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Chamber and committees

Meeting date: Thursday, February 6, 2020

Meeting of the Parliament 06 February 2020

Agenda: Point of Order, General Question Time, First Minister’s Question Time, World Cancer Day 2020, Education, Portfolio Question Time, Budget 2020-21, Scottish Elections (Reform) Bill: Stage 1, Scottish Elections (Reform) Bill: Financial Resolution, Decision Time


World Cancer Day 2020

The Deputy Presiding Officer (Christine Grahame)

The next item of business is a members’ business debate on motion S5M-20184, in the name of Monica Lennon, on world cancer day 2020. The debate will be concluded without any question being put.

Motion debated,

That the Parliament recognises that 4 February 2020 is World Cancer Day, a global initiative that encourages everyone to put cancer on the global agenda; understands that one in two people will get cancer in their lifetime and that over the last 40 years survival rates have doubled, with half of people in Scotland now surviving cancer thanks to the great progress that research has made, and that Cancer Research UK’s vision is to see three-quarters of people with cancer surviving the disease by 2034; believes that it is crucial to address variations in outcomes between cancer types and patient groups where they exist in Scotland; welcomes world-leading research funded by Cancer Research UK and others into those cancers with the lowest survival rates, including lung, pancreatic and brain cancers; notes what it sees as the persistent gaps in outcomes, especially for those in Scotland’s most deprived communities and recognises calls for urgent action to address cancer health inequalities in any form; understands the need to ensure that cancer services in the Central Scotland region and across the country are planned to ensure the best outcome for every patient wherever they live, while allowing patients to decide what matters most to them on their cancer journey, and notes that Members can show their support for World Cancer Day through the wearing of the Unity Band.


Monica Lennon (Central Scotland) (Lab)

It is a privilege to bring this debate to Parliament in recognition of world cancer day, which took place on Tuesday 4 February. I am proud to show my support for world cancer day by wearing my unity band and helping to play my part in making sure that the Scottish Parliament puts cancer on the agenda during this important week. I thank members who signed the motion and those who are in the chamber.

I thank and pay tribute to Cancer Research UK for being the driving force behind the motion and the debate, and helping to ensure that we have good information at our fingertips. I also thank Macmillan Cancer Support, the British Lung Foundation and Pancreatic Cancer Scotland for their helpful briefings and for the work that they do all year round.

Cancer is something that affects us all, either directly or through our family and friends. Half of us in Scotland will be diagnosed with cancer at some point in our lives. That sounds quite scary and very serious, but thanks to the commitment to research and advancements in treatment, more and more of us are surviving.

Half the people diagnosed with cancer will survive—survival rates are now double what they were 40 years ago, which is positive. The ambition of Cancer Research UK is to double that progress by 2034, so that three quarters of those who are diagnosed with cancer will survive. That ambition is one that we can and must meet. However, doing so will not be an easy task.

As Macmillan Cancer Support has pointed out, the number of people who are living with cancer is increasing—it is already up by 15 per cent from 2015. We expect that in five years’ time, 300,000 people in Scotland will be living with cancer.

To improve survival rates, we need to take serious action now to address the shameful wealth inequalities that continue to affect life expectancy in our poorest communities. Inequalities are a big factor in people’s cancer experience. How can it be acceptable that people living in the poorest areas are not only more likely than those in the wealthiest to be diagnosed with cancer, but are less likely to receive an early diagnosis? We know that getting an early diagnosis is crucial to increasing survival rates.

A person’s postcode should never determine their life expectancy and it beggars belief that, in 2020, it still does for so many people. In a country as rich as Scotland, it shames our society. We have been far too complacent. After more than 20 years of this Scottish Parliament, it is a matter of deep regret that we have been unable to reduce health inequalities in the way that is needed. Years of cuts to public services mean that poverty is growing instead of reducing and we continue to face huge challenges—but we have choices to make.

The work of Cancer Research and others in continuing to invest in and develop innovative treatments is vital. There is still so much that we need to learn, especially for types of cancer that continue to be difficult to treat and have low survival rates. Lung cancer continues to be a major concern and a driver of inequalities in Scotland. Not only is lung cancer more common for people living in the most deprived communities; it is likely to be diagnosed late and has a very poor survival rate.

In Lanarkshire—the area where I live and which I represent—almost half of patients with bowel, breast or lung cancer are diagnosed at stages 3 and 4. That is very worrying and we must act to improve that situation.

