Tag: Maggie Throup

The speech made by Maggie Throup, the Conservative MP for Erewash, in the House of Commons on 8 December 2022.

It is a pleasure to follow the hon. Member for Easington (Grahame Morris), who speaks with much knowledge and personal experience, which makes a huge difference. I welcome the report of the Health and Social Care Committee on cancer services, and the subsequent response from the Government. I commend all Select Committee members involved in producing that excellent report and I have every confidence that more quality reports will be produced on this subject and many others under the leadership of my hon. Friend the Member for Winchester (Steve Brine).

I am grateful for the opportunity to discuss the report further. I will focus on community diagnostic centres and the role of diagnostics more generally in supporting cancer services. With 91 community diagnostic centres already open, a further 19 announced yesterday and 40 more to come before March 2025, this is definitely a good news story. I am delighted to have a community diagnostic centre in my constituency at Ilkeston Community Hospital. It opened a year ago. In its first eight months, it delivered more than 6,500 tests, checks and scans. To date, across all the community diagnostic centres that have opened, 2.4 million tests, checks and scans have been carried out. That is excellent news, but not the full story.

The success of the upcoming 10-year cancer plan—we hope that it is upcoming and has not been shelved—as well as tackling the backlog, elective recovery plans and levelling up, depends heavily on diagnostics. Diagnostics, whether in vivo or in vitro, are crucial to the overwhelming majority of patient pathways and are central to health outcomes. I know that the royal colleges, specifically the Royal College of Radiologists, and many other organisations support investment in improving cancer services across England and, at the same time, addressing historic postcode lotteries created over recent decades.

Community diagnostic centres have an important role to play in this, but they bring their own problems. There are already existing chronic workforce shortages and ageing equipment that prevent cancer diagnosis and improvements in cancer care. There is a shortfall of 30%—1,453—full-time equivalent clinical radiologists and a 17%—148—shortfall of clinical oncologists. Those shortfalls vary in severity for each region, but I take a particular interest in the east midlands, where my constituency is. The east midlands has the same shortfall of clinical radiologists as the national average, which is 30%, but the shortfall in clinical oncologists is above the national average, at 28%, while 19% of clinical radiologists and 18% of clinical oncologists are forecast to retire in the next five years, adding even further pressure on a workforce already struggling to meet demand.

A global study has found that a treatment delay of four weeks, which could be caused by a workforce shortage, is associated with a 6% to 13% increase in the risk of death, and that worries me as it could have a detrimental impact on the outcomes for cancer patients across Erewash, however hard those in post work. If we are to improve cancer services in England, we must invest in clinical radiology and clinical oncology training places to ensure that there are enough clinicians throughout a cancer patient’s pathway. I know there is competition for clinicians across all disciplines, but, if we are to improve outcomes for our cancer patients, we need to attract radiologists and oncologists.

I pay tribute to everyone involved in this aspect of medicine, whatever their role, and of course our NHS workforce across all disciplines. I include all the amazing people, whether healthcare professionals or volunteers, at my local hospice, Treetops Hospice Care, who each day make the end of life a better experience for so many of my constituents—a huge thank you to everybody.

I have mentioned that one of the other barriers to community diagnostic centres reaching their full potential is the lack of investment in equipment in the existing system. The UK has fewer scanners than most comparable countries in the OECD: it has 8.8 CT scanners per million of the population while France has 18.2 and Germany has 35.1; it has 7.4 MRI scanners per million of the population, while France has 15.4 and Germany has 34.7. Industry surveys have shown that one in 10 CT scanners and nearly a third of MRI scanners in UK hospitals are over 10 years old, and 10 years is usually the age at which this equipment can be considered obsolete and must be replaced.

In June, the Royal College of Radiologists surveyed a representative sample of its members in England about equipment needs, revealing that 49% of clinical radiologists and 21% of clinical oncologists said they do not have the equipment they need to deliver a safe and effective service for patients in their department or cancer centre. Only 32% of clinical radiologists and 54% of clinical oncologists said their equipment is fit for purpose, with the rest saying it is substandard or only acceptable to some extent. There must be a comprehensive audit of all diagnostic equipment across England so that investment is made in the right equipment where it is needed most.

I have some questions for the Minister, for whom I have great respect. I know just how much she cares about getting it right for patients. First, are clinical radiology and clinical oncology training places being invested in to ensure there are enough clinicians throughout a cancer patient’s pathway and, if so, will that investment include both the 50% of trainee costs covered by Health Education England and the other expenses incurred by trusts? When it comes to equipment, are community diagnostic centres taking the investment preference over and above the replacement of obsolete diagnostic equipment in hospitals, and will an audit of all diagnostic equipment be carried out? Of course, as has been mentioned, one of the elephants in the room—or, more correctly, in the Chamber—is: how do we help to prevent people from getting cancer in the first place?

