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1.57 pm

Caroline Flint (Don Valley) (Lab): It is a pleasure to follow the hon. Member for Taunton Deane (Rebecca Pow). She stressed the importance of combining the twin goals of tackling climate change and poverty globally, and I could not agree with her more. We must show a way forward that is about hope and optimism, and about making it clear that tackling climate change need not lead to impoverishment. Something that our country and other developed countries can contribute to—and, in a sense, we may be a bit jealous in this regard—is the ability of many countries to leapfrog over where we are to a cleaner and greener future. We can enrich the lives of communities and villages and children who live without light, which affects everything that they do in their daily lives.

If we do not challenge climate change, we will not tackle the potential for conflict in the world. The impact of climate change on our food production and water supplies is a starting point for more conflicts. Those who own the means of food production, and have access to and control of water supplies, can be a force for bad as well as good in the communities around the world in which they live.

Robert Flello (Stoke-on-Trent South) (Lab): My right hon. Friend is kicking off what will clearly be a fantastic speech. The present appalling situation in which people are fleeing Syria could occur again, through devastation caused by climate change or, as she says, because people simply want access to drinking water.

Caroline Flint: My hon. Friend makes a very important point. Part of the challenge for all of us is the need to demonstrate, through discussions not just in the House but in our communities and with our partners around the world, that events happening thousands of miles away can have a knock-on effect here in way or another. I believe we have already seen in our own country some of the impacts of climate change. I think the public know that. That is why I thought it was important when my right hon. Friend the Member for Doncaster North (Edward Miliband), as leader of the Labour party, when we had those terrible floods here, said that we should look at tackling climate change as a national security issue. That important point was well made then and it has as much relevance today.

Clive Lewis: The National Academy of Sciences in the United States recently described climate change as a “threat multiplier”, particularly in the context of the middle east, where war, drought and hotter weather will mean a greater chance of increased pressure on water supplies, food and agriculture. That will have an impact on the potential for war and civil war in that area. My right hon. Friend raises an important point.

Caroline Flint: It is an important point. We should all be mindful of that. We should ensure that we do not approach this with an island mentality and that we recognise how those links should lead us to step up even more and paint the portrait of what is happening. We have to speak in pictures. Words, stats and learned prose have their place, but we have to draw a picture of what could happen if we do not step up and make some serious changes.

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Mr MacNeil: Will the right hon. Lady give way?

Caroline Flint: I am going to make a bit of progress because I have been forewarned by Mr Deputy Speaker, who said that we should try to limit our time.

I thank my hon. Friend the Member for Bishop Auckland (Helen Goodman) and the Backbench Business Committee for securing this debate. I was happy to sponsor it. I would also like to mention some people from my constituency. I recently received a copy of a CAFOD petition organised by Gillian McCallum, a constituent, on behalf of two parishes in Don Valley, Christ the King Church Rossington, and Holy Family, Finningley. It called on the Prime Minister to show leadership on climate change. I know they will be pleased that the House is taking note of the Pope’s encyclical today.

I was also delighted to welcome students from McAuley school, a Catholic school in my constituency, when they were here for the “For the love of” Climate Coalition event in June and talked about how important the issue was to them. Last year, I was at that school and met some people from Peru, who vividly talked about the impacts of climate change on their communities and livelihoods. Speaking to those bright young pupils about climate change—all of us have probably spoken to such pupils in our constituencies—provided a vivid reminder of the fact that, although we are seeing the effects of climate change already, it is their generation and their children and beyond who will have to live with the consequences if we do not get this right now.

I also pay tribute to the city of Paris, which has been defiant in the face of the brutal murders there last weekend, and I commend its decision to go ahead with holding the Paris conference in a few weeks.

As shadow Secretary of State for Energy and Climate Change, I led a debate on the road to Paris on the first Opposition day of this Parliament. I did so because the Paris conference means that this year is a vital year for climate change, but also because I wanted to voice the concerns of many that a Conservative majority Government might lead to the consensus on climate change formed in 2008 becoming less secure. In that debate, I asked for a number of reassurances about the Government’s approach in this vital year.

It is important to the success of Paris that the agreement includes a review every five years, so that ambition can be ramped up as progress is made, and that it includes robust and consistent reporting mechanisms so that every country can have confidence others are playing by the rules. I was pleased to see the Secretary of State commit to that as part of the UK’s demands. However, with weeks to go, this debate gives us the chance to look at what else has happened since that June debate.

We now have 140 intended nationally determined contributions submitted by countries that will be attending the talks. Although we know those submissions do not achieve the crucial target of keeping us under 2° of warming, significant progress has been made. The bilateral agreement between the US and China is one important step that would not have taken place without the process we have. When we think of the many years fighting for climate action, and the long road from Kyoto, we know this is no small step.

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For the US, Obama has signalled the intention to ramp up investment in renewables, alongside a role for nuclear and carbon capture and storage, and to prioritise energy efficiency to cut bills as well as emissions. China has pledged up to 1,000 GW of new clean capacity by 2030. However, we have a long way to go, as the opposition of India and Saudi Arabia to a review mechanism in the G20 communiqué last week shows. But the momentum being generated is important in and of itself. If the direction of travel is right, 2° can be kept within touching distance. Not only that but we can reduce the atmospheric pollutants that kill people here and in the developing world, a point made recently by the eminent Lord Stern, as well as by the Pope.

The hon. Member for Warrington South (David Mowat) made an important point. He is right: the EU submission is lower in terms of its ambition on targets than our own enshrined in the Climate Change Act 2008, but that is why we need leadership. I would still like to see the EU raise its ambition but it does have in its submission the line, “at least” a 40% reduction in emissions by 2030, so there is still scope for the Prime Minister to press the point home that we can do better than that and we can do more. I am not ashamed, and I am not suggesting the hon. Gentleman is, that we are leading from the front. We should tackle those individual countries that talk the talk but do not walk the walk and point out when there are inconsistencies in the way they are delivering their energy supply and reducing their emissions as a result.

However, the Prime Minister’s leadership has to be backed by leadership at home. I was concerned when the Secretary of State said that the UK should cease to play a leadership role and move “in step” with the rest of the world. As we have heard, since the election, a number of policy changes are affecting our ability to meet climate change targets and to create that important investment and those important jobs. We have seen the two cheapest forms of renewables undermined, onshore wind and solar. We have seen the green deal axed. I will make no bones about it: I thought the green deal was never a good deal anyway and we tried to effect some changes in the previous Parliament, but the fact is that it has been axed and there has been nothing to replace it.

The ECO—energy company obligation—has not served the needs of those most affected by fuel poverty. As a result of changes to the structure of that scheme, 400,000 fewer homes have been insulated. The zero carbon homes plan has been scrapped, an issue I feel close to as a former Housing Minister. When we set the target on that, in some ways, for the construction sector, it was not about the target date; it just galvanised the sector to think differently about how construction could play a part in ensuring that we have more energy-efficient homes that reduce emissions as well. Renewables have been forced to pay the climate change levy and the contracts for difference auction has been delayed.

The news from Government that a date has been set for phasing out unabated coal generation is welcome, as we know coal is the biggest emitter and the dirtiest pollutant. However, it is ironic to say the least that the Drax power station, which relies on coal to create its electricity, has been so undermined in recent times in its efforts to move to renewables and its support as an important partner for CCS. I urge the Government: please do not give up on CCS. We need it for industrial

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processes such as steel production as well as for electricity generation. Also, there is huge potential for the by-products from that process to create a market that could be good for our economy as well. It seems that that is an important area in which we can lead and not just follow others.

Nuclear is important, too. The hon. Member for Warrington South and I agree on that, but again let us look at the history. Part of the reason that this country and Parliament decided to look at nuclear again was that we wanted to commit to more ambitious climate change goals. I am proud that the last Labour Government took a very difficult decision on that. I remind the House that the Prime Minister said that it should be a last resort and the Liberal Democrats were against it, full stop. So I will not take any lectures about how slow the process has been. It has been difficult. We need to know now what the Government are going to do to ensure that that can play a part in decarbonising our generation.

The last six months have been disappointing, and the policy framework and certainty just are not there. His Holiness said:

“Never have we so hurt and mistreated our common home as we have in the last two hundred years.”

None of us can dispute that. He then expressed a shared love of our planet, saying

“The entire material universe...the soil, water, mountains, everything is, as it were, a caress of God.”

He also said:

“Humanity still has the ability to work together in building our common home... Truly, much can be done”.

His words speak to those of faith and of no faith. What they all share is an optimism that humankind, with the knowledge we have today, can save our planet. I stand with those people. I hope the Government will stand with them too.

2.9 pm

Patrick Grady (Glasgow North) (SNP): I, too, congratulate the sponsors of the motion, and in particular the hon. Member for Bishop Auckland (Helen Goodman) on her substantial contribution.

It is clear we all agree today that climate change is the biggest challenge facing the planet and its people. It exacerbates the existing challenges of poverty, conflict, disease, resource depletion and population displacement and it increases the risk of greater insecurity around the world, reversing the progress made to a more peaceful and just world. The opportunity in Paris in a couple of weeks should not be overlooked, and in the light of the dreadful atrocities of last week, that opportunity is even more important. By the end of this year the city should not be remembered only as a target of terror, but as the cradle of a climate deal that cares for our communities and our “common home”, which, as we have heard, is how Pope Francis describes the planet in his encyclical on the planet Earth.

I thank the Members from various different parties who signed the early-day motion I tabled recognising and welcoming the encyclical when it was published. That was an extremely prophetic call from the Pope. I enjoyed the slightly theological exchanges between the

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hon. Members for Gainsborough (Sir Edward Leigh) and for Bishop Auckland. Catholic social teaching is not usually either/or, and I have something to say about the messages the Church has produced going back over 150 years, as well as more recently—the Pope’s immediate predecessor Benedict XVI should be given credit for the work he did on the environment and this year we mark five years since his visit to the UK. Catholic social teaching does not prescribe specific courses of action; it outlines a direction of travel and broad principles, and it is then for decision makers, including all of us here today, to make judgments on the right course of action.

It is right to describe much of what Pope Francis has said as a prophetic document, in particular in paragraph 49 where he says that

“a true ecological approach always becomes a social approach; it must integrate questions of justice in debates on the environment, so as to hear both the cry of the earth and the cry of the poor.”

That is the challenge before us today.

I also recognise the comments of the hon. Member for Brighton, Pavilion (Caroline Lucas) that many religious leaders, and indeed secular leaders, of good will are behind this call. What the encyclical represents—at least if we come from that perspective—is the pinnacle of a global consensus that now is the time for action. That was ratified, as it were, at the UN back in September when the sustainable development goals were agreed by every single member state.

Robert Flello: Does the hon. Gentleman agree that if we leave it much longer, we will have gone past the time for action?

Patrick Grady: I do agree: the window of opportunity is closing, which is why the need for action is all the more urgent. That is perhaps why the SDGs, unlike the millennium development goals, particularly emphasise in goal 13 the need for urgent action on climate change. We have heard a lot about energy as well, and goal 7 commits the global community to providing

“access to affordable, reliable, sustainable and modern energy for all.”

That is a huge and significant challenge and some of our exchanges on how best to do that have been very important.

Scotland, of course, is committed to playing its part as a good global citizen. It has some of the most ambitious targets for carbon emission reduction in the world, and, despite challenges, it remains on course to meet them. It is worth noting that the Climate Change (Scotland) Act 2009 was passed unanimously by the Scottish Parliament—there were not the three votes against that we heard about here.

Under the current and former First Ministers, the Scottish Government have also championed the concept of climate justice in their approach to climate change. Climate justice recognises that the poor and vulnerable at home and overseas are often affected first and hardest by climate change, yet have done little or nothing to cause the problem. If we adopt that justice principle, we have to take a human rights-based approach to the heart of decisions on sustainable and equitable global development, and it reinforces the strong economic case for a swift transition to a low-carbon economy that can still deliver jobs, investment and trade.

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There is a particularly innovative approach through the Scottish Government’s climate justice fund, and I declare an interest here as before the election I worked for the Scottish Catholic International Aid Fund, which received grants from that fund. That employment gave me the opportunity to see at first hand the impact of climate justice funding, which is helping communities in rural Malawi overcome the effects of climate change through irrigation and sustainable agriculture projects.

