Meeting date: Tuesday, February 5, 2019
Meeting of the Parliament 05 February 2019
Agenda: Time for Reflection, Topical Question Time, Forestry Strategy 2019 to 2029, Vulnerable Witnesses (Criminal Evidence) (Scotland) Bill: Stage 1, Vulnerable Witnesses (Criminal Evidence) (Scotland) Bill: Financial Resolution, Business Motion, Point of Order, Decision Time, World Cancer Day 2019
- Time for Reflection
- Topical Question Time
- Forestry Strategy 2019 to 2029
- Vulnerable Witnesses (Criminal Evidence) (Scotland) Bill: Stage 1
- Vulnerable Witnesses (Criminal Evidence) (Scotland) Bill: Financial Resolution
- Business Motion
- Point of Order
- Decision Time
- World Cancer Day 2019
World Cancer Day 2019
The final item of business is a members’ business debate on motion S5M-15410, in the name of Emma Harper, on world cancer day 2019. The debate will be concluded without any question being put.
That the Parliament notes that 4 February 2019 marks World Cancer Day; understands that one-in-two people will get cancer in their lifetime but that, over the last, 40 years survival rates have doubled, with half of people now surviving cancer thanks to the great progress that research has made; acknowledges the importance of early detection; understands the need for continued action to help prevent cancers; believes that 40% of cases could be prevented by positive action, including by not smoking and keeping a healthy bodyweight, and notes that Members can show their support for World Cancer Day through wearing its unity band.17:06
I am pleased to lead the debate, noting that yesterday—4 February 2019—marked world cancer day. I thank my colleagues who supported my motion, and I am looking forward to everybody’s contributions.
I would like to thank Cancer Research UK for its media support in print and social media in the past week, as well as ITV Border in my South Scotland region for its coverage of my sister’s primary breast cancer treatment and recovery journey. Raising awareness was the whole purpose.
Cancer is a global subject that is possibly too big to cover in the time allocated. In my previous career as an operating room nurse, I assisted with tumour removal and tissue repair daily. One in two people gets cancer in their lifetime but, over the past 40 years, survival rates have doubled and half the people who are diagnosed now survive cancer, thanks to the great progress that has been made in cancer research.
The theme for this year’s world cancer day is unity. I am wearing my unity band because we must unite to beat cancer. No single person, organisation or country is going to beat cancer alone. We must all unite and work together to make faster progress on achieving the goal of three out of four people surviving cancer by 2034.
As Cancer Research UK has outlined, four in 10 cancers could be prevented by actions such as not smoking, keeping a healthy body weight, cutting back on alcohol, eating a healthy balanced diet, keeping active and enjoying the sun safely—I say that as somebody who needs factor 50, at least, when she goes in the sun.
We need to raise awareness of the reduced uptake of cervical cancer screening in Scotland, which was debated recently in Parliament. It is extremely important that women accept their national health service invitation to attend cervical screening. In Dumfries and Galloway, research has been conducted on a simple home self-test for human papilloma virus, which is the cause of 99.7 per cent of cervical cancers. There are 6,000 women in the NHS Dumfries and Galloway area alone who have not taken up their cervical screening invitation, and I encourage them all to do so. That highlights the importance of research to make screening easier, less uncomfortable, more accessible and easier to engage with. When cancer is detected early, treatment is more successful.
I want to highlight the importance of action on smoking. As convener of the cross-party group on lung health and someone who has a sister who is a respiratory nurse consultant, I am keen to support any activity that we can implement to help people to quit smoking. I thank Cancer Research UK for the briefing that it provided ahead of the debate, according to which smoking is the biggest preventable cause of cancer and is linked to 15 cancer types. Unfortunately, smoking prevalence is still close to 40 per cent in some groups in Scotland, and it is a greater cause of health inequality than social position. It is responsible for half the difference in life expectancy between those from the most and those from the least deprived backgrounds.
Smoking cessation services are extremely important in reducing smoking prevalence. NHS stop smoking services are successful in reaching people from communities that have a lower success rate in quitting smoking. My mum was a smoker for 40 years, and she has been able to stop with help from the local NHS stop smoking service. She has achieved non-smoking status for the past 10 years, which is fantastic.
Cancer Research UK is calling on the Scottish Government to ensure local and national investment in the quit your way services so that they are maintained for the duration of Scotland’s five-year tobacco control strategy, and I echo those calls. Last year, the Scottish Government published “A healthier future: Scotland’s diet and healthy weight delivery plan”, which was backed by £42 million of investment and has the aim of improving the health of the people of Scotland. It has a particular focus on obesity, which in Scotland is the second-biggest cause of cancer after smoking. Obesity is linked to 13 types of cancer, such as breast and bowel cancers and some of the hardest to treat ones, such as pancreatic and oesophageal cancers. Pancreatic cancer is particularly difficult to diagnose. I recognise my colleague Clare Adamson’s continued efforts to highlight pancreatic cancer, and I am sure that she will expand more on that in her speech.
It is interesting to note that only one in four Scots knows that being overweight could put them at risk of cancer, which is particularly concerning given that Scotland has among the highest levels of obesity in the UK and that we are among the heaviest nations in Europe. I was therefore pleased that the Scottish Government published “A healthier future”, which sets out 67 action points, including reducing excessive junk food consumption, improving the health of our young people and providing better and easier access to healthier food for families on a low income, all of which are extremely welcome steps. Additionally, the plan calls on the UK Government to bring about a change to broadcasting laws to restrict the promotion of certain foods on television. I ask the Scottish Government to continue to push the UK Government to do that as soon as possible.