In preparation for today’s debate, I have been speaking to constituents and people who work in our health service. One doctor said to me that if there was one thing that we could do, as a Parliament, it would be to encourage people to get symptoms checked out and not to delay. We must tell people that they are not a burden on the health service and their doctor will be glad to see them.

I recall my mum’s cancer diagnosis a couple of years ago. She went to the general practitioner because she had a sore throat that she just could not clear and was feeling run down. She went to the GP for a chat and her doctor took the time to listen and to ask other questions. That meant that, completely unrelated to her sore throat, she was put on a pathway so that she was diagnosed with bowel cancer within two weeks. If she had not made that trip to the doctor there and then, she could have had a much later diagnosis. My mum has recovered well and is a survivor. That reminds me that all of us have to let people know that they are not a burden on the health service and that they should go and see their doctor.

That leads me to thank the national health service staff. We must recognise the massive contribution of our NHS staff, who make it possible for people to be successfully treated for cancer. To those staff, I am sure that we would all say, “Thank you”. I thank them for everything that they do.

However, cancer outcomes cannot be improved by good will and determination alone—staff need support. That is why we need increased, co-ordinated action from the Scottish Government and more investment in the diagnostic workforce. The cross-party group on cancer published its inquiry report in November. The report highlighted that diagnostic workforce pressure is the key issue for survival rates in Scotland and is responsible for the pressure on cancer treatment services.

Our NHS staff are simply remarkable, but growing pressures in our health service are only making their job more difficult. The cancer waiting times target has not been met since 2012—eight years ago.

The latest figures from Government reveal that more than 4,000 vacant nursing posts exist, which is the highest ever vacancy rate.

It is unacceptable that we are in a situation in which the NHS does not have enough staff to be as effective as it could and should be in diagnosing cancer. We can and must do better, which is what we can all focus our attention on in the coming weeks and months. I hope that the Scottish ministers will listen to the calls to create a plan to meet the current and future needs of cancer patients, and will do so as quickly as possible.

Cancer is a disease that, sadly, touches many of our lives, and world cancer day is a global effort to ensure that the focus on how we reduce inequalities, improve research and survival rates and, ultimately, save people’s lives, remains high on the political agenda.

I am proud to play a small part in that by bringing the debate to the chamber today, so we can focus our efforts in this Parliament on improving outcomes for cancer patients in Scotland.


Emma Harper (South Scotland) (SNP)

I am pleased to speak in today’s debate highlighting world cancer day, and I congratulate Monica Lennon on securing it. Members might recall that I led the world cancer day debate last year and focused a lot on unity and the need for us all to stand together to truly win the fight against cancer.

I also spoke about my wee sister Buffy, who is also a nurse, and her breast cancer journey. Four years ago, on 4 February—world cancer day—my sister had her first chemotherapy treatment. She now describes it as having taken her four years to feel the same mentally and emotionally as she did before.

This year’s world cancer day theme is “I am and I will”, but unity is still vital. I am proud to again wear my unity band, and I will continue to engage, listen and pay heed to research to cure cancer.

We know that one in two people will get cancer in their lifetime. However, over the past 40 years, survival rates have doubled and half the people who are diagnosed with cancer now survive, thanks to the great progress that has been made in cancer research. There is still a long way to go and I am pleased that the Scottish Government is delivering on its promises to improve cancer services the length and breadth of the country.

In Dumfries and Galloway, we have 1,135 people currently living with cancer and around 530 cancer deaths each year. As D and G is a large rural region, we have several challenges in the delivery of cancer services.

Along with South Scotland MSP colleagues, since my election, I have been actively lobbying for a change to the cancer pathway arrangements for the region. Currently, NHS Dumfries and Galloway is part of the south-east Scotland cancer network—SCAN—which means that patients who require more complex treatments or radiotherapy often have to travel to Edinburgh. That is a 260-mile round trip, which leads to patient discomfort, distress and frustration, particularly for those from Stranraer and Wigtownshire in the west of the region,.

Continued campaigning by local residents and a local action group led to NHS Dumfries and Galloway last year agreeing to change the current arrangements to have a more flexible approach that is focused on patient choice. That is welcome. However, many local people are concerned about the timescale for implementing the change. Therefore, I ask the minister whether the Scottish Government can assist the board in implementing appropriate changes to the cancer network arrangements, which is hugely important to local people and their families.

