§ Dr. Ashok Kumar (Middlesbrough, South and Cleveland,East)(Lab)
I have been trying to secure this debate for a year and a half. It has taken a long time, on and off, but I have finally secured it. I am happy to have the opportunity to debate such an important issue, and I am delighted that my hon. Friend the Minister is in her place. She is familiar with Teesside, which she has visited many times on the campaign trail and at other times post-election, so the issues that I shall raise today will be no surprise to her.
This is my second debate in the House on the subject. I first spoke about it in January 2001 during a debate on the Science and Technology Committee's report "Cancer Research: A Fresh Look". My comments today will follow on from the spirit of what I said then, but I shall try to extend the debate in two ways. First, I shall spell out the sheer depth of the problem of cancer on Teesside. Secondly, I hope that the Minister will be sympathetic to what I have to say and will examine the case for setting up a new centre of excellence based in Teesside for the research and treatment of cancer.
Cancer is one of the greatest, if not the greatest, scourges of our times. It has yet to be eradicated. One person in four will at some time be diagnosed as suffering from a cancerous condition, so every family in this country will almost certainly experience the loss of a close member from cancer. One third of all cancer sufferers will die of the disease.
The disease has no natural borders of class, race, country or gender. However, it affects some groups more than others; for example, women, people who have worked in polluting industries, people who live in areas with significant levels of deprivation and poorer people who live in areas neat industrial processes. Those last three factors make up much of the social demography of urban. Teesside. Teesside itself is set within the north-east region of England, which has the highest premature death rite in the country for all cancers.
Tragically, the incidence of cancer in my area is very high. I wish to cite a few figures provided to me by the County Durham and Tees Valley public health network. They show that in 1999 and 2001, the number of deaths due to cancers of all types was well above the national averages. In those two years, 3,164 people from a population of 0.5 million died on Teesside. That is equivalent to the entire population of one of the villages in my constituency or one of Teesside's council estates.
The standardised mortality ratio figures, for which 100 is the national average, show the divergence between urban Teesside and the rest of the country. SMRs for all cancers are 128 for Hartlepool, 123 for North Tees and 129 for Middlesbrough. The gap is even wider for specific forms of cancer. For lung cancer among women, North Tees has a staggering SMR of 205, Middlesbrough 162, Hartlepool 169 and Langbaurgh 114. I am told by the South Tees Hospitals trust that one figure—deaths from lung cancer for women under 50— is particularly frightening. For that group, the SMR is 350. That means that the chance of 64WH dying from lung cancer for a woman in that age group who lives on Teesside is three and a half times the national average.
The figures continue remorselessly. For female stomach cancer, Langbaurgh has an SMR of 154 and Middlesbrough 121. The SMR for cancer of the cervix among females in the Langbaurgh PCT area is 169, and in Hartlepool it is 165. In neighbouring Middlesbrough, it is 184. Only in five isolated instances across all Teesside's PCT areas and across all the spectra of cancers are the figures below the national averages.
Dr. Mark Reilly, the strategic health authority's epidemiologist, tells me that the figures, bad as they are, are not totally representative of the real level of suffering in the area, as they measure only deaths. The number of new cancers now being detected and treated significantly outweighs the deaths. Although they will not register on the SMR index, they represent a tidal wave of suffering, prolonged hospitalisation, treatments that are sometimes painful and family grief.
§ Ms Dari Taylor (Stockton, South) (Lab)
The figures that my hon. Friend has given are frightening for the people whom we both represent. When he considers the details, does he believe that one cause of the stark figures is the lack of research on Teesside? We spend about 3 per cent. of the research finance that is available, whereas Oxford, Cambridge and London spend more than 60 per cent. of it. Does he believe that with greater finances and research we would have greater competence to handle the problems that he is outlining?
§ Dr. Kumar
My hon. Friend makes a very good point, which I shall address a little later. I concur with her analysis that the issue is very important in the debate about the setting up of such a centre. I am thankful to her for drawing attention to the subject.
The link between poverty and illness is also graphically shown in the geography of Teesside, which includes areas of comparative wealth and social mobility and areas of high social deprivation. The index of multiple deprivation shows that there are sharp differences in the domains of deprivation. Eleven wards in the Tees valley are in the top 100 of the overall index of multiple deprivation, and 25 are in the top 300. It is in those wards that the majority of cancers are found.
There are, of course, personal as well as social and ecological reasons for the high incidence of cancer on Teesside. Smoking and drinking, particularly so-called binge drinking, play their part. Moreover, people from poorer areas have a poorer diet. A consumer culture in which people rely on street corner, eight-till-late mini-supermarkets and convenience foods sold from local delivery vans does not bring about a balanced diet. Sugar and salt intakes are high, and there is no real balance because of the lack of fresh vegetables and fruit. Housing standards in some areas of Teesside are poor, which leads to ill health. We have a high incidence of estates with a large number of void properties, and a large number of old, Victorian terraces. We have homes that are substandard, and estates and neighbourhoods in which there are few social and health-related amenities such as clinics and GP surgeries. It is therefore no surprise that we have a cancer problem.