Last week, I, along with other members, had the privilege of taking part in a photograph for the organisation Make 2nds Count, and I was pleased to meet Lisa Fleming, who is the founder of the group. Make 2nds Count is a charity in Edinburgh that was created to raise funds to support women and men with secondary breast cancer. One of the charity’s other principal aims is to raise awareness of secondary breast cancer. One woman described how she felt “discarded” and said:
“We want to count, too. We need to be part of research and funding. I wouldn’t be here today without being part of a Perjeta trial.”
All the funds that Make 2nds Count raises go to the research team at the Medical Research Council institute of genetics and molecular medicine at the University of Edinburgh.
I do not have time to mention all the organisations that carry out important work with cancer patients and their families, but I would like to recognise some of the ones in my South Scotland region. In Dumfries and Galloway alone, 1,130 people are living with cancer and we have 530 cancer deaths each year. Dumfries and Galloway has the cancer information and support centre, which is a joint venture between Macmillan Cancer Support, the Big Lottery Fund and NHS Dumfries and Galloway. It offers confidential counselling and support information on living with cancer and on treatment, complementary therapies, stress management and relaxation tips, as well as links to local support groups where people can come together to share their experiences or just have a bit of company.
We also have Ayrshire Hospice, which is based in Ayr and which helps adults in Ayrshire and Arran with life-limiting illnesses such as cancer and other neurological conditions.
I thank the many organisations that are involved and that are made up of extremely hard-working volunteers and staff who work tirelessly together to support anyone who is affected by cancer. No single person, organisation or country will beat cancer on their own. We must all work together to make faster progress towards our goal of three out of four people surviving cancer by 2034. This year’s world cancer day theme is unity—it is about uniting people, communities, researchers and Governments to raise awareness and take action. We must unite in the fight against cancer.
I remind members who wish to speak in the debate to have a wee check whether they have pressed their request-to-speak buttons, because uptake seems to be very low.17:14
I thank Emma Harper for securing the debate, and I thank all the organisations that have provided briefings for it.
I found the story of Emma Harper’s sister, Buffy, lovely and uplifting. The member has outlined what happened; my point is that, as the various campaigns go forward and as we encourage our fellow Scots to buy unity bands and raise funds for clinical research, it is vital that we show the human side to this issue.
There cannot be many in the chamber who have not been touched by cancer or who do not have their own cancer story to tell. I shared mine in my maiden speech, when I talked about losing my mother to breast cancer when I was seven. World cancer day therefore presents an opportunity for all of us to recommit ourselves and our country to tackling cancer and ensuring that people who have cancer live as long and as good a life as possible.
Yesterday, as part of world cancer day, I and the public health minister visited the Edinburgh Maggie’s centre and the Edinburgh cancer research centre. I pay tribute to all the charities and volunteers across Scotland who work to support people—and their families—as they go through a cancer journey. I know that we are all wearing our unity bands, and I pay tribute to everyone who has helped to fundraise in whatever way and to support cancer charities in delivering vital care and undertaking research.
Yesterday, I also met a constituent from Livingston who was about to start a five-week treatment for bowel cancer. She highlighted a number of points that I think are key to the debate, which I said that I would raise this evening. We have fantastic cancer centres, but we often forget the challenges that are faced by those who are undergoing cancer treatment, some of which I have been struck by in conversations that I have had. The issue is not necessarily the treatment itself, but aspects such as transport. There have been certain demographic changes in Scotland, with a number of adults not having children and a larger percentage of people living on their own, and those commencing their cancer treatment are told that they will need someone to drive them places, help them with tasks or support them at home. The message that came over loud and clear from my constituent was that, in her case, that someone did not exist.
It is therefore important that we develop a truly holistic approach to those who are living with cancer and understand what they are going through in their treatment. Although we, in Scotland, have been world leading in the development of Maggie’s centres and in the work of other charities in the field, it is still an area that we should look at and where we can improve. An ask that I make of the minister relates to the cancer patient experience survey. It has provided a great opportunity for us to hear about and learn from people’s experiences, and I ask that any future surveys be fully funded.
On the subject of breast cancer, I, too, was delighted to meet the remarkable ladies from Make 2nds Count last week. I have been campaigning with some of those ladies on other issues, and I find it remarkable that, given everything that they are going through, they can still campaign with such guts and strength. However, I know from those with whom I have campaigned as part of the Perjeta campaign that secondary breast cancer is still very much forgotten about and an issue that needs to be discussed as we look at how we can improve research in this area. Only 5 to 9 per cent of national breast cancer research funding goes towards secondary breast cancer, and that situation has to change.
Nevertheless, there is no question but that there is good news to tell about breast cancer. Indeed, the statistics show that the mortality rate has improved dramatically over the past few decades. In Scotland, the rate in 2017 was 32.5 per 100,000 people whereas, in 1992, the rate was 53.5 per 100,000 people. As a nation, we have made real progress.
Can you start to wind up, please?
World cancer day presents us with an opportunity to look at what is happening not only in Scotland but globally. I recently attended a conference in Oxford, where I met some Syrian cancer specialists. They told me about the tragedy of what is happening in their country—about the loss of all their national health services and how that has diminished their opportunity to treat patients. What they hoped for on a day-to-day basis was just to have access to electricity. How we tackle such issues globally is important. One of the facts that they gave me was the number of the people in the world with cancer who have no pain relief whatsoever.
Can you come to a close, please?
That situation is something that we and all those who are involved in world cancer day should consider so that we can collectively address it.
I forgot to say that the speeches should be four minutes long, but I point that out now. We have a lot of speeches to get through.17:20
I, too, congratulate Emma Harper on securing this debate on world cancer day. I also pay tribute to Emma’s sister, Buffy, for her fight against breast cancer. Anyone who knows Buffy cannot fail to be impressed by her outgoing personality and optimism. We are all really pleased by her recovery.
