Ashley Dalton
MP for West Lancashire · Labour · United Kingdom
“My right hon. Friend is being very generous; I thank him for giving way. It was my sombre privilege to work with him on this matter when I was a Minister in the Department of Health.”
“I recently visited the Liberty Centre in my constituency, a fantastic charitable organisation that supports individuals and families who have been affected by domestic abuse and violence. It told me that it could fill its refuge places three times over, but it does not have the resources.”
“It can be diagnosed after a primary diagnosis—primary breast cancer is potentially curable—or the first time that a person is diagnosed with breast cancer. That is called a de novo diagnosis. That is what secondary breast cancer is and, as we have heard, I have it, along with many, many other people.”
“There is also a myth that the treatment for your primary cancer was somehow wrong or had failed if you get metastatic breast cancer. Again, that is absolute nonsense. Breast cancer can still spread, even after successful treatment for a primary cancer, and even with the best treatments in the world.”
“As ever, it is an honour to serve under your chairmanship, Mr Betts. I first acknowledge the campaigners from Make 2nds Count, METUP UK and Breast Cancer Now and the fellow MBC patients who are joining us in the Public Gallery.”
“I do not say that to terrify people, but to say that it is absolutely imperative that they are aware of the signs and symptoms of secondary breast cancer in case they ever have them, no matter how long it has been since their primary diagnosis—or indeed, if they have ever had one.”
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“My right hon. Friend is being very generous; I thank him for giving way. It was my sombre privilege to work with him on this matter when I was a Minister in the Department of Health. He is talking about driving forward the scheme; can he outline what work he has done with our devolved Governments in Scotland, Northern Ireland and Wales to drive forward the final compensation scheme?”
“I thank the Minister for his kind words earlier. Could he clarify whether co-infected people will be able to make a compensation claim for each round of interferon that they had, or whether those are being lumped together?”
“I recently visited the Liberty Centre in my constituency, a fantastic charitable organisation that supports individuals and families who have been affected by domestic abuse and violence. It told me that it could fill its refuge places three times over, but it does not have the resources. Will the Minister say what the Government are doing to ensure that voluntary and charitable organisations that do such excellent work in this space continue to be supported and sustained?”
“Access to drugs and research makes it possible for me and others like me to see our children grow, to meet our grandchildren and to bury our parents, not the other way round. Lives with metastatic breast cancer matter too.”
“It is literally a process of trial and error, and you keep going until you run out of options, which means that without access to new drugs and without trials, we will run out of options sooner rather than later, and when we run out of options, we die. The cancer plan committed to develop world-class cancer care through world-class research, so I ask the Minister what progress has been made, particularly to establish the cancer trials accelerator by 2027. When we do develop those drugs, we need to know that we are getting them. Changes to NICE criteria, namely the severity modifier, have been touched on, so I ask the Minister what developments have been made on them. Will she explore those?”
“We have some good data for de novo—where it is diagnosed initially—but for people like me who are diagnosed 10, 12 or 20 years later, we do not really know. Without that data, we cannot build the services or estimate demand. The fundamental truth is, if I am not counted, I do not count. We must start this. The cancer plan commits to counting metastatic disease properly, starting with breast cancer, so I ask the Minister what progress has been made, and will she set a deadline for trusts to report? It is literally just counting. On research and lines of treatment, some treatments work and some of them do not. Basically, you try them, and if they work, you stay on them until they stop working or they make you so ill that you cannot carry on, and then you try another one.”
“That does not mean that you are necessarily cancer free, because we know that it lies dormant and we cannot necessarily see it. We know what secondary breast cancer is, so what are we going to do about it? Some of these points have been raised already, but the national cancer plan, which I, as the Minister at the time, was delighted to lead on and launch earlier this year, is perhaps the first national cancer plan that does not have metastatic disease as a brief mention but has it at its heart. I am really pleased about that, because it has not been forgotten about—it is in the plan. The No. 1 thing that I wanted to make sure was in the plan was that we count; this has already been touched on. We estimate that 61,000 people have metastatic breast cancer, but really we have not got a clue.”