Importantly, the climate justice fund is additional to the Scottish Government’s international development fund. It recognises that tackling the impact of climate change means going beyond traditional aid flows and structures. It would be useful to hear from the Minister what discussions she has had with the Scottish Government about this model and whether the UK Government are prepared to learn any lessons from it. This is particularly relevant given research from CAFOD which shows that the vast majority of UK Government support—43% of their total funding for energy projects overseas—is still going to fossil fuels

One reason the Scottish Government are able to be so ambitious is the widespread and unambiguous public support for action on these issues. At the climate lobby here at Westminster in June, many of the SNP MPs—43 of our 56 MPs—were lobbied by constituents. They had travelled—by sustainable and low-carbon methods, I am assured—all the way from Scotland to speak to us about the need for urgent action. I look forward to joining many thousands of others at Scotland’s climate rally a week on Saturday in Edinburgh, which will also send a powerful message to world leaders attending the talks in Paris.

Public support for political action also represents an appetite for deeper and more sustainable changes in our daily lives. People will make lower carbon choices if they are given the opportunity to do so. In my own city and constituency, we have seen a great uptake in cycling since the introduction of a bike-hire scheme, for example, but Governments have a role to play in promoting lifestyle change. Again, therefore, it would be interesting to hear the UK Government’s views on this matter.

I said to the Prime Minister during his statement on Tuesday that his attendance in Paris would be an act of leadership and solidarity, and I welcome the previous confirmation from Ministers that Scottish Government Ministers, and, I believe, representatives from the other devolved Administrations, have been invited to attend as part of the UK delegation and will be present in Paris as well. It is important that Heads of State and Government take part in the conference and do not simply leave negotiations to Ministers or officials. That will be not just an act of defiance in the face of terrorism, but a clear signal of what global priorities can, should, and must be: collective action to tackle climate change, which will otherwise remain the biggest threat to peace, security and the sustainability of our common home.

2.17 pm

Caroline Lucas (Brighton, Pavilion) (Green): I start by congratulating the hon. Member for Bishop Auckland (Helen Goodman) on taking a lead in securing this important debate. It could not be more timely, not only because of the Paris climate talks that are due to start in 10 days’ time, but because just last week the World Meteorological Organisation warned that global average

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temperatures are set to rise by 1°C above pre-industrial levels for the first time. As the WMO’s secretary general, Michel Jarraud, put it,

“We are moving into uncharted territory at a frightening speed...The laws of physics are non- negotiable.”

While that is the crucial context for the Paris climate talks, the challenge of climate change is about much more than degrees Celsius and parts per million. That is why the Pope’s encyclical matters. It forces us to confront the reality that our response to climate change goes to the heart of who we are, and the values that guide our decisions collectively and as individuals.

Similarly, I welcome the leadership that other religious figures and organisations have played. I referenced the Islamic leaders’ initiative earlier, and I also want to pay tribute to the many innovative initiatives in my own constituency, especially that of the Brighthelm church, the first church in the UK to divest by pulling its funds and investments out of fossil fuels.

The case for the Government to adopt a scientifically literate and cross-governmental approach to climate change is coming from many directions—faith groups, business, civil society and, most recently, from the Governor of the Bank of England. It is increasingly clear that there is a strong economic reason to accelerate the transition to a cleaner, greener energy future. Back in September, Mark Carney issued a blunt warning to the fossil fuel industry that investors face what he called “potentially huge” losses from climate change action that could make vast reserves of oil, coal and gas “literally unburnable”. That is because, to remain under the 2° threshold, we as a global population must burn no more than 886 billion tonnes of carbon between the years 2000 and 2049, according to the International Energy Agency.

The global oil and gas companies have declared the existence of 2.8 trillion tonnes of carbon reserves, and their shares are valued as though those reserves were burnable, but the Carbon Tracker Initiative has warned investors that

“they need to understand that 60-80% of coal, oil and gas reserves of listed firms are unburnable”.

That is because, if we burn them, the atmosphere will warm to a catastrophic degree. The threat of ending up with assets stranded by tougher rules to curb climate change could affect the nearly 20% of FTSE 100 companies in the natural resources and extraction industries. As Mark Carney has said:

“Once climate change becomes a defining issue for financial stability, it may already be too late”.

Within the investor community, the early adopters have already begun a substantial movement to divest from fossil fuels, a movement representing $2.6 trillion in assets under management. The world’s largest institutional investors, including the Norwegian Sovereign Wealth and Rockefeller Brother funds, have all expressed their concern about carbon-related investment risk, and they are already adjusting their portfolios accordingly by moving out of fossil fuel holdings.

I believe that Parliament should be taking a lead on this too. That is why I am engaged in an ongoing and, frankly, very lengthy correspondence with our own parliamentary pension fund managers. I hope that the Minister will be able to tell us today that she will use her good offices to make them look at this more seriously

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and with more urgency because, to be frank, I have seen nothing to suggest that they are treating this with any urgency at all.

Divestment also models more broadly the kind of commitments we should expect to be taken by Governments, yet on the challenge of redirecting finance—both public subsidies and private capital—away from fossil fuels and into low carbon energy, our own Government’s policy too often involves doing exactly the opposite. We have seen the ending of subsidies for onshore wind, the slashing of solar subsidies, the awarding of tax breaks for fracking and for offshore oil and gas drilling, the application of the climate change levy to renewables, the ditching of zero carbon homes, the removal of community energy tax breaks and the funnelling of export credits into hydrocarbon projects abroad—the list goes on and on—yet not a penny is being put into the new public infrastructure fund for energy efficiency. Then yesterday, the go-ahead was given for a whole new dash for gas.

The Secretary of State has been treating us to a masterclass in cognitive dissonance. She continually speaks of competiveness being at the heart of our energy system, yet her Government have committed to subsidising outrageously expensive nuclear power stations while slashing support for solar and wind, which are more popular, cheaper and faster to deploy.

Robert Flello: On the basis of that list—that litany of failures—that the hon. Lady has just read out, can she imagine one of the attendees at COP21 saying to us, “Hang on a second. Who are you in the UK to preach to us, given that this is what you have done”?

Caroline Lucas: The hon. Gentleman is absolutely right to suggest that international leadership has to depend on domestic action at home; otherwise, it has absolutely no credibility. That is where I fear that this Secretary of State is letting us down.

Mr MacNeil: The hon. Lady is putting forward some very good arguments. There is an underlying assumption that going green and acting to reduce carbon emissions come at a cost. However, I want to put on record that I recommend Amory Lovins’ TED talk—a well-spent 27 minutes and 10 seconds—entitled “A 40-year plan for energy”. It underpins some of her arguments and shows that we will not necessarily lose out financially by adopting green policies. On the contrary, it demonstrates that we could gain financially and that they could provide a boost to our economy.

Caroline Lucas: Indeed we will benefit economically. We will create hundreds of thousands of jobs, because the green economy is far more labour intensive than the fossil fuel economy that it will replace. That will help us out of our economic difficulties, rather than being a distraction from them.

At the risk of being a little more controversial, I want to say a few words about nuclear power—as though we have not already—and in particular about the issue of baseload power. There is plenty of evidence that those who think that we need nuclear for baseload power are peddling myths based on last-century thinking on energy

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systems. None other than Steve Holliday, the chief executive officer of National Grid, said recently that the idea that we need large power stations for baseload power was “outdated”. He also said:

“From a consumer’s point of view, the solar on the rooftop is going to be the baseload. Centralised power stations will be increasingly used to provide peak demand”.

He also said that energy markets

“are clearly moving towards much more distributed production and towards microgrids”.

Let us take an example from international best practice. The Kombikraftwerk project in Germany shows how a 100% renewables system can be made to work, using variable technologies such as wind and solar backed up by dispatchable ones such as hydro, biogas or biomass—in the UK we could add tidal—and reinforced by a variety of storage methods, with demand-side measures reducing overall demand and flattening peaks.

It is not just in Germany that that can happen. Recently, a study for Greenpeace set out a similar scenario for the UK. It showed that it is possible for the UK’s power system to be nearly 90% renewably delivered by 2030, while electrifying 25% of all heating demand and putting 12.7 million electric cars on the road. However, that is achievable only if we cut demand for space heating by 57% in the next 15 years. That is doable, but it is a major challenge, which again underlines the need for the Chancellor to make energy efficiency a top infrastructure investment priority in the spending review later this month.

These are the kind of positive measures that would make a real difference to reducing emissions while creating jobs and lowering fuel bills. Let me highlight a few more that would enable us to look back on the Paris COP in a positive light. First, as others have said, we must raise ambition before, not just after, 2020. We already know that the INDC—intended nationally determined contributions —pledges will not be sufficient to keep temperatures to below 2°, never mind the 1.5° demanded by more vulnerable nations and many campaigners. That means that Paris must produce a framework to ensure that commitments are rapidly strengthened, with ratchet mechanisms for countries to scale up their national plans every few years, starting straight away.

Does the Secretary of State accept that an honest analysis of the Intergovernmental Panel on Climate Change’s budgets for a “likely” chance of not exceeding 2 °C, accompanied by even weak allowances for equity, would require the EU to deliver at least an 80% reduction in emissions from its energy system by 2030, with full decarbonisation afterwards? That figure is roughly in line with a recent civil society review, highlighted by Oxfam and others, which found that national pledges add up to barely half the emissions reductions needed. Global ambition therefore needs to at least double by 2030.

Secondly, we need a long-term goal to phase out fossil fuels and phase in 100% renewable energy by 2050 at the latest. Countries such as the UK, which are rich financially as well as in bountiful renewable energy resources, should get there faster. It is a scandal that the Government are taking the UK in precisely the opposite direction, with the slashing of support for renewables, a reckless dash for gas, and increasing subsidies for fossil fuels.

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Thirdly, Greens are calling for the Paris protocol to establish adequate and predictable international climate finance for adaptation and mitigation in developing countries, as well as a functioning mechanism to address loss and damage. We could find that money from the revenues from market-based instruments to reduce global aviation and shipping emissions.

Fourthly, we need to kick the fossil fuel industry out of the negotiations. Governments have been meeting for more than 20 years, yet greenhouse gas emissions have not decreased and the climate keeps changing. The forces of inertia and obstruction prevail, and the fossil fuel giants and the politicians who do their bidding are responsible. That is why I am calling for the fossil fuel lobby to be kicked out of the UN climate negotiations.

Finally, we need to maintain human rights at the heart of our work to tackle the climate crisis. The respect, protection and promotion of human rights are prerequisites for effective global climate action. And, very finally, I want to highlight another imperative for ambitious outcomes at Paris—namely, our collective security. The reality of climate change as a threat to national security is something we hear more often from the military than from politicians. For example, just four months ago, the US Defence Department sent a report to Congress warning specifically of growing instability as a result of climate change.

More specifically, a major peer-reviewed study in March made a link between climate change and the Syrian civil war. Here in the UK, last year’s Ministry of Defence report, “Global Strategic Trends—Out to 2045”, warned that if global temperatures continued to rise, the consequent droughts and food shortages could trigger widespread social unrest—[Interruption.] The right hon. Member for Hitchin and Harpenden (Mr Lilley) says that that is absurd. I suggest that he reads retired navy Rear-Admiral David Titley’s report, which puts forward the theory that the droughts in Syria are likely to be caused by accelerating climate change, which has led to more people leaving rural areas and coming into the cities, adding to social unrest. These things are being said by serious people.

In conclusion, for months and years to come, thinking back to “Paris 2015” will bore a terrible, painful hole in people’s hearts and minds. For the sake of our individual and collective security, we should work hard to ensure that Paris 2015 is remembered for the climate talks as well.

2.29 pm

Daniel Zeichner (Cambridge) (Lab): I, too, congratulate my hon. Friend the Member for Bishop Auckland (Helen Goodman) on securing this debate. In my experience, if we ask most people what they want politicians to do, we find that they want us to work together to tackle the really big challenges, and that is quite hard in this place, as any newly elected Member soon comes to appreciate. However, there was one moment a few years ago when this place really did come together; as my right hon. Friend the Member for Doncaster North (Edward Miliband) pointed out, the Climate Change Act 2008 was supported by almost everyone in this House, and rightly so. It was groundbreaking legislation, setting out the structure we need to tackle one of the key problems of our age. The Climate Change Committee, by setting out the carbon budgets—we anticipate the next one soon—creates the framework within which investors and innovators can operate with some certainty, and

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without which we would not be able to make progress. It is a model of how a modern competitive economy can operate, with markets regulated in the interests of the common good. It is good for citizens, good for the environment and good for business; this is the model of how a modern economy looks to many of us in the Labour party.

How disappointing, then, that even with this excellent model, recent actions by the Government have taken us backwards. Their erratic U-turn on renewable subsidies; the selling off of the Green Investment Bank; the green deal disaster and binning of the decade-long zero-carbon homes plan have left the green energy sector infuriated and non-plussed, and left investors nervous. We are already lagging behind Germany, India, Japan, China and the United States in green investment, and cutting our commitment to renewable energy is hardly likely to improve matters.