I wanted to speak in the debate to pay tribute to Buffy and to the hundreds of thousands of people who are affected by cancer. Cancer Research UK and Emma Harper have pointed out that survival rates for cancer have improved significantly in the past two decades, which is in no small part due to the work of Cancer Research UK. A lot of that work is going on here, in Scotland, in our world-leading universities.
I have decided to support that work this month by signing up to Cancer Research UK’s sugar free February campaign, which aims to beat cancer and sugar cravings. I have a hopelessly sweet tooth, but it did not take long for me to stop missing chocolate, cakes and even white wine, which is full of sugar. Of course, we know that, as Emma Harper said, being overweight can increase the risk of getting a range of cancers, so going sugar free sends an important message. I balance that, though, by saying that I have known many fit, slim, healthy people who led impeccable lifestyles but who got cancer. Cancer can therefore be as illogical as it can be unfair, which is also why we need more research.
Through my sugar free February fundraising, I have raised £160 so far. If I can convert a few of those pounds sterling raised into pounds and stones lost, I will be a very happy woman. Here is my pitch: I know that there might be quite a few people in the chamber—not least my political opponents—who would appreciate seeing less of me; now they can achieve that by heading for my Cancer Research UK giving page on Facebook and Twitter. I will move on from that shameless pitch.
This is a day on which to remember that many people survive cancer and that the survival rates are, as we have heard, improving all the time. However, there are still huge challenges.
I will finish by talking about my most recent experience of cancer, which illustrates an issue that we need to talk about more: cancer in older people. My father, Jim, died of an unspecified cancer aged 83. He was a very fit and healthy man who never sat down. He was also a carer who contributed to his community and his church, and, like many older people, he spent his retirement making a difference to his family and the people around him. I know that we were lucky to have him for so long. Miles Briggs talked about losing his mother when he was a child, and many people who lost loved ones much earlier will probably wish that they had had their mum or dad as long as I had my dad. However, cancer in older people can be devastating—it is not true that it always progresses more slowly in older people. That was not the case with my dad’s illness, because he was dead within a few weeks of his diagnosis and he suffered greatly.
Cancer affects a lot of older people. The number of people over 75 who are diagnosed with cancer is expected to rise by 80 per cent in the next 20 years, and the majority of cancer patients at the moment are over 65. Understanding the differences in how cancer develops and behaves in older people is an urgent issue for researchers. I was therefore very pleased to see the briefing from Cancer Research UK on its 2018 report “Advancing Care, Advancing Years: Improving cancer treatment and care for an ageing population.”
Older people respond in different ways to both chemotherapy and pain relief. If there is no understanding of that, we cannot treat them effectively. Despite the prevalence of cancer in the elderly, treatment studies rarely include people older than 70, which means that doctors do not have clear guidance on what works best for such patients. One geriatrician said:
“In geriatrics, we are always having to extrapolate from treatment guidelines based on younger people, but the gap is most extreme in cancer care.”
As our population ages, that is no longer acceptable. Older people live worthwhile lives—like my father, they are often the lynchpins of their community as, for example, volunteers and family carers. I am pleased that progress is being made and that the issue is being recognised, and I hope that, in the next 20 years, we see advances in cancer care for everybody who suffers from the disease, no matter what age they are.17:25
I thank Emma Harper for bringing the debate to the chamber. We all have a friend or relative—a wife, partner or child—who has been affected by cancer. On the face of it, the disease does not discriminate: it impacts on people, be they black, white, young, old, male or female. However, this is a day for telling our stories because that is the way in which we understand and empathise with people who are affected.
Cancer can be a brutal, uncompromising thing. My own da was a big bear of a man who worked as a bricklayer all his life. Cancer took him 15 years ago, at the age of 64. He was reduced to a shell of his former self as the disease worked its way through his body, and I miss him every day. Like too many people in communities such as mine, his life was cut short well before his time because of this disease.
However, the experience of dealing with cancer can also be life affirming and uplifting. When my wife Fiona was diagnosed with breast cancer three years ago—she is wearing my unity band today—I feared the worst. I wondered whether my dad’s experience would be repeated. However, every day I thank the NHS staff, our family, friends and colleagues, every god that exists and—most important—my wife for that not happening and for the fact that today she is back to full fitness and is well. She was lucky but she was also fantastically and skilfully looked after by Dr Barber, nurse Laura and the entire team at the St John’s oncology unit and the Western General radiotherapy unit.
Although the experience of my dad and other relatives, friends, neighbours and constituents has often been grim, brutal and life ending, for others, it can be life changing for positive reasons. Following the tears and emotion of my wife’s diagnosis, within a few days our house was full of cards, flowers and visitors, with people offering their help and support. However, we could not help but reflect on how fortunate we were. How many people are there in all the communities that members represent who get a cancer diagnosis—maybe a terminal diagnosis—and return to a cold, empty house with no cards or flowers and who barely see a visitor or get any offers of help and support?
Think of the feeling of being told that you have cancer and having no one to talk to about it, no one to share your fears or tears, no one to go with you to hospital, make you a cup of tea, sit with you during chemo or take you on the 26-mile journey to the Western General every day for radiotherapy. Trying to imagine that brutal loneliness haunts me every time I think about it.
