Children’s Cancer Care: South-East

I beg to move,

That this House has considered children’s cancer care in the South East.

It is an honour to serve under your chairmanship, Sir Christopher. In 2020, Jackson’s parents received some of the worst news a parent possibly can: Jackson had been diagnosed with leukaemia, at just two years old. He soon began treatment at St George’s Hospital in Tooting; and after three years, in April 2023, he finally rang the bell that signified the end of his treatment. It was a very difficult experience for Jackson, but his family are extremely grateful for the treatment they received at St George’s Hospital. Reflecting on the experience, Jackson’s mum, Samantha, said:

“Thank you St George’s for being such a great hospital and to everyone who works there, you have made our journey so much easier to deal with because you’re the best team.”

Tomorrow, NHS England will make a decision about where to place a new children’s cancer centre, which will serve south-west London and the surrounding areas, such as Surrey, Sussex, Medway and Kent. NHS England will decide between two proposals: one submitted by St George’s Hospital, and the other by the Evelina London Children’s Hospital in Lambeth. After listening to staff, patients and others affected, I am here, with colleagues from both sides of the House, to make the case that children’s cancer care must remain with St George’s.

I thank the hon. Member for making a powerful speech and for referring to Jackson. Does she agree that the independence of NHS England is important, that any decision it makes tomorrow has to be based on the clinical knowledge of medical experts, that the decision must be free from any political interference and that the world-class facilities at Evelina, which the hon. Lady has seen at first hand, should be considered alongside the other hospital? Does she agree that we must ensure that the decision is independent, and that we do not undermine the public reputation of NHS England or put undue pressure on it?

This is not about political interference; it is about ensuring that there has been a fair, balanced and transparent process. I will talk about the process in a moment, but that is the concern. The hon. Lady talks about clinical input. The consultation, albeit that it was run in a very flawed way, had 2,500 responses—some were from clinical experts, and many were from patients and their parents—and it provides very strong evidence that St George’s is best placed and that the Evelina has been predetermined. I have nothing against the Evelina, and in fact I was just about to sing its praises, because I have had personal experience.

To make myself clear, the Evelina is a brilliant hospital that does incredibly important work in treating children. My own daughter, who is nine, is currently undergoing treatment at the Evelina and has received outstanding care. This is not about pitting hospital against hospital; it is about looking at the process and the evidence before us. As the hon. Member for Vauxhall (Florence Eshalomi) has alluded to, I would like to personally thank the medical director at the Evelina, who showed me around its excellent facilities on Monday. However, as I have mentioned, the evidence overwhelmingly demonstrates that, in this case, St George’s is best placed to deliver for this highly specialist cancer service.

Before I come to that evidence, I want to raise serious questions about the decision-making process to date. [Interruption.]

Order. There is a Division in the House. I do not know whether there will be just one Division. If there is only one, we will come back in 15 minutes; if there are two, we will come back in 25 minutes.

To pick up where we left off, before we look at the evidence and arguments for keeping this precious service at St George’s, I want to raise the serious questions that have been highlighted around the decision-making process that has brought us to this point. NHS England first publicly expressed its preference for the Evelina proposal at the start of last year, long before it had even launched its public consultation. This has raised concerns that NHS England has created a process in which the views of patients, clinicians and patients’ families have not been seriously listened to and taken into account.

The hon. Lady is quite right. I congratulate her on this debate. I have spoken to the Department and NHS England about the process, as there have been real concerns about the scoring and whether that has been based on evidence or preference. There is also real concern that clinical outcomes are not being given quite the highest priority they should be, which will be key if we are looking at the cancer survival rates for young children.

Absolutely. There is the point about transparency, the fact that it has been predetermined, and the point about outcomes, which I will touch on briefly in my speech.

In a consultation response submitted by Healthwatch Richmond and Healthwatch Merton, the groups concluded that the consultation design was insufficient because it “fails the legal test” for consultation and appears to have no prospect of altering the decision to award the new service to the Evelina. I am therefore keen to hear from the Minister what assessment her Department has made of how NHS England has carried out this process. Further, can she give an absolute assurance to Members that the decision made tomorrow will have been made fairly?

Regardless of the way in which it was carried out, the consultation received over 2,500 responses from affected groups, such as patients, their families, clinicians and professional organisations. Those voices must be heard, and I will seek to ensure that they are. One of the most important themes raised was specialist knowledge and experience of children’s cancer care. It is undeniable that St George’s has invaluable experience to offer: it has already been treating child cancer patients, in partnership with the Royal Marsden, for over a quarter century. Not only is that experience highly valued by patients and their families, but it has resulted in excellent outcomes, as the hon. Member for Wimbledon (Stephen Hammond) said. According to national data collected from intensive care units, St George’s children’s cancer intensive care outcomes are the best for a large unit in the UK. All the institutional knowledge, specialist expertise and professional networks that have been built over decades risk being lost if cancer care were to move away.

Another key theme that was repeatedly mentioned in responses was that the centre should be conveniently located. Travelling via public transport with a vulnerable and immunosuppressed child is both stressful and very risky, so patients and families have repeatedly stressed that a new centre must be easily accessible by car. Anyone who has lived or worked in central London knows how difficult and unpredictable driving in and out of central London can be. However, located in Tooting, St George’s is much easier to access, and has strong road links to parts of the south-east. That is particularly appreciated by those travelling from afar.

Back Bench speeches in this debate will have to finish by 5.38 pm.

It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate the hon. Member for Twickenham (Munira Wilson) on securing this debate. As a constituency MP and chair of the all-party parliamentary group on cancer, I am particularly pleased to take part in today’s debate, and I absolutely agree with what has been said so far. Like the hon. Members for Twickenham and for Richmond Park (Sarah Olney) and the right hon. Member for Kingston and Surbiton (Ed Davey), my hon. Friend the Member for Sutton and Cheam (Paul Scully) and I have also written to the Secretary of State requesting that this decision be called in.

