That this House has considered the potential merits of a cancer strategy for England.
It is an honour to serve under your guidance this afternoon, Mr Betts. This debate is significant to me for many reasons. When I was diagnosed with breast cancer in 2008, it came as a massive shock to me and my family. Questions whirled around in a haze of uncertainty: “Is it serious? What happens next? What does the future look like? What treatment will I have?” Some people think, “Am I going to die?”, and, sadly, far too many do.
Cancer is an evil that takes your life completely out of your own hands. The hardest thing I had to do was to tell my two daughters about my diagnosis. They were 13 and 14. It was a very emotional time. Was our family of four about to become a family of three? Because of the delay in diagnosis, my cancer spread. I had surgery twice, chemotherapy and radiotherapy. I was one of the lucky ones who survived.
Looking back on my personal experience of the NHS, I can only be grateful and thankful for the service I received. Our NHS consultants, oncologists, radiologists, radiographers, histopathologists and specialist nurses work with diligence and dedication to provide their patients with the best possible care. Yet it is hard not to reflect that being diagnosed in 2008 was in one respect a blessing, because cancer care in 2024 is simply not working.
Lord Darzi’s independent investigation of the NHS in England plainly said:
“The National Health Service is in serious trouble.”
It did not surprise me to read his report calling out the failings in cancer care. I felt genuine anger when he highlighted that some of our services are lagging behind those of other countries. As a stark reminder, the UK has higher cancer mortality rates than any comparable country. One patient in three waits longer than 31 days for radical radiotherapy. The national target to start treatment within 62 days of an urgent referral has never been met since 2015. The Conservative party should be ashamed of those statistics.
In my constituency of Wokingham, most cancer care is delivered at the Royal Berkshire hospital, and I am thankful that we have fantastic people working there. I am sure Ministers in the Department of Health and Social Care are sick of me saying this, but that hospital urgently needs a rebuild. The consequences of delay, disrepair and degradation put patients on the frontline of risk to their health, and they see at first hand the consequences of failing to invest in the future. That is especially clear in cancer care. Some of the Royal Berkshire cancer treatment is performed in buildings that were built when Viscount Melbourne was Prime Minister: in 1839.
A broken estate is one of many issues stopping cancer standards from being met and is putting patients at risk. Across the country, the target of 85% of patients starting their first definitive treatment within 62 days of referral is not being met. The statistics are shocking. These are people with families and friends. They deserve better.
I thank my hon. Friend for securing this debate. The statistics he has shared are truly shocking. I want to draw attention to the five-year survival rate for pancreatic cancer, which several of my constituents have raised with me. They have heartbreaking stories of losing loved ones from a position of diagnosis at stage 4. Does my hon. Friend agree that those statistics highlight the need for a cancer strategy in the UK in order to up early diagnoses and drive forward research?
I absolutely agree with my hon. Friend. This is why we need a national cancer strategy. So many cancers do not get the resources they need. Everything is a bit too general; a lot of cancers need the focused, targeted resources that will lead to better outcomes.
I am grateful to the hon. Member for hosting today’s debate. In the last Parliament, the Health and Social Care Committee carried out an inquiry into future cancer. From all the evidence we received, we came to the conclusion that a bespoke future cancer strategy was needed to support the NHS, and that it should not be combined in a major conditions strategy, which frankly went nowhere under the last Government. I congratulate the hon. Member on his advocacy; will he read the Committee’s report and our letter about all the interventions that this Government could make to drive forward cancer care?
I am aware of that report and will refer to it later in my speech.
The challenges will only grow. Experts state that one in two of us will get cancer in our lifetime. An expanding and ageing population means that the number of cancer cases is only going to grow. Cancer Research UK projects that there will be about 2.2 million new cancer cases in the current five-year parliamentary term, a 21% increase on the previous term. Cancer services are struggling now, and they will continue to struggle to keep up with demand. We have a greater number of people being diagnosed, but we have services that are not working. The challenge is stark, but there is a diagnosis for the problem. We now need to deliver meaningful action to recover England’s cancer care to full health.