My ambition—like all of us here in the week of world cancer day—is of course that we find a cure, but it is also that we improve prevention, especially in the most deprived communities in Scotland, where the mortality rate is 60 to 70 per cent higher, which is absolutely scandalous. That is where cancer discriminates—in communities such as the one where I live. I want us to get a grip on waiting times and I want us to show that addressing a disease that will affect one in two of our population over their lifetime is really, genuinely and truly a national priority.17:28
I start by declaring that I am currently enjoying my third sugar-free February and I am finding it easier this year—and it is already 5 February.
World cancer day is not the only time that we can reflect on what we can do better to reduce the incidence of cancer and to improve survival rates and the quality of cancer care, but it is an important opportunity to step back and take stock—to reflect not only on how far we have come, but on how much more we have to do. I, too, thank Emma Harper for giving members in the chamber that opportunity today and I thank her sister Buffy for her inspiration.
As the motion notes, 40 per cent of cancers are preventable and being more physically active can play an important role in reducing cancer risk. We know that physical exercise helps to tackle obesity, which is the second biggest risk factor, but evidence shows that being more active can help to reduce cancer risk through other mechanisms too, such as by improving our digestive function, which can reduce the risk of colon cancer. There is approximately a 30 per cent lower risk of colon cancer and a 20 per cent lower risk of breast cancer associated with being active every day.
Active travel, and cycling in particular, is associated with the reduced risk of cancer. A 2017 study by the University of Glasgow looked at the impact of travelling to work by bike and on foot and found that commuting by bike, even partially, was associated with a lower risk of adverse health outcomes, including several cancers. Therefore, physical activity is really important for people who are waiting for, having or recovering from treatment. For example, exercising while undergoing cancer treatment can help to prevent decline in physical function and control cancer-related fatigue. We have to do all that we can to make sure that such activity is available for everyone. The Scottish health survey shows that 65 per cent of adults meet
“the guidelines for Moderate or Physical Vigorous Activity”,
but that the figure falls to 56 per cent in our most deprived communities.
Members have heard me talk about investment in active travel before and I will raise it in the chamber again. Many car journeys in Scotland are short, and those journeys could be undertaken on foot or by bike: 33 per cent of such journeys are between 1 and 2 miles and 11 per cent are less than a mile. Let us promote walking and cycling because, in doing so, we reduce risks of cancer.
The motion rightly draws attention to the doubling of cancer survival rates over the past 40 years but, as Neil Findlay pointed out, an individual’s chances of getting and surviving cancer are still very much influenced by their socioeconomic situation. The incidence of cancer is more common in the most deprived areas of Scotland. Incidence rates have typically been 30 to 50 per cent higher in the most deprived areas than in the least deprived areas. The Macmillan Cancer Support and NHS National Services Scotland report, “Deprivation and Cancer Survival in Scotland: Technical Report” found that mortality from cancer is highest among those who are from the 20 per cent most deprived communities and that the difference was statistically significant for eight cancers, including breast, liver and lung cancers.
As the motion notes, early detection is one of the keys to successful treatment. We are still not doing enough to ensure that Scots who are experiencing deprivation are accessing screening programmes and I would be grateful if the minister could comment on that in his closing speech.
I thank the incredible campaigners from Make 2nds Count; I think that their visit last week had an impact on each and every one of us. I thank all those who work with the 50 per cent of us who have cancer. My mum was diagnosed with myeloma—a blood cancer—in 2014. She had a stem-cell transplant and is currently having her three-monthly check with haematology. She is very grateful to two Macmillan nurses who are based in Wester Hailes healthy living centre and she has spoken of not only the health support, but the support in so many other areas, from nutrition to exercise, to entitlements, to transport, to support in getting a blue badge—absolutely everything is covered. I thank all those people who are involved in helping people who have the disease.
World cancer day is a time to reflect on the huge progress that we have made in learning about a disease that will have an impact on about 50 per cent of Scots. I look forward to hearing more from the minister in his closing speech about how we can tackle it together.
I know that people have a lot to say in this debate and a number of members still wish to speak. Therefore, I am happy to accept a motion without notice, under rule 8.14.3, to extend the debate by up to 30 minutes. I ask Emma Harper to move the motion.
That, under Rule 8.14.3, the debate be extended by up to 30 minutes.—[Emma Harper]
Motion agreed to.17:34
I congratulate my friend and colleague Emma Harper on securing this important and timely debate. The motion is succinct and Emma Harper laid out further background in her opening speech.
I am not going to stand here and profess that I am an expert in the field of cancer, because I am clearly not, but cancer knocks on the door of many households indiscriminately. As the motion says, one in two people will get cancer in their lifetime. That may appear to be a high number, but I am not aware of many families who have not been affected by cancer. We all welcome the increase in survival rates, but we recognise that that has not happened by chance. That is why research is so important and why the investment to fund that research is crucial.
We received various briefing notes prior to the debate, and I thank all the organisations that work and help in the cancer field. The figures that those organisations highlight about research indicate not only how much is spent, but the journey that we still have to go on to beat cancer. Cancer Research UK spent £38 million last year and Breast Cancer Now spent just over £16 million, so it is clear that the sector is working hard. I thank everyone involved in cancer research and those who work with patients to provide them with the expert care, attention and information that they require every day.
Every year, MSPs don a bit of pink for wear it pink day to raise awareness of breast cancer and raise funds for breast cancer research. I admit that we can look a bit ridiculous, but it is for a good cause. When the photo appears, my constituents see the funny side, and all, apart from one, appreciate the fun element that highlights the serious message. In my constituency, I have dealings with Marie Curie and Macmillan Cancer Support and I appreciate everything that they do to help make the lives of my constituents better and more comfortable.
