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Chamber and committees

Meeting date: Wednesday, November 18, 2020

Meeting of the Parliament (Hybrid) 18 November 2020

Agenda: Business Motion, Portfolio Question Time, Safe Schools, Declaration of a Nature Emergency, Business Motions, Parliamentary Bureau Motion, Decision Time, Pancreatic Cancer Awareness Month


Contents


Pancreatic Cancer Awareness Month

The final item of business is a members’ business debate on motion S5M-22629, in the name of Clare Adamson, on pancreatic cancer awareness month 2020. The debate will be concluded without any question being put.

Motion moved,

That the Parliament notes that November is Pancreatic Cancer Awareness Month and that 19 November 2020 is World Pancreatic Cancer Day; acknowledges that this condition is one of the most aggressive and least survivable forms of cancer, with a five-year survival rate of less than 8% in Scotland; understands that survival rates have remained almost static for the last 50 years; notes that it can affect anyone, but understands that it is subject to multiple inequalities, with different outcomes in relation to diagnosis and treatment and late stage presentation of the condition being more prevalent in older people, ethnic minorities and people living in the most deprived areas; commends all of the pancreatic cancer charities and their dedicated supporters for their tireless efforts to raise awareness of it, and wishes everyone involved with Awareness Month the very best in their endeavours.

17:38  

I thank all my colleagues who have supported the motion and those who will speak in the debate.

I am pleased to say that this is the fourth year that the Parliament has marked pancreatic cancer awareness month. I thank Pancreatic Cancer UK and Pancreatic Cancer Action Scotland for their on-going work and their briefings for the debate.

Since the first debate on the subject in 2017, the tireless efforts of campaigners have assured that this uniquely aggressive form of cancer is higher up the Scottish health agenda. Over the years, I have on occasion been moved to tears by contributions to the debates. I am glad that John Scott has returned to his parliamentary duties. His struggle and the account of his wife’s tragic diagnosis and passing was a seminal moment in this chamber.

My interest in the subject was sparked by my parliamentary assistant, Nicki, whose mum died from pancreatic cancer. Nicki is no longer with me but, following her graduation, is working for Pancreatic Cancer Action Scotland in what she tells me is her dream job.

It is a source of great sadness that we cannot have the public engagement that usually accompanies a debate on this subject. I have become accustomed to seeing the gallery filled with activists who are determined to make a difference for people with pancreatic cancer. It is usually a sea of purple up there.

Pancreatic cancer awareness month takes place each November to raise awareness of the terrible disease and its impact on those who suffer from it and on their loved ones. People are often shocked to hear the statistics that are highlighted as part of the initiative. Pancreatic cancer is one of the least survivable cancers in Scotland. Only one in four people who are diagnosed with pancreatic cancer survive beyond a year, with the five-year survival rate in Scotland at only 5.6 per cent. For context, the average five-year survival rate for the more survivable cancers is 69 per cent. That alone should tell us why we need this debate every year.

Looking back at previous debates, I see that tragedy is a thematic occurrence. However, tonight, there is also hope for the future. Every November, when we speak about pancreatic cancer, we note that survival rates have barely changed in the past 50 years. Those sobering figures throw into sharp relief the need for sustained investment and continued action.

Although pancreatic cancer can affect anyone across Scotland, we are now seeing research that shows that poorer outcomes relate to socioeconomic background, ethnicity and age. This is not just about survival rates; societal inequality is what brought me to politics, and it drives me to tackle the health inequality that is rife among pancreatic cancer patients.

In the most deprived areas, cancer registrations are up to 15 per cent above the average. From that, we can conclude that income and economic activity are key social determinants of health. That is why the reduction of wealth inequality is not only a crucial economic goal but a health necessity and a moral imperative.

Increasing awareness of the underlying symptoms of pancreatic cancer remains a key challenge. It is estimated that 55 per cent of people know almost nothing about the disease, and 73 per cent cannot name one symptom. A powerful new advert from Pancreatic Cancer Action Scotland featured Gavin Oattes emphasising the importance of knowing the symptoms, and I commend Gavin for his bravery. For absolute clarity, and so that it is in the Official Report, the symptoms to look for are:

“abdominal pain that can spread to the back,

unexplained weight loss and loss of appetite,

new diabetes without weight gain,

a yellowing of the skin or eyes and itchy skin,

or a change in bowel habits and indigestion which doesn’t respond to treatment”.