Yet, what an opportunity we have. There is huge interest in these issues in Cambridge, and I commend to the Secretary of State the Cambridge climate message, which is supported by an impressive array of local organisations. They are clear that they want COP21 to be a success, not a cop-out. Cambridge and the wider East Anglian region is at the forefront of the clean-tech revolution, with more than 1,000 businesses already active in the sector, ranging from product development specialists to multinational enterprises with global reach. Some 10% of the UK total of low carbon and environmental goods and services companies are in the region, which means that the per capita concentration of companies is twice the national average. That emerging cluster is supported by a network of world-class universities and research centres, a highly skilled workforce and some of the world’s leading technical consultancies. Growth there can be built upon to bring about a halo effect for similar success outside our region, but it depends upon attracting investors. At the moment, these investors are scratching their heads and closing their wallets when faced with the Government’s constantly shifting policies on green energy.

I recently met people from Cambridge Cleantech, a highly effective members organisation supporting the growth of clean-tech companies in the greater Cambridge area, with the clear ambition further to develop Cambridge as a leading clean-tech centre in Europe. To fulfil that ambition they need to see better-defined, more stable Government policies that influence confidence in clean-tech investment.

Mr Lilley: Subsidies.

Daniel Zeichner: Not subsidies. One of the outstanding local projects, Cambridge Retrofit, is a network of public and private sector organisations working together to bring at-scale retrofits to the building stock of the Cambridge community.

Mr Lilley: Is the hon. Gentleman giving us the welcome news that these developments can take place without subsidy?

Daniel Zeichner: I thank the right hon. Gentleman for his intervention. What we know is that when the private and public sectors work together effectively, we get a market that works. The problem in the current situation is that without investor certainty, the market does not work.

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Let me return to talking about Cambridge Retrofit, which I commend to the right hon. Gentleman. Led by Professor Doug Crawford-Brown at the Cambridge Centre for Climate Change Mitigation Research, it is helping the UK to meet its CO2 emission reduction targets, while helping the community reduce energy bills and supporting local businesses. When completed, the project will make a massive 20% to 30% reduction in carbon emissions in the Cambridge area. This shows that it can be done; it is about political will and political leadership, and that is what we need in the run-up to Paris.

We need—in fact, the wider world needs—to hear from this Government a clear assurance that they intend to prioritise innovation and reinstate long-term policies that will demonstrate their confidence in clean, green energy and technology. Attracting investment to this sector will help us deliver on our national energy, economic and environmental ambitions, and help the UK meet its international obligations and achieve a just transition. This House has shown before that it can rise to the challenge to come together to meet the great challenges of our age. My question is: can the Government?

2.34 pm

Callum McCaig (Aberdeen South) (SNP): I add my thanks to the hon. Member for Bishop Auckland (Helen Goodman) and the Backbench Business Committee for allowing this debate to happen, in incredibly timeous circumstances. The debate has been very enlightening and well-conducted. The importance of the COP21 meeting should not be understated. The Prime Minister said on Tuesday that he was confident that a deal would be struck; the issue was whether we got a good deal or not. I wish to talk a little about what that good deal should look like.

As we have heard, the UN has analysed the INDCs submitted by 90% of the countries on Earth, suggesting that if they are met, we will get down to a 2.7° increase in temperatures. That represents huge progress from the 4° to 5° that we would have with no change, but it is still not enough. An increase of 2° C is the Rubicon that we must strive not to cross, as the impact on life on this planet if we get things wrong almost does not bear thinking about. As we have heard from a number of hon. Members, the impact will be harshest on the poor. As my hon. Friend the Member for Glasgow North (Patrick Grady) has said, those who have contributed least to global warming stand to lose by far the most. As one of the planet’s earliest industrialised nations, and as a major producer and exploiter of carbon dioxide in terms of fossil fuels, we have a moral responsibility here.

One really encouraging sign, which has been touched on in this debate, is that there has been a decoupling of growth and carbon emissions. According to the International Energy Agency, at the global level we have 3% growth, with flatlined emissions. From the UK perspective, we are talking about 2.8% growth, with an 8.4% reduction. The comments about not offshoring are pertinent, but if we are having 3% growth globally with no increase, the suggestion is that it is possible to achieve growth and prosperity, which is required, but without the detrimental effects on our planet and the ensuing impact on populations—and then the knock-on effect on our economic prosperity.

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What do we require? The commitments to seeking five-yearly reviews are fundamental. Whatever deal we get cannot be seen as enough in and of itself; it will have to be reviewed and improved upon, which will require concerted effort from Governments across the Earth. We also need the commitment to finding the money that is required—$100 billion has been suggested in order for us to feed in the required changes. That money needs at least in part—we hope it will be a considerable part—to be new money, because if it is a redistribution of existing aid, we will not meet the dual aims. We have heard about the sustainable development goals, which are fundamental. These things go hand in hand, and we cannot be seen to be taking money from sustainable development, in terms of some aspects of eradicating poverty, and putting it into climate change. There must be a combination of moneys and a concerted effort to ensure that we do this.

The action we will take in Paris, the words we will use and the power that we will exert—the soft power, in the form of diplomatic pressure on the rest of the world to take a lead—must be backed with action at home. The Secretary of State’s announcement yesterday on coal can be welcomed by most of us. I do not think that commitment should be understated—it is hugely important—but it should not be overstated either. It needs to be taken in consideration with some of the other things the Government have been doing, which we have heard about and which are damaging to our attempts to meet our climate change commitments. Mention has been made of the changes on onshore wind and solar, the removal of the climate change levy from green energy production, the scrapping of the commitment to zero-carbon homes—in England and Wales, I assume—and the decision to privatise the Green Investment Bank. That headline of scrapping coal will be the thing that many in the world will see, and it does provide a certain legitimacy to the Secretary of State and to the UK Government in arguing for change, but let us hope that people do not scrape too far beneath the service, because if they analyse this Government’s action in depth they will find that the world-class rhetoric is not borne out by action here.

As we have heard, the change on coal and its replacement with gas can make a significant contribution, but it will also lock in change, potentially for 30, 40 or 50 years. I have this ask of the Secretary of State: when we are looking at that new generation of gas-fired power stations, can we consider how we can use them, or at least make them ready to be adapted, should CCS be commercially deployable? If they are built ready to adapt to that technology, it will mitigate the amount of carbon that we cannot afford to have released.

I hope that in the autumn statement and the comprehensive spending review next week, the commitment to the funding of CCS is still there. That is essential, and we back the go-ahead of both Peterhead and White Rose. I agree with the Climate Change Committee’s assessment that we need at least another two projects coming out of this Parliament. That is probably the easiest way to adapt to a low carbon economy, but it requires support. Being at the forefront of that technology could allow us to benefit financially as well as ecologically.

I support the calls for a reconsideration of the policies around renewable energy. Again, we need to look at the economic case. I come back to the IEA, which has suggested that, in the coming years, 60% of all money

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that is spent on energy infrastructure will be on renewables. That is hugely important. The Secretary of State is very keen on offshore wind, and she will know that we have the potential to become a world leader in that area. We also need to see what more can be done with solar energy and onshore wind. I welcome her suggestion this morning that there is an open mind to the possibility of subsidy-free onshore wind, and a willingness to engage with the industry to make that happen.

We heard from my hon. Friend the Member for Glasgow North about Scotland’s climate change legislation. We are on track to meet our agenda. It is ambitious—moderately more so than the UK agenda as a whole. We are uniquely placed to contribute to the UK’s carbon reduction and to take more than a fair share of global reductions.

Mr Lilley: Subsidies!

Callum McCaig: The right hon. Gentleman mentions subsidies from a sedentary position. In her speech yesterday, the Secretary of State acknowledged that no form of new generation will be built without subsidies. That is the reality of the energy climate in which we work today. Whether we like it or not, subsidies are required. If we take in carbon costs, the area that is most likely to be developed without subsidy is onshore wind, which, ironically, is the one that has been ruled out.

I welcome the fact that Scotland will be able to play its part in the UK delegation. Our story, as part of the UK story, is compelling, and I look forward to the UK, with Scotland playing a leading role, taking this matter forward, showing true global leadership and ensuring that we get a deal that is worth its name.

2.43 pm

Lisa Nandy (Wigan) (Lab): I thank my hon. Friend the Member for Bishop Auckland (Helen Goodman) and the Backbench Business Committee for not only initiating this debate, but putting on the parliamentary agenda an issue that will be the defining test of our generation of politicians and people.

In just a few days’ time, the world will meet in Paris, which has, in recent days, been the site of so much distress and despair. The attacks that took place at the weekend were acts of hatred, designed to divide us, crush people’s hopes and destroy lives. At the landmark summit, the UK will have the opportunity to show real leadership, to give hope to people around the world and to take real action, collective action, on one of the most pressing issues of our times.

This is urgent. For years, Governments around the world have agreed that temperature rises should be limited to no more than 2°. As my right hon. Friend the Member for Doncaster North (Edward Miliband) said, this month we have learned that the world is already half way to that critical threshold.

Last year, scientists at NASA said that global temperatures have risen to their highest recorded level. With the exception of 1998, the 10 warmest years on record have all been since the turn of the century. Humanity’s greatest scientific minds have warned us time and again that the warming trend is now unmistakeable, and that climate change is no longer a distant threat; it is already happening.

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We are running out of time. This is a direct threat to our national security. Global warming is already worsening extreme weather, putting at risk homes and livelihoods across our islands from worse and more frequent flood events. After the most intense period of rainfall in the record books caused Britain’s worst-ever floods last winter, the head of the Met Office warned that

“all the available evidence suggests there is a link to climate change.”

Climate change is a threat to our broader economic prosperity and to the families and businesses that depend on a growing economy. New research for Aviva Investors found that if temperature rises of up to 5° of warming occurred, it could result in $7 trillion of losses, which is more than the total market capitalisation of the London Stock Exchange. As the hon. Member for Brighton, Pavilion (Caroline Lucas) reminded us some moments ago, the Governor of the Bank of England, Mark Carney, has said:

“Climate change will threaten financial resilience and longer term prosperity”.

He warned:

“Once climate change becomes a defining issue for financial stability, it may already be too late.”

Climate change is also a threat to public health. A major commission by British doctors, published in TheLancet earlier this year and backed by the World Health Organisation, found that rising temperatures constituted a threat to people’s wellbeing because of heatwaves, the spread of infectious diseases and crop failures.

Launching the commission’s findings, Hugh Montgomery from University College London told reporters:

“Climate change is a medical emergency. It demands an emergency response.”

This is an issue of social justice. All of us have a duty to protect some of the poorest people in the world, and here at home, from threats to their security. That is why I do not believe that we or anyone else can afford to turn our back on the issue.

Pope Francis was right when he called action on climate change

“a matter of justice...a question of solidarity.”

He said:

“It is the poorest who suffer the worst consequences.”

When world leaders meet in Paris for UN talks to try to finalise a new global agreement, it is imperative that the outcome keeps the goal of climate safety within reach. Nobody expects that the Paris summit will completely solve the carbon problem, but it is a moment when we will stand at a crossroads. We have a real chance to establish a pathway to the ultimate goal of a global economy that does not rely on destroying the world’s rainforests and burning highly polluting fuels, and that seizes on the opportunities presented by modern clean energy technologies.

The Government should know that they have our full support in the UN talks to strive for an agreement that includes ambitious climate plans from all countries towards the ultimate goal of a completely carbon-free global economy in the second half to the century. It was encouraging to see the Prime Minister and other G7 leaders back this target when they met in June. I hope this will now become a truly international commitment when Governments meet in Paris in a few days’ time.

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As the cost of clean technologies continues to fall, the Paris accord must include an important commitment to strengthen national plans every five years towards achieving this global long-term goal. I had an exchange this morning with the Secretary of State and I was pleased to hear her express her support for this.

We should start from where we are. Some climate change impacts are inevitable as a consequence of the carbon pollution that is already in the atmosphere, so I welcome the Government’s commitment to direct substantial aid towards the poorest and most vulnerable communities. As my hon. Friend the Member for Southampton, Test (Dr Whitehead) knows and reminds me so often, we must take steps to adapt to worsening extreme weather and rising seas through the hurricane-proofing of schools and the building of sea walls.

The UK goes to the Paris summit with a proud history of action on climate change. It was Tony Blair who put the issue on the agenda of the United Nations Security Council and the G7. It was my right hon. Friend the Member for Doncaster North and his brother who passed into law the world’s first-ever Climate Change Act. It was Gordon Brown who took action in Copenhagen to win agreement from other world leaders to set up the UN’s global climate fund to help the poorest countries in the world to protect their citizens from the impact of stronger hurricanes and rising seas.