I take a slightly cold position on cancer—I tend to approach it in a state of defiance. It might mean that I do not show enough emotion when I talk about cancer or work with others on the issue, but that is my self-defence mechanism. I need to try to remain as impersonal as possible about cancer. I know, and have known, too many people with cancer; some have managed to beat it and others have not. I admire and cherish those who have survived and continue with their lives, usually with a different perspective.
Emma Harper talked about social media and television. TV programmes play a hugely important role in portraying a message. “Cold Feet” is on STV at the moment, and one of its characters, Jenny, played by the wonderful Fay Ripley, has been diagnosed with breast cancer. I have not seen last night’s episode, but I will see it later in the week. The connection that the characters have with the audience is testimony to the excellent writing and acting. The breast cancer storyline is extremely powerful and highlights not only the importance of talking about breast cancer, early diagnosis of cancer and treatment, but the mental challenge of facing up to and dealing with cancer. That is where the media have such an important part to play, and I thank the programme makers for introducing that storyline so carefully and sensitively.
Yesterday was world cancer day, but cancer day starts for someone new every single day. I thank Emma Harper once again for securing the debate and, once again, I thank everyone working in the field for their efforts to improve research into cancer and the treatment of the disease. One day, society will defeat this awful, indiscriminate disease forever.17:38
I congratulate Emma Harper on securing this important debate. She listed the ways in which we can protect ourselves against cancer, for example by not smoking, by cutting down on alcohol, by losing weight and by taking more exercise. As a non-smoking teetotaller who has managed to lose three stone in the past year and is currently in training for two marathons, I appear to tick plenty of those boxes.
World cancer day yesterday was a very poignant day for me and my family, because 4 February 2019 marked the second anniversary of my father’s death. I want to say a bit more about the circumstances of my dad’s cancer, which I have mentioned previously in a question to the minister. Neil Findlay quite rightly said that this is an opportunity for us to tell our stories. My father’s story has a very important message attached to it, which I think it is beneficial for me to relate.
My dad worked for a large part of the year in Africa; he had a business interest in Ghana. Just prior to returning to Africa, he noticed, under his false teeth at the base of his mouth, what he thought was an ulcer. As he had false teeth, he tended not to visit the dentist and did not have regular oral health check-ups. For many people, there is often a misconception that if they do not have their own teeth, they do not need to go to the dentist. Anas Sarwar has left the chamber, but as the resident dentist in Holyrood, I am sure that he would attest to the fact that dental checks are about much more than just checking that teeth are okay—they are about wider oral health.
My dad dismissed it and went off to Africa. He was due back for the period that would span his 60th birthday, when we were going to have a big party and celebration. He arrived with a very large growth on his jaw, which he had initially dismissed as probably the result of an insect bite to which his face had reacted. After some time—and nagging from my mother—he eventually made an appointment to see the emergency dentist. From that, he was quickly referred to the maxillofacial clinic, from which he was referred for a biopsy. During this process, I began to join the dots and realise that we were probably heading towards the destination of a cancer diagnosis, but we read so much in the news about cancers being caught early and people being treated effectively and recovering. We have heard this evening some fantastic and inspiring stories about people’s recovery journeys.
However, in June 2016, my father received the diagnosis of cancer and was told that it had developed to a stage at which there was no hope of recovery. Neil Findlay spoke about the effect of cancer on his father. It was exceptionally difficult to watch my father—a man who was always making jokes and making people laugh, and who had himself the most infectious laugh—slowly losing the ability to communicate, to speak and be understood, and to watch the frustration when he tried to make conversation but could not be readily understood because of the effect that oral cancer was having on him.
In 2017, the year my father passed away, oral cancer deaths in NHS Grampian rose from 21 to 28—I have made that point to the minister in the chamber. NHS Grampian officials told me that late presentation is often a key factor. I often think back and wonder, what if my dad had gone to be seen more quickly? What if he had had regular dental check-ups? What if he had taken the steps that might have identified the cancer earlier? Would he still be here with us, laughing, joking, playing with his grandchildren and enjoying time with his family and friends? We do not know for definite, but it would certainly have increased his chances.
A key message that I want to send—and that I have tried to send since my father’s passing, in particular during the recent mouth cancer awareness month—is that if people notice anything unusual, even if they think that it is nothing, they must go and get it checked. People who are qualified can tell us whether it is nothing; if it is something, it is better to know and get it dealt with. If we leave it until later, that often means leaving it until it is too late.17:43
I thank Emma Harper for bringing the debate to the chamber. I am feeling a tad emotional—lots of members have shared personal experiences. My dad died of cancer, so I found Mark McDonald’s contribution to be particularly moving. I thank him, Neil Findlay and the others who have shared their experiences. It is a very brave thing to do.
I also thank my friend and colleague Hannah Bardell MP, who recently had her smear-test recall to hospital and experienced the worries that surround that. She has campaigned tirelessly for years for the Michelle Henderson Cervical Cancer Trust. Michelle was a young woman and friend of Hannah’s from her constituency who died in her twenties from cervical cancer. Hannah has used her own recent experience to remind young women in particular how important it is to take up the offer when we are offered screenings. Among young women, the rate of taking up screening opportunities has fallen, recently. Given all the work that has been done to help people, it is very important that people take up the opportunities so that we can prevent cancers from developing.
Emma Harper mentioned that I have a particular interest in pancreatic cancer. I have that interest because of the Begley family from Lanarkshire, who shared their experience of their father’s cancer with me, and through my colleague Nicola McManus, whose mum died from pancreatic cancer. I know that Nicky and her three children still feel that loss very deeply.
I was not very aware of the issues around pancreatic cancer and, as we have heard today, everyone’s individual cancer journey is unique to them, although there are trends and statistics that we can talk about. I will move on to those in a moment.