However, as I said, this year there is hope and cause for optimism. Scotland has made tremendous strides in recent times. Our country is driving innovation and leading the way with regard to bettering the lives of pancreatic cancer patients. Research initiatives such as the Glasgow cancer tests and the Precision-Panc platform, which is led by Professor Biankin, show that there are pioneering new treatments and precision medicine for people with pancreatic cancer. Precision-Panc seeks to uncover the molecular profile of individuals with pancreatic cancer, ultimately paving the way for patients entering clinical trials by matching their tumour biology to the type of treatment that is appropriate for them. Such ambitious research exemplifies Scotland’s unwavering commitment to a better future for pancreatic cancer patients.

We must emphasise the importance of early diagnosis. For those diagnosed in time for surgery, the five-year survival rate increases by around 30 per cent. With early diagnosis and intervention, lives can be saved and pancreatic cancer patients can have a better quality of life. That is a goal worth striving for.

There is a discernible sea change. Last year, an incredible 100,000 people, nearly one tenth of whom were in Scotland, signed Pancreatic Cancer UK’s petition demanding faster treatment for people with pancreatic cancer. That is key. I know that there has been a great response to the shift in awareness.

Lynda Murray, who has been a tenacious campaigner around pancreatic cancer following the death of her father, William Begley, has doggedly pursued the Cabinet Secretary for Health and Sport to encourage her to look again at the unique aggressiveness of this disease and recognise the change that is needed in patient pathways in order to give people a chance, because all that she and her family wanted was for her dad to have a chance to beat pancreatic cancer. Lynda Murray sends her heartfelt thanks to the health secretary, Jeane Freeman, for her support in getting the disease on to the agenda and for forming the pancreatic cancer working group. Nearly two years ago, Jeane Freeman met Lynda Murray, Dr Ross Carter and I, and she not only listened, she acted.

We have seen an increase in investment in pancreatic cancer research and recognition of the disease in the cancer strategy update that was published in April 2020 as part of Scotland’s cancer recovery plan. The plan commits to delivering early diagnosis centres across Scotland—which is absolutely key—providing a radical change to the patient’s experience of being tested. People will be able to attend the centre and have multiple tests in one go, saving effort, resources and, more importantly for these patients, time—time to give them that chance.

In large part, that change is down to the limitless dedication of the campaigners. Policy makers, our health service and the wider cancer research community must now come together. The figures have been static for many years and will not change unless we can do more to improve the reality for people with pancreatic cancer in Scotland today. From pre-diagnosis and at every stage onwards, there are many points at which a patient can be supported by focusing on the whole care pathway. It is my fervent hope that my constituents in Motherwell and Wishaw and people across Scotland will back pancreatic cancer awareness month and will help to transform the lives of people who are affected by this awful disease.

Tomorrow is world pancreatic cancer day. I hope that by this time next year the gallery will be a sea of purple again and we will be able to hear speeches that focus not on stasis but on continued improvement. We want this to be about change. Let us make 2020 the beginning of a decade of change for pancreatic cancer.

I am delighted to call my friend and colleague John Scott.

17:48  

I congratulate Clare Adamson on once again securing a debate on pancreatic cancer awareness month, and on her consistent efforts over many years to raise awareness of pancreatic cancer, and I thank her for her kind words.

I declare an interest as one who has had a diagnosis of pancreatic cancer and, thus far, survived.

Being told last year that I had pancreatic cancer and that the survival rate was 6 to 7 per cent was one of the most crushing moments of my life. However, 15 months on, I am still here and, today, I want to bring a message of hope to the debate.

