2. Questions to the Minister for Health and Social Services – in the Senedd on 23 October 2019.
2. How is the Minister ensuring access to new cancer treatments for patients in Wales? OAQ54603
Thank you. We have an absolute commitment in Wales to the provision of recommended and proven effective cancer treatments. This is achieved through the new treatment fund for medicines. By August of this year the new treatment fund had provided rapid access to 205 medicines, including 86 for cancer, and has cut the time it takes to provide newly-recommended medicines from an average of 90 days to just 12. Whilst there is much focus on new drugs, it is also worth recalling that surgery can be curative as a treatment for cancer. That is often not highlighted within this Chamber. That's why we continue to invest in both improvements in surgery as well, of course, as therapy provision.
Minister, I’ve been raising concerns about the individual patient funding process with you throughout your time as Minister. I did the same with your predecessor and the same with his predecessor too. My constituent, Gemma Williams, a young mother with two young children, has stage 3 breast cancer. Her oncologist wants to treat her with Kadcyla to prevent the progression of the disease. Like most patients told she needs a drug for a life-threatening illness, she and, apparently, her oncologist, thought it would be straightforward. Now, after two successive refusals by the IPFR panel in Gwent, Gemma is having to launch a fundraising campaign to raise the money to pay for her treatment. Now, even though the difference in cost between Kadcyla and the drugs she is on—which her clinician has acknowledged are unlikely to help her—is a small difference, she will, of course, have to fundraise the full cost of the treatment, some £45,000. Minister, I still don’t believe that the IPFR process is working for my constituents, and it certainly isn’t working for Gemma Williams. Can I ask you whether you can look again at this to ensure that all patients in Wales, including my constituents, are getting the access to the new treatments that their clinicians believe they need?
Look, we had a review at the start of this Assembly term because of issues that Members around the Chamber have raised about the apparent inequalities in access, and people’s inability to understand the system. And, to be fair, the system wasn’t an easy one to understand for clinicians or indeed for members of the public. Following the review, we’ve implemented all of the 27 recommendations that came up, and it’s very clear now the clinician has to support the individual patient funding request to go to a review.
Now, I can’t comment on the individual circumstance that the Member is directly engaged with. Across the system, more than seven in 10 applications for medicines under the IPFR process are agreed. I think it would be helpful if we had yet another conversation with you about what’s happened in this case and about how the health board's IPFR process does and doesn’t work, and about the level of clarity in the explanation provided by both the health board and the clinician about any reasons for refusal and why that is. The awful truth is, from a whole-system point of view, you understand there will be times when there is a refusal to provide a treatment on the national health service. It is always a much more difficult matter to be the individual, to be told by one person in our healthcare system, ‘I think this is what you need’, and to be told overall by the system, ‘You still can’t have it’. I’m happy to sit down to try and understand what that looks like with your constituent, but I really think we need to go back to the clinicians making choices together with the health board, and have real clarity in the decision-making process.
Minister, in yesterday's business statement, I raised the issue of a constituent, Mr Jim Sweet, whose wife passed away on the day she was going to begin treatment for stage 4 ovarian cancer—clearly, a very sensitive issue. There are many people involved, many people suffering from ovarian cancer in Wales, and part of the problem with this cancer is that early diagnosis before stage 4 is more difficult because the disease masquerades as other conditions such as irritable bowel syndrome. So, I wonder if you could tell us what actions you're taking to try and support more research into this particular form of cancer, not as often spoken about as other types of cancer are, but one which leaves victims and families of victims of the disease really struggling with this cancer quite late on in a diagnosis situation, and I think they look to the Assembly and the Welsh Government to see if the situation can be eased a little bit for them.
There are a range of cancer groups taking part in the cancer alliance, including those interested in ovarian cancer, and it's part of our research, interest and activity. I'll happily write to the Member with specifics on what we're doing in the research activity in this area, but we're not in control of all that research activity, of course; that depends on where those clinical studies do and don't take place, and the collaboration that takes place right across the UK healthcare and university sectors as well. But I'll happily provide the Member with some more of what I hope will be helpful detail about the nature of that research here in Wales.