At the pancreatic cancer event that was held last year, only one survivor in the room had lived for more than 10 years after diagnosis. It is a stark reality of pancreatic cancer that the statistics have hardly changed in the past 50 years. Great work is going on to try to reverse that trend.
I was delighted to meet the young leaders from the precision-panc research team at the Beatson west of Scotland cancer centre. The precision-panc programme is funded by Cancer Research UK, which I thank for all that it has done to promote world cancer day, and for the briefing for the debate. I also thank the Scottish Government. The programme seeks to make vital breakthroughs in pancreatic cancer research.
Is pancreatic cancer unique? The five-year survival rate for pancreatic cancer in Scotland is 5.6 per cent. That rate has increased by only 2.1 percentage points in the past 20 years. In 2016, 784 people were diagnosed with pancreatic cancer in Scotland, and 719 people died of the illness. It has an incredible attrition rate. The cancer is quick—its rapidity is staggering—so we have to make some vital breakthroughs in order to change the situation. Although we celebrate every success—everything that is happening and every survival—we must recognise that in the case of pancreatic cancer there is much more to do.
I thank Pancreatic Cancer UK for the work that it is doing. It has a petition to try to get the UK and Scottish Governments to increase treatment rates for cancer. In particular, it is asking that pancreatic cancer be treated as an oncological emergency in order to ensure that people get the vital treatment that they need more quickly.
It has been a particularly good and informative debate this evening. I thank everyone who has spoken. As I said, cancer is something that touches each and every one of us in our lives.17:47
It is a great privilege to speak in the debate, having spoken in the debate on the matter at the same time last year. I am grateful to Emma Harper for lodging the motion for us to debate.
The subject of today’s debate is one that is close to the hearts of many members, perhaps through experiences with constituents, friends or family members. Improving outcomes for people with cancer is a goal that we share, and which crosses the normal political divides. That is why I, too, am pleased to mark world cancer day and to welcome the important progress that has been made in recent years and decades.
As the motion notes, there has been a marked change in survival rates over the past 40 years, which is in part down to advances in medical treatment and technology, as well as to the change in respect of our recognising the lifestyle factors that lead to cancer. In many cases, the changes that are needed to prevent cancer are fairly simple—eating healthily, for example. Some changes are more challenging, such as stopping smoking, but we cannot overstate the importance of a change that can be the difference between life and death.
However, as we look at the good progress and at the work that is being done, it is important that we consider where we could do better. One of the key markers is the Scottish Government’s 95 per cent target for the 62-day standard from referral to treatment. According to the latest statistics, only two health boards have managed to meet that target, with NHS Grampian, in my region, coming in at just 76.6 per cent. NHS Grampian also falls behind on the target for treatment within 31 days of the decision to treat: it is at 90.5 per cent against a target of 95 per cent.
In Scotland more generally, in the last published quarterly information the national average for treatment within 62 days of referral fell from 84.6 per cent to 81.4 per cent. Set against the 95 per cent target, the figures are simply not good enough. There comes a point when good will and good wishes do not cut it: we must see improvement, and we need to see it fast.
I feel that there is another consideration—the quality of life of cancer survivors. Let us be in no doubt that even when it is successful, cancer treatment frequently has long-term side effects that can cause substantial physical and psychological damage. Having been on the receiving end myself, I think that more attention could be paid to making sure that patients who receive treatment can live their lives as comfortably as possible, so I would welcome any work that can be done in that regard.
No one doubts that this is a vital issue that should command our full attention. Important work is being done, and it should continue, but there are areas in which improvement is needed. It is estimated that by 2027 about 40,000 cases of cancer will be discovered in Scotland every year. It is vital that we transform services in order to deliver better and more supportive care, and that we use resources wisely.
I welcome the debate and I hope that we can make the changes that we need in order to ensure that progress over the next 40 years exceeds what we have become used to in the past.17:51
I thank my friend Emma Harper for bringing this debate to the chamber and for sharing her online story of her lovely sister Buffy to raise awareness, and I thank the constituents who have been affected by cancer who got in touch to ask me to take part in today’s debate.
There are so many aspects that we could cover in a debate such as this. I want to concentrate on one of the third sector agencies in my area that works with those with a cancer diagnosis and their families—CLAN Cancer Support. A few months ago, I spent some time at CLAN in Inverurie with a few people and their families who have used its services. I thank the manager, Fiona Cormack, her team and everyone whom I met for making me so welcome.
The phrase “used their services”—as I realised when I wrote it—does not seem adequate to describe people’s relationship with CLAN. When I was there, I met families who told me how CLAN had supported them in all manner of ways while their loved ones were seriously ill. I met cancer patients dealing with the trauma of their diagnosis who needed pastoral care that cannot easily be provided—and which it is sometimes not appropriate to deliver—in a healthcare setting. I met people who had lost loved ones to cancer and continued to visit the centre months and years later for emotional and practical support.
What is CLAN and what does it do? What it does not do would be easier to cover. CLAN does what it can to provide whatever a person needs—whatever they come and ask CLAN to help them with. That could be advice and support, including advice on finances; simple friendship and community; opportunities to share experiences with others with cancer diagnoses; and no shortage of listening ears. CLAN provides complementary therapies such as massage and aromatherapy, too; the sort of thing that can give a person a bit of respite from medical procedures and the stress of their condition. The centre has therapy rooms that are just outstanding. CLAN also has support groups for particular groups. There is one for children and one for teenagers who are affected by cancer.