“The point of treatment is to keep the cancer at bay—to hold it back to allow me to continue to do this work and live my life—not necessarily to cure me. Then there is the myth that metastatic breast cancer means that you are going to die soon. I received some absolutely terrible comments when I went public with my disease. One particularly lovely person on Facebook said, “Oh, there’ll be a by-election soon then,” assuming that I was going to be dead—that was two years ago. It is not necessarily true. Metastatic breast cancer is treatable, but it is not curable. Our treatments are there to hold it at bay and treat pain and other side effects. Sometimes we might even get the holy grail of “no evidence of disease”, which is what everybody hopes for.”
“It is not something from outside that we pick up, or that we get. It is us—it is our own cells that change and do this to us, so our cancer, invariably, is as unique as we are. There is also a myth that all treatments will work for everybody, and that if you have one kind of cancer, a certain treatment will work. Unfortunately—sadly—that is not the case, because we are all unique. A treatment that can be extremely effective for one person can have absolutely no impact on somebody else. There is also the idea that the treatment for metastatic breast cancer is more aggressive than that for primary cancer; actually, it is often the opposite. I cannot be cured, so what is the point of making me so sick that I cannot get out of bed for six months?”
“I do not say that to terrify people, but to say that it is absolutely imperative that they are aware of the signs and symptoms of secondary breast cancer in case they ever have them, no matter how long it has been since their primary diagnosis—or indeed, if they have ever had one. I put on record my commendation and thanks to Jo from METUPUK, who developed the infographic on secondary breast cancer symptoms, which has been extremely useful. We have heard about lobular breast cancer, and there is an idea that secondary breast cancer is one disease. Obviously, it is not: there is ductal, lobular, metaplastic, inflammatory and other sub-groups such as hormone receptive, HER2-positive, HER2-negative and triple negative. The weird thing about cancer is that it is not a disease that infects us.”
“There is also a myth that the treatment for your primary cancer was somehow wrong or had failed if you get metastatic breast cancer. Again, that is absolute nonsense. Breast cancer can still spread, even after successful treatment for a primary cancer, and even with the best treatments in the world. Breast cancer in particular can lie dormant for years and years. That leads me to the five-year myth. We often count survival after primary diagnosis and treatment at the five-year point. Sometimes, that creates the idea that if you get to five years and it has not come back, you are okay. Sadly, that is not true; it does not mean that it will never come back. Breast cancer in particular can come back up to 20 years, if not longer, after primary diagnosis. My breast cancer came back 10 years after my primary diagnosis.”
“My favourite—I know people mean well—is: “If anyone can beat this, you can.” I know people mean well when they say that, but the truth is that I cannot beat it. I will always be in treatment, and I will not recover. It is absolutely terrifying, but we have to be honest about this. If we are not honest and do not grasp the nettle about this disease, we cannot truly tackle it. There are some other myths about breast cancer. One is that when it spreads, it is a new cancer. If you have breast cancer and then you have cancer in your bones, that is not bone cancer; it is breast cancer in your bones. It looks like breast cancer and the cells are breast cancer; they behave like breast cancer and they will need to be treated like breast cancer.”
“It can be diagnosed after a primary diagnosis—primary breast cancer is potentially curable—or the first time that a person is diagnosed with breast cancer. That is called a de novo diagnosis. That is what secondary breast cancer is and, as we have heard, I have it, along with many, many other people. I want to take the opportunity to talk about some of the myths around breast cancer. Colleagues have spoken really well about some of the issues and concerns, and the politics and policies involved, but I want to talk about the reality and some of the myths about secondary breast cancer. The big myth for many people is that it is curable. A number of people have, very well-meaningly, said to me, “How long will you be on treatment?” I will be on treatment until I die. “I hope you make a full recovery.” I am not going to be making a recovery.”
“There is a school of thought that suggests that that may be curable, but the jury is still out on that, so we will stick with the terms that we have. But there are some other words that describe secondary breast cancer: devastating, terrifying, overwhelming, horrifying, desperate, anger, resentment and fear—all of which I have certainly felt. This debate calls it secondary breast cancer. It is really important that we get it right, because I have met many people who think that secondary breast cancer means having breast cancer for the second time. It does not. Let me be really clear about that. As we have heard, secondary breast cancer is breast cancer that has spread outside the breast tissue and is now incurable.”