Across the UK, there are huge health disparities. When heat map after heat map is laid over the UK —whether for high smoking rates, high levels of obesity, high rates of cardiovascular disease, high rates of cancer, excess alcohol consumption or poorer health outcomes—they all show that the same areas are affected detrimentally. Therefore, we need to consider how we are going to achieve the Government’s targets to become smoke-free by 2030 and to halve childhood obesity by 2030. Perhaps, after the festive season, there can be a fresh look at measures to tackle excess alcohol, because alcohol, smoking and obesity are all markers of and can all cause cancer. If we are serious about tackling cancer, we need to be serious about preventing it as well, and it is never too late. We are always excited to hear about new therapies that have been proved to be effective, but surely we need to get as excited about preventing cancer in the first place, so my final question for the Minister is: when can we expect the health disparities White Paper to be published?

There are many innovations to harness across all diagnostics, while community diagnostic centres, genomics and AI have a role to play, as do many more innovations, but until the unprecedented challenges—including the huge workforce pressures, out-of-date equipment and preventive measures continuing to be watered down—are addressed, cancer diagnosis and treatment will never reach their true potential. The Government state in their response to the Select Committee’s report that

“the Government’s forthcoming 10 Year Cancer Plan will set a new vision for how we will lead the world in cancer care, including ensuring we have the right workforce in place.”

That is an admirable ambition, and we all want the Government to succeed. Indeed, they must succeed, as this will be transformational for the life chances of my constituents in Erewash and those of the whole nation. As my hon. Friend the Member for Winchester has said, I look forward to reading the Government’s 10-year cancer plan very soon.

The speech made by Maggie Throup, the Conservative MP for Erewash, in the House of Commons on 3 November 2022.

It is a pleasure to follow the hon. Member for Stockton North (Alex Cunningham). Like him, I could tear up my speech after listening to that of my hon. Friend the Member for Harrow East (Bob Blackman). I congratulate my hon. Friend and the hon. Member for City of Durham (Mary Kelly Foy) on securing this important debate, which I have been eagerly awaiting for some time. I wish the hon. Member for City of Durham a speedy recovery.

I thank the all-party parliamentary group on smoking and health, which is so excellently chaired by my hon. Friend the Member for Harrow East, for all its work on this important area. It has undoubtedly been instrumental in changing the Government’s policy on smoking and their perception of the issue. I am sure that its work has contributed to saving many lives. I thank my hon. Friend for his invitation to become a member of the APPG; I am delighted to accept.

The reasons why we need to tackle smoking and become smoke free by 2030 have been well rehearsed in previous debates in Westminster Hall and this Chamber and repeated today, but I make no apology for highlighting the key reasons again. Smoking remains the single biggest cause of preventable illness and death. Surely we have a duty to do everything in our power to prevent ill health and death. Shockingly, cigarettes are the only legal consumer product that will kill most users: two out of three smokers will die from smoking unless they quit. More than 60,000 people are killed by smoking each year, which is approximately twice the number of people who died from covid-19 between March 2021 and March 2022, yet it does not make headline news. In 2019, a quarter of deaths from all cancers were connected to smoking.

The annual cost of smoking to society has been estimated at £17 billion, with a cost of approximately £2.4 billion to the NHS alone and with more than £13 billion lost through the productivity costs of tobacco-related lost earnings, unemployment and premature death. That dwarfs the estimated £10 billion income from taxes on tobacco products. People often tell me that we cannot afford for people to stop smoking because of the revenue generated by the sale of tobacco, but I argue that as a society, and for the good of our nation’s health, we cannot afford for people to smoke.

Achieving smoke-free status by 2030 will not only save the NHS money but, more importantly, save lives. If we are determined to bring down the NHS backlog, we need to prevent people from getting ill in the first place. If we want to achieve our goal of improving productivity, we need a healthy workforce. It takes a brave and bold Government to implement policies whose rewards will mainly be reaped by the next generation, but that is the right thing to do.

I want to focus on just one of the well-researched and well-received recommendations in the Khan review: the age of sale. The fact that retailers use the Challenge 21 and Challenge 25 schemes indicates just how hard it is to determine a young person’s age. Age of sale policies are partly about preventing young people from gaining access to age-restricted products such as cigarettes and alcohol. More importantly, as Dr Khan states, they are about stopping the start. Dr Khan recommends

“increasing the age of sale from 18, by one year, every year until no one can buy a tobacco product in this country… This will create a smokefree generation.”

That may seem pretty drastic, but so are the consequences of smoking. If we ask smokers when they started, the majority will say that it was when they were in their teens. The longer we delay the ability to legally take up smoking, the fewer people will take it up, and the fewer will therefore become addicted. Let’s face it: never starting to smoke is much easier than trying to quit.

We have already proved in the UK that raising the age of sale leads to a reduction in smoking prevalence. Increasing the age of sale from 16 to 18 in 2007 led to a 30% reduction in smoking prevalence for 16 and 17-year-olds in England. Other hon. Members have mentioned the change in America. I would argue that increasing the age of sale by one year every year is more acceptable than raising it in one go from 18 to 21, for example, or even to 25.

