Cancer Workforce and Early Diagnosis — [Mr George Howarth in the Chair]

Part of the debate – in Westminster Hall at 9:40 am on 8 January 2019.

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Photo of Tim Farron Tim Farron Liberal Democrat Spokesperson (Environment, Food and Rural Affairs) 9:40, 8 January 2019

Thank you, Mr Howarth. It is a pleasure to serve under your chairmanship. I wish everyone a happy new year and congratulate Jim Fitzpatrick on securing this incredibly important debate, which is timely in the light of yesterday’s announcement of the NHS long-term plan.

I will restrict my remarks on the cancer workforce to the radiotherapy workforce and other issues relating to radiotherapy. Sadly, at some point in our lives, one in two of us will have cancer of some form or other, and one in two of those with cancer will receive radiotherapy treatment, so one in four of us will need radiotherapy. Roughly speaking, 1,500 people—clinicians, medical physicists and therapeutic radiographers—make up the entire radiotherapy workforce of the United Kingdom. In the plan that we have been digesting since yesterday, there are many things worthy of remark and which are to be welcomed, but many questions remain unanswered.

On radiotherapy, the focus on survival and early detection is clearly crucial. The United Kingdom is very low down in the league table of European countries when it comes to early detection of cancer, which is the chief reason why survival is so poor compared with other nations of similar prosperity. That is tragic on a personal level and deeply humiliating on a national level. If the Government, the National Health Service and we all are successful in our bid to detect cancer earlier at stage one and stage two, treat it effectively and cure patients—radiotherapy is eight times more likely to be curative than chemotherapy and 50% of those with cancer are already having radiotherapy—it stands to reason that the need for capacity for radiotherapy will increase manifold.

There are 52 radiotherapy centres in England with a number of other satellites. There is nothing in the plan that scopes forward how the national health service will cope with the additional work required if early diagnosis becomes more successful. It is worth bearing in mind that, as things stand, there are significant pressures with a workforce of 1,500. There are two ways of looking at it: one is that the workforce is a very small and precious resource that we need to protect, and the other is to remind ourselves that those are relatively small figures, and that with a relatively small amount of investment, we could make a significant difference to increase that workforce. Relatively small numbers equals a huge percentage, which equals the ability to tackle many more cancers and, indeed, to cure many of them.

I will focus briefly on one profession within the radiotherapy workforce—therapeutic radiographers. I do not know whether hon. Members are aware, but in the current academic year, there has been a 50% drop in applications to therapeutic radiography courses at UK universities. One of the leading universities had to cancel its entire intake altogether due to under-recruitment. The cause is almost certainly—99% certainly—the removal of the bursary from that programme. The standard applicant is a mature student who chooses to do something different with their life, having done something else first, and the withdrawal of the bursary has had a huge impact on those people. If the Minister wanted to do something quickly to tackle that workforce issue, I will throw out there the suggestion that he could reinstate the bursary for radiographers.

I am chair of the all-party parliamentary group on radiotherapy, and one of our vice-chairs is here—Grahame Morris. We and many other hon. Members had a really good meeting with the Minister at the end of November last year. I am very grateful to him and to his staff for their time and attention. They have yet to respond to the manifesto that we presented to them that day, although I did not expect them to have done so by now. That manifesto calls for a number of things: new investment and more money—it would be surprising if we did not ask for that, but I will put it in context.

As I have said, half of those who have cancer in the United Kingdom will require radiotherapy, yet only 5% of the cancer budget goes on radiotherapy. That compares poorly with other countries. In Australia, the figure is about 5% but the European average is something like 7% or 8%. Our cross-party proposition is that the Government invest £100 million every year into machine upgrades for high-quality, targeted, stereotactic, and other advanced forms of radiotherapy. That fund would cover all trusts, which would not have to delve into their own reserves. We also propose a £250 million up-front, one-off investment so that people who live in communities like mine an awful long way from the nearest treatment can have a satellite unit developed close to them.

Many of my constituents in south lakeland have to make three or four-hour round trips to get good treatment at Preston, but a large percentage—up to 50%—of those who could have radiotherapy in my constituency and in other parts of south Cumbria do not get it because they are considered to be too far away for it to be a reasonable journey time. Radiotherapy is so often more curative than chemotherapy, ergo people do not live as long because they live too far from treatment. That is why the radiotherapy satellite centre at Westmorland General Hospital in Kendal is a key example. Access and travel times are a problem in other parts of the country, which is why investment in satellite units is important. They do not necessarily involve that much more staffing because, with proper IT networking, we would be able to do many of those things remotely.

In conclusion, the NHS plan announced yesterday contains much that is interesting, but when it comes to radiotherapy, it is entirely a rehash of things that we already know. Some things are welcome, but there is nothing new. I look forward to the Government’s response to its consultation on radiotherapy, which closed 12 months ago, and I ask for an update on that. I also ask that the National Cancer Advisory Group’s 2018 report is released as soon as possible. Finally, I very much look forward to the Government’s response to the manifesto by the all-party parliamentary group on radiotherapy, which was presented to them in November.