“As ever, it is an honour to serve under your chairmanship, Mr Betts. I first acknowledge the campaigners from Make 2nds Count, METUP UK and Breast Cancer Now and the fellow MBC patients who are joining us in the Public Gallery. If you will indulge me, Mr Betts, I would like to take this opportunity to say a special thank you to my team at the Clatterbridge in Liverpool for the support they have given me through my treatment and diagnosis. I am delighted to be able to speak in this debate on secondary breast cancer. Secondary, metastatic, advanced, stage 4, disseminated, which a new one for me, distant metastatic spread—lots of words that all mean the same thing: incurable breast cancer. For completeness, there is a relatively new term: oligometastatic, which means very small or very few metastases.”
“I wonder whether the hon. Member might clarify something. He stated that the Bill could have come back to be debated in the Commons. A Bill does not come back to the Commons to be debated after it has been to the House of Lords. All the Commons can do is consider Lords amendments. It cannot debate the Bill again. Would he like to correct that?”
“The petition argues that if MPs vote for a Bill and opinion polls suggest public support for its principle, the Government should use their powers to ensure that the Bill progresses. I disagree. Parliament’s role is to pass the best possible legislation, not to vote on a principle and let the detail work itself out later. Sometimes our work begins with campaigning but, ultimately, we are legislators dealing with detail and specifics. MPs, peers and Ministers share a responsibility to uphold the integrity of Parliament not as a matter of dry academic principle, but because bad legislation has truly terrible consequences.”
“Proper parliamentary scrutiny of the laws before us is one of the most important safeguards—perhaps the most important safeguard—in our constitution. Our democracy is not a matter of ensuring that legislation reaches the statute book as quickly as possible. That was not why we or our colleagues in the other place were given the privilege of serving in Parliament. It is not why every single one of us takes so much care over our decisions, speeches and the causes we champion, or why we sit late into the night to ensure that every voice is heard. As time-consuming and as uncomfortable as it can sometimes be, our legislative process was deliberately designed to allow opportunities for challenge, scrutiny and improvement. They are a feature, not a bug.”
“I have stage 4, incurable breast cancer myself, so this is not an abstract debate for me either. Like all of us, I am going to die. However, my diagnosis means that I know what is most likely to kill me, and without the intervention of medical science, it would be killing me a damn sight sooner than it currently is. That does not necessarily give me any more wisdom, but it perhaps gives me a certain clarity on the issue of end-of-life care. One thing that I am very pleased has emerged from the debate is that the state of palliative care is now firmly at the heart of the political agenda. Whatever our different views on the Bill, I hope that the passion of both sides will serve as a clear, united call for better, more accessible care for everyone. I do not think there is similar consensus on the proposal we are debating today.”
“It is a pleasure to serve under your chairmanship, Mr Wishart. I thank the petitioners for giving us the opportunity to have this debate. I know that we are all mindful of the sincere and strongly held views that led to the submission of the petition. The previous Session’s debates on the Terminally Ill Adults (End of Life) Bill were, in both Houses, consistently heartfelt and moving, with people on both sides of the argument often speaking from real, difficult experience. The debates also provided many people outside Parliament with a chance to talk—in many cases, for the first time—about the reality of death and dying, and what compassionate and respectful care should look like as people move towards the end of their lives. As some hon. Members will know, I have actual, first-hand experience of being given a terminal diagnosis.”
“Governing involves more than simply measuring public sentiment at a particular moment in time. If supporters of a Bill are confident in its merits, they should welcome scrutiny. Good legislation survives challenge. Strong arguments withstand examination. Many laws emerge better because difficult questions were asked during their passage through Parliament, including by the experts in the revising Chamber. Ultimately, this debate is not about whether one supports or opposes a particular Bill; it is about what kind of parliamentary system we want. Do we want a Parliament that carefully examines legislation, especially that dealing with matters of profound social change, or do we want one in which surface popularity becomes a reason to accelerate the legislative process and reduce opportunities for scrutiny? I believe that we do not.”