I am proud that we doubled renewable energy generation and put in the work to make sure that the UK was a global leader across a range of clean energy technologies. I am proud of the jobs and the opportunities for young people that those projects have created across the length and breadth of Britain, including in my own constituency. Two thirds of the renewable projects that came online in the past five years started under the Labour Government. But as we were told by my right hon. Friends the Members for Exeter (Mr Bradshaw) and for Don Valley (Caroline Flint), who did so much to keep this on the agenda in the previous Parliament, we cannot ignore the fact that the legacy of the UK’s leadership at home and abroad is now at risk.

We cannot make progress towards climate change safety while we are unravelling all the policies at home that will help us shift towards a low carbon economy. Let us consider what they are. Solar energy support has been cut by almost 90%. The only nuclear power station on stream has been delayed yet again—delayed twice under this Government; delayed yet again. Energy efficiency programmes are being cut in real terms. Carbon capture and storage projects have not been delivered. Onshore wind farms are being blocked, as the hon. Member for Aberdeen South (Callum McCaig) said, even where they enjoy local support. The Green Investment Bank is being sold off without a proper mandate to invest in new green clean energy.

The Energy Secretary was right yesterday when she said that ageing coal-fired power stations would be closed within the next decade and should be replaced with more modern technologies, but new cleaner power stations are not being built at the rate required to replace them and to secure our energy supplies. I will take no lessons from Government Members about Labour’s record on this. We delivered a record number of gas power stations. The nuclear projects that the Secretary

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of State is working on were initiated under Tony Blair. They have twice been delayed on this Government’s watch. When this Government came to power, they inherited a 16% power surplus. It is now down to 5% and National Grid is having to use emergency measures to safeguard our energy supply.

The Government do not appear to have any kind of plan to ensure a just transition that protects the communities that are dependent on those industries for their livelihoods and to ensure that the workforce remain in good, skilled jobs. Only yesterday the Secretary of State acknowledged the role that coal miners have played in this country, doing dangerous and difficult work that changed lives here and boosted our national prosperity. As we move into the future, the skills, the patriotism and the work ethic of people in coalfield communities ought to be our greatest national asset, but where is the industrial strategy that will safeguard jobs and skills in those communities and help us build a new, clean energy system?

The present chaotic, contradictory approach to energy policy has been criticised by the CBI and by Ernst and Young for causing serious confusion. It puts off investment that we badly need for our energy security, and it sends a hugely damaging signal at a time when Britain must harness the momentum that exists internationally to get a deal to tackle the threat posed by climate change. This will be the defining test of our generation. It is a test that we cannot afford to fail. It is right that the Secretary of State has come to respond to the debate herself. I applaud her for doing so. She will have heard what hon. Members said today. She will have heard the words of Pope Francis. I urge her to change course, and if she does so, she will have our full and guaranteed support.

2.53 pm

The Secretary of State for Energy and Climate Change (Amber Rudd): I thank the hon. Member for Bishop Auckland (Helen Goodman) and the Backbench Business Committee for calling this important debate at this crucial time as we enter the climate negotiations in Paris. I thank all those who participated in it. It has been truly inspiring and interesting on account of the many different points of view expressed.

The hon. Lady spoke clearly about the Pope’s encyclical and underlined His Holiness’s points about how it is incumbent on all politicians to limit the increase in climate change in order to protect the poorest of the world, who are already the worst affected by dangerous climate change. She spoke also about the imperative of legally binding agreement—that is our aim—and moved on to comment about sanctions. However, the situation is more delicate than that. Her emphasis on sanctions, the legally binding aspect and the outcomes thereafter misses the point about the intended nationally determined contributions—the INDCs. We are tantalisingly close, I believe, to a successful outcome in Paris. We now have countries involved in these debates and conversations in reaching for an agreement in Paris who were not participating 10 or 15 years ago, but we have to tread very carefully in relation to what is perceived as national sovereignty. I take her advice in terms of wanting this to be legally binding, but I urge her not to make the perfect the enemy of the good.

My hon. Friend the Member for Gainsborough (Sir Edward Leigh) gave us a helpful run-down on the Pope’s central theme about man, nature and God.

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He suggested that we do not “weaponise” what the Pope said. Perhaps Labour Members might remember that as we debate this important issue. I am grateful for his eloquent summary of the encyclical.

I can tell the right hon. Member for Doncaster North (Edward Miliband) that the same people with whom he was in discussions at Copenhagen are still on the circuit, and they remember him fondly and with respect, I am happy to say—although mentioning Copenhagen at the Paris negotiations is like mentioning Voldemort to small children. I share his view that what happens after Paris is key. As he will know, we are ambitious to get a deal in Paris, but what is really key is the nature of the reviews and how binding they are going forward. He will also be aware of how difficult it is to get certain countries to commit, and how delicate it is, as we approach Paris, to try to keep everybody in the tent and yet to have an ambitious deal. The world sought to build on progress in Copenhagen, though the high expectations were not met. The Copenhagen accord did result in a number of countries pledging to reduce emissions by 2020, but we have moved on. Climate change is almost universally recognised as a serious threat to global prosperity, security and wellbeing, and more and more countries are taking action in response.

My hon. Friend the Member for Warrington South (David Mowat) is right that the UK’s ambition is one of the toughest in the world. He made the important point that nuclear power is a critical part of our low carbon future, and he reminded us that achieving our reduction in emissions is not all about new renewables but also about low emissions at least cost. Innovation is important, and progress in low carbon energy and storage is driving down the costs of climate action. The cost of low carbon technology is falling sharply. Solar costs have fallen by 80% since 2008, and wind turbine costs have fallen by 27% since 2009. I would say to the right hon. Member for Exeter (Mr Bradshaw) that that is why we are reviewing the costs and reducing subsidies, and it is right to do so. We now have 8 GW of solar—I would not describe it as a “fledgling” industry—and I hope that we will have much, much more as we go ahead.

My hon. Friend the Member for Taunton Deane (Rebecca Pow) spoke well about her contribution and experience as an environmental commentator. I am grateful for her comments and her involvement in this debate.

The right hon. Member for Don Valley (Caroline Flint) made the key point that we can have emissions reductions and grow our economy. I agree. We are seeing the uncoupling of growth and emissions. This year’s PricewaterhouseCoopers low carbon economy index shows for the first time that while global GDP grew by 3.3% in 2014, energy carbon dioxide emissions rose by only 0.5%. The UK is at the forefront of this development, cutting our emissions by 8.4% last year against a backdrop of a growing economy. The UK is already benefiting from the transition to a low carbon economy. In 2013, the UK’s annual turnover in this sector was £122 billion, equivalent to twice that of the auto manufacturing industry and food and drinks industry.

The hon. Member for Glasgow North (Patrick Grady) highlighted the importance of climate justice, and asked particularly about climate finance. This is a critical area

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for a deal in Paris. The pledge is to demonstrate that the developed world can mobilise $100 billion a year by 2020 to help developing countries. The UK continues to play a leading role in that, and it is right that the Prime Minister was able to increase our pledge in order to support it.

The hon. Member for Brighton, Pavilion (Caroline Lucas) shared her regular view that we are making insufficient progress, but I agree with her on the implications of climate change for the wider economy, as set out by Mark Carney, the Governor of the Bank of England.

The hon. Member for Cambridge (Daniel Zeichner) is a new Member of Parliament, but nevertheless he has learned the skill of calling for unity but then attacking Government policy. I urge him to look at the full statement I made yesterday, which set out a full energy policy, and I hope he will see the pattern in it.

The hon. Member for Aberdeen South (Callum McCaig) made some interesting comments and we agree with him that it is possible to have both growth and a reduction in carbon emissions. I was also delighted to hear his support for our policies on offshore wind.

The final speaker was the hon. Member for Wigan (Lisa Nandy). I am delighted to say that we welcome her commitment towards, and share her feeling of urgency for, what we are trying to achieve, but it is disappointing that the Opposition choose to weaponise our differences in focus, because we should be taking a cross-party approach. However, I will glide over that and simply agree with her that we are united as a country and as a House in wanting an ambitious, legally binding deal in Paris, with regular reviews and a long-term goal. Paris will not be the end but the moment when the world changes direction and kick-starts a revolution to a new kind of growth and development.

3.1 pm

Helen Goodman: I am grateful to all hon. Members who have contributed to this excellent and worthwhile debate on a very important issue. Over the next few weeks, many people will have their eyes on Paris, hoping and praying for a good agreement. I will give the last words to Pope Francis, who asks

“that we may protect the world and not prey on it,

that we may sow beauty, not pollution and destruction.”

He says:

“Enlighten those who possess power and money

that they may avoid the sin of indifference,

that they may love the common good…

and care for this world in which we live…

help us to protect all life,

to prepare for a better future”.

Question put and agreed to.

Resolved,

That this House notes the Pope’s Encyclical, entitled Laudato Si’, Our Common Home, on climate change and international justice which is an important contribution to discussions on this vital subject; further notes that the 2015 climate change conference will be held in Paris between 30 November and 11 December 2015; and calls on the Government to recognise the significant support for a successful outcome to the conference which should commit to take further steps to tackle climate change effectively in the UK and around the world before 2020.

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New Cancer Strategy

3.2 pm

Mr John Baron (Basildon and Billericay) (Con): I beg to move,

That this House notes the findings of the independent cancer taskforce published in July 2015; and calls on the Government to publish an action plan on implementing the new cancer strategy.

I want to begin by thanking the Backbench Business Committee for granting this timely debate. I also thank fellow officers of the all-party group on cancer, some of whom are going to participate in this debate, and the officers of the other cancer-specific all-party groups, who joined me in applying for this debate. This therefore represents a coming together of all the cancer-related APPGs. Although we want to raise specific issues, we are all agreed on the importance of debating the new cancer strategy delivered by the cancer taskforce.

I hope you will not mind, Mr Deputy Speaker, if I mention the fact that on 8 December the all-party group on cancer will hold our annual Britain Against Cancer conference in Central hall. It is the largest gathering in the country of the cancer community, and I warmly invite all Members to join us on the day. My thanks would not be complete if I did not also thank the Under-Secretary of State for Health, my hon. Friend the Member for Ipswich (Ben Gummer), who is sitting on the Front Bench, having stepped into the shoes of the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), who has responsibility for cancer. Unfortunately, she cannot be with us today, but she is a good friend of the cancer community. To help my hon. Friend on the Front Bench, I sent him an advance copy of my speech. He may not be able to answer all of my questions from the Dispatch Box, but I look forward to receiving his written responses to those that he cannot answer today.

Perhaps we need to remind ourselves of the challenge. There are currently 2.5 million people living with cancer in the UK, and by the end of next year it is expected that 1,000 people will be diagnosed with cancer every day. Macmillan Cancer Support has suggested that in a few years’ time, one in two people will have been affected by cancer.

The challenge of delivering world-class cancer outcomes for all patients is growing ever greater. Hospital admissions for cancer in England have gone up by 100,000 a year compared with five years ago. For 17 months, the NHS has missed the target for cancer patients to receive their first treatment within 62 days of an urgent referral. Our outcomes continue to lag behind our European counterparts. Research has shown that the one-year cancer survival rate in the UK is about 13 percentage points behind the best in Europe, which is about 81%. That may not sound like a big figure, but it means that in the region of 10,000 lives a year are lost needlessly, in large part because the cancer was diagnosed too late.

That is the backdrop against which the cancer taskforce delivered its recommendations for a new five-year cancer strategy in July—something that the whole cancer community welcomed. Like others who are campaigning for improvements in cancer services, I was disappointed that the cancer taskforce report ended up being a report to the NHS and its arm’s length bodies, rather than a report of the NHS and its arm’s length bodies. That was

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not the original intention. However, that should not detract from the excellent work that went into it. Our congratulations should go to Mr Harpal Kumar for his efforts and hard work in preparing the strategy.

The recommendations of the strategy are based on evidence and advice from organisations across the cancer community, including the all-party parliamentary group on cancer. It covers the whole cancer pathway from early diagnosis to care after treatment and at the end of life. It aims to deliver a radical improvement in cancer outcomes by 2020.

Since its publication, the strategy has been welcomed by the Government, the health sector, the charities and the cancer-related all-party groups in this place. Attention must now turn to the implementation of the taskforce’s report. I congratulate Ministers on pre-empting the spending review in at least two ways by committing the Government to two of the key recommendations in the strategy. First, there is a commitment to ensure that all patients receive a definitive diagnosis within four weeks of their referral from a GP. Secondly, there is a commitment to ensure that all patients are offered a recovery package by 2020 and to develop a new metric on quality of life.

