What is it about your job that you feel would surprise the public?
The diversity of flipping from one thing to the next, trying to cover a huge range of things with relatively few resources. It’s also what makes your job brilliantly energising, because it’s completely impossible to have a day in this job in which you’re bored. I spend a lot of time with people with blood cancer, and their families, and I think that’s hugely important – that’s what gives us insight and the platform to do everything else we do.
What’s been the biggest change you’ve seen since you started working in health and social care?
The increases in demand and what we want as a health system that is equivalent to the best in Europe – we’re not investing in it at that rate. For blood cancer, there has been a shift to more targeted, high-value and low-volume treatments, and we haven’t got a system set up to deliver that yet, although recent NICE approval for CAR-T cell therapy is obviously great news. Also, conditions that were killing you not that long ago you now live with for the rest of your lives, which is a good news story but has consequences on the system.
If you could make one change to the NHS and social care over the next 10 years, what would it be?
If it were genuinely one, then obviously it’s to make sure that it’s adequately resourced. But assuming that, I would ask for blood cancer to be given the same focus as solid tumours. One in 19 of us will get it, it’s the fifth most common cancer, it’s the third biggest cancer killer, and yet almost all cancer policy and focus is on the ‘big four’ cancers (breast, bowel, lung and prostate), which all happen to be solid tumours.
Change from the top
If you could give Matt Hancock one piece of advice, what would it be?
He needs to set his department and NHS England free. And have confidence they can genuinely co-produce, design and test new policies with the whole cancer charity sector. We need to genuinely open it up to patients and the sector, and say ‘we all know we’ve got problems, here’s the data, here’s what we know about it, let’s come together and work out how to get a policy that works’.
What do you wish people at the top of the NHS understood?
If you design cancer solutions focused on the four most common cancers as a proxy, then you will fail for half of cancer patients, as half of cancer patients do not have one of those cancers. If that was properly understood, it would mean all of our cancer policy is better. There also does need to be a recognition that, much like the NHS, charities’ resources are stretched. You need to give us access to the things you already know.
Policy in practice
What policy have you seen successfully implemented, and why did it work?
The smoking ban. It was a piece of public policy that was co-created – government were involved, charities were involved, the medical sector came together. There was huge opposition and public scepticism, but together they overcame that and it’s genuinely impacted on smoking rates.
What policy have you seen fail, or not be as successful as first intended?
The reforms to the structure of the NHS under Andrew Lansley and the coalition – if they haven’t already failed – are failing. It is so complicated to work out for an organisation like ours or for the patients we represent (or indeed for the MPs we work with) where in the system you need to be at a particular point to influence. And it’s also entrenched a separation of provider and commissioner – we’ve all got to focus on what the financial flow is, which just gets in the way of the problem-solving that we need to do.
What policy and/or change in behaviour are you currently trying to implement, and how’s it going?
The cancer plan within the upcoming long-term plan for the NHS – we want to make sure that the needs of blood cancer patients are met. Three focus points for us are emotional and psychological support for people living with cancer, faster routes to diagnosis, and better access to trials and faster translation of new treatments into the system. As so often, you won’t know if people are actually listening until it’s written down, but people are at least nodding!
The NHS is under pressure because...
Because there’s not enough funding in the system. Because patient demand and expectation is rightly aligned to western Europe. And because we have huge workforce issues. So even if we have the money, we don’t have the staff to deliver what needs to be delivered.
Gemma is the Chief Executive of Bloodwise. Keep your eyes peeled for the next in our new Q&A series on Friday 30 November.