One group whom I met at the centre was a men’s group, who were just back from a walk. They meet up once a week for a walk, a cup of tea and a chat about anything—they were discussing music when I butted in. Two of them took the opportunity to give me some casework, which had nothing whatsoever to do with their health. The group is there for friendship and support. It happens to be made up of a range of people who are affected by cancer—people who are currently dealing with diagnosis and treatment, those in recovery from cancer and a couple of people whose connection to CLAN and the group was through a family member. One regular visitor was the widower of a woman who had died over a year ago, who pops in regularly for a chat with the friends that he has made there. Hospitals cannot provide that sort of thing. That is why third sector organisations such as CLAN are needed.
CLAN also operates in the north of my constituency in Turriff, where it has to meet in the local library—CLAN Turriff does not have the fantastic facility that CLAN Inverurie has—and our paths often cross, as I hold a constituency surgery there. Although it might not have the facilities of CLAN Inverurie, it offers the same support. As in Inverurie, there are monthly coffee mornings at which people can meet and catch up.
There is no manual on how to cope with a diagnosis of cancer—either for the person who receives the diagnosis or for their family and friends. I spoke to many people at CLAN and what came up time and again was the relief that people felt when they found CLAN. They reflected on what they would have done if they had not had it to turn to for support when they needed it.
It struck me that for every person who finds out what CLAN does, there will be another person who needs the charity but has not found it yet. That is why I wanted to make CLAN the focus of my speech. I want everyone in my area to know that CLAN is there. They might be fortunate enough never to have to walk through CLAN’s door, but thank goodness because it is there for the people who do.17:55
I am grateful to Emma Harper for lodging the motion and giving us the opportunity to come together to mark world cancer day. The motion mentions the unity band; the Parliament has united this evening, because we are all touched by cancer.
We have heard a mixture of sad stories—of people who have lost loved ones—and hopeful stories, such as those of Emma Harper’s sister Buffy and Alison Johnstone’s mum, who I hope is doing well. My mum has had her own cancer journey recently. She is going back to work tomorrow, after having had an operation a few months ago.
People often think that politicians are out of touch and do not understand the issues, but I think that all members could have taken part in this debate without receiving a briefing. However, we are all grateful to Macmillan Cancer Support, Cancer Research UK and Breast Cancer Now for their helpful briefings. Of course, we are also grateful for the brilliant jobs that they do to support families who are affected by cancer, and for their tireless campaigning and fundraising.
Like other members, I pay tribute to and thank our wonderful NHS staff who support people and their families through this difficult illness. In the past two years, my family has certainly had its money’s worth—and probably a bit more—out of the NHS.
Cancer used to be a taboo subject, which carried a lot of stigma—families did not talk about it. I am glad that that is changing. Survival rates are improving and there have been positive campaigns to tackle the stigma, such as Breast Cancer Now’s wear it pink campaign, which is a lot of fun, and the work of Jo’s Cervical Cancer Trust to encourage women to go for smear tests. I was grateful to members who took part in my members’ business debate last month to mark cervical cancer awareness week.
Groundbreaking cancer research would not be possible without the incredible fundraising efforts of people in our communities. I see that in my region. Just last week, I picked up the local paper, the Hamilton Advertiser, and read that the Hamilton Bowling Club ladies section had raised £3,000 for Cancer Research UK. Generosity like that happens day in and day out.
Members talked about the third sector and volunteering. I was pleased that Miles Briggs mentioned transport. The Lanarkshire Cancer Care Trust was invaluable to my mum, who did not want to rely on family members having to fit in with her appointments. She was able to make a donation to the volunteer group who ran what she affectionately called “the cancer bus”. The other people who used the bus were experiencing the same thing and could understand what she was going through, and the driver was expert at getting through the traffic and to the right department—my mum had to go to the Beatson west of Scotland cancer centre, University hospital Hairmyres and other places. Even when someone has a family to go home to, they might not always want to open up to their family, as Neil Findlay said. For my mum, that service was really important.
On another positive point, I am pleased that recent stats show that the majority of patients in Lanarkshire have been treated within the treatment time standard. However, that is not the experience nationally, in relation to diagnosis. Perhaps when the minister makes the closing speech he will update the Parliament on that. The cross-party group on cancer has been doing good work in that regard. We all want to support the system to keep improving.
As members said, there is a lot that we can do to prevent cancer. We have to focus on that, but we must also make sure that our strategies and policies are realistic and that we make it easy for people to make lifestyle changes, by considering the barriers that people face in making healthier choices.
We have seen great progress. We know that we can do tremendous things in the Parliament—there is the smoking ban, for example. My gran, whom I loved very much and miss dearly after 16 years, was a heavy smoker. She was a barmaid and worked in smoke-filled working men’s clubs and pubs, and she died of lung cancer. I remember her every day through my daughter, Isabella, who is called after her. I hope that we will see less of such things.
I thank everyone for their contributions.18:00
I thank Emma Harper for securing this important debate. I am pleased to join her and other members in wearing a unity band.
The debate provides us with an opportunity to reflect on the preventable causes of cancer and the steps that all of us can take to reduce the impact of that terrible disease. It is fitting that we should have this debate following world cancer day, yesterday. The day is intended to target misinformation, raise awareness and tackle the stigma that is often associated with cancer. The day is important for those who are currently affected by cancer, for reducing the number of people who develop cancer in the first place, for detecting cancer at the earliest possible stages and for supporting those who have a cancer diagnosis and their families and friends.
I was pleased to mark world cancer day, yesterday, by visiting Maggie’s Edinburgh. My path crossed that of Miles Briggs. Like him, I really appreciated the time that people took to speak to us around the kitchen table. Maggie’s is one example of the many organisations that do fantastic work. Gillian Martin mentioned CLAN, and other members have mentioned Macmillan nurses. There are many organisations that do a lot of good work, and I thank them all.
