The Cancer challenge
The event launched Macmillan’s campaign to make cancer a top priority in the upcoming general election.
Ciaran Devane, Chief Executive of Macmillan Cancer Support (Chair of the event), began by saying it was ‘not good enough’ for the UK to be at the bottom in terms of national cancer statistics across Europe.
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, Macmillan aims to make sure that the political parties prioritise cancer care in their manifestos and that Macmillan has started conversations with all three main parties. Ahead of the general election Macmillan will 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.
Macmillan’s Cancer in the UK 2014 report shows that the majority (3 in every 4) of cancer patients want to die at home, but fewer than a third are able to do so.
Andy Burnham replied that as a junior Health minister 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 per patient funding 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 Macmillan for 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.
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 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 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.
Members of the audience raised the issue of dentists 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.
Paul Burstow said that an aging society affected all of us. Carers who look after relatives need greater flexibility from employers and 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’. He added that 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.
John Baron said it was important to know the community and have good links within it. A former mining community might 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.
Support following treatment
Andy Burnham highlighted ‘whole person care’. He praised the Macmillan centre for post cancer care & support at UCH in London (and 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.
Andy Burnham said 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