Although we have challenges, there is great work going on throughout the region. Research is being conducted in Dumfries and Galloway, and nationally, on a simple home self-test for cervical screening for human papillomavirus. Earlier, I was interested to hear the minister’s response to my supplementary question on the national pilot programme for a self-test for HPV.

I want to touch on a recent cross-party approach with the local palliative care expert, Professor David Clark. A group, along with some local MSPs, are currently exploring the possibility of bringing a Maggie’s centre to D and G to complement—not compete with—other services in the region, including those of Marie Curie, Macmillan Cancer Support and the local health board. The talks are still in the early stages, but we are excited about the prospect of pursuing the establishment of a Maggie’s centre in Dumfries and Galloway, because Maggie Keswick Jencks lived near Dumfries. The group does great work putting on events, and we are trying to develop a process so that there is more support to enable it. I ask the minister to support us in progressing that.

Of this year’s world cancer day theme of “I am and I will”, my sister Buffy said, “I am a cancer survivor and I will be there to support others to survive their cancer, too.”


Miles Briggs (Lothian) (Con)

I congratulate Monica Lennon on securing the debate and on her excellent opening speech—in fact, we have heard two excellent speeches. As co-convener, alongside Anas Sarwar, of the Parliament’s cross-party group on cancer, I am delighted to have the opportunity to take part in a debate to mark world cancer day, which took place earlier this week. I also take this opportunity to thank all the organisations that provided useful briefings ahead of the debate.

The motion is right to highlight the progress that has been made over the past few decades in the doubling of survival rates. Half of people in Scotland with cancer now survive it, and Cancer Research UK aims to accelerate progress so that, by 2034, three in four people with the disease will survive it. What we need to see is an extra and significant focus on those cancers with lower survival rates, such as lung, pancreatic, oesophageal and brain cancers. We also need to see more research into those types of cancer and innovative approaches to treatment.

All of us recognise the critical importance of early diagnosis to improving survival rates, especially in areas of high deprivation. I have been concerned by the waiting times in some parts of the country that have been highlighted recently, especially the waiting times for tests that will determine whether people have cancer. That issue emerged strongly in our CPG’s report, as Monica Lennon highlighted.

I have challenged the Scottish Government to look to trying to change that position by, for example, piloting fast-track cancer diagnosis centres that are based on NHS England’s rapid diagnostic and assessment centres. I hope that the minister will look at that issue again, because it is clear that we need to address the issues of late diagnosis and late presentation in our most deprived communities. We have achieved a great deal with public awareness campaigns in the past, particularly those for breast cancer and lung cancer. Such campaigns are needed to address cancers with very low early diagnosis.

I fully support Cancer Research UK’s call for the Scottish Government to tackle issues in the diagnostic workforce across Scotland. That is essential, as demand for tests increases annually because of both the ageing population and staffing challenges. We need to see that workforce delivered, which is an issue that was outlined in the CPG’s recent report.

Monica Lennon outlined specifically the concerning situation around lung cancer, for which only 27 per cent of diagnoses are for stages 1 or 2. The Scottish Government needs to make progress on some areas, as NHS England is doing, with a properly resourced pilot screening programme of lung health checks across the country. I know that the Government is currently engaged on that, but we need to see progress on it.

The Government must also renew its focus on minimising the time taken from diagnosis to treatment, and I hope that this debate can help take that forward. In December, official statistics showed that 654 cancer patients were still waiting longer than the 62-day standard for their first cancer treatment, with only two health boards meeting treatment targets. Ministers must now set out detailed plans to ensure that those targets are consistently met across Scotland.

I agree with the motion’s recognition of some of the world-leading research into cancer that is taking place in Scotland, a lot of it in the academic institutions in Lothian, which is my region. That is something that, as a country, we should all celebrate. The University of Edinburgh houses Cancer Research UK’s brain tumour centre of excellence, which works alongside University College London on cutting-edge brain tumour research. Dr Steven Pollard and his team are to be hugely congratulated for their work in developing potential new treatments for the most common type of brain tumour in adults. Among many other notable successes achieved at the University of Edinburgh in the past year has been the programme of clinical trials that led to the approval of the new ovarian cancer treatment pathway.

Again, I welcome this debate and the focus that it and world cancer day bring to the treatment of cancer and support for cancer patients. We can rightly point to the progress that is being made and the importance of the world-class research that is going on in Scotland and across the UK. I hope that, as has already been highlighted in the debate, we can work together constructively to make sure that real strides forward continue to be taken over the coming years, especially for those cancers with the lowest survival rates, where we need to see more progress. That is going to take real investment and leadership by Scottish Government ministers, with the Parliament holding them to account on the way.

