Meeting of the Parliament (Hybrid)

Meeting date: Tuesday, February 1, 2022

Official Report 1016KB pdf

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World Cancer Day 2022

The final item of business is a members’ business debate on motion S6M-02749, in the name of Jackie Baillie, on world cancer day 2022. The debate will be concluded without any question being put. I ask members who wish to participate to press their request-to-speak buttons or to put an R in the chat function.

Motion debated,

That the Parliament recognises that 4 February 2022 is World Cancer Day, a day that unites people, communities and entire countries to raise awareness and take action on cancer; recognises that the theme of World Cancer Day 2022 is “Close the Care Gap”, which is about understanding and recognising inequities in cancer care around the globe; understands that one in two people will get cancer in their lifetime, but that great progress in research has seen survival rates double in the last 40 years; congratulates Cancer Research UK on the 20th anniversary of its formation, following the merger of the Imperial Cancer Research Fund and the Cancer Research Campaign; expresses admiration for the way that it considers this institution has dramatically changed outcomes for people with cancer, through what it sees as the pioneering of more effective and kinder treatments, improving diagnostic methods, providing world-class information and campaigning for change, some of which takes place in Scotland; wishes Cancer Research UK well with its future work, and notes that MSPs can show their support for World Cancer Day through the wearing of a Cancer Research UK Unity Band.

17:19  

I am delighted to bring this members’ business debate to the chamber today in recognition of world cancer day 2022, which is on 4 February. I encourage colleagues to wear their Cancer Research UK unity wristbands throughout the week, especially while in the chamber, to ensure that we raise awareness of cancer as much as we can.

I want to start by thanking Cancer Research UK for suggesting the motion and by congratulating the organisation on reaching its 20th anniversary this year. Its work over that period has been truly life changing for many people, and it has been at the front line of the fight against cancer.

I also want to thank Miles Briggs, who is the co-convener of the cross-party group on cancer, alongside me, and who does tremendous work in helping to raise awareness and campaign for improvements to services.

I would genuinely be surprised if there is anyone in this chamber who has not been affected by cancer in some way, through losing a loved one, supporting a friend or family member as they receive treatment or having treatment themselves.

The importance of raising awareness of all types of cancer, as well as ensuring that everyone knows the steps that we can take to avoid and identify it, cannot be stressed enough.

We must celebrate the fact that great progress in research has been made. Survival rates have doubled in the past 40 years, and it is now the case that one in two people will survive their cancer for at least 10 years or more. However, there is always room for improvement in the fight against cancer, and that is why the theme of this year’s world cancer day is “close the care gap”. It is about understanding and recognising inequality in cancer care.

Achieving equality in cancer care means confronting the many differences in care and survival rates across Scotland, and, indeed, across the United Kingdom. It will come as no surprise to any of us that the most deprived areas of our country have far worse outcomes of cancer care and far worse survival rates than are found in the most affluent areas. Indeed, research confirms that areas with more deprivation have a higher prevalence of cancer risk factors. Many people in those communities are less aware of symptoms of cancer and are less likely to participate in screening programmes, and, shamefully, they report coming across many more barriers when trying to seek help and care.

Scotland’s deprivation gap for cancer sits at 32 per cent, with mortality rates for all cancers being 74 per cent higher in the most deprived areas than in the least deprived areas. Those statistics are not new, but they should shock us all into urgent and robust action. There is simply no justification for a country that is as wealthy as Scotland to continue to have such deep health inequalities.

Cancer is still the leading cause of death in Scotland, with 34,000 people being diagnosed every year. I know that organisations such as Macmillan Cancer Support, which provides valuable services in my community, are hugely concerned that the delays in diagnosis due to pauses in the screening programme during the pandemic will soon lead to a sharp rise in the number of cases and their seriousness. Indeed, there are reports of people presenting at accident and emergency departments with stage 4 cancers that have simply not been picked up before.

The people in the Scottish national health service’s cancer workforce do an incredible job, but staff and services have not been given the support that they need to keep up with the growing demand. Far too many people in Scotland are waiting far too long to receive a cancer diagnosis and treatment. Let me be absolutely clear: I do not think that the fault for that lies in any way with the hard-working staff.

Only 83 per cent of patients on an urgent referral due to a suspicion of cancer started treatment within 62 days. The 95 per cent target that was set by the Scottish Government has not been met for a decade, so we need to do things much better.

Macmillan Cancer Support and others are clear that, while the pandemic has undoubtedly added to the backlog in cancer waiting times, those services were already struggling to cope long before Covid-19 hit. Therefore, the Scottish Government needs to prioritise the delivery of the action plan for cancer services and make sure that the long-awaited health and social care workforce strategy addresses the urgent issue of workforce capacity, including by increasing the number of cancer specialist nurses. Cancer Research UK has said that there is genuine concern that, if action is not taken, we could see survival rates go backwards for the very first time.

I want to briefly mention the Blood Cancer Alliance, which is a coalition of 15 blood cancer charities from across the UK. I was surprised to find out that blood cancer is the UK’s third biggest cancer killer, causing more than 15,000 deaths a year, and the UK’s fifth most prevalent cancer, with 40,000 new diagnoses every year. Despite that, from awareness to diagnosis to information to care and support, blood cancer patients are less likely to have their needs fully met than patients with the four most common cancers: breast, colorectal, lung and prostate.

The number of blood cancer patients who had to see their general practitioners five or more times before being referred for specialist treatment is nearly double that of patients with other cancers in Scotland. The disparity between patients’ experience of blood cancer diagnosis and diagnosis of other common cancers needs to be addressed urgently in order to improve blood cancer outcomes and to provide equity of patient treatment across the whole of the cancer sector. I hope that the Scottish Government will recognise that and ensure that there is a greater focus on blood cancers in the future, alongside all the others.

Finally, I want to touch on the impact that a cancer diagnosis can have on children, young people and their families. Every year in Scotland, around 320 children and young people are diagnosed with cancer. Studies have found that young people in Scotland and their families face an average round trip of around 68 miles to access treatment. Young people in remote and rural communities in Scotland can face a journey of more than 400 miles, which is by far the longest in the UK.

Research by Young Lives vs Cancer found that the expenses associated with a cancer diagnosis, especially in relation to travel, food and energy bills, cost families around £600 a month extra during their child’s cancer treatment, and that 61 per cent of parents had accumulated some form of debt. Some 42 per cent of parents had stopped working because of their child’s cancer. That is also borne out by analysis by Macmillan Cancer Support that shows that 87 per cent of people with cancer experience a negative financial impact right from the point of their diagnosis. Help is there from Macmillan. I will quote its helpline number and encourage people who are affected to phone it: 0808 808 0000.