Dr Khan has also called for additional investment in the stop smoking services currently provided by local authorities. However, I am a great believer in making every contact count—every contact that someone makes with a GP, as an out-patient, as an in-patient or on a visit to a pharmacy. Every time a smoker sees a healthcare professional, it should be seen as part of the healthcare professional’s duty to better the health of their patient.

I was honoured to share the stage with Dr Javed Khan at the launch of his review in June, and I was pleasantly surprised by the virtually universal welcome that his recommendations received. Indeed, polling carried out by YouGov backs that up: 76% of respondents support Government activities to limit smoking, or think that the Government should do even more; just 6% say that they were doing too much; 76% support a requirement for tobacco manufacturers to pay a levy or fee, to finance measures to help smokers quit and prevent young people from smoking; 63% support an increase in the age of sale; and, for the benefit of those on the Government side of the Chamber, 73% of those who voted Conservative in 2019 support the Government’s smoke free 2030 ambition.

In our 2019 manifesto we committed ourselves to levelling up, and that commitment has been reiterated by our new Prime Minister. Levelling up is not just about infrastructure; it is also about levelling up our health and life chances. That is particularly important for my constituents, because 16.6% of adults in Erewash are currently smokers, which is above the national average. With average annual spending on cigarettes estimated to be around £2,000, it is not just the health of smokers that is being affected, but their pockets as well. Becoming smoke free by 2030 would lift about 2.6 million adults and 1 million children out of poverty, and so would aid our levelling-up agenda.

Before I end my speech, I want to raise the issue of e-cigarettes, or vaping. The Khan review contains a specific recommendation on this, and I want to explain why it is so important. As with cigarettes, the age of sale is 18, but time after time I see young people at the end of the school day using vapes—and that is outside schools without sixth forms. It is illegal for a retailer, whether online or on the high street, to sell vaping products to anyone under the age of 18, so I am not sure how under- age users are obtaining the devices. The manufacturers are obviously aiming some of their marketing at this age range through the use of cartoon characters, a rainbow of colours, and flavours to match. The function of e-cigarettes should be solely as an aid to quit smoking, and not, as I fear, as a fashion accessory and, potentially, the first step towards taking up smoking.

The proliferation of vape shops in our high streets and online proves that vapes have become an industry in their own right, and are now being used by tobacco companies to maintain their profits as restrictions on tobacco increase. I therefore ask the Minister to work with his colleagues in the Home Office, the Department for Levelling Up, Housing and Communities and the Department for Education to see what more can be done to clamp down on the illegal supply of vapes to those under the age of 18. I also ask him for an update on progress in getting a vaping device authorised through the Medicines and Healthcare products Regulatory Agency—a step that would send the strong message that vapes are an aid to quitting smoking and not an alternative to smoking.

Finally, let me ask a question that has already been asked by other Members today: will the Minister provide a date on which we can expect the tobacco control plan to be published?

The statement made by Maggie Throup, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 16 May 2022.

The Government are delaying the implementation of the volume price promotion restrictions and the introduction of further advertising restrictions on TV and online for high fat, sugar or salt (HFSS) products by 12 months.

We are clear that the delay to volume price promotions does not impact the locations measures which will still come into force on 1 October 2022. Under these measures, less healthy products in scope will no longer be promoted in key locations, such as checkouts, store entrances, aisle ends and their online equivalents. We expect these location restrictions to be the single most impactful obesity policy at reducing children’s calorie consumption and are expected to accrue health benefits of over £57 billion and provide NHS savings of over £4 billion, over the next 25 years.

The delay to restrictions on multibuy deals will allow the Government to review and monitor the impact of the restrictions on the cost of living in light of an unprecedented global economic situation.

A delay to the advertising restrictions is necessary because a delay in the Health and Care Act 2022 receiving Royal Assent has had a consequential impact on the timetable for the regulators’ subsequent consultations and publication of final guidance, meaning it was unlikely this would be ready with sufficient time before implementation.

We have also considered the ongoing concerns from industry about having time to fully implement the final guidance, by restructuring their funding and revenue streams appropriately, and ensuring robust compliance from implementation. We therefore believe this is the best approach to balance tackling childhood obesity in a timely way, managing the unprecedented economic situation and ensuring the smooth and effective implementation of these restrictions. The advertising regulations will now come into force on 1 January 2024.

We included a power in the Health and Care Act to delay implementation of the advertising restrictions if necessary. We will be utilising this power to amend the date of implementation for the advertising restrictions by secondary legislation. The implementation of the volume price restrictions will also be amended by secondary legislation.

This Government remain committed to halving childhood obesity by 2030 and these measures and others, including last month’s new measures on calorie labelling in large restaurants, cafes and takeaways, will play their part in delivering against this ambition.