M613 – Cancer Testing and Treatment Motion 2020.

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Andrew97
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What is this thread about?
This is a motion in the Model House of Commons (MHoC). It's a proposed statement that MPs debate, and there's a good chance that the House will later vote on it, but it doesn't have any legal effect. All are welcome and encouraged to ask questions about the motion's content and join in the debate – you don't have to be in a party or be an MP to do so.

What is the MHoC?
It's a political role-playing game where we pretend to be the House of Commons, and it's been going since 2005. We have formed parties, we have elections twice a year, and we debate bills and motions just like the real-life parliament. If you want to know more about how the MHoC works, your first port of call is the user manual. If you'd like to get involved and possibly join a party, you want the welcome thread.






M613 – Cancer Testing and Treatment Motion 2020, Miss Maddie MP

The UK lags behind other high-income countries in one and five year cancer survival rates [1]. Cancer testing and referrals have been stopped by the NHS in the fight agaisnt COVID-19. April 2020 saw a 60% fall in cancer referrals compared to April 2019 [2][3]. Meanwhile, patients starting treatment for cancer fell by 20% over the same month last year [3]. Furthermore, the number of cancer patients seen in an urgent appointment had fallen from 200,000 in April 2019 to 75,0000 in April 2020. The same is true for breast cancer where there has been a 78% drop in breast cancer referrals in April over the same month last year [4]. In the first 10 weeks of lockdown, it has been estimated 3800 cancers have gone undiagnosed, 12,750 fewer patients have received cancer surgery, 6000 patients had chemotherapy stopped and 2800 had radiotherapy stopped [4]. Overall, 2.1m people have missed out on cancer screening [5].

There is also a worrying drop in cancer funding. Charities fund 60% of all cancer research in the UK. Cancer Research UK expects its income to decline by 25% this year as a result of its charity shops being closed and private donations stopping. Cancer Research UK has already made a £44m cut to cancer research this year [4].

There is also an effect on deaths. Recent research expects there to be 18,000 excess cancer deaths over the next 12 months (18,000 deaths that would not happen if cancer treatments and testing continued) [6].

Fewer people are not having cancer. The UK has a ticking cancer time bomb and by the end, excess cancer deaths will more than COVID-19 deaths. The NHS' COVID-19 response would have taken more lives than it saved. [7].

This House calls on the Government to introduce the following measures

1. COVID-19 free treatment centres where staff are given weekly blood tests for COVID-19 and daily temperature checks.
Cancer patients have a weakened immune system and are extremily clinically vulnerable. These patients need treatment in a setting as free from COVID-19 as possible.
2. Use all available capacity to start clearing the backlog.
3. Monitor all cancer biopsies to predict surges.
4. Refine patient prioritisation to identify patients with the fastest growing cancers and start treatment before later stages are entered.
5. Put all cancer staff working overtime to clear the backlog.
6. To step in and fund any shortfalls in cancer research funding for 2020 that would have otherwise been provided by private entities to ensure current research projects are not delayed and cancelled.

Sources

[1]https://www.thelancet.com/action/showPdf?pii=S1470-2045%2819%2930456-5
[2]https://www.england.nhs.uk/statistics/statistical-work-areas/cancer-waiting-times/
[3]https://www.bbc.co.uk/news/health-52985446
[4]https://www.bloomberg.com/opinion/articles/2020-06-15/coronavirus-is-having-a-massive-impact-on-cancer-care-in-the-u-k
[5]https://www.bbc.com/news/health-52876999
[6]https://www.researchgate.net/publication/340984562_Estimating_excess_mort ality_in_people_with_cancer_and_ multimorbidity_in_the_COVID-19_emergency
[7]https://reaction.life/karol-sikora-interview-the-nhs-cancer-timebomb/

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Theloniouss
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Aye I think, although I don't see the necessity of most of the information in this motion.
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Miss Maddie
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(Original post by Theloniouss)
Aye I think, although I don't see the necessity of most of the information in this motion.
To point out how incompetent the NHS is.
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04MR17
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I'll read the rest of the motion on another occasion, but just to pick up on the action points specifically...

1. COVID-19 free treatment centres where staff are given weekly blood tests for COVID-19 and daily temperature checks.
Cancer patients have a weakened immune system and are extremily clinically vulnerable. These patients need treatment in a setting as free from COVID-19 as possible.


The first sentence feels like it should be asking the government to do something, but doesn't. Perhaps there are some words missing at the start? :dontknow:

2. Use all available capacity to start clearing the backlog.

I'd take an issue with that. Are we freeing up A&E wards to treat routine cancer patients when there are critical patients coming in via ambulance? I'd urge my colleagues in the government to not follow this action to the letter and instead see it as much more flexible than this sentence implies.

3. Monitor all cancer biopsies to predict surges.

No issue


4. Refine patient prioritisation to identify patients with the fastest growing cancers and start treatment before later stages are entered.