I was also pleased to speak at the Scottish cancer prevention network conference yesterday. That is an important gathering of world experts on cancer prevention who are largely based in Scotland. We can be proud that our NHS and academic institutions are working together to highlight the issues and to help everyone in Scotland to live healthier lives. The conference highlighted projects such as the ActWELL project, which is led by Professor Annie Anderson of the University of Dundee. It encourages women across Scotland who attend breast screening programmes to reduce their risk of developing breast cancer by taking up physical activity—Alison Johnstone mentioned that—eating healthily and losing weight. It is delivered in partnership with Breast Cancer Now volunteers, it is supported by the Scottish Government and it is making a real difference to women across Scotland, including in my constituency.
I assure all members that the Scottish Government is determined to play its part in tackling cancer. The current projections from Cancer Research UK tell us that one in two people in the UK born after 1960 will be affected by cancer. We need to reduce that figure over time and ensure that the right support is in place to help those who are affected by cancer. Significant progress has been made over the past 10 years. Overall, the cancer mortality rate has fallen by 11 per cent; however, more needs to be done to reduce the risk factors associated with cancer.
Our £100 million cancer strategy “Beating Cancer: Ambition and Action” sets out our ambitions for the future of cancer services in Scotland to improve the prevention, detection, diagnosis, treatment and aftercare of those who are affected by all forms of cancer. Research is important, of course, and Scotland is to the fore in that area. Clare Adamson mentioned the precision-panc project. The Scottish Government has committed some £4 million to the precision medicine ecosystem, including £700,000 of direct funding for the precision-panc project. That project can potentially make a real difference by ensuring that cancer treatment—particularly for pancreatic cancers, but for other cancers as well—is based on the genetics of the individual patient’s tumour. There is real potential for progress there.
It is also important that the whole journey is as positive as it can be. That is why the cancer patient survey, which Miles Briggs mentioned, is important. I am pleased to say that we concluded our cancer patient survey in December and expect to publish the results in the spring. We will use the results to identify the gaps in services and then focus on addressing them.
Gillian Martin mentioned the holistic support that is available for people with cancer. That is an important part of our cancer strategy. I hope that the cancer patient survey will help us to get that right so that people get the support that they need. Organisations such as CLAN Cancer Support are very useful in helping us to do that.
As Emma Harper said, it is estimated that four in 10 cancer cases could be prevented. That can be done largely though lifestyle changes such as not smoking, maintaining a healthy body weight, eating a healthy and balanced diet, reducing alcohol intake, protecting our skin from sunburn and keeping active.
Neil Findlay rightly made the point that we have a higher mortality rate in our most deprived communities. In each of our strategies on tackling smoking and drinking and on promoting healthy eating, we focus on tackling that health inequality. If I have time, I will talk about some of the success that we have had in that regard and the strategies more generally.
Smoking is the first area in which we have seen success. Just one in five adults now smokes, and the number of 15-year-olds who smoke regularly has dropped by more than two thirds in the past decade. It is clear that smoking is still more prevalent in more deprived areas, but the level of smoking is reducing.
Emma Harper asked about stop-smoking services. I assure her that there is no intention to reduce those services, for which we provide about £10 million of funding annually to health boards. That is important, because we are perhaps getting to the point at which those people who have not given up smoking need more support, and most of them are in the most deprived areas.
As we have heard, obesity is the second-largest preventable cause of cancer. According to Cancer Research UK, it is linked to about 2,200 cases a year in Scotland. It is really important that we make progress in reducing diet-related health inequalities. One of the first things that I did as the public health minister was launch “A healthier future: Scotland’s diet and healthy weight delivery plan” in order to tackle the issue by focusing on prevention.
An area in which we have to work together is foods that are high in fat, salt and sugar. Our consultation on that issue has just closed. We asked about restrictions on multibuy promotions, placement at checkouts and product promotions. That is a really important area in which this Parliament can help our population and make it easier for people to make healthier choices.
A number of members asked about screening and early detection. We know that the early detection of cancer leads to a better prognosis, and our national cancer screening programmes continue to work towards identifying bowel, breast and cervical cancers at the earliest stages. However, as Alison Johnstone and Neil Findlay rightly mentioned, the uptake of screening is lower in areas of deprivation.
Time is tight, so I will talk about one screening test. Scotland was the first country in the UK to introduce a simpler bowel screening test called the faecal immunochemical test—FIT. Since its introduction in November 2017, we have seen increased levels of participation in the bowel screening programme, and statistics that were published today show that we have exceeded the 60 per cent uptake target for the first time. That is really important.
One of the most important things is that the biggest improvement has been among those who live in the most deprived areas, where uptake has increased by 10 per cent. As somebody said, we encourage those who have a bowel test kit sitting in a drawer at home or who receive one in the weeks to come to please take the time to complete it and post it in, because it could save their life.
Monica Lennon asked about diagnostics, and we continue to look at how we can improve that area. In particular, we are looking at the development of rapid diagnostic and assessment centres, which are being piloted in England. The final report on the pilot is due to be published later this year, and our Scottish cancer task force will consider the results and use them to learn where to improve our services.
In closing, I thank all the staff and volunteers who work tirelessly in our NHS and in the charity sector to deliver our strategies for cancer prevention, diagnosis and treatment and to deliver support for people with a cancer diagnosis. The unending commitment of staff and volunteers is invaluable in driving back the disease.
In final conclusion, I give huge thanks to Emma Harper for lodging the motion for this important debate and to her and many others for sharing their personal stories, which are really important in such a debate. Thank you all very much.
That finally, finally concludes the debate.Meeting closed at 18:11.