However, the taskforce has been clear that the recommendations set out in the strategy will deliver a step change in outcomes only if implemented as a whole. It is therefore important that there is urgency in implementing the remainder of the strategy. If he can, will the Minister outline today when he expects to publish the implementation plan and what degree of consultation he envisages before its publication? What assurances can he give that Ministers will ensure that the implementation plan contains clear deadlines and earmarked resources for implementing the strategy’s recommendations?

May I touch briefly on the importance of earlier diagnosis, which is one of the key priorities identified in the strategy? That point is of particular interest to the all-party parliamentary group on cancer and the other cancer-related all-party groups. As some Members will be aware, the all-party parliamentary group on cancer campaigned tirelessly on improving early diagnosis—what we call “cancer’s magic key”. The logic behind our campaign is exceedingly simple: the evidence shows that people who are diagnosed earlier are more likely to survive for over one year and, therefore, to survive cancer generally.

Henry Smith (Crawley) (Con): I warmly congratulate my hon. Friend and all the cancer APPGs on securing this important debate. Early diagnosis is absolutely key, as he rightly points out. Regrettably, my mother died of acute myeloid leukaemia in 2012. She was diagnosed on the day before her death. We really do need to bear down on this issue. Will my hon. Friend pay tribute to charities such as Bloodwise that do such important work in highlighting this area of cancer?

Mr Baron: I will do so by all means. Let me express my heartfelt sympathies to my hon. Friend as regards his mother. He is absolutely right that charities such as Bloodwise, as well as many others across the charitable sector, realise the importance of earlier diagnosis. I will give him one statistic that directly answers his question. I spoke at an event about bowel cancer yesterday. The statistics quite clearly show that 90% of people diagnosed in the early stages of bowel cancer survive for more

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than 10 years, but that figure drops to just 5% if they are diagnosed at a later stage. That is the difference that earlier diagnosis can make.

The logic behind focusing on earlier diagnosis is very simple. We have found over a number of years that the NHS is as good as any other healthcare system at getting patients from the one-year point after diagnosis to the five-year point, but is poor at getting them to the one-year point in the first place. That suggests that it is not good at detecting cancer. We lose the vast majority of those 10,000 lives in the early phase—up to one year—and then it is simply not possible to catch up. We therefore need to do more on earlier diagnosis.

Getting the NHS to focus on the one-year figures will encourage initiatives on the frontline to promote earlier diagnosis. By putting the one-year figures up in lights, we can ensure that the local NHS realises that it is being monitored. It will therefore be up to the local NHS to introduce and adapt a range of initiatives that suit the local population best, whether they are elderly people, black and minority ethnic populations or whatever. The initiatives range from everything from encouraging better screening uptakes to encouraging better awareness campaigns when it comes to education, better diagnostics in primary care and better GP referral rates, all or any of which could be approved locally to drive up earlier diagnosis.

I suggest that earlier diagnosis, as well as being better for patients, can also save the NHS money. Incisive Health and Cancer Research UK published a report last year that set out the cost savings of diagnosing a patient early. One example is in colon cancer. Stage 1 treatment costs about £3,300, while stage 4 treatment costs £12,500, which is a notable difference. If we look at the range of cancers and the number of cancer patients involved, we can see that we could save hundreds of millions of pounds if we raised our game and diagnosed cancer early.

The all-party group on cancer and the wider cancer community, including the Cancer Campaigning Group, have worked collaboratively with the Government and NHS England—I congratulate the Government most heartily on listening to our concerns—and have campaigned together to get the one-year figures into the DNA of the NHS. We have managed to get them into the NHS outcomes framework and the commissioning outcomes framework.

Last year, our efforts culminated in a successful campaign to ensure that a one-year cancer survival rate indicator is included in the delivery dashboard of the clinical commissioning group assurance framework from this April. For the moment, that is the primary mechanism by which CCGs are held to account. Many CCGs have told us that it is the primary tool they use for determining priorities at local level. With the one-year figures now up in lights in the top tier of NHS accountability, commissioners will be encouraged to take action in their local area to improve earlier diagnosis and ultimately to improve cancer survival rates.

Many people may think, “Job done. We’ve managed to get the one-year rate into the DNA of the NHS. We’ve managed to get it on the radar screen of CCGs. Is there anything else we should be doing except following through on those initiatives?” However, many of us are concerned that the recently proposed changes to the accountability system in place for CCGs may undermine

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this work. A few weeks ago, the Secretary of State announced a new scorecard for measuring the performance of CCGs, which will involve each CCG being awarded an Ofsted-style rating with effect from next April. Although the all-party group on cancer approves in principle the improvement of accountability, we strongly advocate, on behalf of the cancer community as a whole, that the use of the one-year figures to drive earlier diagnosis at local level is not lost throughout this process. Will the Minister outline in further detail the Government’s plan to implement a CCG scorecard and the process by which the metrics relating to cancer will be determined? Will he confirm that the focus on one-year survival rates will not be diluted?

Let me mention the reforms suggested in the cancer strategy for the patient pathway. With a growing number of people surviving cancer, it is particularly important that we make improvements throughout the whole cancer pathway, and there are two key parts to that. First, all too often patients report being treated as a set of symptoms rather than as a person, and certain groups of patients—namely older people, ethnic minorities and those with rarer cancers—report a poor patient experience. Secondly, many cancer patients lack the necessary support to get on with their lives once treatment has ended.

The all-party group on cancer welcomes the increased focus on patient experience across the NHS, but we must do more to ensure that we have the right data to drive improvement at local level. Although the cancer patient experience survey is a useful tool, too often the data are difficult to access and not widely used. The cancer strategy recommends the creation of a new metric to measure the patient experience across the whole pathway. Will the Minister set out how the Government plan to implement the strategy’s recommendation on a new patient experience metric, and say how they will ensure that data are used effectively to drive improvement at local level? Will he confirm that there will be sufficient resources for the new metric and the cancer patient experience survey?

We welcome the Government’s commitment to ensuring that all patients have access to a recovery package following their treatment, but if we are fully to address that challenge it is vital that the NHS understands where it is working well and where improvements are needed. As such, it is vital that the strategy for the development of a new quality of life metric is taken forward as a priority. Will the Minister ensure that the Government’s commitment to take forward that recommendation for the cancer strategy to develop a quality of life metric is backed up with clear plans for funding and implementation?

In the few minutes that remain, let me address a couple of key issues including rarer cancers and the cancer drugs fund. It is an interesting fact that the combined number of rarer cancers—those less common than breast, lung, prostate and bowel cancer—outnumber the sum total of those more common cancers. Services for people with rarer cancers are no less important, and we must ensure that people with rarer cancers get access to the right level of specialist expertise, irrespective of where they live. The taskforce recommendation for the creation of highly specialised multi-disciplinary teams for rarer cancers is particularly welcome. Will the Minister assure the House that that will happen, and that MDTs will be supported by technology so that they can deliver specialist care without inconveniencing patients?

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Research efforts into rarer cancers must be redoubled. The Government are leading the world in their investment in genomics, most notably through their 100,000 genomes project, which is sequencing the genomes of those with cancer and rare diseases in general. It is good that the project has so far fully sequenced the genomes of 5,000 patients, but will the Minister update the House on progress with cancer patients? May I suggest that, once complete, Genomics England should independently carry that research forward for the benefit of the NHS and patients, given its excellent track record?

Mark Tami (Alyn and Deeside) (Lab): Is the hon. Gentleman as worried as I am that companies that are investing in finding drugs for rarer cancers are, because of their nature, small in number, and they should not be put off investing in research to find cures for those cancers because they feel that the Government—whatever party is in power—will perhaps pull the plug or concentrate only on the more common cancers?

Mr Baron: The hon. Gentleman makes an excellent point, and one hopes that there is proper dialogue with all the parties concerned to ensure that what he describes does not happen. The approach to science must be collaborative. Nobody has a monopoly on good ideas, but I suggest that the Government should be congratulated on their ground-breaking 100,000 genomes project, as long as it does not freeze out research in the private sector. I hope that there is dialogue to ensure that that will not happen. If there is not, that issue needs to be raised with the relevant bodies in this place.

On the cancer drugs fund, people living with cancer need the best treatment available. We can all agree to that. Approximately 72,000 cancer patients have benefited from the fund. That testifies to the Government’s commitment. We recognise, however, that reform is needed over the longer term. We need a longer term solution to the cancer drugs fund. The Government apparently also believe that reform is essential. Recent NHS England board papers indicated a continuing overspend on the cancer drugs fund, underlining the fact that a long-term solution is needed now.

When reforms are introduced, it will be important that the spirit of the CDF—that patients are able to gain access to the treatments their doctors recommend—is maintained at a cost that is affordable to the NHS. There have been reports about NHS England refusing to discuss some offers of cost reduction with drug companies due to the rules under which the CDF operates. That needs to be addressed urgently if the overspend is to be tackled. I very much welcome—I am sure everybody else in the House does, too—the news that the CDF consultation opened today, at, I think, 1 o’clock this afternoon. I recommend, as I am sure others do, that all relevant parties participate in this very important consultation. Will the Minister provide assurances that the NHS will be supported in demanding the best possible deal from the drug companies, because that will be an important element of the process?

I want to finish by speaking about the importance of leadership and accountability, both at national and local level. The all-party group on cancer strongly welcomes both the strategy’s recommendation to introduce cancer

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alliances to drive improvement at a local level, and for the National Cancer Advisory Board to provide accountability at a national level. The National Cancer Advisory Board, in particular, will be important in ensuring accountability for the strategy, and that momentum and focus is retained. It is vital that this body is set up as a priority, so we can monitor progress and implementation from the beginning and set up the right structures to ensure strong accountability. Will the Minister set out how the Government plan to monitor the delivery of the cancer strategy recommendations and to measure their success?

I thank the Minister once again for responding to the debate. I know this is not his usual brief and I would be very happy for him to write to me after the debate if he does not have the answers to all the questions at his fingertips. As ever, there are a number of areas I have not had the chance to cover. Time simply has not allowed it, but I hope they will be covered by other colleagues speaking in this afternoon’s debate.

I want to finish by emphasising the opportunity presented by the new cancer strategy. By implementing its recommendations in full, and by retaining the focus on the one-year survival rates as a means of driving forward and promoting earlier diagnosis, we have the potential to deliver world class outcomes across the entire cancer pathway: to dramatically improve our cancer survival rates, to deliver care tailored to the patient and to ensure that patients are supported. But action must be taken now. Doing nothing is not an option. The challenge, as I highlighted at the beginning, is huge, but in the cancer strategy we have a clear plan for how to make it work. I urge the Government to take action now, to fulfil our manifesto commitment to implement the strategy in full, and to deliver the care, treatment and world class outcomes cancer patients deserve.

3.23 pm

Mark Tami (Alyn and Deeside) (Lab): I should start by saying that I am, with the hon. Member for Enfield, Southgate (Mr Burrowes), the joint-chair of the all-party group on stem cell transplantation.

I want to raise a few brief points in respect of the care of blood cancer patients who have had transplants and the ongoing care they receive. It is fair to say that at present the level of support can be described as patchy at best. There is a considerable lack of understanding of some of the issues that transplant patients face.

Anthony Nolan estimates that, by 2020, there will be 16,000 people in the UK living with the long-term effects of a stem cell transplant, and they will have a higher risk of secondary cancers, infections, particularly in the early stages, infertility and problems with muscles and joints. Then there is an area not touched on much: the psychological effects of both the diagnosis of blood cancer and a transplant. Graft-versus-host disease will affect the majority of patients in the early post-transplant period, but it can persist for many years. Some element of the disease is not necessarily a bad thing, because it shows the transplant is working, but if it gets out of hand, it can cause organ failure and a host of other problems that can, and do, kill patients. In the longer term, the effects can be as minor as skin irritation, but, if in the gut, they can lead to more complicated problems, resulting in the patient having to go back into hospital.

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As I said, the flare-ups can occur not only in the first few years, but many years down the line, yet a survey of 27 transplant centres in the UK found that while they all provided support for a year post-transplant, only half followed up after five years. Importantly, only 28% offered mental health support. This problem affects not only cancer patients, but a whole host of healthcare issues: we address the physical side of an illness, but then the patient walks out the door without our addressing their mental health needs or asking how they are coping with the diagnosis and other ongoing problems.

Some years ago, I spoke in the Chamber about my son’s experience of having a stem cell transplant. We had to look for support and counselling. Children, particularly younger children, will have questions such as, “Why has this happened to me?” and “Why can’t I run like I used to?”, but we had to ask for that support. It was not necessarily there in the first place or as part of an overall package, as one might have expected.