65WH So far I have tried to highlight the magnitude of the problem, but I want to move on to the centre of excellence. I hope that my hon. Friend the Minister, from listening to my arguments, realises that there is a need for a new centre of excellence for cancer research and treatment in my area—a centre that can back up the work of local cancer charities and organisations. A well-developed network of cancer trusts and charities is working in the wider Teesside area, and I pay tribute to the work of those organisations. I have met many of those groups, and they wholeheartedly and strongly support my call for a new centre of excellence.
Where could such a centre be based? Crucially, the South Tees area has one of the most modern hospitals in the UK, if not the most modern: Middlesbrough's James Cook University hospital. It was due to the excellent planning of the officers and members of the South Tees Hospitals NHS Trust that that hospital was conceived.
§ Sitting suspended for a Division in the House.4.33 pm
§ On resuming: —
§ Dr. Kumar
It was due to the excellent planning of the officers and members of the South Tees Hospitals NHS trust that the James Cook University hospital was conceived and built with a physical research centre. The centre's standing is high. It is a division of the hospital in its own right, and it has equal footing with the clinical groupings and equal representation on the hospital's management committee. It is staffed by a multidisciplinary team whose work now pervades the whole trust.
From the outset, the hospital was also designed to have links with universities in the north-east, and most notably with the new Stockton campus of the university of Durham. The campus houses the Wolfson research institute, which is home to the Northern and Yorkshire public health observatory and to a wide range of medical specialisms, such as the north-east's health development agency.
I have spoken on several occasions to Professor Rob Wilson, director of research at the James Cook University hospital. He passionately believes that more could be done to make the hospital and its research facilities a centre of excellence for cancer treatment and investigation in the UK. However, as my hon. Friend said, he has also observed that there are massive disparities in funding in cancer research and treatment.
At its inception, the South Tees research base was allocated £192,000 of research income. Other centres get far more. As a former member of the Science and Technology Committee, I recall working on a report on cancer research and treatment in 2000. In that report, the Committee called for a greater spread of funding across the nation and for 12 new centres of excellence. That call is still valid, nearly three years on. As much as 60 per cent. of cancer research funding is spent in London, Oxford and Cambridge, but the area between 66WH Leeds and Newcastle gets hardly any direct funding. Those disparities mean that talented people may not get the best backing for their competencies.
The South Tees trust employs some 270 consultants, and although only between 10 and 12 have a research element in their job description, many of the others have done academic and applied research and could easily do so again. They are willing to face the challenge. It was the only European recruiter to run trials on behalf of the United States national cancer institute. It now collaborates with the regional universities of Newcastle, Durham and Teesside on a large number of key research areas, including cancer and cell biology.
A mark of the esteem in which those consultants are held is shown by the fact that they have recently won £4 million from academic sources to build an extension to their clinical academic centre. That will allow the teaching of an increased number of medical students, and it will incorporate new purpose-built laboratories. I believe that that track record, that talent and that expertise could become a base for a regional cancer research centre for the north-east. It could also be part of a wider regional partnership.
As well as the universities, we also have new projects such as the Newcastle-based international centre for life. There is no reason why that centre should not have a Teesside presence. For instance, it could work with James Cook University hospital in cutting-edge research in the entire field of life sciences, which includes cell research—something that could ultimately benefit cancer sufferers and the medical profession.
The work with regional universities would expand naturally and organically if more funding were in place. That work would complement what is being done now, and could provide high-quality research focused on the needs of a community, as argued for in the NHS plan. I guarantee that any Department of Health funding made available for that purpose would attract other funding, and would be matched pound for pound. Properly applied, it could grow to be a major source of investment.
Quite simply, if a centre were built on Teesside it would have immense symbolic importance. It would be entirely fitting for such a centre to be based in an area where the killer condition is at its worst. The work of the centre, visible to the community and supported by a proud region, would also be a tremendous instrument for health awareness and education. It would be a focus for civic pride, and it would improve the health of local people.
The time has come for the establishment of a centre of excellence, and I look forward to hearing the Minister's reactions to the proposal. I wish to take the matter further, and I hope that this debate represents the beginning of a dialogue between the people of Teesside and the Department of Health. Such a dialogue would be of immense benefit to the people of Teesside, as more people would live longer, healthier and more satisfying lives. It would be a hard task, but believe me it would be well worth attempting.
§ The Minister of State, Department of Health (Ms Rosie Winterton)
I congratulate my hon. Friend the Member for Middlesbrough South and Cleveland, East 67WH (Dr. Kumar) on securing the debate, especially as he has been trying to do so for a year and a half. His background in research at Imperial college London and British Steel makes him especially well placed to talk about research issues. I also congratulate him on the passion and eloquence with which he talked about social deprivation and its impact on health. We need to get that point across much more clearly, so that people understand that several factors may contribute to poor health. That is very important if local communities are to engage in the process of examining how they spend their resources on alleviating health problems. He spoke about the devastating effect of cancer on the lives of people in Teesside.