Before I do that, however, I want to thank the many health professionals who have got me to this point: those who first diagnosed my problem; my surgeon, who operated on me for 10 hours; the intensive care unit nurses and other nurses; my consultant, who looked after my chemotherapy; the wonderful nurses who administered my chemotherapy; my general practitioner and his dedicated team in Ayr; my consultant in Ayr and his team, who helped me as I struggled with my diabetes; the Ayrshire Hospice and Ayrshire Cancer Support, which both gave me support; my wife, my family and my many friends, who took me to Glasgow for my chemotherapy; and my constituents, many of whom gave and sent me messages of support. I also want to thank members and staff of the Parliament, who became my support group over what has been one of the most dramatic times of my life. Of course, I also thank my parliamentary staff, who helped me immensely over the past 16 months; and Brian Whittle and his team, who helped me as well. In part, that is why I want to be upbeat in the debate. The fact is that, even with this diagnosis, all is not lost.

The resources of our health service are amazing, and the kindness and dedication of all those involved in cancer treatment are a tonic in themselves. More than that, treatments for pancreatic cancer are improving, and one of the keys to that is early detection.

The drugs available are also much better than even 10 years ago, with Folfirinox being the UK drug of choice for people like me. However, although that drug has thus far apparently served me well, I understand that pancreatic cancer treatment in the future may move towards targeted immunotherapy drugs, which Clare Adamson alluded to and which are currently in use in America, but are not yet widely used in the UK. In the broadest sense, the next generation of drugs is more patient specific and, as I understand it, offers very real hope for better patient outcomes in the future.

A further area of work that is under research is the heredity aspect of some cancers. Identifying families such as my own, regrettably, that have defective genes that predispose them to certain types of cancers is vital. My family and others suffer from Lynch syndrome, which causes one in every 30 bowel cancers and increases one’s susceptibility to almost every other type of cancer as well. It is my view that screening for those with defective genes must be accelerated, and a blood test is often all that is needed to do that. A blood test at birth or in early childhood should become standard practice, particularly for Lynch syndrome, as it would allow targeted monitoring of at-risk patient groups and early treatments; and, ultimately, give better outcomes to people with those and other defective genes and the potential cancers that they may cause.

There are grounds to be optimistic about the prevention and treatment of pancreatic cancer, based on early detection through targeted screening and next-generation drugs becoming available over time. Key to that is, of course, sustaining and developing the skills of our dedicated and brilliant NHS doctors and nurses in these most difficult times and beyond, which I and my party are certainly fully committed to. [Applause.]

Thank you very much, Mr Scott.

17:52  

It is very difficult to follow that speech from John Scott. As I am sure members will recall, we all mentioned John during last year’s debate. It is really good to see him back here and participating in this debate and making that really moving contribution.

I, of course, thank Clare Adamson for bringing the scourge of pancreatic cancer to the attention of the chamber once again. I also spoke in last year’s debate, and I have highlighted the issue in the Parliament since 2012. The subject has never been far away from my thoughts, as I lost my mother to the disease in 1985, when she was only 52. That was, of course, some time ago, but it seems like only yesterday to my family.

We know that pancreatic cancer is one the most challenging cancers to diagnose and treat, since it tends to manifest itself late in the day and with relatively mild symptoms at first. I recall from last year that Pancreatic Cancer UK told us that two thirds of people could not even name any of the symptoms. Although I know that Clare Adamson mentioned the symptoms, they are worth repeating to try and help people spot a few of them if there is a potential problem. Pain in the back or stomach area might come and go at first, and it is often worse when a person lies down or after they have eaten. Other symptoms include unexpected and unexplained weight loss, indigestion, changes in bowel habits, and loss of appetite. Obvious signs of jaundice is also a key one for people to look out for, and there are other symptoms as well. Although we must remember that it is by no means certain that a person with those symptoms has the cancer, being aware of what they are might help earlier diagnosis and treatment.

As Clare Adamson mentioned, the five-year survival rate is very low, but there is some light at the end of the tunnel. At the moment, all patients who have pancreatic cancer get the same cocktail of treatment, which gets a good response in only some of them. However, scientists from the University of Glasgow are developing new ways to predict who will respond to drugs that target DNA in a pancreatic cancer. It is basically a precision-and-tailoring method that was not possible before now. The university team working on it under Dr David Chang are hailing it as a major breakthrough in what might be possible for future treatments.