I said in the Chamber that I was particularly concerned about the lack of support for children going back to school. I believe there are still no national guidelines for how schools should deal not only with returning pupils, but with other, particularly younger, children. How might they feel about seeing a child they have not seen for a while? The last time they saw them they looked like them, but now they might be on steroids or have no hair—a particular issue for girls, although it is not great for anybody. I was concerned about the poor provision and the lack of guidelines. Some schools do it very well, but some show very little understanding. CLIC Sargent has done a lot of work in this area, but we need to do more. We have to look beyond cancer. Cancer is what people are treated for, but there is a host of other issues around it. We need to look at the whole, rather than just the illness itself, and at how we support people after that illness.

We define the transplant period as 30 days prior to and 100 days after the transplant, but this assumes that all patients need the same support and have the same outcomes. It takes very little account of some of the late effects that patients will experience. No patient is the same or will have exactly the same demands, yet there is this idea that we can set an arbitrary period of 100 days, as though at the end of it we can say, “Well, everyone’s fine. We don’t need to give them the same level of support.” However, patients go to their local area and then we are back with this postcode lottery, where some get very good support but some get very little, particularly if people are not exactly sure where they should go to receive support.

I do not think that is particularly fair, so I would like—and I know Anthony Nolan would like—a system that looks a lot further than 100 days and instead looks for support for a five-year period at least. Clearly there will be different requirements within that. Hopefully, some patients will not need a great deal of support, whereas others may need a lot of ongoing support. We need the flexibility to respond to that, rather than taking a one-size-fits-all approach.

We need to do more on ongoing support, and we should not forget either that stem cell transplants are now evolving—they are a lot more common than they were—and it is not just blood cancers we are looking at. Through the work of the all-party group on stem cell transplantation, I know that this is an area that offers

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us a great opportunity. Equally, we cannot ignore the fact that 50% of transplant patients die within the first two years, so there is a lot of work we need to do—generally, it is not the transplant that kills them, but some of the associated problems and immunity issues.

Finally, let me say to the Minister that we need to look more broadly at how we support transplant patients, get beyond this arbitrary figure of 100 days, and support people with the physical illness but also, very importantly, with adjusting to some of the psychological issues that can arise.

3.32 pm

David Tredinnick (Bosworth) (Con): I must start by offering my congratulations to my hon. Friend the Member for Basildon and Billericay (Mr Baron)—who is smiling next to me—who I have watched over the years toiling in this Chamber in the cause of cancer patients. He has done so, if I may say so, very effectively, and not just on cancer outcomes—he focused today on one-year outcomes—but on the provision of specialist drugs for patients. He has maintained a relentless pressure on the Government and it has been a joy to serve with him as a junior vice-chairman on the all-party group on cancer.

I hope today to bring to bear some of my experience in the House, which on Tuesday Mr Speaker generously described as 28 years of experience. He might have said 28 years of pursuing an holistic, patient-centred agenda that broadens choice in the health service. If we look at the cancer outcomes report, “Achieving World-Class Cancer Outcomes: A Strategy for England 2015-2020”, we find that the key themes are integrated pathways, holistic support for patients and a patient-centred service—“Patients should feel empowered”.

The agenda we find in that report is not a new one in the House. I have referred to my long involvement in this side of parliamentary life—I have been chair of the all-party group on integrated healthcare since it was formed and before that I was chair of the all-party parliamentary group for alternative and complementary medicine, so it covers pretty much the whole of my time in the House. If we look back at the meetings of that group, we see that they offer some instruction. The first message to get across to the House is that there is no need to recreate the wheel. If we look back, as I did, at the meetings of the all-party group on integrated healthcare—I discovered that I chaired more than 100 of them over the best part of the last 30 years—we find that there has always been a strong base of holistic and personalised care, which has been developed in certain hospitals and care institutions in this country.

I looked up the information about the 2001 exhibition that we put on in the Upper Waiting Hall for providers of complementary medicine. It was to highlight particularly good practice in the integrated healthcare awards of 1999. The winner was Charing Cross cancer services for offering a multidisciplinary approach to specialist cancer and palliative care services, which integrates complementary therapies, massage, aromatherapy, reflexology and art therapy for patients receiving treatment for cancer.

If we go forward two years, in March 2003, Caroline Hoffman, a nurse consultant in cancer care rehabilitation at the Royal Marsden and editor of Complementary Therapies in Nursing and Midwifery, spoke about her experiences at the Marsden hospital. Chris Perrin,

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a registered general nurse who uses complementary therapies in his work, also spoke. In May that year, the then Member representing Salford, Hazel Blears, launched new national guidelines for the use of complementary therapies for long-term or chronic illness. She was then the parliamentary Under-Secretary of State, and these were new national guidelines for use in hospitals, hospices, primary care, cancer support centres and self-help groups. The document was called “National Guidelines for Complementary Therapies in Supportive and Palliative Care”.

If I blow the dust off this document, I see that it could well have been integrated into the cancer proposals that we have before us now. It looked very closely at the possible options to expand patient choice in holistic care—the very things that the new report calls on. It is worth quoting—I see my hon. Friend the Member for Basildon and Billericay is looking at me intently—Professor Mike Richards, who was the National Cancer Director at the time. He said:

“A substantial number of cancer patients choose to receive complementary therapies alongside their mainstream cancer treatment. Individual patients frequently report that the use of a complementary therapy has helped them.”

He went on to say that there was

“broad agreement, however, that patients should have ready access to reliable information about complementary therapies and complementary therapy services”,

and finished by saying:

“The guidelines will usefully complement the forthcoming NICE guidelines on supportive and palliative care.”

Would that those NICE guidelines had been implemented then—all those years ago! I live in hope, particularly under the guidance of my hon. Friend the Member for Basildon and Billericay and the Under-Secretary of State for Health, my hon. Friend the Member for Ipswich (Ben Gummer), that we will make more progress. In March 2011, Professor Karol Sikora, the medical director of Cancer Partnership UK and Sosie Kassab, director of cancer services at the Royal London Hospital for Integrated Medicine came to give evidence to us.

The message is that a lot of the work that this report calls for has already been done. A lot of effort has already been put in. It is instructive in going through the Macmillan contribution to the 2015 to 2020 proposals to note that it points out:

“More than one in three of cancer patients use complementary therapies and many report finding them helpful.”

Macmillan’s own “Cancer and Complementary Therapies” booklet says it would

“like to see more high-quality research into complementary therapies”.

We have been calling for that for many years. Some evidence is very good; some is not so good—but there is a lot of evidence that patients are content with these services.

Having sat through so many Budget debates, I am not normally a great one for statistics, which I know can send colleagues to sleep, but my second statistic, apart from the one that a third of all cancer patients use complementary therapies, is that one third of the incremental annual cost of cancer care—this can be seen in the small print on page 76 of this lengthy report—is for living “with and beyond cancer”. Once patients have had chemotherapy

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and radiotherapy, it is often to the holistic and alternative world that they turn. It is there that we find a Gruyère cheese landscape. Many of these services are not available throughout the country, and we must address that.

A number of contributions are worth quoting, but I will quote one about acupuncture. “We are Macmillan Cancer Support” says:

“Some studies show acupuncture has helped reduce sickness in people who have had surgery or chemotherapy… acupuncture may help in treating other problems such as breathlessness and a dry mouth.”

In the last Parliament I served as vice-chairman of the herbal working group, under Professor David Walker. We reported on the last day of the Parliament. The Prime Minister generously wrote me a letter, which I received this morning, saying that the Government would respond before the House rose for Christmas. Herbal medicine is part of the two-pronged Chinese approach to treatment. I hope that my hon. Friend the Minister will respond positively by recommending either statutory regulation—for which many have asked—or voluntary regulation.

As I have said, the landscape of treatment available in this country is very patchy. Let us now look elsewhere in the world. The Prime Minister said that he had been to a football match at Wembley with the Indian Prime Minister, Mr Modi, and I believe that that was also mentioned by the right hon. Member for Leicester East (Keith Vaz), my Leicestershire colleague. Prime Minister Modi is quite a supporter of complementary medicine, and India now has a Department of Ayurveda, Yoga and Naturopathy, Meditation and Homeopathy. It has a Ministry—it used to be a Department—that draws all those complementary services together. In February 2012, when Prime Minister Modi was Chief Minister, he said that

“homeopathic medicines are affordable and free from side effects”,

and that

“homeopaths should create awareness...among the people”

of an easy method of treatment. He added:

“There should not be a question of conflict between allopathy, Ayurveda and homeopathy”.

All three systems of treatment had some very good things in them, he said.

It was therefore with some surprise that I saw a headline in—I think—The Daily Telegraph last week: “Prescribing homeopathy on the NHS may be banned”. Given its widespread use in the various complementary centres in the country, I wondered what on earth Ministers were thinking of. The doctors who practise homeopathy have been regulated by Act of Parliament since 1950. Ministers have been encouraging complementary therapists to become accredited by the Professional Standards Authority, and 2,000 members of the Society of Homeopaths have just achieved that accreditation.

What could be behind what I see as a kind of madness? The answer is that a tiny lobby group is trying to stop the use of £100,000 of Government money for homeopathic prescriptions every year. When we look into who those people are, we find that they are closely aligned with the medical establishment, and have been using legal challenges to try to stop health authorities and clinical commissioning groups using these treatments. I think that that is quite

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wrong. During Health questions this week, I pointed out that, according to Clinical Evidence, a review published by

The BMJ

,

“only 11% of the 3,000 treatments looked at in clinical trials”

in the UK

“proved to be beneficial, with 50% being of unknown effectiveness.”—[Official Report, 17 November 2015; Vol. 602, c. 507.]

If The BMJ says that, why are the Government considering picking on the homeopaths? I suggest to the Minister that these people are at best foolish and at worst wicked, because they know that they are trying to remove a very valid medical system from the health service.

In support of what I am saying, in 2001 Professor Edzard Ernst, in a published overview of exemplary studies and available systematic reviews of complementary therapies in palliative care, which is included in the 2003 report “National Guidelines” I mentioned earlier, says:

“Several clinical trials suggested that homeopathy also may benefit patients suffering from cancer. For instance, a recent double-blind RCT included 66 women undergoing radiotherapy after breast cancer surgery. In addition to conventional treatment, they received either a homeopathic mixture (belladonna 7CH, X-ray 15CH, i.e. two homeopathic remedies in high dilutions) or a placebo daily for 8 weeks. The results suggested that the homeopathic mixture was superior to placebo in minimizing the dermatologic adverse effects of radiotherapy.”

If we look at the hospitals where these support therapies are offered, we see that one not far from here offers aromatherapy, homeopathy, massage, reflexology and shiatsu. This is not some tiny clinic buried in a remote part of the capital. This is Barts Health, which is the largest NHS trust in the country. It has 15,000 employees and a £1.25 billion budget.

One of the issues that my hon. Friend the Minister is going to have to address is how we get more properly regulated practitioners into the health service. If we are going to provide the cancer support that this report argues for—the holistic support, the patient-centred support—and if we are going to listen to what patients want, we need to get a greater number of professionals deployed in the health service. He and his colleagues need to look at the Professional Standards Authority, a Government organisation that has 63,000 practitioners on 17 accredited registers covering 25 occupations. The Society of Homeopaths is one of its most recent additions: it now oversees the society’s regulation. However, there are many other groups there. It is important that we do not ignore that valuable resource. One third of the costs of the whole cancer budget is going on care after treatment. We can reduce that bill by using these people. I know the field of homeopathy very well. With acute conditions, if conventional medicine and homeopathic medicine are used, one reduces the acute drugs bill and with chronic conditions one tends to increase patient satisfaction, so it is a win-win situation.

I am not going to speak for much longer as I know other colleagues wish to contribute, but I want to raise the Cancer Act 1939 with the Minister. When his colleague appeared in a Committee Room not long ago, I got the distinct impression that that was not something the Department had looked at very recently. It says—this is important when it comes to trying to get patient-centred health care and broadening the scope of treatments for cancer care:

“No person shall take any part in the publication of any advertisement—

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(a) containing an offer to treat any person for cancer, or to prescribe any remedy therefor, or to give any advice in connection with the treatment thereof.”

That means that it is illegal to advertise or promote any medicine, diets, therapies or treatments as cures for cancer. Well, most of the treatments that I have discussed and referred to today are not claiming to cure. They are claiming to help and to increase the quality of life of those who have the disease. The Advertising Standards Authority and other bodies have been very sharp with anyone who is suggesting that they can assist patients in the provision of therapies that will improve their quality of life.

