Questions and Answers – Steve Brine meeting on 5 April 2016

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THIS IS A DRAFT VERSION. Please send all corrections via the contact form. Thank you!

Health Issues

1. As you have quite extensive knowledge of breast cancer issues, what is your view of the priorities and economics of funding further research, and services focusing on PREVENTION of breast cancer vs TREATMENT, and how nationally the Government can help further that? (AM)
ANSWER – The Generations Study was set up in 2004 to help understand the causes of breast cancer. At the moment, we don’t know why one woman will develop the disease while another won’t. This is an enormous project following more than 113,000 UK women for 40 years. Also, Dr Jeremy Blaydes, based at the University of Southampton, has been awarded a grant of around £200,000 to investigate how breast cancer cells become dependent on sugar to multiply and survive. These studies will contribute towards the prevention of breast cancer.

2. What changes are envisaged to the future funding of the Cancer Drugs Fund? (BD)
ANSWER – Government keeps topping up the fund but it never seems to be enough. Other initiatives may be more effective. George Freeman, MP for Mid Norfolk Minister for Life Sciences announced the Accelerated Access Review (June 2016) with the aim of sharing NHS clinical data to develop personalised medicine. Steve also mentioned the Off-patent Drugs Bill which is a Bill introduced before the Parliament of the United Kingdom by Jonathan Evans in October 2014. It aims to make the British government seek new licences for off-patent medicines that could benefit patients whenever pharmaceutical companies fail to do so because there is no financial incentive. the General Medical Council is clear that a doctor takes on an extra level of personal liability when prescribing off-patent and that licensed treatments should be considered
before unlicensed or off-label drugs/ treatments. Therefore, doctors can be unwilling to prescribe drugs for new purposes, even where the clinical evidence is strong.

3. Given that the majority of oncologists in training are on a non resident on call rota which will be heavily affected by the new junior doctors contract, how are we going to attract the best and brightest to move breast cancer research into the future? (JB)
ANSWER (Incomplete. Need input from JB please) – Steve started by giving a bit of background information about this. There has been 5 studies in 6 years about weekend effect. The goverment wants a safer 7 day NHS. A new GP contract has been done. With regards to junior doctors, the government has been trying for 3 years to sort out a contract. ACAS came up with a memorandum of understanding that consisted of 19 points. 18 points were agreed. Just before the last point could be agreed on, the BMA trade union went on television to announce a strike.

Plan to add 7 day diagnostics to the consultants contract.

Junior doctor contact imposed.

Salford Royal already doing a 7 day service.

Emergency Care Strategy

Patient Safety Conference last month – want safer 7 day NHS

4. Given that the health service already provides a 7 day fully staffed emergency service, and the evidence base shows that the most likely day of the week to die is a Wednesday and not a Saturday or Sunday, what is Jeremy Hunt hoping to achieve by creating a more comprehensive weekend service as this already exists? (JB)

5. Furthermore, how does Jeremy Hunt propose to fund this supposed more complete service within a cost neutral envelope as agreed between the BMA and NHS employers? Surely you cannot stretch an already at breaking point work force further?
-JB