I also very much welcome the Scottish Government’s young patients family fund. I hope that it will be reviewed and that its cover will be expanded to cross-national travel and to families of young people up to the age of 24.

This world cancer day, let us resolve not to go backwards. We need an ambitious catch-up plan. We need adequately resourced services. We need enough cancer professionals to meet demand. We need to get screening programmes back on track—and yes, I include in that breast cancer screening for women over 70. Above all, we need a laser-like focus on overcoming the barriers that are caused by disadvantage in order to close the gap in cancer care and, by doing so, close the gap in outcomes.

Thank you, Ms Baillie. I advise the chamber that the debate is heavily subscribed. Therefore, I would be grateful if colleagues could stick to their four minutes, as far as possible.

17:29  

I congratulate Jackie Baillie on securing this timeous debate. Covid has dominated the health agenda for some two years, and that has had a devastating impact on cancer diagnosis and care, as well on other serious, life-threatening illnesses.

It cannot be said often enough that one in two of us will get cancer in our lifetime. I also echo the statement that when someone suffers from cancer, it affects their entire family and their colleagues. Treatments have improved, early diagnosis had improved and progress has been made on research. We have come on strides in decades, but “cancer” is still a very scary word.

It is obvious that the impact of Covid has led to the postponement of treatment, diagnosis and follow-up examinations. There will hardly be a family that has not been impacted by that fact with stress and anxiety, and by the possibility that the delay might have increased the spread of the cancer, as Jackie Baillie referred to when she spoke of stage 4 cancers being reported at A and E. Therefore, it remains crucial that we all keep Covid at bay to allow the NHS to treat those with life-threatening illnesses.

I want to talk about inequalities in people coming forward. Early diagnosis remains an issue; there is no doubt that in deprived areas and in some cultural communities there is a hesitancy about coming forward. We must take the screening to the people. Travelling breast cancer screening, which was brought to supermarkets, office car parks and nurseries, was excellent. The bowel screening programme, which I have also used, was another excellent thing. People talk to one another about such things, and there is nothing like one-to-one encouragement.

However, the fear that we feel when we hear the word “cancer” knows no class. One of the biggest issues is delay. Delay is dangerous; it is better to find out your diagnosis, so that you can prevent cells from turning into cancer or prevent cancerous cells from spreading, than to put your head in the sand. We should remember the statistics: one in two of us will suffer from cancer. Not one of us in the chamber is invincible.

Diagnosis and treatment is one thing, but emotional and psychological support for the person who has been diagnosed and their family is crucial—as is financial support, which Jackie Baillie also referred to. Organisations such as Macmillan Cancer Support have contacts on their websites for financial support and emotional support, and the local citizens advice bureaux and the local politician can help if you cannot find the information for yourself. I commend the websites of Citizens Advice Scotland and Macmillan Cancer Support.

The possibility that you may have cancer is very scary. You start by worrying about the day-to-day things in life, such as the next food shop or taking the dog for a walk, then suddenly you are at A and E. Next, you have a barium meal, MRI scans and a meeting with someone called an oncologist—that is another scary word. Can I tell you something, though? That is better than delaying. Fear is not your friend. Do not put it off. If people take anything from this debate, I hope that it is that if they think that they might have something serious that could be cancer, they speak to someone and get it checked. That is my key message.

17:32  

I direct members to my entry in the register of members’ interests; I am a practising NHS general practitioner.

I thank Jackie Baillie for securing today’s important debate ahead of world cancer day on 4 February. I commend her for her efforts over the years to raise awareness of cancer, cancer research and cancer prevention. As she can see, I am wearing my wristband.

Cancer affects physical health. It also has emotional impacts. The first reaction to a cancer diagnosis is often shock and numbness. Patients hear nothing other than the words, “You have cancer.” It can take time for patients to accept the diagnosis, especially if they do not feel particularly sick. However, hearing the word “cancer” is really scary for everyone.

There is the worry about treatment, the side effects, test results, what will happen down the road, and how cancer will affect the family, work, independence, relationships and finances. Macmillan Cancer Support has found that 87 per cent of Scots with cancer are affected financially by their diagnosis—by £1,000 a month, on average.

For those who are diagnosed late, there is often anger: “Why me?” In fact, for everyone who is diagnosed, there is some anger: “Why me?” They may feel angry with family or friends, their doctor, the world or even themselves, perhaps because some cancers do not have symptoms in the early stages or those symptoms might have been explained as another condition. There is also the sadness, the loneliness and the overwhelming loss of control when cancer changes day-to-day life or when family and friends have trouble understanding and coping with a diagnosis.

The emotional rollercoaster starts with courage: the courage to seek help from a GP or to pick up the phone and call someone. There is the wait for test results, a referral or treatment. Every day seems like a week. According to Macmillan, a third of patients who are undergoing treatment worry that any delay could affect their chances of surviving cancer. There is a clear need for everyone who is diagnosed with cancer to have a personalised care and support plan and to be signposted to mental health and wellbeing support.

I recently saw a patient who had been diagnosed with bowel cancer, which is spreading. The cancer was only discovered because he was admitted to hospital with Covid. His symptoms were identified by doctors when they took a full history and could make a diagnosis. He had been suffering those symptoms for two years but was too worried about Covid to come and see me. It is too late to cure him. Sadly, his story is far from unique.

Cancer is the leading cause of death in Scotland. Around 34,000 people are diagnosed with cancer each year. Cancer treatments and outcomes have greatly improved in recent years. Half of all patients now survive for 10 years or more, but that is dependent upon people coming forward early and upon our cancer services increasing their capacity.

Scotland has a strong cancer research base, including Cancer Research UK centres in Edinburgh and Glasgow, as well as Glasgow’s prestigious Beatson Institute for Cancer Research. Over the past five years, Cancer Research UK has spent more than £188 million on research funding in Scotland across seven university research centres, thereby contributing to Scotland’s vibrant and productive life sciences sector.

Despite that, there is a lot more to do. Some cancers are difficult to diagnose, as they have vague or non-specific symptoms. Those include cancers of the pancreas, liver, brain, oesophagus and stomach. More than 9,000 Scots are diagnosed with one of those less survivable cancers every year. Sadly, only 16 per cent of those diagnosed will survive for five years, because of late presentation. We must raise awareness among the public of those less survivable cancers and their symptoms, and encourage people to see their GP if they are worried.

I support Jackie Baillie’s motion. I congratulate all those who are engaged in cancer research and fundraising, and recognise the importance of providing patients and their families with high-quality information, advice and support.

I have one thing to say to anyone who is watching. If you, or someone you know, has an odd symptom—something new, such as weight loss, a lump or bleeding—please come forward and see your doctor. It could just save your life.