No issue, though I'd assume this was already standard practice.

5. Put all cancer staff working overtime to clear the backlog.

I'd prefer to see staff transferred from other non-essential departments rather than overwork existing staff which will only lead to increased errors.

6. To step in and fund any shortfalls in cancer research funding for 2020 that would have otherwise been provided by private entities to ensure current research projects are not delayed and cancelled.

Any idea how much that might look like?
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ohdearstudying
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aye, it’s a good starting place.
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Miss Maddie
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(Original post by 04MR17)
I'll read the rest of the motion on another occasion, but just to pick up on the action points specifically...

1. COVID-19 free treatment centres where staff are given weekly blood tests for COVID-19 and daily temperature checks.
Cancer patients have a weakened immune system and are extremily clinically vulnerable. These patients need treatment in a setting as free from COVID-19 as possible.


The first sentence feels like it should be asking the government to do something, but doesn't. Perhaps there are some words missing at the start? :dontknow:

2. Use all available capacity to start clearing the backlog.

I'd take an issue with that. Are we freeing up A&E wards to treat routine cancer patients when there are critical patients coming in via ambulance? I'd urge my colleagues in the government to not follow this action to the letter and instead see it as much more flexible than this sentence implies.

3. Monitor all cancer biopsies to predict surges.

No issue

4. Refine patient prioritisation to identify patients with the fastest growing cancers and start treatment before later stages are entered.

No issue, though I'd assume this was already standard practice.

5. Put all cancer staff working overtime to clear the backlog.

I'd prefer to see staff transferred from other non-essential departments rather than overwork existing staff which will only lead to increased errors.

6. To step in and fund any shortfalls in cancer research funding for 2020 that would have otherwise been provided by private entities to ensure current research projects are not delayed and cancelled.

Any idea how much that might look like?
1. COVID-free treatment centres in hospitals are not common. The government needs to introduce more of them to allow cancer patients to be treated quickly. Nightingale hospitals not being used could act as temporary isolation hospitals giving chemotherapy (as a very quick example). Where these isolation treatment centres are is not my biggest issue. My concern is wanting to see them become widespread.

2. I agree at your flexible interpretation. That's what I intended.

5. Training issue. Cancer treatment and diagnosis requires very specific skills. Chemotherapy involves injecting extremely toxic substances in a delicate way and killing cells (good cells as well as cancerous ones). The patient dies is the smallest mistake is made. It's not as easy as redeploying doctors from one ward to the next without extensive retraining.

6. I couldn't find the exact figure. Cancer Research UK is reducing their research by £44m. Maybe £1bn at most amongst all charities.
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04MR17
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(Original post by Miss Maddie)
1. COVID-free treatment centres in hospitals are not common. The government needs to introduce more of them to allow cancer patients to be treated quickly. Nightingale hospitals not being used could act as temporary isolation hospitals giving chemotherapy (as a very quick example). Where these isolation treatment centres are is not my biggest issue. My concern is wanting to see them become widespread.
Right, so you're asking for more treatment centres (that are covid free) to be used for cancer patients. Point number 1 doesn't say that, which I why I guess it's missing some words.


(Original post by Miss Maddie)
5. Training issue. Cancer treatment and diagnosis requires very specific skills. Chemotherapy involves injecting extremely toxic substances in a delicate way and killing cells (good cells as well as cancerous ones). The patient dies is the smallest mistake is made. It's not as easy as redeploying doctors from one ward to the next without extensive retraining.
You've admitted the high risks when mistakes are made and yet this bit of motion calls for an increased likelihood of those mistakes by working staff overtime for goodness knows how long. I don't believe I've suggested it's as easy as redeploying doctors from one ward to the next, I've made an alternative suggestion that might stop some more people dying.
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Miss Maddie
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(Original post by 04MR17)
Right, so you're asking for more treatment centres (that are covid free) to be used for cancer patients. Point number 1 doesn't say that, which I why I guess it's missing some words.


You've admitted the high risks when mistakes are made and yet this bit of motion calls for an increased likelihood of those mistakes by working staff overtime for goodness knows how long. I don't believe I've suggested it's as easy as redeploying doctors from one ward to the next, I've made an alternative suggestion that might stop some more people dying.
Point 1 is predated by "This House calls on the Government to introduce..." It's obvious the motion wants the government introduce COVID-free treatment centres.

