Accessibility of Radiotherapy

I beg to move,

That this House has considered the accessibility of radiotherapy.

It is a great honour to serve under your guidance, Sir John, and it is a great privilege to have the opportunity to raise the issue of the accessibility of radiotherapy on World Cancer Day.

Three quarters of those in my communities in Westmorland live dangerously too far from radiotherapy treatment. It has been my privilege over the years to drive a number of my constituents to the Rosemere centre at Preston to get treatment, and I am always struck by the quality of the treatment and the warmth and professionalism of the staff, but also by the gruelling impact on my constituents, on whom the daily lengthy journeys take a terrible toll.

I am grateful to my hon. Friend for giving way so early in his speech. He mentioned travel times. Travel times to radiotherapy for my constituents in St Albans and Hertfordshire would certainly be much reduced if the relocation of the Mount Vernon cancer centre to Watford General could proceed, and the only way for that to happen is if the new hospital programme goes ahead sooner than is currently planned. Would he agree with me that shortening the travel time would provide a much better service for local residents?

Yes, I absolutely do agree with my hon. Friend. Travel times, which I will come on to in a moment, do have an impact on outcomes—in other words, whether people survive—because there is an impact on the extent to which a person will be referred for treatment depending on how close they are to the nearest site. What she says is absolutely right, especially for her communities.

For my constituents, the two, three or in some cases four-hour round trip to the excellent but distant Rosemere cancer unit at Preston is not just inconvenient, but debilitating and cruel. It means that many do not complete their treatment, and many choose not even to start such treatment. Some do not even get referred for radiotherapy in the first place, because clinicians understandably conclude that the patient is not strong enough to cope with the rigours of travelling such distances so frequently. For us in Westmorland, longer journeys mean shorter lives.

I congratulate my hon. Friend on securing such an important debate, especially on World Cancer Day. In my constituency of North Norfolk, Radiotherapy UK found that nobody can access radiotherapy treatment within 75 minutes by public transport. Does he agree that we need a two-pronged approach to tackle this—to fix our broken public transport infrastructure and to make more services available closer to where people are, such as at Cromer hospital in my constituency?

My hon. Friend is absolutely correct. Back at the time of the last Labour Government, the national radiotherapy advisory group recommended that it was bad practice for anybody to live beyond 45 minutes of a radiotherapy centre one-way, or a round trip of an hour and a half, yet so many people—7.5 million people—including his constituents and my constituents, live beyond that.

On that specific point, I do not want to show off about who has the worst travel times for radiotherapy, but nobody in my constituency of Frome and East Somerset who does not own a car lives within that recommended 45-minute NHS travel time. Does my hon. Friend agree that reliable, quick and affordable public transport is key, and that the recent increase to the bus fare cap has not helped with the situation?

Yes. By definition, almost all of the radiotherapy deserts—those places that are beyond sensible and safe travelling times—are rural communities. As a result, they have terrible public transport. It is not just about the cost. The increase in the bus fare cap is hugely damaging, but for many of our communities—my hon. Friend’s and mine alike—it almost does not matter what the bus cap is; if there is no bus to spend the fare on, people are stuffed, really. That has a huge impact on their cancer outcomes, which means whether they survive or not.

Could the reason that radiotherapy is used in only 35% of cases, rather than 50% of cases, be that local transport just does not exist to take people to have the treatments that they need?

My hon. Friend makes a good point. There is a combination of reasons, which I will come on to in a moment, but distance from treatment is undoubtedly the critical point that decides whether people can access and take advantage of lifesaving and life-prolonging treatment.

I feel that the hon. Member has a point to make.

First, I commend the hon. Member for championing this issue for all the years I have known him in this House. He deserves credit for that, he has got this debate in Westminster Hall today, and we are looking to the Minister for a response. Does the hon. Member agree that the issue goes more widely, and is also about recruitment? Training and retention of clinical oncologists is needed, with only seven in 10 training places filled in 2024. Does he agree that there is a way forward—bursaries for students, which could begin to fill the training needs in the long term? Students would understand that they will not live under the burden of student debt if they pick a career for life—in other words, help them with a bursary and the NHS will have them forever.

I completely agree with the hon. Member. Many people watching the debate today, whether physically in the Gallery or on television outside, are part of that outstanding workforce, and we are massively grateful to them. What a career for someone to be in, where you are saving lives every day and alleviating pain. That is a wonderful thing, yet there are not enough of them. The workforce is part of the solution, as well as the challenge, to the problem that we face.

