Julie Cooper MP for Burnley and Padiham

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Yesterday I spoke in Exiting the European Union Questions and asked the Secretary of State to make efforts to ensure that Burnley will not be financially worse after we leave the European Union. I asked the following:

“Although I voted in the referendum to remain, I fully accept the outcome of the democratic election and my focus now is to ensure that the people in my constituency are not worse off post-Brexit. Given that we have benefited from EU funding to the tune of around £5 million a year, may I seek a guarantee from the Minister that the Government have a plan to ensure that those resources continue to come to my constituency post-Brexit?”

You can see my question and the Secretary of State’s response on Parliament TV at (please copy and paste the link): http://parliamentlive.tv/Event/Index/bc6244d0-4cfe-43e5-8677-f929b7db0a08

Julie asks the Government to ensure Burnley is not worse off after Brexit

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This week in Westminster Hall, I joined together with other members of the House to call for more funding to be made available to tackle childhood cancers. I also raised my deep concern that Britain leaving the European Union will have a knock on effect on current levels of cancer drug funding particularly those drugs that are currently used to fight childhood cancer. In my speech I said the following:

“It is an honour to serve under your chairmanship, Mr Davies. This debate has arisen in response to a petition signed by more than 115,000 people, including 922 from my constituency, following the sad passing of Poppy-Mai, the little daughter of Mr and Mrs Barnard. First and foremost, my thoughts are with that Lancashire family and all the other families who have endured a similar devastating loss of their children. There can be nothing worse than the loss of a child, so this debate is especially important.

It is important that we increase awareness of the scale of the problem facing children and young people who have cancer and their families, and look for ways to tackle the problems. How can we improve diagnosis? How can we improve research? How can we ensure better access to treatments? Ultimately, how can we improve survival rates? The debate, outlined so well by Ben Howlett, has given us the chance to search for answers to those important questions.

In the UK every year about 4,000 children and young people under the age of 25 are diagnosed with cancer. Worryingly, research by CLIC Sargent published last year found that 44% of young people and 42% of parents felt that their local GP did not take them seriously when they presented with symptoms, and 53% of young people felt that their diagnosis had been delayed. Clearly that is not an acceptable state of affairs. Inevitably, delayed diagnoses mean delayed treatment, with implications for survival rates.

In an attempt to improve awareness among GPs, CLIC Sargent embarked on a joint project to develop an e-learning module specifically focused on cancers in children and young people. That welcome work will go some way in helping to improve diagnosis and primary care support for children and young people with cancer, but far more needs to be done. It is a fact that children in the UK with a brain tumour can take up to three times longer to be diagnosed than children in other countries, most notably the United States. Reducing the time to achieve an accurate diagnosis improves survival rates and can reduce long-term disability, which many children and young people diagnosed with a brain tumour currently experience. I hope the Minister can give us some understanding of what the Government intend to do to improve diagnosis times.

Recent figures published by Cancer Research UK demonstrate that in the past 20 years we have seen a 32% reduction in the child cancer death rate. We have also seen five-year-survival rates increase from 40% in the early 1970s to 82% today. It is widely believed that those improvements have arisen as a result of more research and better treatments. While they are extremely welcome, they go nowhere near far enough, because the fact remains that cancer is still the leading cause of death among children. Five children and young people die of cancer in Britain every week, and those who survive often go on to suffer long-term side effects from their treatment that can continue into adulthood.

A considerable amount of research is carried out each year in the UK by a multitude of organisations including Cancer Research UK, the Brain Tumour Charity, the Institute of Cancer Research, the Institute for Child Health, Great Ormond Street Hospital and the Teenage Cancer Trust. Last year, Cancer Research UK committed to double research spending on children’s cancers. That will go some way in helping to discover new treatments. We all thank it and welcome that commitment, because currently only 3% of UK funding into cancer goes to child cancers.

It is important to remind the Government that many of those organisations are charities, which have relied on high levels of funding from the European Research Council. The Brain Tumour Charity stated that the result of the referendum on EU membership has created great uncertainty for charities conducting research into childhood cancers. Post-Brexit, the Government must ensure that the UK medical research community continues to have access to EU funding programmes once Horizon 2020 has ended. Similarly, I seek reassurance from the Minister that any shortfall in research funding as a result of our exit from the EU will be met by the UK Government. If we are to improve outcomes for children with cancer, it is paramount that we have research conducted to understand further these awful diseases.

Following improvements to diagnosis processes and research, we must ensure efficient access to treatment. Children and young people with cancer face a range of barriers in accessing new and better treatments, including drugs not being tested in their age group or in the cancers they are likely to get, even when a drug may be effective in treating their cancer. Simply challenging the age restrictions set on new trials is already increasing participation rates. That should be done in tandem with the provision of age-appropriate information about trials delivered by skilled, specialist staff.

Currently, the cancer patient experience survey does not collect data on cancer patients under the age of 16, and we have seen a 40% decline in response rates from teenagers over the age of 16 and young adults in the past five years. It is unacceptable that little or no progress has been made on this issue. Understanding patient experiences is important to improve future services. The cancer strategy includes plans to deliver a methodology to collect under-16s’ experiences, and NHS England is doing that alongside CLIC Sargent. Will the Minister helpfully update us on that work and tell us when we can hope to see the data being collected?