The Liberal Democrats have made cancer care one of our top priorities for health. There are many policies that we think are crucial to boosting cancer survival rates. We are calling for the introduction of a guarantee for 100% of patients to start treatment within 62 days of urgent referral. We cannot just be content with replacing old radiotherapy equipment; we need replacements, but we also need more equipment. We are calling for the recruitment of more cancer nurses so that every patient has a dedicated specialist supporting them throughout their treatment.
Those crucial policies all feed into the very first step we must take, which is to give England the dedicated cancer strategy that it needs. It beggars belief that we do not have one. A cancer strategy is the best route to delivering genuine improvements for patients, for their families and loved ones and for those who work in our health system to research, prevent, diagnose and treat cancer.
The recent announcement of a 10-year health plan for England and its aim to improve health outcomes for all is very welcome, but I fear that the plan for all could be a plan for none. For example, analysis from Bowel Cancer UK found that the existing NHS long-term plan failed to sufficiently address the barriers to early diagnosis for bowel cancer. That is the case for many cancers. The approach is just too broad. We need detail, we need political will to be focused and we need a rapid and urgent turnaround.
The hon. Member is making an incredible and powerful speech. Will he add one more ask to his list: for the cancer strategy to be joined up with a life sciences strategy? The UK is fantastic at primary research around cancer, but there is work to be done in scaling that research and translating it into delivering a holistic product for the whole of cancer care, with the ensuing treatments and therapies.
I thank the hon. Member for her very good intervention. We are lucky in this country to have many life science businesses, many of which would really like to work as part of a joined-up cancer strategy. I have several in my constituency that I know would really like to do that, so I thank her for making that very good point.
Let us utilise this crucial opportunity to fix our cancer services. Some 360 people will die of cancer in the Wokingham area in the next year, and there will be around 2,000 cancer deaths over the next five years of this Parliament. We need to do our best to ensure that that figure is not reached but comes down.
Order. I count seven Members who would like to speak, so that gives us about a six-minute maximum for contributions. I am not imposing a rigid time limit, but that is an indication of how long you should try to speak for.
It is always a pleasure to serve under your chairship, Mr Betts. I thank the hon. Member for Wokingham (Clive Jones) for securing this important debate.
I will start by talking about a constituent who emailed me last week. She is a cancer patient, and when she was discharged from hospital she was informed that there is no specialist cancer rehabilitation and recovery support in Folkestone—a town of 52,000 people. She was told that the nearest support could be accessed only in the neighbouring constituency of Dover or in New Romney, which is 14 miles away. However, she does not have a car, and the effects of the cancer treatment make it challenging for her to move around. Folkestone has been allocated a single cancer support nurse, but they are expected to cover the patients at eight GP surgeries in the area of Folkestone and Dover—a town with a population of 116,000. We obviously do not need to be maths geniuses to work out that the ratio of nurses to the population is unacceptable.
Cancer is the UK’s biggest killer, and as we speak more than 3 million people are living with it. Lord Darzi’s recent report highlighted in stark terms that cancer patients are waiting far too long to be diagnosed and treated, and when they leave hospital there is inadequate support for recovery and rehabilitation.
The lack of a national cancer plan correlates with, and is likely to be one of the causes of, the geographical inequalities in access to cancer care and rehabilitation, which affect my constituency. I appreciate that the NHS long-term plan includes important commitments for cancer services, but it does not provide the comprehensive transformation needed across all areas of control, including research and prevention. A critical question for the Government is: what can we do to ensure that a national cancer strategy generates additional capacity in cancer care and rehabilitative support?
I do not want to go down the road of party politics. The previous Government poured shedloads of money into the national health service, but throwing money at the problem is not the answer. I am not saying that there is not any demand for more capital expenditure—there is—but that is not the point. Unless we get the structure right, we will go on wasting more and more money. We need to be grown up about this; we must all understand that.
In the few minutes I have, I want to concentrate on an issue that the hon. Member for Wokingham (Clive Jones) touched on, but only briefly: the incidence of cancer in young people. It is many years since my eldest son used his wedding—and probably his bride too—to raise money for the Teenage Cancer Trust. In the time between then and now, sadly not a very great deal has changed. That is lamentable. The point was made that, every day, seven young people between their teenage years and their mid-20s are diagnosed with cancer. By the end of this decade, that figure is likely to have risen to 10 per day.