There are many examples of good support services across the country. I am not going to mention them all, but I do want to mention Coping with Cancer in Leicestershire and Rutland, an independent local charity that provides practical and emotional support to anyone affected by cancer. It offers counselling, complementary therapies, befriending and drop-in centres.

We heard today on the news that in China there is now a superbug that defeats all antibiotics. The last resort antibiotic has no power, and I suggest to my hon. Friend the Minister that we have to go back to the future. I served on the Science and Technology Committee for most of the last Parliament when we looked at antimicrobial resistance, and I was on the Health Committee for the whole of the last Parliament when we looked at this issue. If we have not got the antibiotics and nothing is coming through the pipeline despite the efforts of those the Front Bench, we will have to go back to the future, as medicine is going back to the dark ages, as a commentator said this morning on Radio 4. That means we will have to look more at natural remedies. We will have to listen to people who have used acupuncture for thousands of years and know their way around herbal medicine.

I will end on the following note. I have served with many Secretaries of State in this House. One of them once called me the hon. Member for Holland and Barrett which I took as a great compliment as its headquarters are in my constituency. I am sure it helped me in the 1997 general election, which was not the easiest for Conservative Members. I would like to quote the former right hon. Member for Holborn and St Pancras, Frank Dobson. He said when he was Health Secretary:

“I believe that what works is what counts and what counts is what works. With so many threats to our health we can’t afford to ignore anything that works and is safe.”

I agree. Where patients are gaining benefits, those services should be available.

3.52 pm

Nic Dakin (Scunthorpe) (Lab): It is a pleasure to follow the hon. Member for Bosworth (David Tredinnick), who painted a very broad canvas of things for us to think carefully about as we take this strategy forward. May I also begin by praising the hon. Member for Basildon and Billericay (Mr Baron) for his leadership in this area and for the way in which Members across the House have worked together in this important field?

It is worth saying from the outset that a large part of the challenges we face are the challenges of success. Success in tackling many cancers has led to a right and proper rise in expectations. It is therefore important to pay tribute to all who work in this field—clinicians,

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patient groups, charities and a host of other people and organisations—for the outstanding work they do. However, the cost and challenge of treating cancer will continue to rise rapidly during this Parliament. The “Five Year Forward View” projections indicate that expenditure on cancer services will need to grow by about 9% a year, reaching £13 billion by 2020. This growth is between two and three times the rate of other health spend.

The commitment for everyone to have access to the recovery package by 2020 and the development of a quality of life metric by 2017 are welcome, but clear plans need to be put in place for these to happen. It is vital that there are commitments, both in terms of funding and resource, to deliver the full living with and beyond cancer programme, cancer alliances and a workforce review.

A national cancer advisory board, as recommended in the strategy, needs to be set up urgently to hold all the arm’s length bodies to account on delivering the recommendations laid out in the strategy. It is vital that this board is fully independent, with an independent chair. The Government must also fund and implement the recommendations set out in the independent review on choice in end-of-life care to ensure that there is choice and quality in that care.

Such investment in the national choice offer should result in a significant increase in out-of-hospital care, including through district nurses, allied health professionals, pharmacists, social care services and specialist palliative care teams, to ensure that every dying person has access to round-the-clock care seven days a week. That investment should also result in greater co-ordination between services to improve the quality of end-of-life care and to support carers and families; more empowered patients and carers who are able to exercise greater choice in their place of death; a reduction in hospital admissions for people at the very end of their lives; and the use of the latest technologies to support end-of-life care.

As chair of the all-party parliamentary group on pancreatic cancer, I strongly welcome the cancer strategy, and in particular the recommendations relating to improving early diagnosis and improving patient care and end-of-life care. I am concerned, however, that despite recognising the existence of a group of cancers with high incidence but low survival rates—highlighted as group 3 in the strategy—the strategy fails to acknowledge the need for specific actions to tackle the problems unique to that group.

Pancreatic cancer is the fifth most common cause of cancer death in the UK, and it is a clear example of an unmet need in cancer care. On average, one person is diagnosed with pancreatic cancer every hour, yet its five-year survival rate has remained virtually unchanged over the past 20 years and remains shockingly low at around 4%. That is the worst survival rate of the 21 most common cancers.

The hon. Member for Basildon and Billericay rightly welcomed the fact that the strategy recognises the need to improve early diagnosis by reforming the referral system. Improving early diagnosis is the key to improving survival rates. Only 80% of pancreatic cancer patients are currently diagnosed at a stage where surgery—the only real hope of a cure—is still an option, and only 10% go on to receive that life-saving surgery. Ensuring that more patients are diagnosed earlier, while surgery is still a viable option, is therefore essential to improving the appalling survival rates faced by pancreatic cancer

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patients. That is also an issue for other cancers, such as blood cancers. At present, 50% of acute myeloid leukaemia diagnoses, 37% of myeloma diagnoses and 35% of chronic myeloid leukaemia diagnoses are happening in emergency settings. I echo the comments of the hon. Member for Crawley (Henry Smith) on the excellent work being done by Bloodwise in this area.

The recommendation of a four-week diagnosis target is welcome, and I am pleased that the Department of Health has committed to looking at adopting that recommendation by 2020. I also welcome recommendation 21, which calls on NHS England to pilot the implementation of multi-diagnostic centres as a priority. Such centres would allow patients presenting with vague symptoms, such as abdominal pain, to have multiple tests on the same day, preventing the need for them to present at their GP surgery repeatedly before being diagnosed, thus speeding up their diagnosis. That could be especially significant for pancreatic cancer patients, who report having to visit their GP on multiple occasions before being referred for tests. A UK-wide survey carried out by Pancreatic Cancer UK found that 23% of pancreatic cancer patients had to visit their GP seven or more times before they received a diagnosis. The introduction of multi-diagnostic centres would therefore be a big leap forward.

The call for GPs to have direct access to investigative tests by the end of 2015 is also very welcome. None the less, it is important to ensure that GP surgeries have the imaging capacity—in terms of equipment and of staff training—to carry out investigative tests such as CT scans. Will the Minister tell us what assessment the Department of Health has made of GP practices’ current imaging capacity and the capacity that would be needed to ensure that all GPs were able to carry out investigative tests?

The measures in the strategy to improve patient experience are to be warmly welcomed. National cancer patient experience surveys show that the pancreatic cancer patient experience continues to fall short of expected standards, especially in the lack of appropriate information about their diagnosis, about treatment options and about what to expect following discharge from hospital. Access to a clinical nurse specialist is a key factor in improving the patient experience, but it is also essential to ensure that clinical nurse specialists have the resources needed to provide a good quality service. In a survey of these specialists carried out by Pancreatic Cancer UK in 2015, only 28.36% of respondents said they felt they were able to spend as much time with their patients as necessary and had enough resources to provide a good quality service.

The need for more clinical research into cancer is also highlighted by the new cancer strategy, and I strongly support this recommendation, as the kind of change needed to make any significant impact on survival rates will be achieved only through research: research that will aid earlier diagnosis and screening; research that will result in more and better treatments; and research that, we hope, will offer opportunity for a cure. Despite accounting for 5% of cancer deaths, pancreatic cancer received only 1.4% of the National Cancer Research Institute partners’ research spend in 2014. Although that is an increase on the 2013 research spend, pancreatic cancer research funding continues to lag behind many other areas of cancer research.

The strategy also makes reference to the need for

“a sustainable solution for access to new cancer drugs”.

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That has exercised the minds and thoughts of Members from across this House, as well as plenty of people outside it who know a lot more about the matter. It is only a fleeting reference in the strategy, yet access to drugs is one of the most important issues for pancreatic cancer patients. In particular, pancreatic cancer patients face a persistent lack of access to treatments, making access to new drugs especially important. That is demonstrated most starkly by the removal of the life-extending drug Abraxane from the cancer drugs fund list recently. The CDF decision is compounded by the fact that the National Institute for Health and Care Excellence has also reviewed and rejected Abraxane for use on the NHS, on the grounds of it not being cost-effective enough. In a way, that is not surprising, as between 2007 and the end of 2013 NICE recommended only 31% of cancer drugs for use on the NHS. That is why the setting up of the CDF is to be commended, as it is to compensate for this bias by NICE against cancer drugs. The NICE scoring system is even less flexible than the CDF one. Again, it is not fair to judge a new treatment for a disease with such poor survival rates and very few treatment options on the same criteria as other treatments for other cancers and other conditions. We need more imagination and more flexibility if we are to make the strides forward that need to be made.

There is ever such a lot to welcome within the strategy, but it could have gone further, by including measures to deal with group 3 cancers. Despite identifying cancers with high incidence but low survival rates, the strategy has not yet set out any measures aimed at tackling that precise problem. Greater awareness of the symptoms of these cancers, which can be non-specific, alongside more research into diagnosing and treatments, and the creation of a fair and flexible drugs appraisal scheme remain essential. I hope that in taking the work of this strategy forward, the people involved will endeavour to put those things in place.

4.3 pm

Rebecca Harris (Castle Point) (Con): I, too, begin by thanking the Backbench Business Committee for scheduling this very important debate and my hon. Friend the Member for Basildon and Billericay (Mr Baron) for his endeavours. A great deal has happened since we last had the chance to debate cancer, and I am pleased to be able to discuss the Independent Cancer Taskforce’s report on a cancer strategy for England, which is a major step in the right direction for all those affected by cancer.

As chair of the all-party group on brain tumours, I particularly welcome the focus of the report on early diagnosis. A target for 95% of patients to be diagnosed within four weeks of being referred by a GP by 2020, which has recently been implemented by the Government, is absolutely crucial for improving cancer outcomes for patients, especially those with brain tumours. Currently, 58% of brain tumours are diagnosed in accident and emergency, which unfortunately is far too late for many. That has contributed to brain tumours being the biggest cancer killer of children and adults under 40. Patients diagnosed with brain tumours have a five-year survival rate of just 19.8% compared with cancer as a whole, where 50% of patients can expect to survive for at least 10 years. Cancer survival rates doubled between 1970 and 2010, while, shockingly, brain tumour survival rates increased by a mere 7.5%.

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The current poor level of early diagnosis and a general lack of awareness of brain tumours contribute to the stories of far too many people. The Green family from my constituency had a son, Danny, who was a normal, happy, energetic 10-year-old who suddenly suffered a dizzy spell after playing football one afternoon. It was eventually confirmed by his local hospital that he was suffering from a brain tumour. Tragically, despite having an operation to remove the tumour, chemotherapy and radiotherapy, Danny lost his fight for survival in July 2012. He died from pneumonia.

Although the Greens believed that something was really seriously wrong with their child, they found that when they initially took him to hospital, doctors dismissed his symptoms as nothing more than a migraine. It was only when his condition deteriorated and he collapsed in A&E that he was sent for a CAT scan and an MRI scan. Brain tumours are relatively rare, but as Danny’s mother, Lisa, says:

“They are not rare enough when it’s your relative.”

That is why the family would like to see patients with possible brain tumours sent for MRI scans much sooner than they currently are.

I very much welcome the new cancer strategy, but I have a number of concerns, including the lack of a clear, ambitious commitment to improve research. That lack of commitment impacts on the cures and treatments of the future for cancers with low survival rates, such as brain tumours. Those cancers of “unmet need” will not see the boost in survival rates that the more common cancers will, because early diagnosis and prevention alone do not affect the effectiveness of treatment to a significant extent. For example, there are no lifestyle factors that are proven to increase the likelihood of getting a brain tumour, which means that a focus on prevention will do nothing to stop the incidence of the disease, which, for whatever reason, is rising. There should be a stated priority to increase research and to find new curative and palliative treatments for rarer cancers.

The two excellent charities that I work with as part of the all-party group, Brain Tumour Research and the Brain Tumour Charity, have issued their own response to the new strategy. They, along with the two charities in my constituency, the Danny Green Fund and the Indee Rose Trust—the Indee Rose Trust is also tragically named after a little girl who lost her life at the age of three, five months after being diagnosed with a brain tumour—do exceptional work in raising awareness of brain tumours and of the importance of early diagnosis. They also increase the amount of funding for research and improving treatments.

For the strategy to be effective for people with brain tumours and to allay the concerns that I have raised, we need to focus on a few particular areas. First, we need to streamline the process of repurposing drugs. The repurposing of drugs and compounds to tackle brain tumours could open up new treatment options for patients. Repurposing refers to a process whereby a drug or a compound that has previously been used to tackle a certain illness—for example, depression—is examined and studied to see whether it can be used to tackle another illness, such as brain tumours. There is solid evidence that treatments can be developed through repurposing that are safe and effective, and that add years to the lives of patients with terminal cancers.