For us in Westmorland, longer journeys mean shorter lives. The answer is clear for us in Westmorland, and that is to build a satellite radiotherapy unit at the Westmorland general hospital in Kendal as part of the Rosemere unit, following the model of the many excellent satellite units around the UK. The number of cancer patients travelling from south Cumbria each year for radiotherapy provides demand for at least one linear accelerator at the Westmorland general hospital. If the experience of other new satellite centres around the country is replicated, such as at the new Hereford site, which is a satellite of Cheltenham, a satellite centre in Kendal would attract at least 20% more patients than existing demand, because people who would not have had radiotherapy treatment at all beforehand would now be able to access it, simply because it is closer to them. That a satellite unit in Kendal has not already happened is an indictment of the lack of responsiveness to the obvious need from NHS England, and of a lack of concern for cancer patients and their families who live in rural communities.

I commend the hon. Member for his advocacy on this subject over a long time. The satellite centres are one thing. I represent Northern Ireland and my constituency of Lagan Valley, and I note that there are people in the Gallery involved in the All-Island Cancer Research Institute. Does he agree that geography is important and that cancer knows no boundaries, so our efforts to tackle it should also know no boundaries?

The hon. Member makes wonderful points, and it is absolutely right that in every corner of the United Kingdom we need to ensure that we have the staffing, the kit and the level of technology to meet need close enough to where people live for people to be kept safe and treated in a convenient way.

In Westmorland, we successfully campaigned to bring chemotherapy, greater amounts of surgery and a new diagnostic hub to Kendal. All of that is welcome, and all of that has saved lives. I am unbelievably grateful to all those in our communities who campaigned alongside us, and to the wonderful NHS professionals who deliver and run those services, but the failure of successive Governments, including the one I was a part of, and NHS management to take the people of Westmorland out of the radiotherapy desert is utterly inexcusable given the multiple opportunities to do so over the last 30 or so years.

So my first ask of the Minister is that he takes a personal interest in the call for a satellite radiotherapy unit at the Westmorland general hospital in Kendal, and that he meets with me and with oncologists, commissioners and patients, to kickstart that bid.

Does my hon. Friend agree that we must also do more to help local groups providing clinical and non-clinical support for radiotherapy patients after treatment, such as the Macmillan radiotherapy late effects service and the Cancer Connect group in my constituency of Yeovil?

My hon. Friend makes a great point and does a great service to his community by standing up for those groups who support people after cancer, and their families. I know that personally in my own family, so I congratulate him on making a really important point.

My second ask—the Minister should be delighted to hear that I only have two—is that he separately meets with the all-party group on radiotherapy and the leading fantastic clinicians who support us, to look at how the Government and NHS England can turn the tide on radiotherapy nationwide, because the problems of access do not just affect Westmorland; they affect the whole country.

Although in Westmorland our issue is unacceptable distance from services, the problem across the country is that we lack sufficient capacity, lack up-to-date technology, and lack an effective workforce plan. Britain is behind our neighbours on the number of radiotherapy machines, and we are behind our neighbours in how advanced that machinery is. In France, for example, there are twice as many linear accelerators per head as we have in the United Kingdom. Across the OECD, roughly 9% of cancer budgets are spent on radiotherapy; in the UK we spend a paltry 5%. One in two of us will have cancer at some point, and one in two people with cancer should have radiotherapy—to be precise, 53% of us should—yet only 35% of cancer patients in the UK had radiotherapy as their primary treatment. In fact, the regional variation in access to radiotherapy ranges from the lowest of only 29.8%—by the way, that is in my constituency—up to 50%.

There are shocking variations based on tumour type, too. Only 11% of lung cancer patients in some regions receive radiotherapy, compared with 43% in other regions. Only 18% of rectal cancer patients receive radiotherapy in some areas, compared with 62% in others. People’s chances of surviving should not depend on their postcode. Inadequate and inequitable radiotherapy capacity is costing lives. Over the past decade, more than 500,000 patients have waited more than two months for their first cancer treatment. Yet the chilling reality is that for every four weeks of delay in treatment we have a 10% reduction in our chances of surviving.

Thank you, Sir John, for your chairmanship today. In Northern Ireland, one in two people who need radiotherapy do not get it at an early stage. Does the hon. Member agree that a strong focus on awareness and early diagnosis is needed?