The Precision-Panc programme, which was referred to by my colleague Clare Adamson, involves a number of initiatives that are under way, and the one that I have highlighted lets clinicians analyse individual cancers in more detail than ever before. The clinical description—which I do not fully understand, but here goes—is that the process uses

“cells grown in the lab ... and mini replicas of patients’ tumours ... to identify molecular markers that can predict which tumours will respond to a number of drugs that target damaged DNA.”

That is a clinical description. I do not fully follow it, but that is what I understand it to be.

With the pursuit of a vaccine for Covid bringing the importance of clinical trials to the attention of the whole world, it is good news to hear that clinical trials are to begin in Scotland to help doctors work out who might be responsive to that new approach. Ultimately, the hope is that it helps us to produce new and tailored treatment strategies that, frankly, we did not have available to us before.

Cancer Research UK has made a substantial investment of £10 million into that research—one of its biggest yet—and trials are due to open this month. As I said, there are a number of related trials going on in that programme that are looking at different variants of the cancer to see if we can make further progress in tackling this disease. As far as I understand, more than 300 patients across the UK are involved in this programme of work. All of that is encouraging news, despite an inevitable pause in the work that was caused by the Covid situation.

Pancreatic cancer is one of the most difficult cancers to spot and treat, but with those new trials there is new hope. It is what my family dreamed of and hoped for as far back as 1985. However, with the wonderful work that is going on now comes genuine hope that we might, at last, be able to make some inroads against this difficult cancer.

Once again, congratulations to my colleague Clare Adamson for bringing this issue to the attention of the people of Scotland through this debate. I also welcome back John Scott.

17:57  

I, too, congratulate Clare Adamson on securing this important debate and on the quality and depth of her speech.

Like her, I miss the activists in the public gallery this evening. Hopefully, when we hold this debate next year, we will find our gallery full of the activists who brought so much flavour and dynamism to the debate.

I agree that it is great to see John Scott back in action this evening, and he gave a first-class speech. Like all members, I am sure, I missed John when he was out of Parliament. We work very closely in the cross-party group on aviation, and I am delighted that he is back with us to speak this evening.

As we have heard, this month is world pancreatic cancer awareness month and tomorrow is world pancreatic cancer day. Across Scotland, specifically in the Highlands and Islands, there will be celebrations. Ness bridge in Inverness, Dingwall town hall and McCaig’s tower in Oban will be lit up purple both to remember those who have sadly passed with this horrible disease and to celebrate the lives of those who have survived it.

Pancreatic cancer is one of the deadliest forms of cancer because the symptoms are difficult to spot. The cancer often spreads to other parts of the body before diagnosis. It rarely occurs before the age of 40, but if we look at cases globally, the bulk of them occur in those who are over age 70.

As we have heard, the primary symptoms are jaundice in the skin and eyes as well as unexplained weight loss or loss of appetite. Of course, the inevitable backlog of undiagnosed cancers due to the knock-on impact of the Covid-19 pandemic is deeply concerning. Macmillan Cancer Support, Pancreatic Cancer Action Scotland and others do sterling work and continue to support those going through cancer treatment, but that needs to be supplemented by continued diagnosis, even through the pressures of the pandemic. Pancreatic cancer has only an 8 per cent survival rate outwith the Covid-19 situation, so we need to ensure that symptoms are acted on as early as possible.

I therefore congratulate Pancreatic Cancer Action Scotland on its launch this week of the first TV advertising campaign on the issue, which we heard about from Clare Adamson. It will initially run on STV for two weeks and will highlight the symptoms and provide advice on what to do when individuals have symptoms specifically during the pandemic. Our general practitioners and front-line hospital staff are currently under the most intense pressure, but they would much rather that cancer patients are treated early before it develops in other parts of the body, and that can happen only if patients make contact with the NHS and have screenings and treatment.

Pancreatic Cancer Action Scotland has noted that, of the 22 most common cancers, pancreatic cancer has the lowest five-year survival rate. That is why it is important that we as MSPs continue to do all that we can to ensure that the public is aware of the symptoms and to press for substantial resource allocation to fight this awful disease. I was shocked to learn this week that pancreatic cancer receives less than 3 per cent of all cancer research funding.

