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Cancer Plan

October 12, 2011 5:55 PM
By Peter Black
Originally published by Peter Black and South Wales West Liberal Democrats

Peter Black: The motion that we have tabled very much feeds into the development of the cancer plan. I hope, therefore, that the Minister will support it. I notice, however, that she did not answer Kirsty Williams's question about value-based pricing, whether she is committed to it and whether she will be introducing it in Wales at the same time that it is introduced in England. That is an important question that requires an answer from the Minister now, or at a later date.

6.00 p.m.

The Minister makes the point that we are spending £5 per head more in Wales than in England, but the fact is that the outcomes and uptakes are worse here than they are in England. Although we are spending more, it seems that the money is not being spent effectively, because England is getting better outcomes for people who suffer from cancer.

Other countries develop person-centred cancer services: Welsh policy is lagging behind with an approach still dominated by the clinical and acute aspects of care. Government policy focuses on prevention, early detection, improved access and better services, but not on how people who have survived cancer can rebuild their life, or how care should be centred on the needs of the patient-a point made by Lindsay Whittle.

There are also questions about access to medicine and treatment. England has a cancer drugs fund, which means that patients over the border are able to access treatment that is denied to Welsh patients. Despite the fact that clinicians in Wales have recommended certain drugs for them, the drugs are not funded and the patients are denied. These patients often receive treatment in English hospitals, sitting next to English cancer sufferers who can access those drugs. The principle should be that if the clinician prescribes a medicine, it should be funded.

David Rees: I often hear about patients having access to drugs in England. However, is it not true that not every patient in England will have the ability to get those drugs, but that only a limited number get them? Yes or no.

Peter Black: The point is, David, that there is a fund, so patients are able to access those drugs. That is not the case in Wales. There are patients in Wales who cannot access those drugs who are being treated next to patients in England who can. That is the problem.

We believe that the cancer plan needs to be driven forward by a co-ordinator who is a clinician in their own right and able to understand and deliver the treatment that sufferers need. We are in danger of losing the best cancer doctors and of not having access to trials because we are not delivering the latest treatments or medicines.

Mick Antoniw implied that the cancer drugs fund is somehow a conspiracy by the drugs companies to boost their profits. I am shocked by such cynicism. The fact is that many of those disputed drugs can prolong life, even if it is just for a few months. Other drugs are not even evaluated, because they apply to rarer cancers, so NICE takes the view that they are uneconomic because of the small numbers of patients involved. These drugs will sometimes be more effective for some individuals than others, and I suggest that we should be led by clinicians; as I said, if they recommend a contested drug, it should be funded. That is what a people-centred service is all about. We talk on all sides of the Chamber about providing a people-centred service, but if you are not providing the drugs that clinicians say people need, you are not delivering it.

It is when rarer cancers affect the kidneys, for example, that the drugs fund comes into its own. About 500 people in Wales suffer from kidney cancer, and fewer than 9,000 in the UK every year. A drug such as Afinitor could extend life by up to nine months, but it is considered uneconomic because of the small number of people affected by that particular type of cancer. However, it is available in England for patients for whom it is recommended by their clinicians, but it is not available in Wales. I find that unacceptable.

I also find it unacceptable that English primary care trusts appear to have more funding routes available to them for those drugs than Welsh local health boards, and there is also less bureaucracy involved.

Rhodri Glyn Thomas: Will you take an intervention?

Peter Black: I have less than a minute left, Rhodri, so I will give you 10 seconds to come in.

Rhodri Glyn Thomas: Just for clarification, are you suggesting that clinicians should be given total freedom to prescribe whatever drugs they see fit to their patients?

Peter Black: I am certainly not suggesting that I should prescribe the drugs, as I have no idea what they do. The clinicians are the people who know what is needed for their patients and what drugs are necessary for diseases. Are you saying that clinicians should not be trusted? I trust doctors and clinicians because that is what they are paid to do, and that is why we pay a fortune on training them to such a level. Why are we putting more money into this service than in England, yet patients are getting a worse service?

The Minister complained that we are spending too much time on this issue. I am not complaining, as I do not think that we are; I do not think that we can spend too much time on it until we get it right. We need more debates until the Government listens to what needs to be done for Welsh patients.