The Deputy Presiding Officer

I respectfully ask that members try to keep their speeches to four minutes, otherwise I will have to seek an extension to the debate, and that may not be appropriate.


Clare Adamson (Motherwell and Wishaw) (SNP)

I, too, thank Monica Lennon for bringing this motion to Parliament today. I have spoken in many members’ business debates on world cancer day over the years. I am always struck that this is a moment when party politics are truly left at the door of the chamber and we are all reminded that, including through members tributes’ to colleagues, we share a common experience of friends and families who have been touched by cancer. The fact that so many of us can tell those stories speaks volumes about how important it is that we mark world cancer day and that we continue to raise this topic in the chamber.

As someone whose father died of bowel cancer, I highlight the plight of some of the less survivable cancers, such as brain, lung, oesophageal, stomach, liver and—I have raised this type of cancer many times in the chamber, so it is no surprise that I will raise it again today—pancreatic cancer. The Less Survivable Cancers Task Force charity does work in relation to those cancers. Some 44 per cent of cancer deaths in Scotland are caused by the less survivable cancers, only one in five people are diagnosed early enough for life-saving treatment and the five-year survival rate is fewer than 14 per cent. I hope that the minister will be able to update us on how the Government is supporting research and better clinical outcomes for patients suffering from those cancers.

Today is also about highlighting the amazing work that is done in support of those affected by cancer. Under the theme, “I am and I will”, each and every one of us is challenged by world cancer day to do something to support better outcomes for cancer patients in Scotland.

Like my colleagues, I am wearing my world cancer day unity band. I know that there is a call to do a 10,000 steps a day challenge in March. The brace on my knee means that I will not be doing that. However, last week, I attended a wonderful event in the home of Professor Andrew Biankin. He is the regius chair of surgery at the University of Glasgow and a Cancer Research UK clinician scientist. He is also the director of the Wolfson Wohl cancer research centre, which is focused on precision oncology, and he has leadership roles in national and international consortia in cancer genomics and therapeutic development.

Professor Biankin’s work on precision medicine for pancreatic cancer—it is known as precision panc in this country—is truly world leading, and will make a huge difference in how cancer is treated in the future. The precision panc project was founded in 2017, bringing together expertise in pancreatic cancer from the University of Glasgow, Cancer Research UK’s Beatson institute, Cancer Research UK’s Cambridge institute, Cancer Research UK’s Manchester institute and the Institute of Cancer Research in London, the University of Oxford and the national health service.

With 10,000 patients in the UK—and 330,000 worldwide—diagnosed with pancreatic cancer each year and 9,300 deaths a year in the UK, pancreatic cancer is predicted to become, by 2025, the second most lethal cancer after lung cancer. Pancreatic Cancer Scotland has asked that we recognise this as the decade of change, because we have to change those statistics and outcomes for less survivable cancers.

I spent a wonderful day with Professor Biankin in his house, where some 80 people celebrated Burns night and Australia Day and raised more than £5,000 for pancreatic cancer. He said:

“Fifty years ago, women didn’t know how to examine their breasts, recognise breast cancer or have screening, but with a lot of investment of time, energy and money we have seen death rates from breast cancer fall from 50% to 10%. That’s the difference we can make and that’s what we need to do for all cancers, and particularly for pancreatic cancer.”


Lewis Macdonald (North East Scotland) (Lab)

I, too, congratulate Monica Lennon on securing this debate to mark world cancer day, which is an opportunity for people everywhere to reflect on what can be done to support those with cancer and reduce the incidence of cancers in the future.

Today is a particularly important milestone in the battle with cancer in the north and the north-east of Scotland, with the board of NHS Grampian meeting this morning to approve the full business case for the ANCHOR centre at Foresterhill. The business case will now go to ministers for approval, with construction hopefully due to begin later this year. I hope that the minister can confirm that that final approval will be given very quickly.

The ANCHOR centre will allow joined-up services for patients with cancer and blood and bone marrow disorders. It will have specific provision for teenagers and young adults and it will facilitate clinical trials, research and teaching on the Foresterhill campus, which is shared with Aberdeen University medical school.