Members have touched on the risk factors, which are well known. They include smoking, obesity and diabetes, but there are other factors that are well known about in Scotland and that have a link with social disadvantage and health inequality. Therefore, the motion is right to say that

“older people, ethnic minorities and people living in the most deprived areas”

of our nation suffer disproportionately. We therefore need to ensure that those groups, who are also more vulnerable to Covid-19, are prioritised in awareness-raising efforts.

Diagnoses are usually done by a combination of medical imaging techniques such as ultrasound scanning and PET—positron emission tomography—scanning, and by blood tests and biopsies. I highlight to the minister, who I can see is working actively in the chamber at the moment, that my campaign to have a PET scanner in the Highlands and Islands to fight geographic inequality is important in relation to this debate, and I am sure that he will mention that in winding up.

I will finish with a quote from Carol, who has been mentioned by Pancreatic Cancer UK. She is 49 and she is a survivor. She said:

“I am getting fitter everyday, even though I now have trouble maintaining any weight, but I am determined to live life to the full. I’m hoping to get back to my voluntary work within the next couple of months.

I’m one of the lucky ones, but it shouldn’t be down to luck.”

Although there is still much to do to beat pancreatic cancer, the ways in which families, communities and charities have supported and continue to support people who are going through treatment brings out the best in who we are—it is about being there for each other in a time of need.

18:03  

I, too, congratulate Clare Adamson on securing more time in the chamber to debate and highlight such an important issue. We debate many topics in the chamber and, too often, we do so from a distant viewpoint, if I can put it that way. However, as has been noted, we have a speaker in today’s debate who has walked this path. It makes it all too real when someone we know has had to fight this battle. In this case, of course, it is my friend and colleague John Scott. I remember all too well visiting John during his treatment, and I can say that it was not easy seeing the struggle that he was going through, despite his valiant efforts to hide it.

Each time I visited John, I carried warm messages from members across the chamber. It is fair to say that we were all concerned for his wellbeing, given the particularly aggressive nature of the cancer and the potential prognosis. With that in mind, it gives me real pleasure to be able to speak in the debate alongside John. It just shows what can be achieved with early detection coupled with unlimited stoicism and boundless black humour, which I certainly could not repeat in here, Presiding Officer—I am sure that you are aware that Mr Scott has a command of the vernacular that would not be used in the chamber. He has shown what can be achieved with that sort of positive outlook. Once again, I am happy to say how great it is to see the man himself swinging the bat in the chamber again.

I have a particular interest in the impact of pancreatic cancer on ethnic minority groups, which is mentioned in the motion. A friend of mine happens to be the head consultant urologist and andrologist at King’s College hospital, and he wrote his thesis on the subject. I am not in any way claiming to have either read his thesis or understood it, but it highlights research on the impact on different groups, and developing data around that research can only improve the potential prognosis and outcomes for those who are diagnosed.

How we ensure adequate testing and early intervention for Scotland’s whole population, irrespective of their background or personal circumstances, must be a priority. Not only that, I push the Scottish Government to promote the need for regular testing. It is not enough to have the testing available—we also need it known that the testing is available and easily accessible, and we must encourage all those who should have the tests to have them. For all cancers, especially pancreatic cancer, early detection greatly increases the survival rate and can reduce the severity of the intervention that is required. As David Stewart noted, there is a report out just now that highlights that the number of people who were diagnosed with cancer in Scotland after lockdown fell by a staggering 40 per cent, which cancer charities are saying could mean more people dying of cancer than would otherwise have been the case. As I am sure the Scottish Government knows, that issue must be considered as Covid-19 restrictions are discussed.

We discuss many conditions, cancer being one of them, and when we do so, I always take the opportunity to highlight the actions that can be taken to help with prevention. For instance, we know that smoking, a bad diet and lack of exercise have a significant impact on the risk of a cancer diagnosis, and there is definitely a socioeconomic divide when such factors are considered. Much good work is being done in the Parliament to reduce smoking, but there is a huge disparity between those from the most deprived communities and those from the better-off communities. Thirty-four per cent of the lower Scottish index of multiple deprivation communities still smoke, compared with 9 per cent of the highest SIMD communities. Therefore, there is much work still to be done. There are similar findings for addiction, obesity and exercise frequency.