I do not want to repeat much of what has already been said, as many other hon. Members wish to speak, but I want to emphasise a few points, particularly the fact that paediatric cancer is incredibly rare and that treating it is a highly specialised service that the NHS provides. I understand that the NHS is concerned about co-locating the deliverables of that care on one site, but as has already been pointed out, and as St George’s keeps saying, that hospital is standing ready to be able to do that. St George’s is investing a lot into its campus, as is the University of London. St George’s stands ready to provide what parents are asking for, and it has 25 years of specialist experience, alongside the Royal Marsden, to do so. Therefore, it would be a mistake to take the decision to move the children’s cancer service to the Evelina.

Like the hon. Member for Twickenham, I am confident that the Evelina is a fantastic hospital with amazing staff and that it does amazing work, but this is about clinical deliverables.

My hon. Friend is right: the Evelina is a great hospital. The other point about St George’s is that it not only has a specialism in paediatric cancer; it also has a wider specialism in neonatal and paediatric services. There is a concern that those would be lost if the co-location was based at the Evelina.

My hon. Friend is absolutely right. That is a key concern, which is precisely why we want to avoid that happening.

It is also worth stating that St George’s does not just have 25 years of experience. The data really does speak for itself. It has been rated outstanding by the Care Quality Commission for delivering cancer services for children. St George’s proposal is to consolidate the primary treatment centre on to the St George’s site in a new state-of-the-art children’s cancer wing, delivering outstanding facilities to match the outstanding care already provided. The services that matter most for children with cancer are already available at St George’s. For some 80% of children with cancer, St George’s campus can already provide or is poised to provide key treatments that the Evelina will have to take time to develop.

Through its experience and expertise, St George’s can already deliver what parents say they want. The hospital is reliant on that experience and incredibly rare expertise. Only about 20 paediatric oncology surgeons with that uncommon skill are registered in the UK, and three of them are already at St George’s. Parents have consistently said they would prefer the children’s cancer centre to be outside the city centre, with better parking provision; again, that is something that St George’s is already able to provide. We do not need to wax lyrical about how awful the traffic is in central London—we say that every day anyway as we try to get into work.

Consolidating the children’s cancer services at St George’s will be easier and less costly for the NHS to deliver. A large part of the service is already there and the existing non-clinical space can, at relative speed, be transformed into a new state-of-the-art cancer centre. But beyond the financial impact of the individual institution we are talking about, there will be wider costs to the NHS as a whole if it is relocated. St George’s has estimated those costs to be around £2.5 million in the first year alone if the service is moved. That could have an impact on other children’s services, and indeed wider services, that are at St George’s at the moment.

I do not want to take up too much time—I know that lots of people want to say things in this debate—but I would like to speak on behalf of some of the parents and children who have been involved in the consultation. They have made it clear that they want the cancer services to remain at St George’s Hospital—as we would imagine—for practical reasons and particularly transport and parking.

It is St George’s that offers dedicated parking spaces and a drop-off zone directly outside the entrance of the proposed new state-of-the-art children’s cancer centre. We can just look at Angela’s case to see how critical that is. A children’s nurse at St George’s, she has cared for hundreds of kids during her decades-long career, but her worst fears were realised when her own teenage daughter was diagnosed with cancer. Angela has been staunchly opposed to plans to move the services. She said:

“I can’t imagine travelling to Central London for cancer care with a vulnerable child is in anyone’s…interest.

Luckily we were able to drive to St George’s when Meg was here, and for our family it was invaluable. We were able to keep some semblance of normality.”

This is not just about Megan and Angela. Philip has a 10-year-old son, Daniel, who has just finished cancer treatment and spent countless days and nights at St George’s. Philip said:

“You can’t use public transport when your child is immuno-suppressed, and I can’t imagine having to drive into central London every time Daniel needed urgent care.”

Little Jackson Hall was diagnosed with leukaemia in February 2020 after a rash appeared on his skin and would not go away. He was treated by an “amazing team” at St George’s. His dad, Shaun, said:

“If we had to transfer to Evelina it would be added stress and worry and take away what we can give to Jackson.

I congratulate the hon. Member for Twickenham (Munira Wilson) on obtaining this debate. It is a little interesting that we are having it before we have got the report. We cannot really add to or comment on the report, because we do not have it, but one thing that we will all agree on is that there is no doubt that a centre is required, so, like everybody here, I am waiting for the report with considerable interest.

I listened to the story from the hon. Member for Mitcham and Morden (Dame Siobhain McDonagh) about Jackson. It is always a delight to hear these stories—cancer treated by St George’s, with a delightful story to follow it. Equally, however, every hospital that I know of that treats cancer and children’s cancer has similar stories, and St George’s has more than just the few that she has given.

I am a huge supporter of St George’s Hospital. As Members will know, I spent a considerable number of years on its health board when St George’s was being rationalised, reorganised and rebuilt. St George’s is world-class in many respects, although not all, right across the spectrum of medical treatment. The rebuilding that taken place at St George’s has centred on making the buildings as welcoming as is feasible for adults and children and for medical and surgical care. I know St George’s well; it is a delightful, functioning national health service hospital that gives much to our community and that will, if the hon. Member for Twickenham has her way, give much to the whole south-east.

However, access to St George’s is by tube and then by foot or by bus. If someone goes by car, they then have to hope they can park. Hon. Members have said that parking spaces are easily available, but I can remember sitting for ages in the car park at St George’s, especially in the morning, and not being able to park. Some of the consultants I know at St George’s drive in hours early just to get a space for their car in the consultants’ car park. So parking at St George’s is not as simple as has been said.