ANCHOR stands for Aberdeen and north centre for haematology, oncology and radiotherapy. The existing ANCHOR unit at Aberdeen royal infirmary has been providing care and support to cancer patients from across the north of Scotland since 1997, and the new ANCHOR centre will build on that fine legacy.

The Friends of ANCHOR is one of the north-east’s foremost healthcare charities. I know that Jimmy Milne and his fellow fundraisers will continue to back up the work of healthcare professionals in the new centre of excellence that they have helped create and inspire, which will support patients in Aberdeen and Grampian, and across the north and the north-east. A regional approach has been critically important to cancer care in the north of Scotland for a generation, and it will be critically important in reducing waiting times and improving outcomes for cancer patients in the future. Prompt decisions and an early start on the new centre would certainly send all the right signals about the intentions of the board and the Government.

It is important to acknowledge the challenges that the project has already faced. Those challenges have not been made in the north, but have come from the calamities that in recent months have overcome the Queen Elizabeth university hospital in Glasgow and the new children’s hospital in Edinburgh, which caused further investigation in Aberdeen. Those serious setbacks to NHS care in Scotland’s two largest regional centres inevitably had implications for Foresterhill, and they have added to the costs and the time required to complete the ANCHOR centre and the Baird family hospital, which has also been given the go-ahead by NHS Grampian today.

Public bodies and, indeed, ministers are rightly called to account when projects go over schedule and over budget, as we heard at First Minister’s question time today. In this case, it is far better that we have ensured at this stage that there will be no repeat of the things that went wrong elsewhere, and I hope that the Baird and ANCHOR plans can now go forward with support from all concerned.

I want to mention the latest fund-raising initiative of another locally based cancer charity, CLAN, which stands for Cancer Link Aberdeen and North. It supports patients travelling to Aberdeen for treatment and their families. CLAN’s light the north initiative will create a trail of lighthouse sculptures in public places across Grampian, Orkney and Shetland, to raise awareness of and funding for cancer care. The sculptures will be auctioned at the end of the year.

Tackling cancer is a job for Governments and health boards, but not for them alone. CLAN, Friends of ANCHOR and the many other cancer charities that we have heard about today also do a fantastic job on behalf of us all.


Stewart Stevenson (Banffshire and Buchan Coast) (SNP)

I endorse Lewis Macdonald’s remarks about the excellent work that is done by Friends of ANCHOR, CLAN and other charities in the north-east of Scotland. Of course, I thank Monica Lennon for the opportunity to discuss this important subject.

I had a look at my previous speeches on the subject, and I found four: one on breast cancer, one on lung cancer, one on skin cancer and, most recently, one on young people’s cancers. We are all aware that there is a wide variety of cancers.

I turn to the number of cancers that we are diagnosing. By 2027, we will be looking, perhaps, at as many as 40,000 per year, and 110 people will be diagnosed with cancer every day.

Both my parents died of cancer, some considerable time ago: one of breast cancer and one of prostate cancer.

Mortality rates have decreased by 12 per cent in males and 7 per cent in females over the past 10 years, so we are making progress. As we increase our diagnostic capability, we are improving our treatment capability and outcomes.

The lowest survival rates are those for lung cancer and small cell lung cancer, smoking being the cause in many cases. Of course, people being overweight is also a significant cause of cancer. I sit on the very edge of the normal range of body mass index, occasionally dodging out of it and then struggling to come back in. However, too many people in our communities—for all sorts of reasons, and particularly in areas of social and economic disadvantage—are suffering from problems due to being overweight or greater consumption of tobacco. There are a wide range of risk factors that we have to address, as other speakers in the debate have mentioned. Deprived communities are part of the inequalities that we have to tackle.

Cancer Research UK tells us—it is an exact figure—that 41.5 per cent of cancers are potentially preventable. Beyond the prevention work that we have to undertake to get smoking, obesity and our consumption of alcohol under control, one thing that is helpful is early detection. I am in the age group of people who get an annual postal thing that allows them to test for blood in their stool, which is a primary indication of potential bowel cancer. I welcome the fact that the number of samples that one has to take went down from five, as it was when I entered the system, to three, and that it is now just one. The process is not highly engaging or exciting, and the more that we can deconstruct barriers to people doing the test, the better.

That is particularly important for me because I have another condition that tends to give false positives. NHS Grampian has been extremely good in showing in the follow-up that there was a false positive. I have far too intimate knowledge of one of its cameras, which has looked at my innards. I hope that NHS Grampian will continue to give me support as and when it may be necessary. Most recently, it offered me an appointment on a Sunday, which I thought was superb because it did not interfere with other things. That is an example of the innovative approaches that are being taken.