Just as I am getting up a head of steam, I realise that I must conclude. We know where the greatest challenges are, we recognise the importance of a preventative spend on the health of the nation, and all that is required is the political will. Early detection is certainly one element of the solution, but we must be prepared to take bold action to help to prevent a cancer diagnosis in the first place. Improving access to an active, healthy lifestyle may not prevent us from such a diagnosis, but it would certainly stack the cards more in our favour.

18:08  

I welcome the opportunity to speak in this evening’s important debate. I congratulate Clare Adamson on securing the debate and for all the work that she has done in Parliament to raise and champion pancreatic cancer awareness. November is pancreatic cancer awareness month, and tomorrow, 19 November, is world pancreatic cancer awareness day.

I also welcome John Scott’s return to Parliament and wish him continued good health. I agree with and support John’s words of thanks to and recognition of national health service staff. It is interesting to hear from John how a simple screening blood test can help to identify the risk of developing pancreatic cancer.

I will focus my time tonight on raising awareness of the Precision-Panc platform’s research, so that health professionals and people who are diagnosed with pancreatic cancer are aware of the specific research that is currently happening across Scotland and the rest of the United Kingdom. Precision-Panc brings together expertise from the University of Glasgow, Cancer Research UK, the Beatson Institute for Cancer Research, the CRUK Cambridge institute, the CRUK Manchester institute, the Institute of Cancer Research in London, the University of Oxford and the NHS.

There is excellent evidence that participation in clinical trials is associated with improved outcomes for patients. Early diagnosis is critical so that referral to trials can be made. A poster that I found on the internet, and which Jason Leitch tweeted yesterday, talks about the symptoms, which are, as others have mentioned, often pretty vague.

My experience as a theatre nurse included supporting surgeons in the extensive and complex surgery for pancreatic cancer, which is called the Whipple procedure—a pancreaticoduodenectomy. It is a very long and complicated procedure that has five-year mortality of 20 per cent to 25 per cent, following it. That indicates that research is critical. We must encourage people to engage in the clinical trials that allow researchers across the country to share expertise and knowledge, and to create and share the infrastructure platform that leads to trials that are quick to set up and to recruit for.

Precision-Panc has a proven track record of delivering positive outcomes in research for pancreatic cancer patients. Precision-Panc has made progress in defining the genetic characteristics of pancreatic cancer, has developed biomarkers of prognosis and response to treatment and has successfully identified why pancreatic cancer is resistant to some drug therapies, thereby allowing for research to be undertaken on new therapies.

Primus-001 is in phase 2; it is a study looking at two different chemotherapy regimes. There are four other current Primus studies—one of which Willie Coffey described extremely well. Research work is so important. I ask the Minister for Public Health, Sport and Wellbeing to give a commitment that the Scottish Government will continue to support it.

Finally, I want to highlight an issue that faces my constituents across Galloway in accessing treatment for pancreatic and other cancers. People who live in Galloway—particularly, people in Wigtownshire—are means-tested for travel reimbursement for appointments and treatments. However, patients from across the Highlands and Islands can participate in the Highlands and Islands patient travel scheme, which allows for the costs of 30 miles of travel to be reimbursed for cancer and other medical appointments and treatments. I have raised the issue with the Cabinet Secretary for Health and Sport previously. Given the challenges of Covid, I again ask the Government to consider the issue. I would appreciate some assurances from the minister that he will look at the issue of cancer travel for patients.

I congratulate Clare Adamson on securing the debate, and I welcome the on-going work to advance the treatment of pancreatic cancer. I look forward to a response from the minister

18:12  

Anna’s annual Burns supper was always an enjoyable occasion: well-attended, good food, fun friends and various well or badly played instruments, accompanied by the signing of traditional Scots songs—equally well or badly. Her house in Currie burst at the seams on such occasions, with her brother Andy’s family—his wife, Kirsteen, and their many sons—in attendance. It was her standing joke, for reasons that always eluded me, that I was somehow responsible for seeing that an extension to her house would be built.