My hon. Friend will be aware that we published the NHS cancer plan in 2000, and produced a three-year progress report this October, which showed that cancer remains a top priority for the Government. We are making great improvements. Prevention, screening, diagnosis, treatment and care are all improving due, I must say, to the hard work done by staff in the NHS and elsewhere, which has been backed up by millions of pounds of new investment. As a result, death rates have fallen by more than 10 per cent., which is halfway to our 2010 target. Lives are being saved and patients are receiving better care.
My hon. Friend highlighted the dreadful mortality rate for lung cancer in Teesside. especially among younger women. I am pleased to report that NHS smoking cessation services have been especially effective in the north-east. The figures will be of interest to hon. Members. The highest proportion of people in England who have successfully given up smoking through those services is in the north-east. Some 740 people per 100,000 in the northeast quit in 2002–03 compared with 312 per 100,000 nationally. Last year in Middlesbrough, 1,049 people successfully quit through an NHS smoking cessation service. Those figures are incredibly impressive.
We are also making real progress on research, as my hon. Friend the Member for Stockton, South (Ms Taylor) highlighted. I should add that the national cancer research network is designed to bring the benefits delivered to patients participating in research to all parts of the country. The amount of funding allocated to Teesside, South Durham and North Yorkshire per head of population is the same as that allocated in other areas, but I take her point on board.
In the past three years we have managed to double the number of patients entering clinical trials. The cancer plan identified two key weaknesses in cancer research: insufficient high-level strategic planning and co-ordination between different funders, and an inadequate infrastructure for clinical research. We have made major steps forward in both those areas with the establishment of the National Cancer Research Institute, the National Cancer Research Network and the National Translational Cancer Research Network.
68WH The National Cancer Research Institute was launched on 1 April 2001. It brings together the major funders of research, including the Government, the voluntary sector, which my hon. Friend the Member for Middlesbrough, South and Cleveland, East mentioned, and industry, together with cancer patient representatives, to ensure that we have a national strategic approach to identifying and supporting cancer research. The NCRI oversees two research networks, both funded by the Department of Health: NCRN, which provides infrastructure for larger, multi-centre clinical trials; and NTRAC, which leads on translational research.
The NCRN is already achieving its aim to provide a world-class base for the conduct of clinical trials. The percentage of cancer patients participating in trials in England is now twice that in the United States of America. Teesside has played its full part in that success. The Cancer Care Alliance of Teesside, South Durham and North Yorkshire joined NCRN in October 2001. Its clinical lead for research is Professor Robert Wilson, to whom my hon. Friend referred. This year, Department of Health funding to that research network is £250,000, and the network has put it to very good use: last year, only 3 per cent. of cancer patients in Teesside, South Durham and North Yorkshire were entered into clinical trials of new cancer therapies, but this year the figure has doubled to 6 per cent. That is an impressive achievement.
With regard to translational research, NTRAC was established in May 2001 to help to improve the quality of cancer care by speeding up the process for bringing scientific breakthroughs from the laboratory bench to the patient's bedside. It will ensure that a greater number of patients are able to take part in early clinical trials of the newest diagnostic agents and treatments.
That was the national picture, but I should like to consider in more detail the contribution that is being made to cancer research in my hon. Friend's area. He highlighted the track record of the local NHS and academic organisations in cancer research, and made particular mention of the work of South Tees Hospitals NHS trust in collaboration with the universities of Durham and Newcastle. The trust receives £368,000 per year in NHS research and development funding from the Department of Health, of which £120,000 is used to support its ongoing programme of research on cancer cell biology. The programme is led, as has been said, by Professor Robert Wilson. I was pleased to note that the trust has attracted a further £200,000 of research funding from other sources, including Cancer Research UK.
I know that the programme based at James Cook University hospital in Middlesbrough is making progress in the fields of colorectal, ovarian and prostate cancer, and my hon. Friend also mentioned the Queen's campus at Stockton, which is the focus for Durham university's new school for health and the home of the Wolfson research institute. Professor Pali Hungin, whose clinical practice is based in Teesside and who has been active in NHS research and development for many years, has been appointed dean of medicine at Durham university.
69WH My hon. Friend suggested that Teesside should become a centre of excellence for research into and treatment of cancer. I reiterate that the contribution that Teeside has made—and continues to make—is incredibly impressive. I hope that, through the debate, we have acknowledged the strides that have been made. We congratulate those in the area on their hard work and encourage them to continue to build, in collaboration with near neighbours, towards a centre of excellence such as my hon. Friend described. We will watch developments with interest. Both my hon. Friend the Member for Middlesbrough, South and Cleveland,
70WH East and my hon. Friend the Member for Stockton, South made particular mention of the voluntary organisations that work so hard in the area. It has been impressive that many organisations have come together and have been able to access funding.
I shall ensure that my ministerial colleagues are fully apprised of all the points that have been made today, particularly the comments about the centre of excellence and the progress that is being made, of which we are all very proud.
§ It being nine minutes to Five o'clock, the motion for the Adjournment of the sitting lapsed, without Question put.