The Scottish Government’s detect cancer early programme, which has been running for a number of years, is a major contributor to detecting early signs of cancer, and I hope that it continues to do so. I hope that we all manage to avoid cancer or, if we get it, that we get the treatment that we need. I am sure that we shall.


Alison Johnstone (Lothian) (Green)

I thank Monica Lennon for bringing this debate to Parliament and I thank all the organisations that have supplied us with briefings. It is really important that we continue to discuss cancer in the chamber, given that it affects so many of our families and friends and so many of the people whom we represent. As has been discussed, one person in two will now develop cancer in their lifetime.

Debates such as this give us an opportunity to highlight the great work that is being done in research and treatment. As the motion states,

“over the last 40 years survival rates have doubled, with half of people in Scotland now surviving cancer”.

However, such debates also allow us to highlight that those efforts are sometimes hampered by workforce challenges. Miles Briggs and Stewart Stevenson touched on the importance of early detection, but there is currently a 10 per cent vacancy rate in diagnostic consultants, which means that services are struggling to meet a level of demand that will only increase as our population ages.

It makes sense that the earlier cancer is diagnosed, the better, but our overstretched services will not be able to diagnose it early if they are subject to increased pressure with no corresponding increase in the workforce. It is essential that we properly resource and staff our cancer services, and Cancer Research UK is calling on the Scottish Government to urgently create a workforce plan to meet current and future need.

We must continue to use these debates to draw attention to rarer cancers. I met the British Dental Association this week, and I note that Scotland has one of the highest incidences in Europe of oral cancer, and rates are rising. There is low awareness of oral cancer, and of pancreatic and hepatocellular cancers. Like others here today, I spoke recently in a debate about pancreatic cancer awareness. That was a great opportunity to draw attention to that particular type of cancer, which has the lowest survival rate, given that its symptoms are vague and not commonly known.

As members know, in previous world cancer day debates, I have highlighted the benefits of physical activity. I want to reiterate that point. Being regularly active can, for example, reduce the level of inflammation in the bowel, helping to prevent bowel cancer, and reduce oestrogen levels, lowering the risk of breast cancer. A 2016 study showed that leisure-time physical activity was also linked to reduced risks of liver cancer, stomach cancer, kidney cancer, myeloid leukaemia, myeloma, and cancers of the head and neck, rectum and bladder. I wholly appreciate that we will never succeed in preventing all cases of cancer, but we must emphasise the importance of physical activity in prevention.

Physical activity and exercise can also lower the risk of being overweight and obese—the second biggest preventable cause of cancer in the UK after smoking, as Stewart Stevenson mentioned. However, as the motion states, deprivation is a major determinant of who develops cancer and who does not. Deprivation also has a significant impact on surviving cancer: the risk of developing lung cancer is higher, and the probability of surviving lung cancer is lower, among people living in areas of socioeconomic deprivation. Historically, engagement with screening services has been low in deprived areas and Cancer Research UK has stated that bold, innovative efforts are needed to improve the early diagnosis of cancer. We must do everything that we can to optimise cancer screening. Clearly, addressing health inequalities must be at the centre of efforts to improve cancer outcomes. It is our duty to reach every person who is at risk.

We know that access to good-quality green space and sports facilities is not equitable. We can talk until we are blue in the face about physical activity helping to prevent cancer, but if there is nowhere nearby for people to play football or to jump on their bikes—if there is even nowhere nearby to go for a long walk that is not along a congested, polluted road—opportunities to be active are limited. We must remove the barriers to people making choices that will improve their health and lower their risk of developing cancer.

I appreciate that I have gone over time, so I will conclude my remarks.

The Deputy Presiding Officer

You just went a smidgen over.


David Torrance (Kirkcaldy) (SNP)

I thank Monica Lennon for securing this important debate on recognising world cancer day. Today, our thoughts go out to the individuals and families who are affected by this dreadful disease. In the debate, we will also raise awareness of cancer, emphasise paths towards prevention and highlight recent research. The entire world unites to save millions of preventable deaths each year by educating individuals to take action against the disease early on.

For many of us, cancer is not an unfamiliar disease. Unfortunately, almost every one of us knows someone who has been deeply affected by it. In fact, Cancer Research UK reports that one in two people in Scotland will be diagnosed with cancer in their lifetime.