6. Lyme Disease Testing:
I have mentioned to Steve before about the problem in the UK of people not being tested soon enough or fully tested for Lyme Disease. I don’t fully understand it as is complex but know from friends who are affected by this & also by what I have read in the media. My friend, as many other people in the UK, is having to pay a fortune for treatment from America as was not treated soon enough or correctly by GP’s in the UK.
It appears the initial problem is the lack of awareness by many GP’s & that tests need to be done as soon as possible if there is the slightest suspicion of a person having Lyme Disease. Often Lyme is diagnosed much later in life & then it is so much harder & more expensive to treat.
Also many that are tested come back as negative but can often be false negatives as Lyme mimics many other illnesses & there should be further test done. Apparently, UK only test for the Burrelia Burgonferi bacteria but in Germany & America for instance, they tests for many other bacterial infections so they can be ruled out. There are not enough testing labs in UK therefore many people are told its negative & treated for other illnesses but all the time actually have Lyme.
Please can I ask :
A. That it be strongly requested the Government Health Department engage with LDA (Lyme Disease Action) group to ensure this disease is made an awareness in the medical profession.
B. Also testing is followed through thoroughly so that people are treated asap.
The cost to the people who are not treated properly is so unfair & to others that cannot afford to obtain treatment abroad often die or are treated for other illnesses at a very high cost to the NHS when all the time they actually have Lyme which could be treated cheaply.
-SE
ANSWER – Steve printed out an answer & handed to Sandie – Click here to view the answer
7. Lymphoedema Services in NHS:
Lymphoedema is caused by the lack of lymph nodes in a persons body which can be removed during surgery & called Secondary OR if a baby is born with less lymph nodes than needed then it is called Primary. We need lymph nodes all over our bodies in order to move fluid around & help protect us from infection. If we do not have enough lymph nodes or they are damaged then this can create a blockage of fluid which results in swelling in that part of the body & serious infections. It is then treated as an infection & specialist can help massage the fluid away & prescribe suppression garments. There is no cure although can be managed with professional help.
I have been treated for bilateral breast cancer & as a result have lymphoedema in both arms & part of one breast. Luckily my treatment at Winchester hospital has been good & I can now manage this myself by the wearing of suppression sleeves & doing massage & exercising myself. I also see the specialist nurse, Helen Woolley, 6 monthly & as an emergency when necessary. However, last year Hampshire Hospitals were going to remove Helen’s weekly services completely & if they had would have been appalling for people like myself who have lymphoedema as a result of surgery & also other who have primary lymphoedema from child birth.
After many letters of protest were sent to Mary Edwards, CE of Hampshire Hospitals, Helen was kept on at Winchester but only on a fortnightly basis. As my lymphoedema is managed ok this is fine for me but I have heard others say that they cannot get an early appointment with Helen now & have to wait months. This does not sound satisfactory enough as to delay specialist treatment means patients conditions can become much worse. Also many GP’s & Consultants are not fully aware of how patients with or at risk of lymphoedema should be treated, ie., no needles or blood pressure to be used on an infected or a at risk of limb. I personally have had to have arguments about this with 2 different consultants at Winchester Hospital so obviously the medical profession need to be made more aware of this very unpleasant & painful condition.
Therefore I ask please:
A. That the NHS Lymphoedema Specialist services across the country are made sufficient for the demand. In Winchester that means at least a weekly service.
B. That GP’s, Consultants & Nurses are all made aware of Lymphoedema & how the patients should be correctly treated.
-SE
ANSWER – Helen who is running lymphoedema clinic in Winchester was on loan from St Michaels hospice in Basingstoke who then withdrew her services. Mary Edwards CoE of Hampshire Hospitals then funded her services back into Winchester.
SE commented that this was really only after she & many others had written letters to Mary Edwards after being requested to by the Breast Care Nurses & Helen herself. Now the service was only once every 2 weeks rather than weekly & people waiting far too long for initial appointments, some she knows having to wait 3-4 months which isn’t good enough.
ANSWER  – Winchester hospital are currently training 2 lymphoedema breast care nurses & will be ready in the middle of 2016. Government decided not to nationally commission lymphoedema services and just keep it local.

If the Critical Treatment Hospital and Cancer Treatment Centre proposals go ahead, there may be reduced services in Winchester. See also http://www.hampshirehospitals.nhs.uk/about-us/fit-for-the-future/frequently-asked-questions.aspx

8. Despite a government requirement to do so, it seems many hospitals in England are still not recording the number and nature of secondary cancer patients they see. How can they possible resource-and plan for and support these People without any data?

ANSWER – NHS has started data collection on secondary cancer. GP dashboard Care Comission Group. Secondary cancer now part of GP dashboard. Dennis Morgan – runs Breast Cancer NOW. Around 36K women with secondaries in UK.

