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Let's beat cancer sooner

A photo of Lib Dem leader Nick Clegg

Nick Clegg MP, leader of the Liberal Democrats

In a month when speculation has been rife over whether the Liberal Democrats might join forces with Labour or the Conservatives in a hung Parliament, we can bring you an exclusive interview with Liberal Democrat leader Nick Clegg.

We’ve already interviewed PM Gordon Brown and Conservative leader David Cameron – so what do the Liberal Democrats plan to do to help beat cancer?

Britain’s cancer survival rates are worse than many of our European neighbours – what are the Liberal Democrats planning to do to tackle this?

Nick Clegg – Early detection is key. It simply doesn’t make sense for people to be turned away from screening programmes because they’re thought to be too old or too young, so we’d scrap age limits on screening for a start. And we need to get more people to go and get screened in the first place, by getting the message out to everyone that the best way to beat cancer is to catch it early.

Jade Goody’s death showed how important awareness is in getting people to get themselves checked. But right now take-up rates for cancer screening vary dramatically from place to place and between different ethnic groups.

We also need to make sure that the tight constraints on public finances don’t now undermine the treatment given to cancer patients. I believe that if we cut waste in the NHS we can protect the doctors and nurses on the frontline who are treating these patients and supporting them through what is an extraordinarily difficult time.

Research shows that a significant proportion of all cancers could be prevented by changes to lifestyle. What role do you see for Government in helping people make healthy choices?

NC – While I don’t think it’s government’s job to tell people how to live their lives, we do need to face up to the fact that poor lifestyle choices are costing our health service billions. Government has a big part to play in raising the profile of public health, and making sure that when people smoke, or drink excessively, or eat unhealthily, they have been made aware of the consequences.

Government and the NHS can then work together, and with charities, to help people who want to make healthier choices see them through. It’s no good just moralising about people’s choices. You have to empower them, through information, support, and incentives, to help themselves. Where there is that support – like through programmes to help people quit smoking, or schemes like MEND, which promote healthy living for families to help tackle child obesity – we see results.

How will you raise awareness of cancer symptoms amongst GPs and the public?

NC – GPs have to be able to reach people. People get to know their doctors, get to trust them. We have to make sure GPs are able to spend time with their patients, talking them through the risks of cancer and looking for early warning signs; especially in deprived communities where there is still a shortage of GPs.

We also have to be open to new, innovative ways of connecting people to their doctors.I’m interested in some work that has been done in America to show how GPs can use IT systems to monitor patients in at-risk groups and encourage them to attend screening programmes.

We know that if cancer is detected earlier, treatment is often simpler and more likely to be effective. What will you do to make sure cancer is diagnosed earlier?

NC – Certainly we need to make sure that people have rapid access to referrals. But we also have to ask ourselves why people aren’t going to talk to their GPs or attend screening programmes in the first place, and then we have to remove those barriers.

Men for example are much less likely to visit a GP regularly than women, which can cause delays in diagnosis. Sometimes the problem can be fixed relatively easily. For example, if the issue is finding the time, we can make it easier by allowing patients to register at more than one practice, which means you can visit a practice near home as well as near work. But there are bigger, cultural barriers that we need to tackle too, like the stereotypes that stop men going to get advice from their GPs.

If we want to increase early diagnosis, we also need to look at what’s working round the country, and then roll those practices out to other places. For example, there’s a great programme in Doncaster which encourages people with persistent coughs to visit their doctor to ask for an x-ray. It’s led to more cases of lung cancer being diagnosed, with treatment being made available earlier. That’s the kind of scheme we need to see more of.

How will the Liberal Democrats ensure patients have the right to rapid access to the best cancer treatments, regardless of where they live?

NC – Everyone is entitled to swift, quality care, and if waiting times are exceeded we believe people should be treated privately. And it must not be difficult for patients to make appointments, which is why there should be a duty on healthcare providers to meet access targets. We also support changing how NICE works so that it can make decisions on new treatments as quickly as possible. NICE should set its own agenda and come to decisions sooner than it currently does.

We should also be looking at existing treatments to see whether best practice is being shared across the country. Too often PCTs hide behind delays in the NICE process to avoid prescribing new drugs which could bring real benefits to patients.

How will you make sure patients get the information they need after diagnosis?