Staff have working limits. All staff working overtime does not mean all staff breaking legal limits and working when fatigued. The safeguards in place to stop that will still be in place. You suggested moving staff from non-essential departments. You have suggested moving unqualified, inexperienced staff to a department where they can practice medicine in a field they know nothing about. That's more dangerous than having staff work overtime.
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SnowMiku
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I support this, as it'd avoid any more deaths from people not getting treatment during lockdown. Aye.
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CatusStarbright
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1. Sure. I assume by 'blood tests' you mean the antibody tests.
2. Fine.
3. Sure.
4. Logical.
5. I'm not sure this is necessarily the right thing to do as a blanket rule.
6. Maybe. I'd certainly back at least part of it being funded.
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04MR17
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(Original post by Miss Maddie)
Point 1 is predated by "This House calls on the Government to introduce..." It's obvious the motion wants the government introduce COVID-free treatment centres.

Staff have working limits. All staff working overtime does not mean all staff breaking legal limits and working when fatigued. The safeguards in place to stop that will still be in place. You suggested moving staff from non-essential departments. You have suggested moving unqualified, inexperienced staff to a department where they can practice medicine in a field they know nothing about. That's more dangerous than having staff work overtime.
That would render point 2 onwards grammatically incorrect then. "This House calls on the Government to introduce Use all available capacity"


You make the assumption that my suggestion did not (for the very obvious reasons you've outlined) include the required training.
I'd like to see evidence of your claim about dangerousness.
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Miss Maddie
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(Original post by 04MR17)
That would render point 2 onwards grammatically incorrect then. "This House calls on the Government to introduce Use all available capacity"


You make the assumption that my suggestion did not (for the very obvious reasons you've outlined) include the required training.
I'd like to see evidence of your claim about dangerousness.
I can live with grammatical errors. The meaning was clear.

A valid assumption to make when training takes at least a year. In a year's time there won't be non-essential departments. Even if there were the cancer patients would be dead, and if they weren't dead they would be stage four.
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Aph
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3. Monitor all cancer biopsies to predict surges.

Surges in what? The number of cancer cases? You know that cancer is not pathogenic and doesn't work like that right?
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Theloniouss
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(Original post by Aph)
3. Monitor all cancer biopsies to predict surges.

Surges in what? The number of cancer cases? You know that cancer is not pathogenic and doesn't work like that right?
'surges' in the severity of the cancer, I assume. I didn't think they could be predicted though.
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LiberOfLondon
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Aye.
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Aph
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(Original post by Theloniouss)
'surges' in the severity of the cancer, I assume. I didn't think they could be predicted though.
Certainly not in biopsy I belive.
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Napp
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I see nothing inherently wrong with the motion. Although i do take certain exception at using this as an excuse to bludgeon the NHS as "incompetent", given the order for the reallocation of resources came from the government.
With that being said, a few points i wouldnt mind getting some clarity on;
1. COVID-19 free treatment centres where staff are given weekly blood tests for COVID-19 and daily temperature checks.
Cancer patients have a weakened immune system and are extremily clinically vulnerable. These patients need treatment in a setting as free from COVID-19 as possible.
This seems to be a statement of fact as opposed to asking the government to do anything?

3. Monitor all cancer biopsies to predict surges.
I'm not entirely certain what this means? A biopsy will tell you if someone has cancer, it isnt a magic eight ball to predict any form of 'surge', from ones understanding.
5. Put all cancer staff working overtime to clear the backlog.
I'm not sure how over stressing cancer doctors will result in better outcomes as opposed to missed/wrong diagnosises and such. After all, it is a truism that overworked doctors make mistakes and the doctors, at present, are already over worked. Surely it would be more sensible to call for a diversion of medical staff working on less pressing issues to 'muck in'.
6. To step in and fund any shortfalls in cancer research funding for 2020 that would have otherwise been provided by private entities to ensure current research projects are not delayed and cancelled.
This is more a personal query, but aren't you, generally speaking, for as little government intervention/spending as possible?
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Rakas21
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Mr Speaker, i shall support this motion at this stage symbolically however i would prefer to offload cancer patients to the private sector as a means to solve the fundamental issues raised.
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drvramachandran
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I can understand the principles behind this motion. Unfortunately there are many practical problems

One of the problems is that surgery is most important treatment for most cancers. Most cancer surgeries are high risk procedures and require intensive care unit admissions and support from intensive care doctors as the complication rates are very high.
Similarly most for the intensive chemotherapy regimes for haematologic malignancies, especially high dose chemo and stem cell transplant too require high dependency unit support. Many of these patients end up in ITU. Because of the low immunity, they are at a high risk of covid infection and its complications. The covid fatality is very high in patients receiving cancer treatment, both surgery and chemotherapy.
The intensive care doctors and nurses are extremely busy caring for patients with covid. Many of them did not have adequate personal protective equipment.
At present the hospital work force has been depleted because of covid, as many of the nurses, doctors and other health care professionals have been off sick or isolating because of covid.
Three doctors I know have been in ITU and one has unfortunately passed away from covid.
Only if the covid is well controlled can the cancer services, as well as other essential health care services be resumed normally.

it is easy to legislate with out any resources and without understanding the risks involved.
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Connor27
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I largely support this one.
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