17:37  

This annual debate is important in reminding society of one of the greatest challenges that we face, which is finding a cure for cancer. I pay tribute to Cancer Research UK on its 20th birthday for everything that it has done over that time. Cancer survival rates have undoubtedly increased, which is no mean feat.

Every cancer survivor has a story to tell and can be an inspiration to others. The greatest part of their story is them going on to live the fullest possible life that they can.

Yesterday, I met Pancreatic Cancer UK and said that, once we are in an even better position regarding the global pandemic, I would like world Governments to re-double their efforts to find a cure for cancer. The pace of work and the finance that was provided globally to develop vaccines to deal with Covid-19 shows that, where there is a will there is a way. The vaccines are helping us to deal with Covid but, thus far, will not eradicate it. Who knows what the future will bring in that regard, but, in terms of cancer, which is a wide and varied illness, we know that, despite the magnificent efforts that have been made and the huge amount of money that has been spent over many years, the problem still has not been solved. That unfinished business shows how great the challenge is.

The motion highlights this year’s theme of closing the care gap. Members received various briefings for today’s debate. Macmillan Cancer Support told us:

“The most recent cancer incidence, cancer staging and cancer mortality statistics all show that if you live in a more deprived area, you are more likely to have cancer and for it to be diagnosed at a later stage, and you are more likely to die from your cancer.”

Jackie Baillie referred to the Macmillan support line. I will do that too. The more people who know that number, the better. The number is 0808 808 0000.

Macmillan also published analysis that showed that 87 per cent of people with cancer in Scotland experience some kind of financial impact caused by their diagnosis. For those affected, that reaches an average of £1,000 a month, on top of their usual expenditure. One in three people with cancer in Scotland are severely financially affected by their diagnosis, and more than three quarters of people with cancer, or 78 per cent, experience a loss of income.

As the MSP for Greenock and Inverclyde, which has an industrial legacy as well as some of the most economically challenging areas in the country, as highlighted by our position with Scottish index of multiple deprivation data zones, I know that the challenge facing many of my constituents will be all too clear for many. In our industrial past, people faced many challenges over the years, particularly in relation to asbestos-related health matters. The Parliament has acted to help those people, and I look forward to the publication of the Scottish Law Commission discussion paper on damages for personal injury. A constituent has already written to me about that.

I certainly hope that that paper will provide the positive basis on which Parliament can provide greater services and support to people in the future. The past two years has affected every aspect of society and I welcome the introduction of the cancer plan “Recovery and Redesign: An Action Plan for Cancer Services”. Society clearly has a lot to catch up with as a consequence of the past two years, and the situation with cancer patients is no different.

Every MSP will have a close link or relationship with either a cancer survivor or someone who, sadly, lost their fight. Despite the pain and loss that cancer has brought, I am grateful for all the time and happy lifelong memories I have of all the great times and fun in those years.

For me, cancer is the challenge ahead and I know that if we can improve survival rates, we can ensure that many more people create many more memories and life-changing experiences. That is a fight worth fighting.

17:41  

I begin by thanking my colleague Jackie Baillie for securing this debate and for her work in Parliament to ensure that cancer and its diagnosis, treatment and holistic support remains firmly on the agenda.

I am pleased to be able to speak in this debate as we mark world cancer day on Friday. Many of us will have been impacted by cancer in our own lives, whether through a personal experience of the illness, or through walking with a family member or friend through it. The speeches that have already been made this evening show how deeply personal the debate is for many colleagues.

Cancer is the leading cause of death in Scotland—approximately 34,000 people are diagnosed with cancer in Scotland every year—so it is important that we take this opportunity to reflect on progress made, and to look at what more needs to be done, particularly in the context of Covid-19, to move forward in our shared aspiration to speed up progress and see three in four people surviving the disease by 2034.

That is Cancer Research UK’s ambition, and I thank it for its briefing in support of tonight’s debate and for its work in highlighting world cancer day, along with countless other charities, some of which I will talk about later in my contribution and some of which have already been referred to by colleagues.

As we have heard already, the theme of world cancer day 2022 is “close the care gap”, and it focuses on understanding and recognising the inequalities in cancer care around the globe. For many of the most marginalised in our society, their chances of getting cancer, and their experience and outcomes of cancer, are worse because of factors and circumstances beyond their control.

As we know, here in Scotland, mortality rates for all cancers combined are 74 per cent higher in the most deprived areas compared with the least deprived, and the past two years have exacerbated the challenges in diagnosis and treatment. Waiting times statistics show that too many people are waiting too long for cancer treatment. Only 83 per cent of patients on an urgent referral for a suspicion of cancer started treatment within 62 days. The target is 95 per cent. Although some of the waits are due to backlogs and additional Covid-19 safety measures, cancer services were struggling pre-pandemic. Shortages in staff and equipment mean that cancer waiting time targets have been missed for years. Just last week in the chamber, I raised with the First Minister the issue of delays to cancer surgery in the region that I represent and the need for a dedicated cancer catch-up plan.

As we have heard tonight, this issue is a deeply personal matter for many people, and the worry that has been described by colleagues is what motivates us. I hope that the cabinet secretary will hear those calls and respond in his closing remarks.

I appreciate the member taking an intervention. We have heard about inequalities, and being in a rural area brings its challenges regarding cancer treatment. We have also heard about the importance of someone having a care network around them when they are receiving treatment.

With the member’s permission, I take the opportunity to call on the cabinet secretary to look at the situation in Dumfries and Galloway as a matter of urgency. People in Stranraer are still expected to travel to Edinburgh for cancer treatment, when there are facilities in Glasgow that are far closer. That has an effect on families’ budgets and the people receiving treatment lose the communities around them. It is a lamentable situation. I call on the cabinet secretary to look at the issue, because people are potentially having less good outcomes as a result—

Thank you, Mr Carson.

I hope that Finlay Carson will repay my kindness at some point in the future. However, the point is well made. In her remarks, Jackie Baillie also made the point about rural provision, and I know that colleagues across the chamber recognise the need to have such facilities in place. I am sure that the cabinet secretary will have more to say on that.

In my remaining time, I will highlight the work of blood cancer charities in Scotland. I might repeat some of what Jackie Baillie said in that regard, but as I am the shadow minister in her team, she usually assures me that repeating what she says is absolutely the way to go, so it should be fine.

I met the Blood Cancer Alliance, which clearly articulated that blood cancers are often misunderstood and underdiagnosed. It can often feel like the Cinderella service of cancer care, and awareness of blood cancer symptoms, care, and treatment remains limited relative to solid tumour cancers.

To focus on our theme of closing gaps in care, it is clear that as the NHS continues its recovery from Covid-19, it is important that we see parity in the care and resources that are given to blood cancers, including improvements to diagnosis, pathology services, patient support and the NHS workforce. That is a critical factor in improving all cancer patient outcomes in Scotland, and would have long-lasting benefits across the entire healthcare system.

