Hansard

I thank the cabinet secretary for that intervention.

As I was saying, Scotland is leading in bowel cancer screening. The faecal immunochemical tests that NHS Scotland sends out have a sensitivity level of 80 micrograms of blood per gram of poo. We have led the way for a long time, but I have to say that I am now disappointed to find that Wales has caught up—as a Scotsman, I never like to see Wales too close to us when it comes to these things. Wales has equalled that target, so I believe that it is time to move on, and the following figures should help the Government in that decision.

First, we know that, if you catch bowel cancer early, at stage 1, there is a 90 per cent chance of survival after five years. If you catch it at stage 2, there is an 85 per cent chance of survival. However, if you catch it at stage 3, that drops to 65 per cent, and, at stage 4, it is 40 per cent. That indicates that the earlier you can catch it, the better it will be. If you catch it earlier, it means not only that there is a greater chance of survival but that less treatment is needed, at less cost.

No one really talks about treatment for bowel cancer, but it can be quite invasive. For me, it was radiotherapy, then chemotherapy and eventually surgery. The chemotherapy is a hard course to go through. It involves three hours of sitting in a room with other cancer sufferers, on a drip, getting your chemotherapy, and then two weeks of pills—12 pills, morning and night—and feeling pretty sick on the back of it. You are not able to do little things, such as getting milk out of the fridge, because you cannot touch anything cold. You are made to feel pretty tired by the treatment, and pretty isolated.

My view is that there is every reason why we should ensure that people can avoid the treatment. Let us be clear, too, that there is a huge cost in treatment to the national health service. The “Cost of cancer in the UK” report has shown that, if someone’s cancer is caught at stage 1 or stage 2, the cost is about £33,000 in the first year; if it is caught at stage 3 or 4, the cost goes up to about £46,000. That is just for the treatment—it does not include surgery. If someone goes for surgery, the costs can be huge. I know that personally, because I saw the bills related to my treatment. The total for surgery is probably the two figures that I have quoted, combined together, on top of the original costs. There is a huge cost to not catching bowel cancer early.

So, how do we catch it early? As I explained, in my opinion, increasing the sensitivity of the FIT would be the easiest way of doing that. I have discussed that with the Minister for Public Health and Women’s Health, who I know takes a personal interest in the subject—she does not have much of an option, because I pester her about it the whole time. The cost of increasing the sensitivity of the test is that we will need more colonoscopies. I have done some research across Scotland, and I know that the average cost of doing a colonoscopy in the NHS is about £18,000. If you go private, you can get it done very quickly, and the cost is about £3,000. It does not take a lot of maths for me to be able to highlight the situation to members: if the costs for treatment are going to be close to £60,000, how many colonoscopies would we need per patient to make it justifiable?

My call to the Government, and to everyone, is that we need to catch bowel cancer early. We can do that by increasing the sensitivity of the test, and we should—to my mind—be pleased to know that there is no reason why we cannot do that if we train more colonoscopy teams across Scotland. I say to the minister that, if we cannot do that, we should rely on the private sector to deliver those colonoscopies. The benefits of that approach are that we will be saving Scotland money and saving lives—what is not to like about that?

Let us be honest: if we make the test more sensitive, Scotland will be leading the way again, which is where we should be.