Sadly, it was not to be. In February 2018, Anna was diagnosed with pancreatic cancer, which she bore with her usual uncomplaining dignity and quiet resolve. We have heard how pancreatic cancer is a deeply unpleasant affliction for anyone to experience. Survival rates are the lowest of all common cancers, and it can be lethally swift. It is a distinctly awful experience for anyone to go through themselves or to see happening to a close friend or loved one.

World pancreatic cancer day tomorrow is a reminder of it to us all. At the end of Anna’s life, after NHS care and treatment could help no more, she was moved to the Accord Hospice in Paisley. There, she received exceptional care from dedicated, caring and highly trained people. That is an important reminder of the charities and volunteers who play an invaluable role in caring for the sick and dying, and of the importance and inherent value of every human life—something about which Anna herself, as a committed Christian, was firm in her belief.

Sadly, 70 per cent of people in the UK with pancreatic cancer will never receive any treatment and only a tenth receive surgery.

People who work in public health services should rightly be praised for their efforts on behalf of us all. At the same time, we must not make the mistake of thinking that we have somehow all arrived. Structures and methodologies that provide cancer diagnoses and treatments should be looked at carefully and scientifically to examine where improvements are possible and practicable.

In Scotland, we are told that three fifths of people are diagnosed at a stage that is so late that curative surgery is no longer possible. That must change. Apparently, Scotland has one of the worst five-year survival rates in the concord-3 programme, with a ranking of 35th out of 36 countries with comparable data. Therefore, I am encouraged by the gradual steps that we are taking towards improvement. Indeed, improvements to the cancer recovery plan should help us to focus on less survivable cancers, and to make sure that treatment pathways are cohesive, sensible and well structured. The creation of early diagnosis centres, which we have heard about, is also something to welcome; I look forward to their being brought into operation.

We need to ensure that those ideas are carried through and, ultimately, that we see new methodologies being reflected in earlier detection, greater awareness of the signs and symptoms that pancreatic cancer confers on people, and much-improved survival rates from it.

Anna, I am sorry that the extension never happened, but you never needed it. Your parties were legendary and we will not forget you.

Thank you very much, Gordon—I mean, Mr Lindhurst. I got too familiar and called you Gordon. I was getting carried away—the speeches are very touching.

18:16  

I, too, thank Clare Adamson for securing this important debate and for her continued dedication to raising awareness about this uniquely aggressive form of cancer.

I am very pleased that John Scott is here to take part in the debate this year, and I thank him for sharing his personal experience. His message of hope is so important—he cannot ever really know just how important—for anyone who goes through the challenge of having that difficult diagnosis, and I thank him for having the courage to stand up and talk about that in our national Parliament.

I also thank the other members who have shared their personal experiences and stories. It is important that people are able to hear from their politicians on such important matters. Debates such as this one are never party political, and it is important that the people of Scotland realise that many of our parliamentarians are speaking with personal understanding of the issues.

Over the past 10 years or so, we have made amazing progress in cancer care. Mortality rates have fallen by around 10 per cent. However, as we have heard from members across the parties, the advances are not equal among all tumour types. For pancreatic cancer, mortality has fallen, but only by 4 per cent during the same period. Critically, it remains, as many others have said, one of the least survivable cancers. Therefore, it is imperative that we continue to work together to improve that.

For world pancreatic cancer day tomorrow, many of us will be wearing purple in solidarity. I am pleased to confirm that, tomorrow, St Andrew’s house will again be lit up purple to help raise awareness of pancreatic cancer and as a reminder to us all how much further we have to go in tackling it.

I must commend the fantastic work of our health service, its staff and our charities for their invaluable work in supporting people with pancreatic cancer. Obviously, my thanks are nothing compared with the thanks that John Scott gave based on his personal experiences. However, it is important that we all remember the huge work that goes on not only in our health service but in the third sector and charity organisations that support this important area. I am impressed with the resilience shown over the recent months and, as we live through the pandemic, we can still reform and redesign our services to further improve patient experience.