I hope that the cabinet secretary will address some of that in closing, although he might be too busy to do so, given Finlay Carson’s intervention. I am sure that he will write to me, or we will have the opportunity in the future to go into more detail on the matter.

On this world cancer day, as we continue to enter the new reality of life with Covid, we must put cancer diagnosis, research and treatment at the heart of that. I think that that is what those who are living with cancer, and their families, expect.

Thank you, Mr O’Kane. Just to warn you, Ms Baillie might be luring you down a dangerous path.

17:47  

I am pleased to be speaking in the debate, and I congratulate Jackie Baillie on securing it.

As others have mentioned, the theme of world cancer day 2022 is “close the care gap”. It is about understanding and recognising inequalities in cancer care around the globe and lobbying for improved outcomes and equal treatment for all persons with cancer. I am pleased that the Scottish Government has a commitment to improve cancer services across our country, including establishing a new fast-track diagnostic cancer centre at Dumfries and Galloway royal infirmary in Dumfries.

The Covid pandemic had, and continues to have, a direct impact on cancer services, and I look forward to seeing how that can be improved as we move out of the pandemic. However, we do not have to look too far from home to find inequality in cancer care. In my South Scotland region, some patients are not receiving equal treatment, and I am pleased that my colleague highlighted the issues that I am about to address.

In Dumfries and Galloway, 1,135 people are currently living with cancer, and around 530 people lose their lives to cancer each year. Dumfries and Galloway is a large rural region—from Canonbie in the east to Kirkconnell in the north, Stranraer in the west to Whithorn in the south Machars—and we also have many challenges with the delivery of cancer services.

Since my election to Parliament, I have been actively lobbying for change to current cancer pathway arrangements for the region. Currently, although we in D and G are in the south-west of Scotland, we are not in the West of Scotland Cancer Network. NHS Dumfries and Galloway is part of the South East Scotland Cancer Network, which means that patients, particularly those who are in the west of the region and Wigtownshire and require more complex treatments and radiotherapy, must often travel north-east to Edinburgh for treatment. That is a 260-mile round trip from Stranraer, which can cause distress and discomfort, and exacerbate the negative effects of cancer treatment.

After continuous campaigning by local residents and elected members, including my efforts over a five-year period and those of colleagues across the chamber, and by the Galloway community hospital action group, which includes a campaigner who has highlighted the issue for more than a decade, in 2019 NHS Dumfries and Galloway agreed to change the existing arrangements so that a more flexible approach that was focused on patient choice could be taken to people’s treatment destination.

However, constituents are concerned that very little progress has been made, and that patients are still being asked to travel to Edinburgh, without even being offered the choice of going to Glasgow for radiotherapy and other treatment. I understand the pressures that the pandemic has caused, but we are talking about a long-standing situation that the former health secretary said that she would help to improve. Similarly, in July last year, I was told by the current health secretary that NHS Dumfries and Galloway’s cancer pathway arrangements would be addressed as part of the Scottish Government’s modernising patient pathways programme. I have spoken to a few people in order to progress matters, but I have not had any response from the modernising patient pathways programme. I will continue to pursue the issue.

I ask the cabinet secretary to provide a commitment that I will receive an update on the work that has been undertaken regarding cancer pathway arrangements across NHS Dumfries and Galloway. I also ask the Scottish Government to impress upon the health board the importance of the work on cancer pathways being carried out immediately so that patients in the south-west of Scotland can be offered a choice about whether to be treated in Glasgow or Edinburgh, depending on their preference.

I welcome the debate, the work that the Scottish Government has done and the opening of the fast-track cancer diagnostic centre in Dumfries, and I reiterate the need for action to bring about equality with regard to cancer pathways for patients across Dumfries and Galloway.

17:52  

I thank Jackie Baillie for bringing this important debate to the chamber.

I want to start by congratulating those who took part in an impressive fundraising achievement in the community that I am proud to represent. Last Tuesday night should have seen the biggest of Shetland’s annual community events. Of course, it was cancelled because of Covid. However, community members decided to do a continuous overnight relay around Lerwick for 12 hours to raise funds for Cancer Research UK’s relay for life. Those efforts have raised more than £13,000 for CRUK. The fact that such a sum has been raised in a small community demonstrates the strength of feeling and support for CRUK in Shetland.

Covid has had a large impact on community events, but it has also significantly impacted fundraising for charities such as CRUK. In addition, there has been a fall in the diagnosis of cancers in recent years. As the motion highlights, one in two people will get cancer in their lifetime. We all know someone in that position.

I have been urging those who are eligible to go for their cervical screening, following reports of a fall in attendance in Shetland and across Scotland. Over its 20 years, Cancer Research UK has done a great amount of awareness raising, which has saved lives. I say to people that, if they notice changes in themselves or their bodies that they are concerned about, please get them checked out. The NHS and their GP are there for them. As Christine Grahame said, do not delay.

Every year in Scotland, around 1,000 people are diagnosed with brain tumours and around 470 people die from brain tumours. I am wearing my Cancer Research UK bracelet on my jacket, but I am also wearing my wear-a-hat day pin to highlight the need to help to find a cure for brain tumours. Brain Tumour Research is a cancer charity that I hold particularly close to my heart.

Before the lockdown measures in March 2020, I was set to host an event here in Parliament with Brain Tumour Research. The charity was going to launch its manifesto, “Together we will find a cure”. March is brain tumour awareness month. The manifesto called on the Scottish Government to invest more in brain tumour research, to improve the patient experience and outcomes, and to drive improvements in the patient experience across NHS Scotland.

I wanted to sponsor that event because it would have highlighted inequities and because a member of my family has faced a brain tumour diagnosis. As with any cancer diagnosis, nothing prepares you for it. However, when you are faced with it, you look at the stark data. Brain tumours kill more children and adults under the age of 40 than any other cancer does, and they are the chief cause of cancer deaths in children and young people. Only 12 per cent of brain tumour patients survive beyond five years of their diagnosis, whereas 70 per cent of patients diagnosed with breast cancer and more than 40 per cent of those diagnosed with leukaemia survive beyond five years.

Historically, there has been underfunding of research into brain tumours, with just 1 per cent of the national spend on cancer research allocated to brain tumours, according to Brain Tumour Research.

I urge us to work together to support Cancer Research UK, Brain Tumour Research and other valuable cancer charities to close the care gap.

17:55  

I thank Jackie Baillie for securing the debate. In just over two weeks, I will turn 55. I mention that because we lost my brother Andy at that age to a malignant brain tumour. Fifty-five was far too young. He had already achieved some amazing things in his life, and he absolutely lived his life to the full, but he still had much more to do. Time is an important point that I want to talk about.

