Rare Cancers Bill

The Committee consisted of the following Members:

Chair: Graham Stuart

† Arthur, Dr Scott (Edinburgh South West) (Lab)

† Brickell, Phil (Bolton West) (Lab)

† Costigan, Deirdre (Ealing Southall) (Lab)

† Dalton, Ashley (Parliamentary Under-Secretary of State for Health and Social Care)

† Fenton-Glynn, Josh (Calder Valley) (Lab)

† Gilbert, Tracy (Edinburgh North and Leith) (Lab)

† Harding, Monica (Esher and Walton) (LD)

Holmes, Paul (Hamble Valley) (Con)

Hurley, Patrick (Southport) (Lab)

† Johnson, Dr Caroline (Sleaford and North Hykeham) (Con)

† Jones, Clive (Wokingham) (LD)

† Kane, Chris (Stirling and Strathallan) (Lab)

† McDonagh, Dame Siobhain (Mitcham and Morden) (Lab)

† Murray, Katrina (Cumbernauld and Kirkintilloch) (Lab)

† Stainbank, Euan (Falkirk) (Lab)

† Swann, Robin (South Antrim) (UUP)

† Wood, Mike (Kingswinford and South Staffordshire) (Con)

Anne Marie Griffiths, Committee Clerk

† attended the Committee

Public Bill Committee

[Graham Stuart in the Chair]

Rare Cancers Bill

09:25:00

I have a few preliminary reminders for the Committee. Please switch electronic devices to silent. No food or drinks are permitted during Committee sittings, except for the water provided. Hansard colleagues would be grateful if Members could email their speaking notes to hansardnotes@parliament.uk. My selection and grouping for today’s sitting is available online as well as in the room. There will be a single debate on all the Bill’s clauses. Clause 1 Review of law on marketing authorisations Question proposed, That the clause stand part of the Bill.

With this it will be convenient to consider clauses 2 to 6 stand part.

It is a pleasure to serve under your chairship, Mr Stuart. I was happy with the unanimous cross-party support that the Bill received on Second Reading and look forward to examining it in detail today. The term “rare cancer” might imply that this is a relatively niche issue that is unlikely to have an impact on many of us, but the reality is that 47% of cancers diagnosed in the UK fall within the “rare and less common” category, and they account for 55% of all cancer deaths. That second statistic is partly due to the survival rate—five out of six less survivable cancers are also rare cancers—but survivability is not just a function of the aggressiveness of the cancer. It also depends on the treatment options available, and for less survivable cancers the options are limited. They receive a mere fraction—roughly 16%—of the funding that more survivable cancers receive. At this point, I should clarify that I have had some contact with a charity that represents younger people. It is the case that the Bill covers younger people and that all childhood cancers are rare. The situation is unlikely to change without Government intervention. Markets encourage pharmaceutical companies to prioritise the highest return on investment. Inevitably, that favours the development of drugs with the largest potential patient pools. When a company does pursue taking a rare cancer drug to market, having to access a limited patient pool can make the creation of sufficiently robust studies and trials a struggle. The Bill is an attempt to intervene on behalf of patients and their families, and to enable pharmaceutical companies and the Government to re-evaluate the strategies for funding, research and finding treatments. It has been drafted carefully in consultation with a wide range of cancer charities—I am pleased to see a few of them represented in the Public Gallery—and expert bodies. The Bill reflects the solutions that scientists, doctors and those with lived experience think are necessary. In practical terms, by passing this legislation we can, first, remove the barriers to participation in potentially lifesaving clinical trials; secondly, drive investment in under-resourced yet vital drugs and treatments; and thirdly, enhance connectivity between various organisations and individuals working to find cures. That last one is an incredibly important point. I have attended many meetings of the all-party parliamentary group on brain tumours, chaired by my hon. Friend the Member for Mitcham and Morden; we often we see that those connections are not being made, and we all lose as a result. Clause 1 will enable regulations to be made that compel the Secretary of State for Health and Social Care to conduct a review of the marketing authorisations for orphan medicinal products for the diagnosis, prevention or treatment of cancer, and to prepare and publish a report setting out the conclusions of that review. I have never been a great fan of the term orphan drugs, which refers to drugs for rare conditions. The clause provides that the review process will specifically consider the regulatory approaches adopted in other countries. That will help to avoid research and patients in this country losing out. The clause sets a timeframe for the publication of the report, namely within three years of the Bill being passed. We consulted broadly on that three-year point. We obviously all want to see progress on this issue as quickly as possible, but we have to balance that against the need for the review to be authoritative and impactful. That is where the three-year duration comes from, but I recognise that some people want it to move faster. A review of best practice at international level should surface a variety of effective strategies that the Government could consider implementing to drive pharmaceutical industry investment into lifesaving research and treatments. Clause 2 will enable regulations to be made that will encourage the Secretary of State to facilitate, or otherwise promote, research into rare cancers. The clause will specify that the Secretary of State must ensure that arrangements are in place that will, first, enable potential participants in clinical trials to be identified and contacted, and secondly, ensure that a person—to be known as the national speciality lead for rare cancers—is appointed to promote and facilitate research into rare cancers. That person will hold an advisory and facilitatory role, offering input on the design and planning of research, as well as building collaborative networks between key bodies and individuals. Appointing a specific individual to hold that role will provide a structure for greater accountability and a more strategic approach for the delivery of rare cancer research across different organisations. Clause 3 will enable regulations to be made that will facilitate data sharing in the context of contacting and identifying potential participants in clinical trials that are focused on orphan medicinal products for the diagnosis, prevention and/or treatment of rare cancers. The clause does not authorise the processing of information that would contravene existing data protection legislation. The twin benefits to enhanced data sharing are a greater access to clinical trials for patients, which could be lifesaving, and more higher-quality trials taking place in the UK as a result of a larger potential participant population for researchers. Clause 4 explains the territorial extent of the various clauses. Clauses 2 and 3 will extend to England and Wales only, while the remainder of the Bill extends to England, Wales, Scotland and Northern Ireland. Where the Bill does not extend to the entirety of the UK, we have been assured by the devolved Governments, which were consulted during the Bill’s formulation—I thank Department of Health and Social Care colleagues for that—that they will work alongside us to achieve the policy goals it outlines within the context of their unique legal landscapes. In that regard, I acknowledge the work of the hon. Member for South Antrim to ensure that Northern Ireland generally, and his constituents specifically, benefit from the Bill. Clause 5 will provide for commencement, which will occur two months after the Bill is passed, and clause 6 provides the short title for the Bill. I hope the Bill has real impact, because so many people in the charity sector and elsewhere are working so hard to raise often small amounts of money, which they hope will have a big impact. I hope the Bill amplifies their work and helps it to go further. I look forward to Committee members’ contributions to the discussion of this important Bill, and I commend the clauses to the Committee.