“There is no doubt whatsoever about the primacy of the elected House, which is why peers do not vote against legislation that secured a mandate from the public because it was in a Government’s manifesto. In fact, they rarely vote against legislation at all—as we have heard, they did not vote against the Bill. Still, however, the House of Commons is not sovereign—our Parliament is. Our Parliament is a trinity of the Commons, the Lords and the Crown, and each has a distinct and critical role to play. We cannot believe that a piece of legislation is serious and important, but also demand a weaker and worse process for passing it. I am also cautious about relying too heavily on opinion polls as a justification for altering parliamentary processes. Public opinion matters enormously, of course, but polls can be crude instruments.”
“I will not; there is not enough time. Once we begin asking Governments to override democratic protocols or decide that the revising Chamber’s scrutiny should be optional, we create a precedent. Constitutional principles must apply consistently. We have our constitutional arrangements because it is our responsibility to consider not only the outcomes we want today, but the outcomes we might not want tomorrow. The petition is specifically about the role of the House of Lords. In my time as a Minister, it was a great honour to work alongside Members from the red Benches as well as the green. Peers are our colleagues, not our enemies or rivals. The Lords, as an institution, has made a vast contribution to the work and reputation of our Parliament.”
“There is much good in the Government’s plans. The vast increase in specialist places and the training and upskilling that will give our teachers more tools to help SEND students will make a real difference to the lives of children and their families. SEND parents are no different from any other parents. Every day, they fight to give their children the best possible start in life, and it is so important that this Government support them to do so, without them having to fight endless layers of bureaucracy and constantly push back against a “computer says no” culture that requires individuals to fit cookie-cutter templates to get bespoke assistance. We must ensure that, through these changes, we are giving parents respite, not just inadvertently moving the fight from one place to another.”
“I congratulate the hon. Member for Farnham and Bordon (Gregory Stafford) on securing this really important debate. Children in West Lancashire have previously felt let down by the SEND system. People lost faith in the very system that is meant to support the children in our communities who need it the most. That is the inheritance that this Government took from the last Government. I know how important getting this right is to the Secretary of State, and the work that this Government have done in the past few years has not gone unnoticed by my constituents, but it is so important that we get these changes right. The people who write to my inbox or visit my surgeries are simply desperate for a system that treats SEND pupils with dignity and truly recognises them as individuals filled with all sorts of potential.”
“Friend the Secretary of State’s commitment to give every child the best possible start in life, I would be grateful if the Minister gave a clear reassurance today that the legal right to an EHCP or similar for those who need it will remain, and that the ability of families to enforce provision will not be weakened by reforms.”
“Reform-led Lancashire county council has failed to provide tailored support for children in my constituency, and has failed to support families in my constituency who are fighting tooth and nail for their children to have the same opportunities that the rest of us rightly expect as standard. It would be an abdication of my duty to represent my constituents if I did not seek to give parents every tool in the box to defend the right of their children to a decent education, in the face of a local authority whose leadership turns its gaze away and plugs its ears. I am proud that this Government are tackling this issue in a constructive way—parents have waited for these changes for far too long. As part of my right hon.”
“Had that not been the case, her son might still not be in education. My constituent agrees with the Government that the system we inherited is not working, and she is not asking us to scrap these reforms, but we must ensure that the changes we are making to an unfair system support SEND children and their families as much as we possibly can. Last year, Reform took control of Lancashire county council, the authority that makes decisions about SEND provision for my constituency. It is obvious that, despite claiming that it would tackle the issue, Reform has demonstrated no interest in it. Its national party does not care—as has already been pointed out, not a single one of its Members is present for this evening’s debate.”
“I know that this Government are committed to ensuring that these changes make life easier for SEND children and their families, not harder. Twice, I have met a constituent who has a son with severe and complex special needs—he is nonverbal and has sensory challenges. Even when her son was offered a place at a special school, the local authority did not accept that place, despite it being cheaper than the local authority provision. It ignored recommendations and assessments, and my constituent’s son was out of education for seven months. My constituent had to use the rights that exist in current legislation to fight for the most basic right—for her son to have an education—and the issue was only resolved because of his legal right to legal enforceability and the tribunal power to name a school.”
