Non-Invasive Precision Cancer Therapies

Part of the debate – in the House of Commons at 4:15 pm on 18th July 2019.

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Photo of Gillian Keegan Gillian Keegan Conservative, Chichester 4:15 pm, 18th July 2019

It is a pleasure to follow Grahame Morris. Half of everyone in the UK will develop cancer at some stage in their lives and a quarter of us will receive radiotherapy treatment. Radiotherapy is highly effective, especially when compared with other therapies, given that survival rates improve by 16% compared with just 2% with other therapies such as chemotherapy. That is important because the UK has the second worst survival rates for lung cancer in Europe and we lag behind the European average in nine out of 10 cancers. We know that our population is ageing and that, more and more, our lifestyle choices are detrimental to our health. This means that over the next six years, cancer rates are expected to increase by a quarter, so ensuring that we get cancer treatment right is of fundamental importance.

The Government are making progress in this area. Since 2010, rates of cancer survival have increased year on year. It is thought that 7,000 people are alive today who would otherwise not have been. The NHS long-term plan has set out a way to ensure that future radiotherapy treatment will be faster, smarter and more effective. Although it is a welcome strategy, we in the all-party group on radiotherapy have been looking into the detail and have highlighted some pressing issues, which we look forward to publishing in due course.

As has been mentioned, there are serious workforce shortages; for example, radiotherapy clinical scientists have a current vacancy rate of 8%. We need to take swift action to address that, and specifically, to support the education and training programmes that feed the pipeline of talent. There are only 10 therapeutic radiography degree programmes in England and that will soon reduce to nine, as one very close to me in Portsmouth is due to close soon.

Since 2016, entry-level training for this industry has fallen by 23% since the loss of the bursary; last year, only 240 students undertook this training. I therefore hope that the Department for Health and Social Care and the Department for Education will review the impact of terminating the bursary programme and consider how to attract students to this profession. The Society of Radiographers recently developed an apprenticeship standard at degree level to provide another entry point to the profession. I believe that that is exactly the right approach, whereby the next generation of industry professionals can learn and earn on the job. Sadly, however, the Institute for Apprenticeships and Technical Education offered a funding band of around £19,000 for the programme’s delivery, but given the high-tech and expensive infrastructure needed to support it, the level of funding was insufficient. I urge the Institute of Apprenticeships to carry out a review of the scheme and ensure that we have the right funding requirements.

During evidence sessions for the all-party group on radiotherapy, the current tariff system came up again and again, including the fact that the tariff is paid per fraction. Clearly, if we have new technology that will reduce the number of fractions, there may be a perverse incentive that would discourage the use of it. Earlier this year, the all-party group visited Elekta in West Sussex, which is pioneering the future of advanced radiotherapy technology, including the MRI LINAC—linear accelerator—machines. Ironically, West Sussex does not have a single LINAC machine—neither the MRI version nor even the standard version—so many of my constituents are travelling as far as London and Brighton for their treatment. Time and again, I have heard from them, and from charities including CancerWise, which is based in Chichester, just how gruelling these daily journeys are. Many adjacent counties have this capability, and I started this journey to make the case for having that capability for my constituents.

It is worth highlighting that £130 million was invested in 2016-17, and that upgraded and replaced machines right across England’s cancer centres. It was the largest investment for 15 years, so we thank the Department of Health and Social Care for it; it was very welcome. However, we are concerned that in the long term, the equipment may not be maintained unless there is a rolling fund. The way we budget for this seems stochastic. We know that the equipment has a life span. As it is all new, perhaps we can now plan for when it is old, and ensure that there is a rolling budget in place. We have mentioned IT. It is vital that we have the latest network, to ensure that all the constituent parts are interconnected.

Radiotherapy is the most incredible resource, and is involved in 40% of cancer cures. It is a cost-effective treatment, taking up just 5% of the cancer budget while treating 50% of cancer patients, but it needs a bigger voice, and I am grateful to my colleagues on the APPG for securing this debate and allowing us to give it that voice.

I would like to take this opportunity to thank the NHS staff across our country who deliver this phenomenal service. The changes that we are discussing could save many more lives. Britain has always embraced innovative technology, so I have no doubt that advanced radiotherapy and integrated IT networks will be the standard in the future; the question for all those suffering from cancer is merely when.