Speaking in the Scottish Conservative debate on Cancer Drugs and their availability, Murdo Fraser MSP, Scottish Conservative Health Spokesperson, said

 We have all seen the newspaper headlines: “Scots ‘worst’ for cancer survival”, “Lung cancer survival among the lowest in Europe”, “Scotland has the lowest breast cancer survival rate”. 

 The inconvenient truth is that report after report tells us that Scotland lags behind a plethora of other developed countries in survival rates for cancer.

 Norway, Sweden, the US, Canada and France are just a few examples of countries which boast of better five-year survival rates across a range of cancers than we do in Scotland.

 And if all this wasn’t bad enough we Scots also lag behind a significant proportion of Europe for access to new cancer medicines even though successive price cuts and exchange rate movements have meant that UK prices are currently amongst the lowest in Europe.

Taking all cancers together, the five year survival rate for men has increased by 18% and almost 15% for women since 2003.

 It is our job as Parliamentarians, as compassionate members of our society, to ensure that when someone is diagnosed with a terrible illness like cancer they have the best possible fighting chance of beating it or in the most extreme cases can at least extend the time they can spend with loved ones for as long as possible.

 In June this year one of my constituents, Gillian Bauld, sadly died after being diagnosed with advanced metastatic breast cancer. 

Her husband had contacted me prior to her death to raise concerns about the difficulty his wife was having accessing lapatinib, a drug not approved by the SMC but one which presented the best way of controlling the disease’s progression after her chemotherapy came to an end.

The Baulds made two separate exceptional prescribing requests, by two different consultants, and were rejected both times.

Because this drug was not approved by the SMC and because the exceptional prescribing route had been closed down to them, Gillian’s consultant advised that the only option left to them would be to pay for the treatment themselves.

A proposition most people would find unthinkable given the cost of a twelve week course is £10,000.

The really devastating fact for Gillian was that had she been living in England she would have met the specific criteria laid down for access to lapatinib through the Cancer Drugs Fund.

As her husband wrote in The Scotsman, “The Interim Cancer Drug Fund is intended to help people like my wife.  If we lived in England, then she would fully meet the criteria for funding, whereas in Scotland she isn’t considered worthy of further help.”

Presiding Officer, there are many cases all across Scotland like my constituent Gillian Bauld and I am sure there are Members here today who have dealt with or are dealing with such cases.

According to a report published by the Rarer Cancer Foundation there are now 23 cancer treatments which are not routinely available in Scotland but which could be funded through the Cancer Drugs Fund set up by the Conservative-led Coalition in England. 

Now, I know the Cabinet Secretary wants to get to her feet and dispute this number.  I have read the correspondence she sent to my colleague David McLetchie yesterday and I have also seen the vigorous rebuttal from the Rarer Cancers Foundation which was sent to the Health Services Research Unit on 8 September.

I am not here today to go into the detail about the reasons why the Scottish Government have chosen to attack the experts, indeed the very fact that the Cabinet Secretary couldn’t explain away at least 12 medicines in her letter to my colleague suggests that the principle is clear even if we can’t agree on the number.

The Cancer Drugs Fund, which totals £600m over three years in addition to an initial £50m, has helped 5,000 patients in England to get access to the cancer medicines they need.

It is facts like these which convince me that the Rarer Cancers Foundation are right when they argue that around 14 treatment requests per million population are being approved in Scotland compared to almost 48 such requests in England.

Indeed Lapatinib, the cancer my constituent required for her breast cancer, has an approval rating nine times greater in England than it does in Scotland.

In fact, if Scotland were to set up its own fund and achieve the same approval rate as England across a whole host of drugs then there would be a 235% increase in the number of cancer patients in Scotland gaining access to life enhancing and extending treatment.

Now it is true that the fund is an interim measure.  It will run until 2014 when it is hoped that the Department of Health will replace the current Pharmaceutical Price regulatory Scheme with a Value-based Pricing system for drugs.

A system I hope the Cabinet Secretary will support.

This change will link the price of a drug to cost-effectiveness based on clinical evidence.  It is hoped that the new system will lead to more innovation and investment being focused on patient needs.

However, until that time we cannot morally accept a system whereby Scottish patients are being denied access to cancer drugs which are available to other UK citizens by virtue of where they are domiciled.

Of course the Cabinet Secretary will no doubt extol the virtues of the Individual Patient Treatment Requests arrangements, the default position of the Scottish Government whenever challenged on the availability of cancer medicines.

But the fact remains that even with this system, as my constituent Gillian Bauld found out, access to cancer drugs is still being denied – vital drugs which are being made available in England.

The Divided Nations report highlights that in the group of medicines that are declined by the SMC patients do not access them through the IPTR route and that is why patients in Scotland are three times less likely to gain access to a cancer drug not routinely available than those in England.

As one clinician has told me Bevacizumab is a very good example of such a medicine.  This drug has no SMC approval and no successful IPTR appeals despite this drug being the gold standard of treatment of advanced colorectal cancer in the Western World and now in England with the introduction of the Cancer Drugs Fund.

Presiding Officer, Scottish Conservatives, cancer sufferers, clinicians and experts on this issue can all see the evidence of a £600m Cancer Drugs fund working for cancer patients in England.

Cancer Research UK welcomed the English Fund stating that “This cancer drugs fund could make a real difference for some cancer patients, allowing them to get the treatments they need.”

The RCF as estimated that the cost of achieving a comparable level of access in Scotland would cost the Scottish Government only £5m.  We believe that this would be money well spent, and that the cancer sufferers of Scotland deserve to be treated as least as well as those south of the Border.