“I thank the hon. Member for his intervention and his kind words, and I agree that we cannot simply say that there is overdiagnosis. It has been said previously that there were not as many people with SEND before; the reality is that we do not know that, because for many years, SEND simply went unnoticed. People were not diagnosed, and were simply written off as naughty or backward. We must recognise how important these children are and how much support they need. Dozens of parents in West Lancashire have contacted me to request that I come to the Chamber today to protect the rights they have under current legislation to enforceable provision based on a child’s particular needs. We all know the deficiencies that exist in the current EHCP system, but we must make sure that we listen to SEND parents.”
“My hon. Friend has outlined clearly the issues caused at Simonswood in my constituency, which my constituents are also really concerned about. Constituents on the other side of my constituency are also dealing with a very similar problem at the St Joseph’s college site. Would my hon. Friend agree that, if the Environment Agency cannot or does not act promptly and robustly when we have these problems, it leads to a significant erosion of trust in the Environment Agency—and, actually, in Government agencies as a whole?”
“Thank you, Mr Speaker; I am delighted to take up this place. People in West Lancashire are concerned about the potential relocation of the children’s accident and emergency department at Ormskirk following the joint integrated care board committee’s “Shaping Care Together” consultation. Folk, and I, want a co-located children and adult’s A&E in Ormskirk. What can my constituents do to ensure that their voice is listened to in the process?”
“The national cancer plan, which I launched about two weeks ago, will end the postcode lottery. Wherever people live, they will receive high-quality cancer treatment. We have already invested £70 million in 28 new cutting-edge radiotherapy machines, reducing waiting times and providing 15% more treatments. This allows 27,500 more patients to be treated every year, which means more equal access and better outcomes for cancer patients across England.”
“I commend my hon. Friend’s continued advocacy for radiotherapy. I have met the hon. Member for Westmorland and Lonsdale (Tim Farron) and the other members of the all-party parliamentary group on radiotherapy to discuss how the Government will improve outcomes for cancer patients. While trusts retain responsibility for recruitment, we are continuing to increase our cancer workforce: between November 2024 and 2025, it grew by more than 4%. In the cancer plan, we have committed to ensuring that we have the staff where and when we need them, and we are rebalancing cancer training places targeted at trusts in rural and coastal areas—such as east Durham—to improve patient outcomes.”
“The hon. Gentleman and I share part of that integrated care board area. In the cancer plan, we committed to ensuring that coastal and rural areas receive the services that they need. We are investing more in radiotherapy machines, and we are working with ICBs to ensure that they are providing the services that their communities need, and that we are supporting the recruitment of the cancer workforce who will be able to go into those rural areas.”
“The 10-year health plan announced ambitious measures to make the healthy choice the easy choice. They include tackling the obesity epidemic through mandatory healthy food sales reporting, business targets to increase the healthiness of products sold and restrictions on junk food advertising.”
“I thank my hon. Friend for outlining the very real crisis of childhood obesity. It is a problem that robs children of the best possible start in life and sets them up for a whole lifetime of health problems. It is why this Government have come down hard and delivered our commitment to restrict advertisements for junk food on TV and online. That action will remove around 7.2 billion calories from children’s diets every single year.”
“The regulators are doing their job. This is a perfectly ordinary occurrence in certain research trials. As the hon. Member has made the House aware—I am sure it was already aware—the trial has been paused. We will leave the regulators and the clinicians to do their jobs to ensure that all the trials, including this one, are done in an appropriate fashion.”
“What the hon. Member highlights is part of this rigorous process. That is what happens. Why the MHRA has changed its view is a question for the MHRA, but it is up to the MHRA to raise these issues through the process. That is why we run such trials. [ Interruption. ] It is an independent regulator.”
“We are revolutionising our country’s health and wellbeing through our 10-year health plan, which will deliver the three major shifts, boost life expectancy and improve mental health for everyone, everywhere. We are shifting from prioritising the tackling of sickness to prevention, including through action in the Tobacco and Vapes Bill to create a smoke-free generation.”
