Election fever is in the air – and health is already a hot topic. On the day that the Conservatives publish their draft health manifesto, we bring you an exclusive interview between Harpal Kumar and Conservative leader David Cameron MP.
Cancer’s not just a medical issue – it’s a political one. We want to see politicians from all sides agreeing to make cancer a priority in the next Parliament. We’ve already heard from Prime Minister Gordon Brown in September 2009 about Labour’s plans to beat cancer.
So what are the Conservatives thinking?
Harpal Kumar – Britain lags behind the best performing European countries when it comes to cancer survival rates – what is the Conservative party planning to do to tackle this? How will you achieve the best cancer outcomes in Europe?
David Cameron – First, early diagnosis is often the key to this – as flagged up by the Government’s Cancer Tsar [Professor Mike Richards, National Cancer Director] in his recent report. He said action in this area could save up to 10,000 lives a year.
That won’t be achieved simply by setting another target though. One of the problems which the whole NHS has faced is the priority it has been forced to give to centralised targets. This has ended up distorting clinical priorities and overriding the judgement of professionals. We need to get attention focused on outcomes, not targets, and to make professionals accountable to patients.
Once diagnosis of the condition has occurred, we also need to make sure there is proper access to drugs and other treatment – which we will be coming on to later.
HK – How are you planning to measure those outcomes?
DC – The Tsar urged a focus in particular on one-year survival rates, as a measurement of early diagnosis, as well as the existing five-year survival rates. If we want greater accountability to patients, the important thing is to publish as much information as possible on survival rates in individual hospitals.
HK – Half of all cancers could be prevented by changes to lifestyle. How will you empower people to make changes to help prevent more cancers?
DC – For many of the biggest causes of premature death in Britain, factors such as smoking, diet, excessive drinking, as well as local environment and poverty, are even more important than the capacity of the local NHS.
But one of the problems is that these are often seen as ‘long term’ factors, and public health budgets end up being first for the chop when short-term financial pressures arise. We would ring-fence public health budgets to stop the money getting siphoned off.
It’s not just government which has a role to play. We are also working on a ‘Responsibility Deal’ with business and the voluntary sector, covering issues like food labeling. And local communities too need to be empowered to work in partnership with others to deliver a healthy living agenda – in schools, places of work, local clubs, as well as through the NHS – and our plans for local directors of public health will help to achieve this.
HK – How will you promote better awareness of cancer symptoms?
DC – Part of the role of public health campaigns is not only to promote lifestyles which help to prevent illness occurring, but also to publicise symptoms of those illnesses so people go to their GP earlier. This is vital if we are to achieve the earlier diagnosis I was talking about.
HK – If we detect cancer earlier, treatment is simpler and more likely to be effective. What will the Conservatives do to make sure cancer is diagnosed earlier?
DC – There are three things we can do.
First, make people aware of the symptoms.
Second, make people aware of the cancer screening services which are available.
And third, make sure GPs themselves are fully aware of the symptoms so they can refer people swiftly for diagnosis.
HK – How will you give patients faster and more equal access to the best cancer treatments?
DC – We need to start by making sure that the Government’s promises on access to radiotherapy are kept.
We also need a big reform of drug pricing in the UK, to ensure that all new treatments that are clinically effective are made available. The current system is out of date, and the Government itself has admitted that usage of new anti-cancer drugs is estimated to be a lot lower than in other developed countries.
Drug companies should be paid strictly according to the benefits that a drug brings to patients, including some reimbursement for innovation if appropriate – rather than through the arbitrary flat-fees that exist at the moment. Such ‘value-based pricing’ was recommended by the Office of Fair Trading as a way of getting greater benefit for patients from the same level of spending.
We will also reform NICE, allowing patients to access new drugs within three to six months, rather than the average eighteen-month waiting time which exists at the moment.
HK – How do you plan to tackle cancer inequalities?
DC – Part of this is about improving information to the public – both public health information and information on the services available.
But as well as geographical inequalities, there can also be inequality of treatment based on age. If there is too disproportionate a focus on five-year survival times, those aged over 75 suffer. Paying more attention to one-year survival times would help to address this.
HK – In the current economic climate, what will you do to protect frontline cancer services?
DC – We have pledged to increase spending on the NHS in real terms every year. Given, as you say, the current economic climate – and the absolutely dire state of the public finances – that is a very real indication of the priority we give to the health service.
However that still won’t be enough to improve the service enough, and deal with the range of pressures it will face, unless we also get more of the money to the front line. By the end of the fourth year, we plan to have cut spending on central bureaucracy and administration by a third. That will mean more money for frontline services like cancer services.
HK – Cancer Research UK spends over £300 million a year on research – how will the Conservative party support scientists and researchers to maintain the place of science in the UK economy and to support the international reputation of the UK in this field?
DC – Cancer Research UK plays an invaluable role, and I would like to pay tribute to all you and your supporters have done in the fight against cancer.
Government too has a vital role to play if we are going to be as competitive as possible in Research & Development. Its role includes providing the right number of pharmacology clinicians and also helping professionals identify and select suitable participants for trials. My colleagues in the health team have been liaising with the Royal College of Physicians about how best to achieve those goals.
HK – What will you do to support charity research in universities?
DC – We want the Government’s review of university funding to consider ways in which more funding could be directed towards academic research in support of charitable causes. Developing stronger links between charities, universities and business can also help to attract more money into research from private sources. And our various policies aimed at boosting charities’ incomes will also allow greater investment in charitable research.
Then we need to make sure that research funding goes to the areas that need it most. That includes looking at ways in which bodies such as the Sector Skills Councils and the Charity Research Support Fund could be improved so that Government research funds are better spent.
HK – Britain is unique as so much of our medical research is funded by charities like Cancer Research UK, thanks to the generosity of the public. What will you do to help charities?
DC – If we are going to achieve a stronger sense of social responsibility in Britain, charities have a vital role to play.
So we’ve set out a number of ways in which we would help charities – including ending the hijacking of lottery funds, cutting the bureaucracy involved in gift aid, and establishing a level playing field between charities and private providers by allowing charities delivering public services to earn a competitive return on their investment.
I see charities, social enterprises and voluntary organisations as important engines of future social progress, and I want to do all I can to help their work.