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The Government can help to streamline that process by reducing the regulation and red tape on scientists along with incentivising pharmaceutical companies to release compounds for research. The research and trials that will be sparked could result in huge strides being made in the field and in ground-breaking treatments for patients.

Secondly, we need a national register of all site-specific research to track all research work, grants and results. Currently, there is not a great deal of transparency in the research field. There is no clear idea of what research is being funded and what results are being achieved. That leads to confusion, duplication of work and a system that prioritises research in more common cancers rather that in diseases such as brain tumours. A national register will make research more transparent, reduce duplication and allow greater variation in the type and scope of research.

Thirdly, we need an innovation fund for research into rare and rarer cancers. Grant applications to existing research funding bodies require evidence of previous research—pilot work as well as published results. That results in something of a catch-22 situation. Applications must be deemed low risk in nature and as having a high likelihood of success before a grant is awarded. That means that there has to be a pre-existing bank of evidence. Novel research, particularly relating to brain tumours, suffers as a consequence of a lack of existing research. This ring-fenced fund should be set aside for areas of new research on rarer cancers and diseases. There should be a lower threshold for grants to be awarded in new projects, or in existing schemes such as the 100,000 genomes project. This stimulus will create a new wave of research that previously would not have been possible, widening our knowledge of cancer and creating the treatments we need.

Finally, we would like the Government to devote an absolute amount to brain tumour research. Brain tumours represent 1% of cancers diagnosed, yet 3% of cancer death. Within the innovation fund a consistent or growing absolute figure should be devoted by the Government to brain cancer research. Some 16,000 people are diagnosed with a brain tumour every year, and those affected are disproportionately children and young adults, who may have young children themselves. I hope that the Minister will commit to implementing and funding the new cancer strategy so that those 16,000 people, and indeed the tens of thousands more diagnosed with other forms of cancer, get access as quickly as possible to the treatment and the funding for research that they need to give them the best chance of survival.

4.10 pm

Jo Churchill (Bury St Edmunds) (Con): I am vice-chair of the all-party parliamentary groups on cancer and on breast cancer. I welcome the strategy and the hard work of those who have put it together. Looking at a situation with a fresh pair of eyes is always beneficial, for all the reasons that my hon. Friend the Member for Basildon and Billericay (Mr Baron) pointed out.

My hon. Friend the Member for Castle Point (Rebecca Harris) and the hon. Member for Scunthorpe (Nic Dakin) highlighted one of the problems: there are more than 200 types of cancer, which makes it highly complex to deal with unless we have an overarching strategy.

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That goes not only for the cancers and their different forms, but for how we approach the use of drugs, research into them, and so on.

The new cancer strategy has the ability to be transformational, inspiring us to lead the world or at least to match those who are ahead of us. That is where we should be in patient outcomes. For me there are positives, but in order to achieve these things we need full implementation and adequate funding. There are some key asks—the national ambition for early diagnosis is probably one of the principal ones. As individuals we can help in diagnosis by presenting early enough. Some 20% to 40% of people find out that they have cancer only when they present at accident and emergency, and by then it is usually too late, so early diagnosis is key. My hon. Friend the Member for Basildon and Billericay referred to the figures for bowel cancer. Some cancers have much better outcomes if diagnosed early. That gives people a better quality of life and a better journey through the cancer path.

The strategy asks for a definite diagnosis within four weeks of referral, to be achieved by 2020. Ensuring that CCGs are held to account for improving one-year survival rates is crucial to drive early diagnosis. How will we hold the CCGs to account and make sure that rates are improving from June 2016? Linked to this is the way in which we improve cancer commissioning, as we have heard. The current picture is fragmented and confused.

Accountability, responsibility and transparency are needed, and with modern advances in medicines and diagnostics flexibility is hugely important, as is communication. Currently no one body or person at local, regional or national level holds responsibility, and this does not aid clarity in the system. Clinicians and patients are liable to fall foul of duplication or fall through the gaps, wasting precious time and resources, which neither the NHS nor the patient on the receiving end can afford.

The creation of cancer alliances can support the commissioning process and ensure that the strategy is delivered. Living with and beyond cancer is a growing challenge. There will be 3 million of us by 2020 and 4 million by 2030. Speaking from personal experience, I know that being a cancer patient is at times a bit of a challenge. Being medicalised is no fun, as I know, but both the new five-year guidelines on living with and beyond cancer and the new quality of life metric that has been spoken about are vital to drive service improvements. As the hon. Member for Alyn and Deeside (Mark Tami) said, sometimes it is the not-so-obvious things that people need help with. His child needed help in comfortably settling back in at school and ensuring that those around him understood the journey, too.

Scan anxiety sits heavily on people who are being tested to see whether they have cancer. The hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) did a lot of work in that area before she came to this place. It puts a great deal of pressure not only on the individual but on their family.

Under the strategy, those living with secondary cancer have emerged as a very distinct group. For example, 36,000 women are living with secondary breast cancer, and to date their needs have been neglected. The ambition of the strategy is to focus on the long-term quality of life, including for those who

“are living with an advanced and incurable form of the disease”.

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This highlights the importance of multi-disciplinary teams in planning the care of all cancer patients.

The NHS is changing and adapting. Ensuring that the organisation has the right skills in the right places is the key to delivery not only of our cancer strategy but of many of the ambitions we hold. The strategy asks for everyone to have access to clinical nurse specialists, and I would wholeheartedly support that. Today, as I stand here, I would like to say a huge thank you to our nursing profession—a highly skilled group of people. I know from constituents and others that their professionalism, care, and, at times, very “no nonsense” approach has been as important as anything else in the recovery process.

If the aims of the strategy are to be achieved, working smarter and doing things differently may well be the key. Nurse consultants are now becoming a feature in the profession, and workforce planning will be crucial. The strategy focuses on the needs of older people and those from the black and minority ethnic community, who are often much more reticent about going to seek help. We know that we are living in an ageing society. The upside is that we are living longer; the downside is that there are more health challenges. In 1949, at the start of the health service, 50% of our population died before they were 60. Thankfully, that is not the case nowadays, but the strategy highlights the need to focus on treatment for older people—another sign of the changes in our NHS.

The cancer strategy is to be applauded in calling for a national action plan to address obesity. That is welcome, but there are individual responsibilities too. Obesity is a known causal risk factor in breast cancer and many other cancers. There is good evidence to show that five 30-minute bits of exercise a week, like a brisk walk, would help not only with obesity but with the likelihood of the disease recurring. There is plenty for people to do in this regard.

I would like to mention drug innovation and the cancer drugs fund. How will the cancer strategy’s recommendations on NICE guidelines on the use of bisphosphonates be taken forward? I would really appreciate understanding a little more about how we are going to use off-patent drugs and drugs that have been shown to have a secondary purpose beneficial to cancer patients. I would like to see communication between clinicians, pharmaceutical companies and others so that we can ensure, along with the accelerated access review and the cancer drugs fund, that we are getting to patients, in a timely fashion, the drugs they need and deserve.

Finally, I ask that the right accountability structures are in place, and that the national cancer advisory board ensures that what needs to be done is being done to secure optimum patient outcomes for all.

4.19 pm

Mark Durkan (Foyle) (SDLP): It is a pleasure to follow the hon. Member for Bury St Edmunds (Jo Churchill), particularly as she ended by referring to off-patent drugs. She spoke powerfully on Second Reading of the Off-patent Drugs Bill, which was promoted by the hon. Member for Torfaen (Nick Thomas-Symonds) only a couple of weeks ago. This debate draws on many points made in previous debates, including that Second Reading debate and Westminster Hall debates. There have been debates about the cancer drugs fund, specific cancers and, recently, secondary breast cancer.

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I am an officer of a number of all-party groups, including that on cancer, which is so ably led by the hon. Member for Basildon and Billericay (Mr Baron), who secured this debate. We have also heard from colleagues who are members of other all-party groups, including the hon. Member for Scunthorpe (Nic Dakin), who is on the all-party group on pancreatic cancer, and the hon. Member for Castle Point (Rebecca Harris), who is doing so much to raise awareness and to promote action on and understanding of brain tumours.

I welcome the fact that the Backbench Business Committee has afforded us this opportunity to join up what might otherwise appear to be disparate work. The APPGs are not rivals—their efforts are entirely complementary. The cancer strategy is a benchmark document and this debate gives us an important opportunity to consider how we can marshal parliamentary effort and will behind it. We need Ministers in the Department of Health and elsewhere to know that we are not taking it for granted and that, just because we have had unmet need for a long time, that should not continue to be the case. I would like to hear a Minister tell us that their portfolio means that they see themselves as the Minister for meeting unmet need. If they set that target and seek to make that change and turnaround, they will have many backing vocalists from the different all-party groups.

Other hon. Members have said that there may be some issues with aspects of the cancer strategy, but it clearly lays down some important standards, not least on a recurring message that the APPGs get from the evidence we receive, namely the question of early diagnosis.

Mr Baron: The hon. Gentleman is a good friend of the all-party group on cancer. He will already know this, but it is worth putting it on the record that the separate all-party groups on cancer are endeavouring to get their act together and to speak with one voice where there is a common interest—and there are many when it comes to cancer.

Mark Durkan: I fully recognise that point. That was what I was trying to say when I said that the APPGs are not rivals. This debate allows us to bring together their work and their common message, and to acknowledge the work of the hon. Gentleman and the chairmen of the other APPGs. In that regard, I should also mention the hon. Member for Washington and Sunderland West (Mrs Hodgson). She cannot be here this afternoon, but she has done so much on the all-party groups on ovarian cancer and on breast cancer.

Early diagnosis is a common theme and the issue is not just about making sure that there is more access to diagnosis. The hon. Member for Bury St Edmunds has mentioned how many people end up being diagnosed in A&E, which is not what should happen. Although certain cancers raise more sensitive and technical questions than others, there needs to be more awareness among GPs, and diagnostic tools are also key. However, this is about not just ensuring earlier diagnosis with better use of diagnostic tools, but ensuring much clearer referral pathways. The cancer strategy sets a target of making sure that, by 2020, 90% of people are diagnosed within a month to see whether or not they have cancer. That is a very good working standard.

All the APPGs, particularly the all-party group on cancer, have strongly suggested that the indicator of one-year survival rates would be a very good test of our

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ambitions and efforts and of the actions of health authorities. That working standard needs to be adopted, because it would help us to monitor and manage our progress.

I am conscious of the fact that I speak as a Member from Northern Ireland, whereas the cancer strategy and much of this effort relate to England. However, as everybody knows, in a lot of these areas we are talking about predictive policy. When we set frameworks or national strategies on particular diseases or illnesses for the NHS in England, they can extend, through policy airspace principles, to the devolved areas. That is one reason why I have no hesitation in joining in the work of the APPGs here—it helps to advance understanding at home.

Of course, that was not the case with the cancer drugs fund. We do not have a Northern Ireland version of that, which has led to the frustration that was identified by the late Una Crudden, who suffered from ovarian cancer. Many of the drugs that were available in England under the cancer drugs fund had been the subject of clinical trials in the excellent centre in Belfast, yet they were not available to patients in Belfast.

The success of the cancer drugs fund has shown its limitations, which is confounding us in thinking about how to develop and replace it. When considering the future of the cancer drugs fund and what will succeed it, I ask him to think not just about doing something for England and then seeing whether the devolved Administrations can match it or do better, but about the possibility of a UK-wide funding pool for some of the newer drugs and for some innovations in research and diagnosis, such as molecular diagnostic testing, which comes under the cancer drugs fund. Perhaps this is a conversation that we need to have with the Chancellor in the context of his announcement next week and what will happen beyond that. I am saying not that it should all be funded by London, but that there could be a pool of money to which the devolved areas contribute, with common standards and bands. It might be that certain groups of patients would then be covered by further arrangements made at the devolved level.

The more commonality and consistency we can bring to funding, the better. It would make it so much better for the many good cancer charities and policy advocacy groups that work with cancer patients, which have to busk around the different Administrations to see who has what bit of money. That also creates a lot of confusion at the parliamentary level. It is hard for us to join up our efforts and marshal our arguments when we are dealing with different structures and systems. The more commonality we can create in funding, particularly in the area of innovation, the better.

Perhaps there should be a UK-wide effort, or perhaps it should go beyond the UK. The British-Irish Council includes all eight Administrations on these islands, including the south of Ireland. Perhaps there should be a common effort at that level, given some of the clinical networks that will be involved. When we consider the rarer cancers that will not be treated in some of the other places, perhaps a more united effort would help to take the thinking forward. A lot of the ingredients in the cancer strategy for England might best be brought forward as part of a combined strategic effort on cancer across these islands.