I very much like the tone of the discussion today, because this is a really emotive issue. We've all got family or friends who have had or have cancer, so it's really important we are very measured in the way we discuss this.

I think one of the biggest problems with cancer is that people are often very slow to come forward. People really do need to listen to their bodies and think, 'This is not normal, perhaps I need to go to the doctor.' And I think it's a well-known fact that men are much less likely to come forward quickly than women. But also I think people who have poor self-esteem, who have low expectations of what services are going to be able to do for them, just assume that it's part of their story and they just think, 'Well, I'm not feeling well, but nobody's going to do anything about it.' I think it must be really difficult for clinicians to be able to distinguish between the worried well and the reluctant visitor to the GP who may or may not be telling the clinician the full story and be thinking, 'Oh, I don't want to bother the doctor.' So, I think it is really, really difficult, and there's no point in everybody being sent off for a cancer test, because obviously that would completely clog up the services that people who really do have suspected cancer actually need. But it also requires the GP to think intellectually, 'Is this just something that a simple medication will resolve, or is there something more going on here? Has this person lost weight recently?'

So, I think it's a very difficult issue and, in the end, we all die of something, and often we die of cancer because we've outlived our usefulness. But clearly, the worst types of cancer are those that are suffered by very young people, including children and young people generally, because the cancer is so much more virulent. I know somebody who's been living with prostate cancer for 15 years; this is quite normal if you're elderly. People do live with cancer perfectly okay with the support of appropriate treatment.

I've got a friend, a close friend, who is dying of pancreatic cancer, which I'm aware is one of the most difficult cancers to treat, and so I was particularly interested in taking up the offer of a meeting with Pancreatic Cancer UK recently, and there was an expert witness involved who was the wife of somebody who had died of pancreatic cancer during the pandemic. It was really, really useful to listen to this person about the way in which her husband had been treated, how he had finally got round to seeing the GP during lockdown, but it was only at his insistence that he got to see the nutritionists, so I was very interested to read the national optimal pathway for pancreatic cancer, which unfortunately was published in February 2020—not a good month for instituting change, for reasons we're all aware of. But I am very pleased to see that that pathway states really, really clearly that people should not wait for a local multidisciplinary team discussion before referring somebody to the local upper gastrointestinal cancer group, but also to the nutritionists. This is absolutely key in order to consider the administration of pancreatic enzyme replacement therapy, because by nature of having pancreatic cancer, your body is not capable of digesting food. It seems blindingly obvious, but I want to understand from the Minister why she thinks it is that only three in five people—according to the Pancreatic Cancer UK organisation—are getting PERT, which is the prions that you need. Because although it didn't save the life of the person whose widow was in the discussion, it did enable this man to have a reasonable quality of life while he was able to, in order to share meals with his family, and I think that that is absolutely crucial and is a good illustration of how treating cancer isn't just for the physician who is a specialist in cancer, but is for a whole multidisciplinary team of people, because it affects so many people. Thank you.