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NHS Funding Bill

Part of the debate – in the House of Commons at 7:29 pm on 27th January 2020.

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Photo of Grahame Morris Grahame Morris Labour, Easington 7:29 pm, 27th January 2020

It is a pleasure to follow Mrs Elphicke, who made powerful arguments in support of improving maternity services in her area, as well as other hon. Members who made their maiden speeches this evening. I am sure that we will hear a lot more from them.

I want to make a familiar argument about access to and funding of radiotherapy services. The Minister for Health, Edward Argar, has heard this argument on previous occasions, but I am going to make it again because I am not convinced that the Secretary of State understands it. It is not rocket science: in the United Kingdom, radiotherapy accounts for just £383 million of the NHS resource budget, despite the fact that one in four of us is going to need it at some point in our lives. In his opening remarks, the Secretary of State referred to the Government’s commitment to invest in new diagnostic equipment and scanners. I very much welcome that, but he did not seem to get—I did not hear the penny dropping—the important link between diagnosis and treatment.

I must declare an interest: I am vice-chair of the all-party parliamentary group on radiotherapy. I am a cancer survivor myself and have benefited from this particular treatment. Basically, I want to make three points. I want to cover the cancer challenge, to briefly discuss the current state of radiotherapy and to set out a future vision for NHS radiotherapy. I am talking in the context of the Bill. I have tried to make key points in interventions about how vital workforce planning and capital budgets are. This is not just a case of replacing hospital car parks; it is about vital equipment. It is essential to improve cancer outcomes for our patients.

About 50% of people develop cancer at some time in their lives, and I am sure that even those fortunate enough to be spared the disease will all have a loved one who has been touched by cancer. I am not arguing from a completely selfish point of view, here—putting a case for me, my constituency or my region. As a magnanimous sort of individual who recognises the sentiment in the House, I am arguing that we should improve cancer services across the whole country. Access to world-class cancer treatment really matters to every single one of our constituents in every constituency in the United Kingdom.

I want to take issue with a statement that the Secretary of State has made on more than one occasion about cancer survival rates. Figures comparing nine comparative countries were published in The Lancet in November last year, just before the election. They showed that the United Kingdom had the lowest survival rates for breast cancer and colon cancer and the second lowest for rectal cancer and cervical cancer. Some 24% of early-diagnosed lung cancer patients are not getting any treatment at all.

In truth, although our cancer survival rates are improving—the Secretary of State is not telling a lie—we still have the worst cancer outcomes in Europe; the baseline is very low. I welcome the Government’s commitment to considering ways to improve cancer diagnosis, with a plan to set new targets so that patients receive cancer results within 28 days. That is great. But we still need to address issues of staff capacity and there is a desperate need for more radiologists and more skilled people in the imaging teams to address shortages in endoscopy, pathology and the vital IT networks.

Unlike chemotherapy, which I have also had on a couple of occasions, which impacts the entire body with chemicals, advanced radiotherapy targets tumours precisely, to within fractions of millimetres, limiting damage to healthy cells in close proximity to the tumour. Improved radiotherapy technology allows us to treat cancers previously treatable only with surgery, chemotherapy or a combination of both. Radiotherapy is also cost-effective for patients, the NHS and Ministers, who are obviously very keen to ensure that we get value for money. A typical course of radiotherapy costs between £3,000 and £6,000—far less than most chemotherapy and immunotherapy cures—and patients experience very few side effects.

The problem is that access to radiotherapy centres and this life-saving treatment is not evenly distributed across the United Kingdom. A 2019 audit showed that 32% of men with locally advanced prostate cancer in the UK had been potentially undertreated, with 15% to 56% of trusts in the survey not offering the sort of radical radiotherapy that those patients really required. In England, advanced curative radiotherapy is actively restricted for no good reason, with only half the 52 centres having been commissioned by NHS England to deliver advanced radiotherapy—stereotactic ablative radiotherapy, or SABR. That is despite the fact that its use is specifically recommended by the National Institute for Health and Care Excellence.

We are coming up to World Cancer Day on 4 February. The Minister understands this issue because we have spent a deal of time on it. I want him to make a commitment on behalf of the Government that the UK will become a world-class centre for patient-first radiotherapy so that we can improve our cancer survival rates. That will require an increase in investment. We need to address the issue of capital funding. Currently, radiotherapy gets 5% of the cancer treatment budget; we need that to be closer to the European average of 11%. There is an immediate need for £140 million of investment to replace the 50 or so radiotherapy machines—the old linear accelerators—that are still in use despite being beyond their recommended 10-year life by the end of 2019. We need investment in IT and to help establish the 11 new radiotherapy networks, which the Minister touched on. Again, that comes under capital and workforce training.

The all-party parliamentary group’s manifesto for radiotherapy is calling for a modest increase in the annual radiotherapy budget, from 5% to 6.5% of the revenue budget, and for the Government to establish some basic standards to secure our vision for radiotherapy. We need to recruit and train highly skilled clinicians, radiographers, medical physicists and healthcare professionals and to guarantee that every cancer patient has access to a radiotherapy centre within a 45-minute travel time. In 2020, the Government should set themselves a 2030 target for the UK to go from having the worst cancer outcomes to the best cancer survival rates in the world. We could do that, and we could make a start by delivering a world-class radiotherapy service.