John Baron (Shadow Minister, Health; Billericay, Conservative)
I agree with my hon. Friend and I shall address the issue of the postcode lottery shortly.
One reason why the Government's additional funding for cancer services has not produced a marked improvement in the longer term mortality trend is that the two-week and one-month targets, to which Dr. Stoate referred, have focused attention and resources on the front end of the patient pathway, to the detriment of the other end. The later stages of cancer care have been neglected as a result. The Government's targets may have been successful in getting more people into the system more quickly, but staff shortages have created bottlenecks further down the line. Radiotherapy offers an example.
The importance of radiotherapy is that more than half of all cancer patients will undergo it at some stage of their treatment, yet in January a report in the British Medical Journal observed that pressures on cancer units across the UK have led to longer waits for radiotherapy patients and may be reducing chances of survival.
High staff vacancy rates are causing real concern. In evidence to the pay review body, the Society of Radiographers noted that vacancy rates for therapeutic radiographers in England stood at 17 per cent. There is a particular shortfall of experienced, specialist radiographers. The Government may have increased student numbers, but new graduates do not possess the skills needed to fill that type of vacancy. According to the society, the current high number of vacancies and Government targets have made managers reluctant to release existing staff for further training opportunities, so it does not look as though the situation is getting better. As a result, waiting times for radiotherapy have lengthened since 1997. According to figures collected by the Royal College of Radiologists, radiotherapy waiting times in 2005 were worse than those documented in 1998; for example, whereas in 1998, 32 per cent. of patients in need of radical radiotherapy waited longer than the recommended maximum of four weeks, by 2005 the figure had grown to 53 per cent. More than half of all patients receiving curative radiotherapy now wait longer than the recommended maximum of four weeks.
For their part, despite a recent assurance at Health questions that hidden waits would be measured, the Government have insisted that no official monitoring of radiotherapy waiting times will take place. That is a great shame. I put it to the Secretary of State: how can the Government hope to resolve the serious problems in radiotherapy if they have no official idea of the extent of the problems because they are unwilling to collect the statistics? Although I wrote to the Secretary of State about the issue after our exchange at Health questions in January, I am still waiting for a response.
Radiotherapy is not alone, however. There are similar problems for other treatments. According to the Dr. Foster organisation, there has actually been an upward trend in waiting times for surgery for the 10 most prevalent cancers since 2001. Meanwhile, according to research cited in a report by the cancer capacity coalition, a number of clinical directors expected rising demand for chemotherapy to lead to longer waiting times over the next five years.
Things must change. The Opposition believe that one solution to the problems would be to move away from targets, which distort clinical priorities by focusing resources on the front end of the patient pathway, and to instruct NICE to draw up standards and entitlements for patients covering the entire pathway—a point to which my hon. Friend Bob Spink referred. In other words, we should shift entirely the emphasis for cancer care from politicians dictating targets for patients to patients having entitlements to standards of care decided by medical professionals; the entire journey should be covered, including the later stages of treatment such as radiotherapy. Such an approach directly recognises the fact that there is no use in getting more people on to the patient pathway sooner if we do not ensure their access to all stages of life-saving treatment.