Most of us in the Chamber probably have family members who have had experience of cancer—or even have personal experience, as the hon. Member for Wokingham clearly has. We all know somebody who has had cancer, and sadly some of us know, only too well, people who have died of cancer. But the instances of cancer among young people are widely disregarded and neglected within the health service and beyond. It is not infrequent for a young person, subsequently diagnosed, to have to make at least three visits to a general practitioner before even being referred, because it is assumed, completely wrongly, that cancer is something that affects old people—people like me. I am expected to get cancer, but young people do not get it, do they? Well, sadly, yes they do, at a rate of seven a day, rising to 10 a day by the end of the decade.
Thank you, Mr Betts, but I will not make a speech.
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A dedicated cancer strategy would provide a huge opportunity to fix the entire system, not just for the present but for the future—for our children and our grandchildren. It will not be simple or easy: that is why a strategy requires political will and bold leadership to bring Whitehall together and make tackling cancer a priority.
It is clear that when there is strong, bold leadership, cancer strategies work. That is the case across the world. At present, internationally and across our four nations in the UK, England is an outlier in not having a cancer strategy. Comparable countries with a cancer strategy have seen greater improvements in survival rates. For example, having started from a similar position in the 1990s, countries such as Denmark have raced ahead of England in improving survival in recent decades. Denmark’s success is linked to a series of cancer strategies that successfully and strategically built on one another over a 20-year period to tackle critical issues facing cancer services.
Past cancer strategies in England have worked. The 2000 cancer plan for England set ambitious targets across research, prevention and care outcomes. A report by the National Audit Office found that that strategy had supported progress in most aspects of patient experience.
The last Conservative Government launched a consultation on a 10-year cancer plan for England in February 2022. They promised to wage a war on cancer, yet the then Health Secretary, the right hon. Member for North East Cambridgeshire (Steve Barclay), scrapped the dedicated cancer strategy, turning it into a broader major conditions strategy. Delays, delays and more delays meant that the strategy was never published. That is just another legacy of failure from the Conservatives.
In May 2024, the Health and Social Care Committee wrote to the Government and argued that it was a mistake for the Conservatives to abandon the 10-year cancer plan. The current Government have the opportunity to turn that around. Having a cancer strategy is very popular with the public. Almost eight in 10 people think that the Government need to develop a long-term and fully funded plan for cancer. Organisations ranging from Cancer Research UK and Breast Cancer Now to global biopharmaceutical companies and medical institutions support having a cancer strategy for England. Yes, this requires effort, cross-Government thinking and focus, and the ambition to make England and the UK a world leader in cancer outcomes and research. But that effort will mean that we have the chance to save tens of thousands of lives and that millions of people will not need to suffer the upset of losing a loved one or friend.
Last week, I tabled a private Member’s Bill—the National Cancer Strategy Bill—calling for the Government to implement a cancer strategy for England. But unlike other private Members’ Bills, mine does not need to be law for that to happen; the Government could make the decision tomorrow to kick-start the work to implement it. Indeed, if my interpretation of Hansard is correct, they may well be intending to do so. In response to a question from my hon. Friend the Member for North Shropshire (Helen Morgan), the Secretary of State for Health and Social Care recently said that the Government will
“work tirelessly through a national cancer plan to make sure that we deliver the cancer waiting time standards that the last Labour Government met”.—[Official Report, 15 October 2024; Vol. 754, c. 684.]
A national cancer plan sounds quite similar to a national cancer strategy, and I would like to use the final section of my speech to make some recommendations to the Secretary of State as to what his cancer plan could and probably should include, because if the Department is seriously considering doing this, it will need to get it right. Broadly, the plan needs to cover all aspects of cancer prevention, research and care. It requires political leadership to bring together stakeholders to develop a strategy and co-ordinate implementation. It requires dedicated governance. There must be a robust central oversight function with a mandate to bridge the gap between disconnected Government structures. It must clearly detail how it will implement the strategy, with measurable objectives and achievable timelines. It must have regular, robust and transparent reporting of implementation and, inevitably, it needs dedicated resources to enable the right change.