It is a pleasure to serve under your chairship, Mr Stuart. I thank and congratulate the hon. Member for Edinburgh South West on bringing forward this private Member’s Bill, which will have life-changing effects for many individuals across the entirety of the United Kingdom. I applaud him for it, because I know some of the driving reasons behind him doing that. I have a couple of points to make about the Bill. I am fully supportive of it, but I note the geographical challenge it brings. The Northern Ireland Assembly passed a legislative consent motion for clause 1 on Monday, so we are already stepping into line for this legislation. Much of the relevant work was discussed in the Northern Ireland cancer strategy, which was published in 2022 when I was Minister of Health there. It looked at our specific challenges with regard to research and clinical trials. At that point, cancer charities highlighted that only 15% of cancer patients in Northern Ireland are offered the opportunity to take part in cancer trials, compared with 31% across the rest of the UK. I hope the Bill increases awareness among Northern Ireland patients and cancer sufferers, and their families, of what is out there and their ability to take part. The other concern often raised by some of my Northern Ireland colleagues—you are aware of this, Mr Stuart—is the EU implications. I can state that novel treatments do not fall under the scope of the EU, so hopefully any medication, treatment or supply that comes forward will be equally accessible and applicable to the entirety of Northern Ireland. The only difficulty and challenge we have in progressing the Bill’s other provisions is the legislation that allows Northern Ireland to use secondary data for cancer registries. I am aware that the current Health Minister in Northern Ireland, who is my party colleague, has a one-clause Bill ready to move forward to rectify that. I wanted to make that small contribution in support of the work done by the hon. Member for Edinburgh South West in bringing forward the Bill. It has been a pleasure to serve on this Committee.