Although cancer is a common threat, actions to combat it seem to be uncommon in our society. Despite current communication strategies highlighting the importance of early detection, people do not seem to have a clear understanding of the purpose of screening. Research that was conducted in 2018 concluded that awareness of the preventability of cancer through screenings was low across all demographic groups in the UK.

Two weeks ago, I had the pleasure of meeting the incredible staff from Jo’s Cervical Cancer Trust. The trust reports that one in four Scottish women do not get a regular smear test. Although 75 per cent of cervical cancers are prevented by cervical screenings, over a quarter of young women are too embarrassed or ashamed to attend smear tests and over two thirds do not think that the tests will reduce their risk of cervical cancer.

That concerning level of stigma, anxiety and misunderstanding of smear tests steers women away from getting an important test that could ultimately save their lives. It is not a test for cancer; rather, it is a test that can prevent cancer. There are overwhelming statistics to prove that early detection can lead to prevention. We are lucky to have organisations such as Jo’s Cervical Cancer Trust that are particularly focused on improving women’s understanding of smear results while addressing fears about cancer.

Promoting early detection has proven to be successful in combating some cancers. Over the years, Scotland has seen overwhelmingly positive survival rates for bowel cancer due to increased screenings and tests. According to the Scottish Public Health Observatory, it is the third most commonly diagnosed cancer among men and women. In June 2007, national health service boards initiated the Scottish bowel screening programme, which invites individuals aged 50 to 74 to participate in the screening test for cancer every two years. The test aims to catch cancer at an early stage and identify pre-cancerous growths. Ten years later, the programme reduced barriers to early diagnosis by simplifying the collection process with the aim of increasing participation, and so effectively increasing survival rates to 60 per cent for both sexes. That notable survival rate comes as a result of Government intervention to encourage people to seek out precautionary action.

Although we have made great improvements in bowel cancer detection and treatment, more action will be necessary if we are to improve the early diagnosis of cancer. In particular, new approaches are needed to improve steps to combat lung cancer, which happens to be Scotland’s biggest single cause of death. The survival rates for lung cancer are strikingly low: only 9.5 per cent of people who are diagnosed with lung cancer will survive. Unfortunately, Cancer Research UK has not seen much improvement in survival rates over the past 40 years.

Smoking is a major cause of lung cancer. Action on Smoking and Health states that

“current smokers are 15 times more likely to die from lung cancer than life-long non-smokers”.

As well as being the single greatest cause of cancer, smoking is also the single most avoidable risk factor for it. Scotland has made tremendous progress in tobacco control, by setting out a range of measures to shift attitudes towards smoking. It has introduced legislation on making public places smoke free and continues to make investments in tobacco control activity that have included more than £15 million a year on smoking cessation services and measures to stop young people smoking.

Since the implementation of those programmes, the proportion of Scotland’s population who are smokers has dropped to 18 per cent. Through the 2034 tobacco-free initiative, we hope to see that number fall below 5 per cent. Today, on world cancer day, I urge members to help their loved ones to quit smoking or, if they themselves are smokers, to make the decision to quit for good.

In my constituency—

The Deputy Presiding Officer

No, I am sorry—you must conclude there. I am being quite hard on members, because the Parliament resumes at 2 o’clock and we do not have a lot of time.


The Minister for Public Health, Sport and Wellbeing (Joe FitzPatrick)

I thank Monica Lennon for securing this important debate, in which we have made it clear that tackling cancer remains an absolute priority that is at the forefront of all our minds. It makes me immensely proud to join other members in wearing a unity band, which shows the solidarity and unified approach that best represent how we should tackle the disease.

I take this opportunity to commend the fantastic work of all our national health service staff who help in the fight, and also the valuable work of many cancer charities that support people with cancer in Scotland.

If I might take this opportunity to move off script for a second, I will thank the staff at Aberdeen royal infirmary. My dad, who was suffering from stomach cancer, recently had fantastic treatment there from Mr Shayanthan Nanthakumaran—who, fortunately, was very happy to be called Shay. That is a difficult form of cancer to treat, but I am absolutely delighted to say that my father got out of hospital at Christmas time, having had the all-clear. He is now doing really well and no longer needs care support. I say a huge thank you to Shay and all the staff at the infirmary for the support that they gave my dad at what was a difficult time.

In mentioning Aberdeen, I should also thank Lewis Macdonald for his comments on the Aberdeen and north centre for haematology, oncology and radiotherapy. I hear his request to ensure that when the business case for it comes before ministers, approval for it should be given timeously, as it should be.