John Scott and others highlighted that early diagnosis is critically important to improving the five-year survival rate for pancreatic cancer, which, as Clare Adamson said, remains one of the least survivable cancers. We know that the earlier a cancer is diagnosed, the easier it is to treat and even cure. Therefore, improvement in that area remains a priority for the Scottish Government.

Throughout the pandemic, there have been concerns that the public are staying at home. David Stewart mentioned that people might be staying home with potentially serious symptoms of cancer and other diseases. I am pleased to have heard that cancer referrals are now above the pre-Covid levels. That is very important.

All through the pandemic, we have made it clear that the NHS is open. We launched that campaign on 24 April, and it concluded on the 7th, but we are all aware that the number of cancer referrals throughout the pandemic was way down on where it should have been so, again, it is heartening to see that levels of cancer referrals are now above the pre-Covid levels.

The new cancer recovery plan, on which I will provide more information in a moment, will focus on reducing the inequalities that have been exacerbated by the pandemic and ensure that patients receive treatment equally across Scotland, using a once for Scotland approach. Mr Whittle raised the issue of inequalities. To go slightly off script, I note that Mr Whittle frequently makes the point that, when it comes to the wider causes of cancer, not smoking is just one of the lifestyle choices that we can make to improve our chances. It is important that we keep trying to get those messages out and I appreciate his using some of his time to cover those points.

As Gordon Lindhurst mentioned, we are in the process of developing Scotland’s first early cancer diagnostic centres, which will create a person-centred, fast-tracked pathway for patients with symptoms suspicious of cancer. The centres will focus on patients with non-specific symptoms. We know that, for some cancers, there are very obvious symptoms but, for other cancers, such as pancreatic cancers, there are non-specific or vague but concerning symptoms, so those centres will be important for that range of cancers, where there are no obvious symptoms. The introduction of those centres marks a radical change in how cancer is detected in Scotland; they will provide faster access to specialists, adopt a holistic approach to diagnosis and support the patients with vital one-to-one contact through the process. With the pandemic, the delivery of the ECDCs is timelier than ever.

Alongside that, continued research and investment is vital, and a number of members focused on research. Clare Adamson was the first to raise the Precision-Panc project, which the Scottish Government seed funded. Across Scotland, we can all be proud of that project; it seeks clinical and biological information from individual patients, who are enrolled on to a master protocol, so that they have the best possible chance of accessing clinical trials.

Emma Harper outlined the wider benefits of clinical trials for patient outcomes. John Scott and Willie Coffey talked about some of the research that is being supported by the Precision-Panc project, and the blood test that John Scott mentioned is exactly the sort of innovation that we are keen to consider as we deliver the national cancer recovery plan. The test that he talked about is available in some areas but, if we are having a national plan, we need a once for Scotland approach to make sure that best practice is everywhere. Therefore, I will take a task away to check where that test is available and why it is not more widely available and to make sure that we are looking at it seriously as part of the national plan.

I see that Mr Scott wants to intervene.

Yes, now that he has found his card.

The blood test that I was advocating is for Lynch syndrome, but blood tests are available for other familial gene deficiencies. A screening programme to identify those syndromes that predispose people to cancer would be of enormous help to early diagnosis.

I thank John Scott for elaborating; that will help me to make sure that I am following it up as fully as I can.

We have talked about the cancer strategy and the cancer recovery plan. Pancreatic cancer has been a priority for the Scottish Government for some time, as can be seen through a number of the actions that are outlined in our cancer strategy refresh, which was published in April this year. Clare Adamson mentioned some of the points from it.

I am over time, but I will briefly thank all the partner organisations that have worked with Government in bringing together the recovery plan, because it is important that we get it right. The Government cannot do it alone but, working in partnership with all the organisations and clinicians, who do such an amazing job, we can really make a difference.

Again, I thank Clare Adamson for securing today’s debate and members for joining such an important discussion this afternoon. I also thank all our partners and NHS staff for continuing to work tirelessly, under extreme pressures, to look after all of us. Without them, none of the work that I have described would be possible.

Meeting closed at 18:26.