Achieving viable numbers for clinical trials on child cancers is understandably problematic given the relatively small numbers and rarity of some child cancers. However, we cannot allow that to be used as an excuse for not improving treatments for children and young people with cancer; instead, it should push us to innovate. Cancer Research UK has led the way in challenging the age restrictions on clinical trials, calling for more flexibility when it comes to age and ensuring that researchers justify age restrictions so that they rethink approaches to include children and young people.

It is essential that the UK’s exit from the EU does not negatively impact on further research. We must benefit collectively from work done in other countries. To pick up on the point other Members made, we must pool good practice and ensure that our good practice and successful research are shared throughout the world and that we benefit similarly from experience elsewhere.

In the cancer strategy, there were specific recommendations relating to children, teenagers and young adults’ services and how they can be improved. I was concerned, though, that in September the Government made an announcement on wider measures in the strategy but failed to mention anything about the important issue of seeking consent from children and young people for their data and tissue collection to be used in future research studies and the development of services, nor did they include a requirement significantly to increase access to clinical trials for teenagers and young adults with cancer.

Currently 30% of teenagers and 14% of young people aged 20 to 24 enter trials for common cancer types in children and young people. In 30 years there has been no progress in that area. The cancer strategy set a target for NHS England to recruit at least 50% of children and young people in cancer centres or designated units treating teenagers or young adults. That is welcome, but will the Minister give us a progress report and tell us how long it will be before the target is likely to be met?

I pay tribute to the Barnards, to the other families mentioned today and to the children and families across the UK affected by cancer for their courage in the face of this most awful of illnesses. I ask the Government to understand those families’ need for support. We have heard some moving stories today. They need support in a wide sense—from specialist units and through better access to information. Importantly, they also need financial support. Several hon. Members have powerfully made the point today that the costs of cancer are physical and emotional but also financial. We must do more and better.

I want to hear what specific plans the Government have to improve the speed of diagnosis; I want a guarantee that the Minister will protect research funding post-Brexit; and I want to know what plans she has to increase the number of clinical trials, to ensure that access to life-saving treatments is the best possible. Children and young people deserve no less.”

You can see my speech at (please copy and paste the link): http://parliamentlive.tv/event/index/eac0e840-b934-48c7-87d3-41432f643ae5?in=17:39:54&out=17:50:42

Julie Raises Concerns Over Future Childhood Cancer Drug Funding Post Brexit

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Yesterday I had the pleasure of closing the Shadow Health team’s Opposition Day debate on Government cuts to community pharmacy funding, which will see many pharmacies close. As many of you are aware, this is a subject that is very dear to my heart. I worked with my husband, who is a pharmacist in community pharmacy, for 24 years. I must make it clear that I no longer have any financial interest in community pharmacy and haven’t had since 2010 but I do have a clear understanding of the contribution that community pharmacies make to patients, communities and to the wider NHS.  The Government’s pharmacy access scheme, which it argues will help pharmacies at risk of closure, disproportionately helps pharmacies in rural areas and does little for urban areas like Burnley. All of the 24 pharmacies in Burnley will not be protected from the planned funding cuts and 6 face the real risk of closure. In my speech I argued against the planned cuts. You can watch it here at: https://www.dropbox.com/s/o8czu30wc4k068m/HoC%202%20Nov%202016%20Cooper.mp4?dl=0  

In my speech I said said the following:

It is my pleasure to respond to this interesting debate. I was not feeling very well today so on my way here I called at my community pharmacy, and I am feeling much better now. This is a very important subject. I wish first to pay tribute to my hon. Friend Michael Dugher for his sterling work in standing up for community pharmacy, and to the chair of the all-party parliamentary group on pharmacy, my right hon. Friend Kevin Barron for ensuring that the contribution of pharmacy is always recognised.

I have to say that this subject is very dear to my heart. I worked with my husband, who is a pharmacist in community pharmacy, for 24 years. I must make it clear that I no longer own a community pharmacy, but I do have a clear understanding of the contribution that community pharmacies make to patients, communities and the wider NHS. Many members have spoken powerfully today about the pharmacies in their constituencies and how much they mean to the people they serve. We have heard from my hon. Friends the Members for Hyndburn (Graham Jones), for Bolton South East (Yasmin Qureshi), for Bristol South (Karin Smyth), for Stoke-on-Trent Central (Tristram Hunt), for Oldham West and Royton (Jim McMahon), for St Helens North (Conor McGinn), for Wirral West (Margaret Greenwood), for Sedgefield (Phil Wilson), for Bradford West (Naz Shah) and for City of Durham (Dr Blackman-Woods).

Make no mistake, community pharmacy is for many the gateway to the NHS, providing far more than prescriptions and paracetamol. As my hon. Friend Luciana Berger pointed out, it is a lifeline for many people. The Minister spoke last week about the need to move to a focus on quality and not just on the volume of scripts dispensed. He also spoke of the desirability of community pharmacies becoming an integrated part of the primary care team. I say to him that that has been happening for years. The fact that he does not know this is in itself proof that he needs to take his plans back to the drawing board.