At the end of the day, we all die one way or another. Immortality is not an option. The time that we have on this earth, the quality of the life that we lead, the personal goals that we set and conquer, and the people we get to touch in our time are the things in our lives that we can judge as important.

Andy was taken too young, but there are things that we can be thankful for. He was diagnosed with his tumour 15 years before it ended his life, and for at least 13 of those years, he lived every moment of it. As Beatrice Wishart pointed out, not too many years ago, he would not have survived for more than two or three years at most.

Had it not been for the genius of the surgeons who gave Andy the operation to remove most of the tumour, the chemotherapy that gave him another five years, the radiotherapy that extended his life even further, and the care and attention from the fabulous team at the Beatson in Glasgow, who guided him from the very beginning and gave him every chance and option, his illness could have been much worse. They gave him precious, precious time.

Even when Andy knew that his time was coming to an end, he was fortunate enough to have a place in the Cornhill hospice in Perth, where the care, respect and dignity that the staff gave him and us were beyond words. He died as good a death as we could have hoped for. For that, all of us who knew him and got to spend time with him can be truly thankful. I intend to climb Kilimanjaro with a group of his friends and colleagues later this year to raise funds for the Cornhill hospice, as a tribute to Andy and in recognition of the utterly selfless and amazing work that the people who work there do.

My real point is that we have made huge strides in cancer care. Cancer is not always the death sentence that we once feared it was, and undoubtedly, we now have hope that we did not have before. Even when cancer wins, if we can give people more time, as Andy had, those precious days, weeks, months and years are invaluable.

There is no doubt that there is much more that we can and must do in trying to deal with cancer. Some of the groundbreaking work that is being done in Scotland is fabulous. The new early diagnosis centres are to be welcomed, and the sooner they are rolled out across the country, the better. As my colleague Christine Grahame said, early diagnosis is so important.

The elective treatment unit that is being built in the Perth royal infirmary will be transformational in allowing patients to be treated more quickly and effectively across Tayside. Again, the sooner the unit is completed, the better.

Cancer treatment, cancer care and cancer management are issues on which all members of Parliament and people across society can unite behind. Since coming into Parliament, one of the things that I have struggled to square in my own thinking is the big-picture stuff. I get that, as legislators, we have to look at the big picture and discuss details, budgets and statistics, but my mind always goes to the individuals we are affecting. They are somebody’s mum, their granny, their uncle, their auntie, their brother, their sister, a wife or a husband, sons and daughters, and they matter to everyone who knows and loves them. Therefore, they matter to us in this chamber.

We should all try and do the very best that we can to make sure that those who are affected by cancer get the same help, support, care and dignity that Andy did, and which we would want for ourselves or any of our loved ones. [Applause.]

Well done, Mr Fairlie, and best of luck up Kilimanjaro.

I am conscious that there are many members who have pressed their buttons and wish to speak—take note, Mr Carson. I am therefore looking to accept a motion without notice, under rule 8.14.3, to extend the debate by up to half an hour.

Motion moved,

That, under Rule 8.14.3, the debate be extended by up to 30 minutes.—[Jackie Baillie]

Motion agreed to.

18:00  

I, too, would like to thank Jackie Baillie for bringing the debate to the chamber. I also thank those organisations that have provided briefings. My thoughts are with everyone who has lost a loved one to cancer, those who are going through treatment and those who live with the worry that their cancer will return.

As has been noted, the theme of this year’s world cancer day is “close the care gap”. The theme is timely, as the pandemic has highlighted the health inequalities that still blight Scotland and impact on cancer outcomes. According to a report published by Public Health Scotland, cancer mortality rates are 78 per cent higher in the most deprived areas than they are in the least deprived, incidences of cancer are 34 per cent higher in the most deprived areas, and people living in deprived areas are more likely to get cancer and less likely to survive.

Those horrifying statistics are a reminder of the lack of progress that we have made in tackling health inequalities. Some of the main causes of cancer include alcohol consumption, smoking, poor nutrition and diet, lack of physical activity, and air pollution, but as Christine Grahame pointed out, cancer knows no class.

We know that people living in deprived areas are more likely to be affected by those factors. This morning at the Health, Social Care and Sport Committee, we heard from the Minister for Public Health, Women’s Health and Sport about the extent to which inequality is a driver of poor health. We need to ensure that everyone has timely access to cancer diagnosis and treatment, but we must also address the root causes of cancer, which means reducing poverty.

The pandemic has placed enormous pressure on cancer services, and we know that workforce issues and waiting times were impacting cancer care before Covid. It is vital that we build the workforce to enable the NHS to work through the backlog of care that has built up over the past two years. The earlier that cancer is diagnosed, the more the chances of survival are improved. I do not think that anyone could do more justice to how that feels than Christine Grahame did.

Cancer diagnosis involves a range of tests and a specialist workforce. Cancer Research UK has highlighted shortages of staff across radiology, radiography, pathology and endoscopy. Macmillan Cancer Support estimates that if the number of specialist cancer nurses stays at current levels, by 2030, the gap in the number of specialist cancer nurses in Scotland will be 348. I recognise that the Scottish Government has published its cancer recovery plan, and that a new health and social care workforce strategy is forthcoming. Cancer Research UK is calling for the strategy to include both short-term and long-term actions that will ensure that we have in place the right staff to detect, diagnose and treat cancer, and I would welcome any comments from the cabinet secretary on that.

In its briefing for today’s debate, Macmillan highlighted the financial impact on people who are diagnosed with cancer. According to its analysis,

“87% of people with cancer in Scotland experience some kind of financial impact from their diagnosis”

and a third

“are severely financially affected”.

I am sure that we all agree that no one should be financially penalised for being diagnosed with a health condition. However, for too many people, that is the reality of living with cancer. Financial penalties come in many forms, not just in the form of reduced earnings. Figures provided by Macmillan reveal that 47 per cent of people with cancer in Scotland see an increase in day-to-day living costs, 26 per cent experience extra costs of travelling to and from their appointments, and 19 per cent see their household fuel bills rise.

As many members already mentioned, Macmillan has a support line that is available seven days a week, 8 am to 8 pm, on 0808 808 0000, for anyone who has anxiety or concerns about their cancer diagnosis, including financial worries.

I would welcome any comments from the cabinet secretary about what more the Government can do to give practical support to people have been diagnosed with cancer.

I echo the pleas from my colleagues around the chamber for people to attend their screening appointments. From personal experience, I can say that they are never as scary as people think that they are. Our incredible nurse practitioners will be able to answer questions. Certainly, they put me more at ease.

People should also get their human papillomavirus vaccinations, if they can. There is now a whole generation who are less likely to develop cervical cancer as a result of that vaccine.