It is important that we recognise that some 40 per cent of cancers are preventable, so we should continue to take brave and often world-leading public health actions to tackle them. Scotland has proudly led the way through initiatives such as the ban on smoking in public places and minimum unit pricing on alcohol. In a similarly brave approach, we are working on a bill to reduce the promotion of foods that are high in fat, sugar or salt.

We all know the ramifications of smoking. It is the single most significant threat to public health in Scotland, which is why we have a national target—a UK first—for all health boards to achieve quits in smoking populations from the most deprived communities, in which smoking rates are highest.

Monica Lennon mentioned wealth inequalities. Scotland is the only part of the UK that sets targets based on its least well-off communities. Through the collective efforts that have been made across the country, we have already reduced smoking rates by 7 per cent since 2013, and in 2018 the smoking rate went down to just 19 per cent. Alison Johnstone made the very good point that other factors particularly affect people in our most deprived communities. We need to ensure that we focus our attention on those, in addition to smoking.

Screening is also a key weapon in our armoury and we work hard to maximise the opportunities around it. David Torrance talked about cervical cancer: in recent years, thanks to the roll-out of the HPV vaccine, we have seen a huge reduction in the amount of cervical pre-cancers. Emma Harper talked about the self-testing pilot and I am very pleased that Scotland will roll that pilot out across the country later in the year. I hope that that important initiative will help to remove some of the barriers to that potentially life-saving testing. Similarly, thanks to a new UK-leading bowel screening test, which Mr Stevenson talked about, we detect more bowel cancers than ever before.

It is one thing to talk about those exciting developments, but another to ensure that they are available to people who need them. Thirty-four different projects have been funded by the Government in order to tackle screening inequality and to ensure that everyone has equitable access to those potentially life-saving interventions.

Stewart Stevenson also talked about early detection. We know that the earlier a cancer is diagnosed, the easier it is to treat and even cure. That is why we launched our £41 million detect cancer early programme.

I am mindful of the time, but I will make this important point: 25.5 per cent of people in Scotland were diagnosed at stage one in 2017 and 2018, which is an increase of 9.4 per cent from the baseline years of 2010 and 2011. That means that 743 more people are diagnosed at the earliest stage and 1,026 more people are diagnosed at stages one and two combined, compared with the baseline numbers. More people are being seen and more people see their family and friends survive a cancer diagnosis than ever before.

Lung cancer, as Monica Lennon said, is one of the most difficult cancers to treat. Compared with the baseline, we are seeing a 46 per cent increase in the number of stage one lung cancer diagnoses, which equates to 75 more people being diagnosed at stage one each year. That is very important.

The new, overarching detect cancer early social marketing campaign, survivors, is live. The campaign has been developed in close consultation with the Scottish cancer coalition and aims to reduce fears around cancer and to empower people to take early action, be that visiting their GP practice or attending screening when invited.

Miles Briggs mentioned innovative approaches to treatment. Scotland leads the way in radiotherapy and is the only UK nation to implement a rolling refresh programme that ensures that all five of our cancer centres regularly use the most up-to-date linear accelerators. As a result, all our centres deliver cutting-edge modern radiotherapy.

Alison Johnstone rightly talked about the workforce. In the midst of all the Brexit uncertainty, our health workforce continues to deliver, with care and commitment, for Scotland’s patients. NHS Scotland’s staffing figures are at record high levels, having grown over the past seven consecutive years. I have a whole lot of stats here about how we are making a difference with regards to recruitment in areas such as radiology in particular, but I will skip on.

With regards to world cancer day, a prime example of the theme of unity is our £18 million partnership with Macmillan Cancer Support, which is the first of its kind in the UK and will ensure that every cancer patient in Scotland has access to a key support worker, who can provide emotional, financial and practical support.

A lot of work has been done and we have to continue those efforts. The cabinet secretary will shortly announce an update on our cancer strategy that will set out a range of new actions to help to drive that continued improvement, and I can assure Clare Adamson that action around less survivable cancers will be key to that update. I hope that colleagues across the chamber will welcome and support those new actions when they are taken.

I thank colleagues across the chamber for coming together and I thank Cancer Research UK, Marie Curie and other charities, as well as all of our fantastic NHS staff, who work tirelessly to look after us when we most need it.

13:34 Meeting suspended.  14:00 On resuming—