It is a pleasure to serve under your chairmanship, Mr Stuart. I congratulate the hon. Member for Edinburgh South West on bringing forward this very important piece of legislation. I declare an interest as a consultant paediatrician who has looked after a number of children with rare conditions such as teratoma, rhabdomyosarcoma, Wilms’ tumour and retinoblastoma, to name but a few. One of the issues with rare cancers, which transposes to rare diseases in general, is that they are often diagnosed late, because people do not recognise that they have symptoms of a rare disease and their health professionals are not as familiar with them because they are rare. The presentation and diagnosis are then late and, as such, the treatment is more difficult. That is compounded further because there has been less research on those topics, so it is not clear what the best treatment for those conditions is. On top of that, the patient may have to travel very long distances to see a specialist who is familiar with the condition, adding both logistical difficulty and cost to that patient’s care. Some steps are in place to try to improve the situation. The orphan drug regime gives market exclusivity for 10 years, and it provides for lower and refunded fees from the Medicines and Healthcare products Regulatory Agency for the services it provides. Nevertheless, it can still be non-commercially advantageous to put money into developing a drug that is going to be used on no more than a handful of people, however beneficial it is for the individuals concerned. I welcome the Bill, but wish to make a couple of points. First, in principle it is best that trials are first broached with the patient by a member of their healthcare team. Of course, a member of any given healthcare team—I speak as one myself—will never be aware of all the trials available to all patients at any one time. I welcome the Lord O’Shaughnessy review—commissioned by the last Government and accepted by the current one—which talks about getting a consensus on how best patients can be informed of trials. I wonder whether we should have a system in which patients opt out of not the trial itself but being asked about trials. At the outset, they could be asked, “Would you like to receive information on trials—yes or no?”, so that more people can be aware of how they can contribute. When people are diagnosed with something rare, they often want to contribute to helping others who will come after them. Will the Minister tell us more about the national cancer plan, which was consulted on earlier this year? I welcome the fact that the children and young people cancer taskforce, which was paused, is being reinstituted. Also, how will the Bill apply to repurposed drugs? Sometimes new medicines are developed for a particular condition, but we often find that medicines can be reformulated and used in a different way to provide a different form of treatment to help individuals with a different condition. How will that apply in respect of both the measures in the Bill and the O’Shaughnessy review? As a paediatrician, I am very pleased that the Bill applies to children. Overall, I think the Bill is great. It offers hope for many in the future. Will the Minister say something about other rare conditions? As well as rare cancers, people get other rare conditions, and they are affected by the same challenges with research and treatment, and by delays in diagnosis and travel. Overall, doctors are able to save people’s lives, and improve people’s lives, one at a time, but Parliament and research offer the opportunity to do that on a much bigger scale. I am very grateful to the hon. Member for Edinburgh South West for what he is doing today.

It is a pleasure to serve under your chairmanship, Mr Stuart. I congratulate my hon. Friend the Member for Edinburgh South West on his Bill reaching Committee stage. That is a huge achievement for any colleague, but especially for one who has served in this place for almost exactly a year to the day. The Government welcome contributions from Back Benchers, we welcome effective scrutiny from Committees, and we value the vital role that Parliament plays in holding us to account. In April, my right hon. Friend the Prime Minister announced that clinical trials would be fast-tracked to accelerate the development of the medicines and therapies of the future. Through this new drive, patients will have improved access to new treatments and technologies. We see the Bill as contributing to that ambition. We want to go further for patients with rare cancers, and this legislation will act to incentivise recruitment, oversight and accessibility of rare cancer research, so that NHS patients are at the front of the queue for cutting-edge treatments. Clause 1 will ensure our regulatory competitiveness. It places a duty on the Government to publish a review of the legislation around orphan drugs within three years of the Bill becoming an Act. The review will examine our legal framework and compare our approach to that of our international partners. We want the UK to lead the world in this space, as the prime destination for clinical research. Clause 2 will raise the profile of research for rare cancers by placing a new duty on the Secretary of State for Health and Social Care to facilitate and otherwise promote research in this area. The Government want to give patients greater choice and control over their healthcare, and rare cancer patients should have access to research if they choose. The clause also ensures that the Government will develop a bespoke registry service for rare cancers, to be delivered through the “Be Part of Research” programme—our groundbreaking research registry service provided by the National Institute for Health and Care Research—and that we will appoint a national specialty lead for rare cancers, which we will designate within the NIHR research delivery network, who will have oversight of the overall rare cancer studies portfolio in England. The Government are committed to going further for rare cancer patients, and that means making clinical trials more accessible. Clause 3 will introduce an innovative solution to allow rare cancer patients to be contacted as quickly as possible about clinical research. The clause creates a new power to allow patient data to be shared from NHS England information systems.

Does the Minister agree that keeping a list of people with rare cancers is only any use as long as there are some drug trials? Last night we launched a first trial, in my sister’s memory, for glioblastoma, with every penny raised by people donating, holding bake sales and running marathons. Is that any way to tackle rare cancer?

I congratulate my hon. Friend on the launch of the trial in her sister’s name. We do want to see more research and trials coming forward, particularly for rare cancers. She will be aware of the consortium that the Department has developed to work directly with the brain tumour community in particular, to improve the quality and number of research trials that come forward for funding.