The typical community pharmacy, whether it serves a rural or an urban population, provides a wide range of services to support the sick, the elderly and the disabled, together with a host of initiatives to promote health and wellbeing in the community. Community pharmacies have close working relationships with other members of the primary care teams, including GPs. Of all those health professionals, the community pharmacist, who employs a no-appointment-necessary approach, is the most accessible and often provides the only continuity of care in a health service that is struggling to recruit and retain staff.

On the subject of NHS staff, the promise of more than 1,000 additional pharmacists in GPs’ surgeries is a red herring. It is a separate issue and will do nothing to mitigate the loss of local community pharmacies. The Minister spoke last week of the need for pharmacists to move to a more clinical approach to healthcare. Again I say to him that that has been happening for years. All community pharmacies have consulting areas where patients can speak privately. They also provide a perfect space for the provision of a variety of important services. There is an ever-expanding list of services, which a number of Members have described in their speeches. My hon. Friend Maria Eagle mentioned the fact that pharmacists often go above and beyond the call of duty, sometimes delivering prescriptions at 8.30 in the evening. I well recognise that situation. The list is limited only by the Government’s unwillingness to engage and the clinical commissioning groups’ lack of funding to commission services.

Let me make it clear that community pharmacies, far from being a costly drain on NHS resources, actually save the NHS money through a variety of schemes, some of which have been mentioned today. The minor ailments service is already available in some areas, and I welcome the Minister’s suggestion that it will have a full roll-out. Medication use reviews carried out in the pharmacy often identify medicines that are routinely ordered but are no longer taken, and wasteful stockpiling of such items can therefore be avoided. In addition to the specific services, every prescription item dispensed presents the opportunity for a productive health intervention. Given that the average community pharmacy dispenses thousands of prescriptions each month, the potential impact is enormous and the professional advice of the pharmacist is undoubtedly invaluable in the promotion of health and wellbeing. Norman Lamb rightly identified the prevention work that pharmacists do, and mentioned the fact that the promotion of health and wellbeing can reduce demand on the NHS overall.

Despite statements to the contrary, community pharmacies have been making substantial efficiency savings in recent years. The vice-chair of the all-party group, Oliver Colvile, mentioned a 40% increase in funding over the past 10 years, but he omitted to mention that prescription numbers have increased by 50% during the same period and that pharmacy funding has been static for the past two years.

Under the Government’s current plans, pharmacies would have to implement a year’s worth of cuts in four months with only six weeks’ notice. As someone with considerable experience of community pharmacy, I know that the plans will force the closure of many pharmacies and a service reduction in others. I do not know how many will close and neither does the Minister. Alistair Burt suggested that the number could be as high as 3,000, and I can assure the Minister it will not be the large pharmacy chains that close but the small independents, the owners of many of which have put their heart and soul into providing an excellent service to the community.

Those that do not close will reduce services. An NPA survey of 250 pharmacies found that 76% are likely to reduce services from April 2017 if the cuts go ahead. The assessment of the financial impact of the closures is flawed and provides no evidence to support the Department of Health’s claim that access to services will not be compromised. It is clear that community pharmacies satisfy an ever-growing demand for services. When they close, that demand will not just disappear. Where will all the patients go? Some will pack out their GP surgery and others will head straight to A&E. The NHS is already in the throes of a staffing and funding crisis. Forcing community pharmacies to cut back services and close down is short-sighted in the extreme and could be catastrophic in the long term.

The Minister has frowned on the growth of pharmacy clusters, but he really needs to understand that clusters have grown, often in the most deprived areas, in response to considerable demand. My hon. Friend the Member for Bradford West outlined examples of such areas of deprivation. Is the Minister really suggesting that forcing the closure of such pharmacies is the most effective way to reduce demand for healthcare in deprived communities? The Minister has got this wrong. The proposals on the table are short-sighted and will do more harm than good. They will have a negative impact on patient care and will force extra demand on already stretched GP surgeries and hospitals. The proposals will not save money. They will not reduce the number of patients with long-term conditions or the number of medicines they require.

It is right to review the situation. I agree with the Government Members who said that it is right to examine the funding issues, but instead of forcing through damaging changes to a service that the Government clearly do not understand, I ask the Minister to listen to pharmacists and sit down with them to discuss how pharmacies can help to ease the burden on the wider NHS in a planned and cost-effective way. I ask the Minister to listen to his Conservative colleagues who spoke against these simplistic cuts, which have not been properly planned. I ask him to recognise that the access scheme will do little to protect the long-term future of urban or rural community pharmacies.

The Government have shown time and again an unwillingness to listen to professionals. I urge the Minister to listen to community pharmacists, to the pleas of Members and to people across the country, and to rethink the funding cut. I ask him to sit down with pharmacists and their representatives and work with them to develop and extend services that will take the burden off GPs and off the NHS. I ask that he do so now before he makes a decision that will devastate a whole sector and bring even more pressure to bear on our overstretched health service.

 

Opposition Day Debate on Cuts to Community Pharmacies


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