A cancer strategy also provides the opportunity for us to unlock innovation in the future. We are living in a golden age of cancer science. New types of cancer treatment, from immunotherapies to cell and gene therapies, are enabling clinicians to attack cancer from multiple angles. These advances are helping to improve cancer outcomes. Therefore, I implore the Government, if they do take up a cancer strategy, to look at how the National Institute for Health and Care Excellence can be reformed to unblock barriers to investment and to strengthen the current infrastructure to increase genomics and biomarker testing.
I could go on. We could discuss the historical lack of strategic direction in terms of having a national policy for blood cancer, or the fact that every day 12 children and young people hear the news that they have cancer. Sadly, 10 die every week, making cancer the biggest killer by disease of children and young people in the UK. Despite that, it remains overlooked in existing strategies and reviews. That reflects the scale of the challenge we face in English cancer services; it feels like a never-ending list of things that we need to fix.
I will use this opportunity to ask the Minister a few questions. Can he assure people living with cancer and cancer charities that the Government will address the current crisis facing cancer services and build long-term resilience through a dedicated cancer strategy? Will he give his support to my private Member’s Bill, which would put into legislation a requirement for the Government to establish a 10-year cancer strategy? Will he meet me and, more importantly, representatives of the cancer community to discuss the need for a cancer strategy? Finally, will he make the case to his colleague the Minister for Secondary Care that the Royal Berkshire hospital requires an urgent rebuild?
The statistics are shocking and a national disgrace. According to Macmillan Cancer Support, in 2023 almost 90,000 people with cancer across the UK waited more than two months from either urgent referral or when the cancer was first suspected to start treatment. The most recent cancer care waiting times for England, to July 2024, showed that only 68% of people received a cancer diagnosis and started treatment within 62 days of an urgent referral. As the hon. Member for Wokingham reminded us, the 85% target has not been met since 2015.
The situation is not inevitable. I agree that we need to start with a comprehensive plan for cancer of the kind that many of our European partners have. When the 10-year NHS plan is published in spring 2025, it should contain a national plan for cancer that focuses especially on how waiting times for diagnoses and treatment can be reduced and on how geographical variations in the quality of cancer treatment and care can be tackled. The plan should focus on how we as a nation can recruit and retain cancer care and rehabilitation specialists; how we can use new technologies and medicines to improve treatment outcomes and increase survival rates; and how we can use our thriving life sciences sector, to which my hon. Friend the Member for York Central (Rachael Maskell) referred, to reduce diagnosis and treatment waiting times.
I fully appreciate the state of the NHS that the Labour Government have inherited—it struggles to recruit and retain, it has been starved of capital investment, and its workforce have had their morale beaten down by successive Conservative Governments—but we can do better. It falls to the Labour Government to lead the way forward so that we have an NHS that can effectively treat, rehabilitate and support patients, and prevent this terrible disease.
I pay tribute to charities such as Macmillan, which do a brilliant job of providing cancer care to patients. We must never forget their compassion, empathy and service; that should inspire us every day in this House.
My plea is for the Minister to take away this message: however much money is being pumped into the health service and being made available for investment in diagnostic kit, there is a real need to address one area of the population that has been neglected. That area is teenage cancer victims. It is the largest single killer of young people in this country—bar none—yet young people are overlooked when it comes to clinical trials that could be lifesaving. There is a real reason why young people as a proportion of the population should be included in clinical trials, but they are not—they are overlooked. Why? Because there is the assumption that it is not a disease that affects young people. But it does.
I make my plea on behalf of those in my family who support the Teenage Cancer Trust, and those in the Teenage Cancer Trust who have taken the trouble to brief Members of Parliament. I ram home this message to the Minister and ask him to take it away to the Secretary of State: when we set up, as I am sure we will, a national cancer strategy, the Government must make certain that the 13-to-25 age group is given the recognition it deserves, so that they get the diagnoses in time, before they die, and the treatment they need, and so they are included in clinical trials.