NC – Hearing that you or someone you’re close to has cancer can be terrifying. But what can help patients and their loved ones get to grips with that ordeal is clear information and support from the professionals treating them. It’s impossible to underestimate the role that these professionals – staff, specialist nurses, counsellors – play in helping people get through their cancer treatment.

We need to make sure that these valuable services aren’t now cut because of bureaucratic excesses elsewhere.

How do you plan to tackle cancer inequalities between different social groups?

NC – I think that one of the biggest issues here is the lack of access to high quality primary care. The poorest areas of the country are generally also the ones with the fewest doctors. And the people in these areas often can’t afford to take time off to visit a GP during working hours, which is why people have to have the option of visiting their GPs in the evening and at the weekend.

We are going to be proposing policies to tackle both these problems: paying GPs a bit more to work in deprived communities, and allowing people to sign up for any GP that’s convenient – like one near work, instead of near home, for example.

I am also conscious of the role that prevention can play in these communities – smoking rates, obesity and alcohol consumption are often far higher in deprived social groups, and I think the way GPs get paid should change to give them more incentive to get patients to improve their health.

In the current economic climate, what will you do to protect frontline cancer services?

NC – As with all of our public services, the NHS is now in a difficult situation and we need to be honest about that. Unless we can improve efficiency, the NHS is going to struggle to keep pace with increasing demands and the development of innovative and expensive new treatments. But there is money to be saved – through ending waste and cutting inefficiency: we all love the NHS but we have to ask questions given there are more NHS administrators than there are hospital beds to put them in.

It sounds technocratic, I know, but it is vital if we want to safeguard front line services. It isn’t just right, it’s rational too – the more we prevent cancer and treat it early, the more money we can save in the longer term.

Cancer Research UK spends over £350 million a year on research – how will the Liberal Democrats support the UK’s world-leading scientists and researchers?

NC – I see science and R&D as absolutely at the heart of the new economy we must now build. Britain’s research communities are among the best in the world, which is even more impressive considering the years of neglect they’ve suffered under successive Conservative and Labour governments more interested in courting the City of London.

I want to give our research communities certainty in the current economic climate, which is why I support the principle that once allocations are made to research budgets they aren’t then snatched away. And I believe funding should be allocated according to our broad, shared priorities – like improving public health – not distorted by the current tick box approach which gives politicians and bureaucrats ultimate say over which particular projects are and aren’t worthwhile.

Thanks to the generous support of the British public, much of our medical research is funded by charities like Cancer Research UK. What will you do to help the charity sector thrive?

NC – Charities play an absolutely essential role in complementing the work of public and private sector providers in almost every area of life. The current government has run out of ideas over how to harness the potential of the third sector.

The Tories, meanwhile, are asking charities to do more with less money leaving them underwriting the costs of delivering public services.

The Lib Dems are committed to ensuring that the third sector has the support, infrastructure and access to funding it needs. That’s how we ensure that the real strengths of the sector are built upon – its independence, flexibility and innovation.

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Comments

Dr. Hugo Cassian June 6, 2010

I would just like to point out to Mr. Clifford Mobely that Nick Clegg is not an oncologist or medic of any kind. We have to allow for that fact.

Oliver Clifford-Mobley February 23, 2010

Nick Clegg is in danger of openning a can of worms over screening for cancer. I am afraid that it can make sense to only screen people in certain age groups in some screening programmes.

In any screening situation we have to balance the benefit of increased early detection of the disease against the occurance of ‘false-positive’ results – that is people who screen positive, but do not have the disease. It is important to remember that the implications of a positive screen can be massive. Often the next step is further testing, which can be much more invasive, and may carry its own risks to the patient. This will use up NHS time and resources, thus reducing the amount that can be spent on those who really do need it. On top of the extra medical attention, the individual concerned will have the psychological burden of thinking that they have the disease. For these reasons limiting the false-positive rate of any screening protocol is of paramount importance.

For a screening protocol with a given sensitivity for detecting disease, as the prevelance of the condition in the population decreases, so the false positive rate rises. This is a statistical consequence of tests not being 100% perfect. Therefore selecting populations with higher pre-test probability of having disease makes the programme more efficient. Cancer is very much an age-related disease. Young people can also suffer form certain types, but for most cancers your probability of developing it increases with age.

As long decisions on which populations to screen are based on sound epidemiological evidence on the risk of developing the cancer, it is only sensible that screening is targetted at specific groups.