This year’s world cancer day also marks 20 years since Cancer Research UK was formed. I thank all the people at Cancer Research UK, who are working hard to raise awareness and improve outcomes for people with cancer. I have found their expertise and knowledge to be incredibly useful during my time in Parliament so far and I am sincerely grateful to them.

18:06  

I am grateful for the opportunity to speak in this important debate and thank Jackie Baillie for securing it. Unfortunately, all members know someone who will be affected by cancer in some form, whether through a personal diagnosis or that of a partner, family member or friend.

According to NHS Research Scotland, every year, about 30,000 people in Scotland are told that they have cancer. Trends predict that that number is likely to rise to almost 40,000 by 2027. The impact of a cancer diagnosis is devastating for many people. It is vital that we get services back on track and maximise the support that is on offer to people with cancer and their families. We must then use that opportunity as a platform to transform the services that are on offer so that we improve them beyond the previous levels of our cancer plan.

I praise the excellent work of Macmillan Cancer Support and thank it for the briefing that it provided for the debate. I welcome what Macmillan is doing with the Scottish Government transforming cancer care partnership. That partnership will ensure that, by 2023, Scotland will be the first country in the UK in which every cancer patient has access to a key support worker and gets dedicated financial, practical and emotional support.

From my previous job as part of the nursing team at the St Margaret of Scotland Hospice in my constituency, I know about the full impact that cancer has on the physical, mental and financial welfare of people with a diagnosis. As inequality is a driver, the financial impact of cancer must not be ignored. Macmillan advises that 87 per cent of people with cancer in Scotland experience some kind of financial impact from their diagnosis. Therefore, a holistic support package is essential if we are to provide the best help at the time of greatest need.

I highlight the work of the Beatson Cancer Charity, which supports people affected by cancer every step of the way. It does brilliant work at the Beatson west of Scotland cancer centre and in the hearts of our communities.

In the past 20 years, the majority of cancers have shown improvements in survival rates five years post diagnosis. Cancer that is diagnosed at an early stage is more likely to be treated successfully. For instance, almost all women diagnosed with breast cancer at the early stage survive their disease for at least five years.

With the pause of screening appointments due to Covid, it has become even more imperative that the most vulnerable receive invitations as soon as possible. We must also fully understand why many people do not attend their appointments. It is not enough simply to urge people to attend appointments; we need to understand any unexpected barriers or misinformation that needs to be addressed.

In a recent debate to raise awareness of pancreatic cancer, I shared the experience of a constituent who, sadly, did not get an early enough diagnosis of their cancer. Their heart-breaking experience highlighted the need for early diagnosis and to have access to effective and compassionate care where it is needed most.

For world cancer day, let us unite around a cancer plan that gets beyond Covid, does more than pick up from where we left off, lets us reduce the barriers that are fuelled by poverty and inequality, and helps us to save lives.

18:09  

As co-convener of the Parliament’s cross-party group on cancer, I congratulate Jackie Baillie on securing this evening’s debate, and for the work that she has done in Parliament during 20 years of campaigning on health issues.

I also thank those organisations that have provided us with useful briefings ahead of the debate. I specifically thank Cancer Research UK, which has supported the CPG for more than 20 years as our secretariat. As a member and co-convener of the CPG—I am sure that this is true of many of its members—I really enjoyed the work that we did during the previous parliamentary session.

One of my greatest concerns is the impact of the pandemic on cancer services. We have seen cuts to research projects and patient trials. We have also seen the huge amount of work that is going on across Scotland and the wider UK to support people living with cancer and their families being set back and undermined in many cases.

I do not think that we can overestimate the impact of the pandemic on cancer services and outcomes. We need to rededicate ourselves to turning that around, because, as has been mentioned, approximately 34,000 of our fellow Scots are diagnosed with cancer every year, and that number is expected to reach 40,000 by 2027.

It has been estimated that more than 650,000 patients in the UK have had treatment disrupted during the Covid pandemic. We know that the pandemic has had a profound impact on cancer services, including on early diagnosis of cancer in Scotland, with screening programmes paused and a fall in urgent referrals from GPs; on cancer prevention measures, with reduced service capacity and delays to planned legislation; on cancer treatment, with surgery delayed or cancelled, and staff shortages; and on the care of patients, with many experiencing poor mental wellbeing and limited provision of the holistic support services that we have all campaigned to see improved.

As Jackie Baillie has outlined, it is clear that staffing is a significant issue and one on which we must focus all our attention if we are to see a proper recovery. The Scottish Government must develop and resource such a plan early if we are to meet the targets now and in future. We should also focus on the design of new services.

We should all be seriously concerned that Cancer Research UK estimates that, as Jackie Baillie has said, survival rates might go backwards for the first time in decades if we do not take action to address backlogs and deliver the workforce that we need. It would be absolutely disastrous, were that to happen. I hope that we can all be united in dedicating ourselves to ensuring that it does not.

I have consistently raised my concerns about, for example, the breast screening programme in Scotland not being fully recovered, and I have spoken out about the fact that women over 70 still cannot self-refer into the breast cancer screening programme. I hope that the cabinet secretary can update us on that in closing the debate.

In my remaining time, I want to talk about the future, because I think that that is what we should all be looking towards. Jackie Baillie said that we should

“resolve not to go backwards.”

I absolutely agree, so I want to talk about a piece of work that many campaigners have been doing during the pandemic. A lot of people who work in the cancer community have not let the pandemic get in the way of what they want to do. One of my constituents, Jen Hardy, was diagnosed with stage 4 breast cancer in October 2017. Many members in the chamber will have met Jen, who has been campaigning for many years to improve opportunities for people. During the pandemic, she developed Cancer Card. I recommend that members visit www.cancercard.org.uk. Cancer Card has looked at how we change and provide the information that people need and are desperately looking for when they are diagnosed with cancer.

I hope that the Government will look at some of the work that has gone on during the pandemic, because there are a lot of positives to take from that.

On world cancer day, I hope that we can send out a message of hope and a call to action to the global cancer community to come together and for all of us once again to focus on working together to beat cancer.

18:14  

I thank Jackie Baillie for bringing the debate to the chamber and the other members who have spoken for their compassionate, heartfelt contributions this evening.

As we have heard, the theme for world cancer day is “close the care gap”. It is about recognising and understanding the inequalities of cancer care that can cost lives around the world. We know that every one of us has the ability to make a difference, large or small, for the people and families who are affected by cancer. Only by working together can we reduce the global impact of cancer.