BC monitor 5 year stats

96 points – Independent Cancer Task Force

Kelly Palmer

CRUK website

Rethink Cancer Campaign – getting cancer on national curriculum

The focus of cancer treatment seems to be on survival rates after primary cancer and shockingly to me, the clock for that starts when you are diagnosed and not when you have finished your treatment. It is logical therefor to assume cancer treatment is aimed at whatever cost to the individual patient,to achieve the initial goal (survival years after diagnosis) which would be seen as the achievemnt, when surely it should be planned for whole life support and quality of life?
How can we be sure the diagnostics and treatments being used to achieve the short term measured goal aren’t actually causing secondary cancers and making them more resistant to treatment. If the whole spectrum was considered and planned better including prevention treatments for those at higher risk, don’t you think the whole nature of the cancer treatment and support would no doubt change for the better?

I believe the very wealthy pharma companies have far too much influence and because of the training and targets doctors work to they do not consider the whole picture they deal with a very narrow window and set of guidance that could be very detrimental over the long term.
-KR
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Pensions

9. I have always looked forward to being able to retire and collect my pension at the age of 60 but have been informed that I won’t be able to get it until I am 66 in 2022. Following treatment for cancer in 2013 I returned to my job as a teaching Assistant but ended up leaving after a year because i was just getting too exhausted and didn’t feel my condition was given due consideration. I am pleased I have done this but know I will have very little money until I am 66 and to be honest who knows if my cancer will return and I might never make 66. Would the government allow women of my age to take a smaller pension at an earlier date? This would make things easier for many people and not cost any more in the long run.
-MM

10. For many years the retirement pension paid by the Government has been frozen to some immigrants who went to certain countries. Retired people going to USA, Israel, Turkey, the EU, Jamaica – hundreds of other countries, – receive their oension updates ( to which they contributed all their working life) and all updates. However, those in New Zealand, Australia, South Africa, Canada, Trinidad, India and some other “chosen” countries have their pension frozen at the date they left UK.
Example. Mine was frozen at AUD129 (£60) a week so approximately £240 every 4 weeks for 24-1/2 years, yet when I returned to UK I now receive £719 every 4 weeks! This, to me, is discriminatory and unfair.
Many migrants who went to join family or, in some cases, had been made redundant and went in order to find work, are returning to UK unable to afford to stay where they are.
The British Government fails to see that those who are away save them a lot of NHS costs, and those returning will not only have updated pensions like mine, but costs for NHS care will happen.
A Motion is going before Parliament shortly, tabled by an MP early March, challenging this freeze.
Question: Will you support and sign this new EDM 1235 please. (NC)
ANSWER – Steve does not sign EDMs and believes that it is a waste of parliamentary time. He asks that this is emailed to him so he can look into it.

11. Is the government going to revise the transition of pension age from 60 to 66
for women born in the 1950s?
-BD
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EU and Local Issues

12. What is your position on the UK’s EU membership? And what are your reasons / arguments for in or out? This question is linked to another question received …..exactly what do we get from the EU for the £55 million pounds per day we pay to them, we want some guidance as to whether we Vote IN or OUT in the Referendum in June.
-VS
Update (1 Apr): Steve Brine MP gives his view on the 2016 EU Referendum and explains why he will be voting to Remain in June …

13. Why does the Barton Farm development mean the closure of the Andover Road? Can you explain the Planning and Highways reasons for this, which seems to me and many other people to be utterly ridiculous, and would cause lots of traffic problems for many of the surrounding roads. There is a public, local movement to oppose this closure – how intrinsic to the future overall Winchester Local Plan is the proposed closure, and therefore how likely is it to be overturned by the opposition group?

14. Why does the redevelopment of the Silver Hill area of the city keep being promised and then not delivered? Why has planning been so difficult – it’s a very shabby part of Winchester, especially the area around Friarsgate, so why has there been so much opposition to the redevelopment? What is the latest position?
-CS

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