at home. This is often less stressful and better for them, as well as being cheaper for the National Health Service.
End of life care
We know from reading
Macmillan’s
Cancer in the UK 2014 reportabout numbers of people who want to die at home, with the right support, three in four people with cancer would prefer to die at home, but fewer than a third are able to do so.
Jane Maher said it was important that palliative care registers are more widely used and that people need joined-up health and social care, 24 hours a day. She added that this should not be means tested, when people are at the end of life.
Andy Burnham replied that as a junior minister to Patricia Hewitt he had taken previous legislation on this area through parliament, but he said that Labour did not go far enough in linking social care up with pain management or enshrining in the NHS constitution that patients can choose where they want to die.
Paul Burstow said that as a minister he commissioned the first ever end of life care experience survey. He said that end of life care is often poor, but that both hospice and home staff do a fantastic job, so these options should be there for sufferers. Per patient fund was important in this respect, as towards the end of life people’s decisions change so flexibility in the system is crucial.
John Baron MP agreed that flexibility was important and that the government and NHS needed to embrace the good work which the charity already does in this area. He specifically thanked
Macmillanfor the ‘fantastic’ work they undertake, as well as other charities including Sue Ryder.
Members of the audience commented that the hospital experience has to be improved with more compassion and dignity offered to patients. The lack of central funding to hospices was also raised, with much of their funding coming from private donations. Paul Burstow added that the ‘per patient’ scheme being piloted was getting some funding into hospices, but said that many hospices guarded their independence from the wider NHS. Andy Burnham concluded by saying that social care was left out of the original NHS, and that now we view the whole person, through physical, mental and social care. He said that in this respect the hospice movement was ahead of the rest of the Health Service.
Early detection of cancer
John Baron said that the APPG on Cancer published a ‘Cancer inequalities’ report in 2009, which highlighted 1 in 4 cancer patients are still diagnosed as late as A&E. As the NHS was often poor at detecting cancer, this made for poor one year survival rates. Mr Baron called for more diagnostics and a better GP referral programme to improve the situation. He has secured a full breakdown of statistics for each Clinical Commissioning Group in the country and these will be published at the end of June.
Andy Burnham said it wasn’t right to always blame the GP for poor rates of early detection. He added that we needed public campaigns to raise awareness and make information more widely available. He also said people need better access to GPs and education to identify cancer earlier. He highlighted the importance of the 2 week urgent referral programme.
Paul Burstow said that the APPG has been laser like in its focus on one year survival rates. He added that it was important to make sure people are going down the pathway to correct and early diagnosis. He said the ‘Be clear on cancer’ campaign was important and quipped that he was probably the first ever minister at the despatch box to talk about poo, but that changing our own behaviour and looking for tell-tale signs is also part of increasing early diagnosis. He said the introduction of standardised packaging for cigarettes was also important in combatting lung cancer and reducing smoking.
Members of the audience raised the issue of dentists still not doing spot checks when they see patients. A recent survey of dental patients on a Saturday surgery of 30 patients found 2 with cancer, who were immediately referred. This should be implemented after discussions with the dental community.
John Baron agreed, and said that any medical professional on the care pathway could help diagnose and ensure the best chance of survival. He was clear that once the 1 year survival figures for each CCG were published, work could be done to bring poor performing areas up to speed.
Reducing inequality
Paul Burstow said that an aging society affected all of us. Carers who look after relatives need greater flexibility from employers. He added that it was important to collect mortality data for all, not just up to 75 years old.
Andy Burham said ‘we know there is too much variation’. We ‘need a real national NHS, with NICE approved care options. He also said other factors needed to change including the level of sugar in children’s diets. He also said it was not good enough that only 25% of adults are physically active. He said that it was reasonable to double this to 50% of adults by 2025.
John Baron said it was important to know the community and have good links within it. If it is a former mining community then it will have higher levels of Mesothelioma. BME communities would also sometimes have higher levels of some diseases.
Improving the patient experience
Andy Burnham said that one of the primary concerns for most sufferers in his experience was parking charges and these sorts of worries could add to already large burden of cancer.
Paul Burstow said it was about placing the person at the centre. John Baron said the NHS needs to learn lessons from complaints and that it was often reluctant to say sorry for fear of litigation. He called for a better neutral system for simply gathering all the facts of a case which if necessary could be passed to a lawyer later.
Support following treatment
Andy Burnham highlighted ‘whole person care’. He praised the
Macmillancentre for post cancer care and support at UCH in London and a similar centre in Trafford. Paul Burstow said the key question for recovery is ‘am I feeling better and am I functioning well’.
John Baron said the real experts were often other patients and we need to listen to them carefully to ensure that services are meeting their needs.
Members of the audience said that officially cancer was a disability and covered by the Equality Act. If employers failed to grasp this and were being unhelpful, then John Baron said they should come and see their MP who could help.
Paul Burstow said that going back to work could be an aide to recovery and wellbeing, but not if it was too early, forced or not properly supported. Andy Burnham concluded by saying often people in lower parts of the job market receive little support or are more likely to have a zero hours contract. He added that Labour, which had brought in the Equality Act just before the 2010 general election, would now consider calling for a review of it to see how it was being implemented in practice.
More information on the Macmillan 2015 General Election priorities is available
here