Recently, I had the privilege of meeting staff from Ayrshire Cancer Support, which is a charity in Ayrshire that works tirelessly to provide emotional support and practical help to cancer patients and their loved ones. It provides a number of free services, including hospital transport, which it provided for close to 14,000 people from Ayrshire in the year 2019-20, over 80 per cent of whom had to travel to the Beatson in Glasgow. It also offers counselling, carers groups and specialist information and support. I would like to express my gratitude and admiration for the truly outstanding work that it does.

However, the charity faces struggles, particularly involving applying for local and national funding. Previously, it was possible for charities such as Ayrshire Cancer Support to apply directly to the Scottish Government for funds. Under the new system, charities must apply through the local third sector interfaces that distribute funding. That results in the charity having to apply three separate times to eight different local authorities in Ayrshire, each with its own processes, timescales and criteria.

To add to that, Ayrshire Cancer Support does not meet the national and regional criteria to access the Scottish Government’s cancer recovery fund or pain management fund, as the charity is viewed as being too local an organisation. However, under the system for the local third sector, it fears that it is considered too large an organisation to receive funds at the local level.

If we are to have any hope of closing the cancer care gap, we have to make it easier for organisations such as Ayrshire Cancer Support to provide all the care that it does. We must help them and not hinder them. Without their work, health inequalities would rise, as patients would struggle to get to hospital for the treatment that they need. I ask the cabinet secretary to look into the funding discrepancy for charities such as Ayrshire Cancer Support.

Someone who knows how important that service is is Hayleigh Lawrie, who tragically lost her mum to cancer. Hayleigh will camp overnight at Ayr racecourse to raise funds for Ayrshire Cancer Support, which provided help with transport, mobility and counselling. I am sure that MSPs will join me in wishing Hayleigh the very best of luck with her big camp-out.

I also want to share the work my constituent Gaby Williamson, from Ayr. Gaby sadly lost her dad to oesophageal cancer in June 2020, when she was just 19 years old. Her mum, Victoria, is currently battling breast cancer. After the death of her father, Gaby found herself in a situation that would hit hard even the strongest of us, never mind a 19-year-old. Not knowing exactly how to deal with her emotions, Gaby started the blog “Let’s Blether” on Instagram, in which she could fully express her feelings and find support for other young people who found themselves in similar situations.

Realising the number of young people who struggled with grief, Gaby set up a fantastic initiative called the let’s blether box. The box contains a range of items, including practical advice and support strategies for children and parents, a journal, seeds for planting flowers in memory of a loved one, a memory jar and a lot of other things. With the backing of South Ayrshire Council, the let’s blether bereavement box has been distributed to young people in South Ayrshire who are experiencing grief or loss.

Gaby’s younger sister, Poppy, who is only 10, has started another initiative, called little blethers, to reach out to the younger community who are going through long-term grief. Gaby’s mum Victoria told me:

“We sadly live with cancer every day in our household and it comes in many different guises, whether it is physical, emotional, or financial and practical management. We also deal on the bereavement side of it on a daily basis—all of which Ayrshire Cancer Support has been a great help with, living with Cancer and the challenges it brings”.

I believe that one day we will see a world that is cancer free, but that will not happen without people, such as Gaby, Poppy and the volunteers at Ayrshire Cancer Support, who dedicate their time to go that extra mile in providing care and hope for all those who face the many struggles and hardships of cancer.

Although cancer is an awful disease, it is hard to deny that it can bring out the very best in people and draw us closer together as we fight to close the cancer care gap and see a cancer-free world.

18:19  

I thank my fellow Scottish Labour colleague, Jackie Baillie, for bringing her members’ business debate to the chamber. I could not be here today and not speak in it.

The theme of world cancer day 2022 is “close the care gap” and it is about understanding and recognising the inequalities in cancer care around the world. I am sure that members will agree that I am not shy about raising in the chamber the inequalities in prevention, care and access to treatments.

Health inequalities in Scotland and across the globe are very real. For many of the most marginalised in our society, the chances of getting cancer and the experience of the outcomes of cancer are worse because of factors and circumstances that are beyond their control. Acknowledging and dealing with the root causes that blight many of our communities is key to reducing cancer and cancer inequalities.

Across Scotland, we know that the most deprived populations have worse experiences and outcomes than those in the least deprived areas. Recently, of course, the Covid-19 pandemic has shone a light on health inequalities and their devastating impacts. The pandemic has impacted our lives in so many ways, and one of the most concerning impacts has been the reduction in cancer diagnosis at an early stage. Staff shortages, pressures on the NHS and long GP waiting times are among a whole host of factors that have contributed to figures that Cancer Research UK recently called “devastating”. In Scotland, we have to act with purpose to reverse those concerning factors, resume early detection and give those who have cancer the best chance of life.

In the short time that I have in the chamber, I want to mention cervical cancer. Yesterday, I met a nurse from Kilmarnock who has many years of experience supporting women with health screening and family planning. She talked me through aspects of women’s health and factors that may hamper people from coming forward for screening. Cervical cancer is one of the most preventable and successfully treated forms of cancer if it is detected and diagnosed early and managed effectively. It is essential that we in this chamber battle to ensure that screening services are accessed and accessible. In my discussions last night with Nurse Kenyon, it was clear that encouraging women and explaining the procedures to them is important. If they understand their bodies and what is happening, they are more likely to attend. We should encourage everyone who meets the criteria for screening to ask questions. Our wonderful NHS staff are more than happy to walk people through what will be happening to them and the associated benefits.

Once again, I bring to members’ attention the health inequalities that underpin survival rates for cancer. According to Public Health Scotland, there are links between increasing deprivation and poorer survival rates for cancer, as we have heard in the debate. It is unjust and unfair that that remains the case in 2022. Much more work needs to be done to address the clear health, social and economic inequalities that mean that a person’s postcode can result in a stronger or weaker chance of survival from deadly diseases.

I know that everyone in the chamber wants to see improvements in the awareness of and outcomes for cancer. I thank members for their contributions and for their work. I thank Jackie Baillie again for bringing the debate to the chamber and I applaud world cancer day and the work of Cancer Research UK. I hope that we go on to work as hard as we can to eliminate cancer from society.

18:24  

I thank Jackie Baillie and I am grateful that we are debating her motion commemorating world cancer day on Friday. Like all members, I hope and pray for a day when humankind will find a way to defeat cancer in all its types.

Cancer is probably still one of the most dreaded words in the English language. I do not know how it feels to be told about a diagnosis of any type of cancer—at least, not yet—but I have sat beside the person whom I love most in the whole world as she was told that she had cancer. As I looked into her face, I felt more hopeless and useless than I had ever felt in my life—or have felt since. The moment is frozen in time for me. I did not know what to say or what to do. We held hands and we both trembled—but help came. The consultant and everyone at the Beatson provided much-needed medical treatment and, more especially, they freely dispensed hope laced with gentle kindness.

