6 April, 2023

“Last month, I participated in the Royal Society’s Parliamentary Pairing scheme. Thirty scientists shadowed MPs, Lords or civil servants to learn how their scientific expertise can be used to influence policy. I was paired with my local MP, Bim Afolami, who I had previously met on behalf of Breast Cancer UK.

Prior to doing the pairing scheme, I imagined that MPs were busy. They really are incredibly busy; when parliament is in session, voting can go very late into the night. To fit in time to have a proper conversation about cancer, Bim invited me to breakfast at The Wolseley in Green Park.

One thing that I have now appreciated is that politicians are very resource orientated. They want to support policies to improve people’s lives. But they are mindful that spending money in one area means taking it away from somewhere else. Make one group of people happy, make others angry. Politicians need more people to be happy than angry.

Breakfast with Bim Afolami

I raised the issue of chronic understaffing of clinical oncologists in the NHS. The Royal College of Radiologists showed a 17% shortage in 2021 (189 staff), which is expected to be 26% (381 staff) by 2026. Bim was very interested in understanding why the cost of treating cancer has increased and why the NHS needs so many staff to deliver cancer care. I explained that it wasn’t just an ageing population increasing cancer cases; we have so many treatment options for cancer that it takes a lot of staff to deliver them.

In the case of breast cancer, with ~55,000 women diagnosed each year in the UK and 85% surviving for five years or more, the number of check-ups alone is enormous. There is likely to be an increase in testing for BRCA1 in 2024. I’m currently on the NICE committee looking at testing for familial ovarian cancer. The laboratory testing for BRCA1 and other genes is the cheap bit; it’s the genetic counselling and preventative surgery that will cost. However, these costs are nothing compared to the cost of people getting cancer.

What did Bim have to say?

Bim was concerned that an NHS focused on personalised care wasn’t financially sustainable. So here is where I got the big point across for the morning. We need a government cancer strategy with prevention at its heart. If we can prevent at least 30% of breast cancers, we are going to save the NHS a fortune, as well as have many more workers in the economy.

We then had a debate on what we could do to deliver cancer prevention. I asked Bim what he thought the balance was between a non-interventionist government, i.e., freedom of choice and the need to improve overall health. Bim said he is leaning more toward the need to intervene in public health. He has concerns about the practicality of any interventions and convincing his colleagues to support changes.

I suggested introducing legislation to increase the fibre content of bread and pasta, something akin to the sugar tax. Bim didn’t think that alone would have much impact on public health. But the problem is that bigger changes affecting more people’s diets would be harder to introduce as policy. I think it’s still worth doing, but given the cost of living crisis, many people can’t afford to choose whole-grain foods. We discussed banning smoking and/or vaping. Bim confirmed that the government would not ban smoking. But said that regulating the amount of nicotine in vaping could be looked at to make it less addictive.

Commenting on our time together, Bim said: – “It was a real pleasure to spend time with a real scientist who actually understands issues regarding cancer and obesity from a rational and rigorous perspective. It makes a change from a lot of political debate! I look forward to spending time with Britta later in the year when I get to spend time in her world for a couple of days, where I hope to learn a lot.

My relationship with Bim doesn’t stop there. I have a friend in parliament now. Bim will join us at Middlesex University for the Breast Cancer Prevention Conference in June.”

-Deputy Chair, Britta Stordal

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