Constituencies in Yorkshire, such as the one I represent, do particularly poorly with research funding—I think 5% of research funding for cancer trials goes to the area. With this Bill and a renewed focus on cancer, I hope we will look to expand the number of research-active hospitals to give people throughout the country a better chance.

09:45:00

I should clarify that there is no regional specificity in the allocation of research funding. We welcome all funding bids for research on cancer and rare cancers from anywhere in the country, and I encourage them to come forward. The new power in clause 3 to allow patient data from NHS England information systems to be shared will allow more patients to be contacted about existing trials. Practically, it will allow us to join up data from the national disease registration service with “Be Part of Research”. As I have said, we are encouraging people to bring forward more research proposals, all of which are considered. For the first time, patients with a rare cancer could be automatically contacted about research opportunities that are relevant to them and offered innovative new treatments, which means rare cancer patients could have access to research at their fingertips. That is the kind of change that the Government support as part of the shift we are making from analogue to digital—one of the three shifts that will be covered in the 10-year plan that will be launched tomorrow, when more details will become clear. Clause 4 covers the Bill’s territorial extent. Due to practical and legal differences between the nations, the devolved Governments did not wish to legislate in their individual countries. Our manifesto promised to reset our relationship with the devolved Governments, and we have developed the Bill with them. I am delighted that they expressed their support on Second Reading. Clauses 5 and 6 cover the Bill’s commencement and title. The Government are fully committed to supporting the Bill through the next stages so it can become the Rare Cancers Act 2025. The shadow Minister talked about the national cancer plan, which I can confirm is being worked on. We have had over 11,000 representations on that plan, which will be published later this year, following the publication of the national 10-year plan for health tomorrow. The children and young people cancer taskforce was launched earlier this year and continues to meet, and has now ensured that young people and children’s voices are part of the taskforce.

When the national cancer strategy is published, I hope that part of it will focus on boosting the survival rates for rare cancers. Will the Minister confirm that that will be an important part of the strategy?

I can confirm that the overall objective of the whole cancer plan will be saving lives and reducing the number of lives lost to cancer, including rare cancers. The plan will be published later this year. It is important to note that the Bill is specific to cancer; there will be opportunities to discuss other rare conditions in the future. I thank my hon. Friend the Member for Edinburgh South West for presenting the Bill, and I pay tribute to the charities that are backing him, some of which I had the pleasure to meet recently to discuss further how the Government can better support people with rare cancers. Together, we will improve outcomes for people across our country, and I look forward to working with everybody to get that done.

I am grateful for all the contributions to debate. The charity partners carefully picked the Committee members, given their interest in this subject, and we can see the benefit of that. I thank the hon. Member for South Antrim for his efforts to make sure that the legislation works in Northern Ireland. I am also grateful for the comments from the hon. Member for Wokingham and my hon. Friend the Member for Calder Valley, who both asked for more progress in this area generally. Of course, I have to mention my hon. Friend the Member for Mitcham and Morden. I attended the reception yesterday evening and, first and foremost, it was a fantastic celebration of her sister’s fantastic life. We should be grateful for her. I wish Paul Mulholland and his team all the best with that trial. It really did fill me with hope to hear that update from him. My hon. Friend the Member for Mitcham and Morden mentioned marathons, so at this point I have to mention my daughter, Ruth Arthur, who ran the marathon in Edinburgh for the Brain Tumour Charity and raised just over £3,000 in the memory of her grandfather. I am very proud of her. I am grateful for the shadow Minister’s comments and the insight and depth of thinking she brought to the debate. One of the best things about this journey has been working with the DHSC team who are working on the cancer strategy, and seeing how much they care about getting this right. We have often reflected on the point that the shadow Minister made about diagnosis. Too often when we go to events in this place hosted by charities that include somebody with life experience, late diagnosis is where their story starts. It is often avoidable. It is fantastic that the DHSC cancer team acknowledge that. Hopefully our GPs in particular will get more support to make sure that the early signs are not missed and the dots are joined together. It is good to see the Minister nodding vigorously as I say that. I thank her for her leadership right across this policy area and for her support for the Bill in particular. I thank all Committee members for coming along today and contributing, and I thank the civil servants who helped to draft the Bill. If it passes—and I really hope it does—it will incentivise and create an environment in which more research into rare cancers is fostered, potentially helping us to save, in the longer term, perhaps thousands of lives. What an aspiration that is. I once again commend the Bill to the Committee. Clause 1 accordingly ordered to stand part of the Bill. Clauses 2 to 6 ordered to stand part of the Bill. Bill to be reported, without amendment.

09:52:00