An effective cancer screening programme, with speedy call-back and diagnosis, makes all the difference. Colleagues have spoken about that eloquently tonight, with an expertise that I cannot muster. I simply echo everything that has been said in the debate. I urge everyone who receives a call to take part in the cancer screening programme to take up that invitation—please go.

I hope that the cabinet secretary is moving heaven and earth to ensure that all the cancer screening programmes in Scotland are quickly back to full strength. I hope that people who missed out due to the coronavirus restrictions get screened, get the diagnosis and, most importantly, get the treatment that they need—and quickly.

World cancer day is a day when we, collectively as parliamentarians and the elected representatives of the people of Scotland, should redouble our efforts to ensure that screening takes place and that diagnosis is made as early as possible. It is literally a matter of life and death.

I call the cabinet secretary to respond to the debate.

18:26  

As is customary, I start by thanking Jackie Baillie sincerely for bringing the matter to the Parliament and for facilitating such a good debate involving members from across the chamber. In particular, I thank members who have shared their personal stories. I am following a very powerful speech by Stephen Kerr and some excellent speeches from members across the chamber. I will touch on many of the questions that have been asked and the themes that have been raised.

I, too, will start with a personal anecdote. As many members have already said, one in two of us will be affected by cancer, and there is probably not a single person in the chamber who has not been affected in some way, shape or form by it. We know that a couple of our parliamentary colleagues have had, or are still having, recent challenges with a cancer diagnosis and are having, or have just completed, treatment. I am delighted that some of them are back with us in the chamber right now.

My story is about my uncle Azhar. He was the cool uncle—we all have one. That is no disrespect to any of my other uncles and aunties; I love them all, but even they would say that he was the cool uncle. He was the youngest of the siblings, and they are always the coolest—he says, as a middle child. In the eternal battle of children versus grown-ups, my uncle Azhar was always on the side of the children. It is always good to have an ally like him.

He was more than an uncle to me. He took me to my first Celtic match and taught me how to play football. Presiding Officer, you and I have been on the same football team, so I should say that the deficiencies in my playing are mine alone and are not the fault of my uncle. When he took me to the football, my mum would say, “He is not to have any more junk food, Azhar.” Of course, my uncle disregarded that instruction from my mum.

He also helped me to train for the half marathon—the only half marathon that I have ever run in my life—when I was raising money for Islamic Relief. He ran with me and helped to train me for the eight weeks prior to the run. When I crossed the finish line at Glasgow Green and keeled over through dehydration because I had not taken his advice and drunk enough water, he was the one who put the medal around my neck.

He was an extraordinarily fit individual and played every sport that you can imagine, so imagine my shock at the news. I was on a Government visit to Pakistan, in my role as Minister for External Affairs and International Development, when I got a phone call at two in the morning—a phone call at two in the morning is never good news—from my sister to tell me that my uncle, who had been complaining of stomach and back issues for a while, had been diagnosed with pancreatic cancer.

I did not know much about pancreatic cancer—in fact, I knew nothing about it—so, of course, I did what anybody without a clinical background does and went on to Google. I will never forget the feeling as I doomscrolled down the page on my phone to find any semblance of good news about pancreatic cancer and found—I am afraid—that there was none. I remember that moment, and having to do Government visits the next day while being a hollow shell of myself.

My uncle battled with pancreatic cancer for two and a half years and eventually succumbed to it. Again, I will never forget that moment. In the Islamic tradition, it is often the children of the deceased who wash and prepare the body before it is laid in a coffin. I was asked to do that with my cousins, and I will never forget washing my uncle to prepare him, at just seven stones—a man who was a stocky 13 or 14 stones prior to his cancer diagnosis, but there he was, just skin and bones.

I mention that story because pancreatic cancer and less survivable cancers have been raised by many colleagues across the chamber. Dr Gulhane spoke very well from a clinical, and a human, perspective about the importance of early diagnosis of less survivable cancers. Marie McNair also mentioned pancreatic cancer in her speech.

I give a personal commitment and—perhaps more important—a commitment as the Cabinet Secretary for Health and Social Care that we will move heaven and earth to ensure that we restore cancer services. That is important to me, and it is important to the Government. I suggest that there cannot be a more important priority for the Government or for me as health secretary than the recovery and remobilisation of our NHS. Right at the top of that priority pile must be the restoration—in fact, it is right to say the full restoration—of cancer services.

In relation to the less survivable cancers that have been mentioned by many colleagues across the chamber, it is important that the Government works with third sector organisations to raise awareness of the symptoms. I mentioned some of the symptoms that my uncle had when it came to pancreatic cancer. For many other less survivable cancers—as, I think, Jackie Baillie or one of her colleagues said—the symptoms can mean that it takes four or five visits to a GP to get a referral. Of course, by the time someone gets a referral, they can already be at stage 4, as my uncle was, so we must do more.

I hope that we can do so through the early cancer diagnostic centres that we have developed across the country. We look at the data from those centres daily. Jim Fairlie—who gave an excellent and powerful contribution, which I know that Andy would have been very proud of—said that he is looking forward to the centres being rolled out. I promise him that we are exploring that. We, of course, want to see the early data from the early cancer diagnostic centres.

We also have the national cancer plan. That document is backed by £114.5 million of investment and is not just to lie on a shelf.

The point about inequality was well made by every speaker. I will not repeat the statistics about the unacceptable care gap—which is, of course, the theme of world cancer day this Friday—because they have been well articulated in the debate. We are determined to not only narrow but close and eliminate that unacceptable inequality gap. Some of the money that we have already provided is being targeted directly at where inequality exists most obviously. I can give more details on that to any member who wishes them.

I am, of course, running over my time. There are lots of issues that I could talk about.

On screening, I am happy to have meetings with members about self-referral for over-70s. Our concern is that, if we were to resume such services at the moment, that would have a detrimental impact on people at the highest risk, because of our current capacity issues. However, the challenge from Miles Briggs and from other members across the chamber who raise the issue with me regularly is to get such services resumed as quickly as possible. I promise that there is no delay on our part.

Our workforce is incredibly important, but I am the first to admit that there are challenges among the workforce. Although we have made strides forward, I promise that we will redouble our efforts, particularly in relation to shortages of medical oncologists. At the moment, such shortages are felt most acutely in NHS Tayside, but there are issues across the entire country.

I, again, thank Jackie Baillie and colleagues across the chamber for raising exceptionally important points. On any issue, but particularly on this issue, my door is always open for us to work together to close the unacceptable cancer care gap that exists around the country.

Whatever your football deficiencies, cabinet secretary, I know that you can lay claim to having scored a goal at Celtic park, because I was there to see it. I am sure that your uncle is enormously proud of that fact.

Meeting closed at 18:35.