“My hon. Friend will know that that is a question for Treasury colleagues. However, we are a mission-led Government committed to healthy outcomes across Government, not just in the DHSC.”
“Sorry, Mr Speaker; I did not hear you. I can confirm that a written ministerial statement will be tabled at 4 pm in which the contract for 2026-27 will be laid out.”
“We acknowledge the important issue of the potential negative impact that gambling advertising may have on children and young people’s health. My officials continue to work closely with officials at the Department for Culture, Media and Sport, and I will be discussing the issue with the Minister for Gambling, who is responsible for gambling advertising policy. We continue to keep the public health evidence under review, and to consider suitable action to protect individuals and communities from gambling harms.”
“As the hon. Gentleman is probably aware, this Government’s cancer plan, which I launched just over a week ago, is the first ever cancer plan to have a section on children and young people with cancer and to commit to supporting children holistically throughout their cancer journey. I am more than happy to have a conversation with him about the issues that he has raised.”
“This Government is on their side. We wrote this with them, and we cannot deliver it without them. Let us do it together. I commend this statement to the House.”
“I am so grateful to them, and I want people to hear their voices as they read the plan, because it is rooted in the voices of patients, families, clinicians and charities. It will turn cancer from one of this country’s biggest killers into a chronic condition that is treatable and manageable for three in four patients. It delivers the ambition of the 10-year health plan, embodies this Government’s three shifts and sets a clear path towards earlier diagnosis, faster treatment and world-leading survival rates by 2035. This plan does not belong to the NHS, and it does not belong to the Government; it belongs to us all. We all must play a part in making it work. Over the past year, I have met the patients, families, carers, clinicians, researchers, cancer charities and voluntary groups who all contributed to our plan.”
“Our children and young people cancer taskforce asked for support with travel costs, because when someone’s child has cancer, the last thing they should worry about is how they will pay for their train ticket. Today, I can announce that we will fund those travel costs. Alongside rare and less common cancers, we will make research for children and young people a national priority. I take this moment to thank the children, young people and families who made up our children and young people cancer taskforce. It was a pleasure and a privilege to meet them earlier this week. I thank the many families and loved ones of people lost too soon who continue to fight to make change for others.”
“They told us we need a special focus on these cancers, and our plan sets out how they will benefit from the deployment of genomics, early detection and the development of new treatments. That was asked for by patients and will be delivered by this Government. I pay tribute to my hon. Friend the Member for Mitcham and Morden (Dame Siobhain McDonagh) for her campaigning in memory of her late sister Margaret. We should also remember that the late Tessa Jowell raised this issue in 2018, and her family have campaigned ever since. Our plan also gives pride of place for children and young people. We will improve their experience of care at every level, from hospital food to youth worker support and play support. I pay tribute to my hon. Friend the Member for Leyton and Wanstead (Mr Bailey) for his campaigning on that point.”
“By 2035, it will bring together genomic and lifestyle data with the single patient record to advise every patient according to their risk. That will benefit people in rural and coastal communities who can find it difficult to access specialist care simply due to geography. Finally, we will use the neighbourhood health service to make the shift from hospital to community. That will mean more care, from prehabilitation to recovery support, delivered closer to home. We will help people live well with cancer through tailored support closer to home. People will be given personal cancer plans, named neighbourhood care leads and clear end-of-treatment summaries so that no one feels abandoned after their treatment. For too long, those with rarer cancers have seen little to no progress for many of their conditions.”
“We will start people’s care earlier using liquid biopsy tests, which can return results up to two weeks faster than conventional testing. We will harness AI to read scans, plan radiotherapy and identify the right path for each patient. We will harness genomics so that every eligible patient has access to precision medicines. We will harness data to make sure that all metastatic disease is counted properly—starting with breast cancer—so that people with incurable cancer are properly recognised and supported. When people are not counted, they feel like they do not count, but we will end that. Innovation will also help us fight inequalities and make the shift from sickness to prevention. We will turn the NHS app into a gateway for cancer care. By 2028, it will host a dashboard for cancer prevention, with access to tests and self-referral.”