PARLIAMENTARY DEBATE
Cancer Strategy for England - 31 October 2024 (Commons/Westminster Hall)

I beg to move,

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?

Order. I remind Members that interventions are supposed to be brief and to the point, not a substitute for a speech.

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.

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 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?

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.

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.

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.

I call Noah Law.

Thank you, Mr Betts, but I will not make a speech.

Jim Shannon probably will want to make a speech.

There is hardly a day when I do not make a speech, Mr Betts.

I thank the hon. Member for Wokingham (Clive Jones) for securing the debate and for sharing his personal story. Demonstrating an issue is best done with a personal story, if possible, so I thank him for that—it was incredible. I am minded of his story, and I think of my dad as well. My dad is dead and gone now, but when he was living in this world he had cancer on three occasions. It was many years ago, and the expertise for cancer care and healing were not as good then, but he survived because of the surgeon’s skill and the nurses care, and because he was a Christian and he believed very clearly in God’s help and the prayers of God’s people.

I start by saying how pleased we are to see £22 billion set aside for the NHS. That is constructive and positive and we should welcome it. Within that £22 billion there will be money for radiotherapy, and hopefully for training and bringing staff forward—it is important to have that as well. The hon. Member for Wokingham referred to the Royal Berkshire hospital, and in Northern Ireland we have similar problems.

I am going to tell a story that has been heard often. I am sure that most of us in this House were struck by the candid and very emotional video released by the Princess of Wales to inform the nation that she was going through the valley of cancer. The video was in response to a concerted campaign of disinformation against the princess of my heart, and probably all our hearts. She was disgracefully confronted with that every day. She was forced into a declaration of her intensely private journey with cancer, highlighting the effect on her husband, children and family. That very public declaration and the updates that she has so wonderfully provided have started a wide conversation about the dreaded C-word. We are deeply indebted to the Princess of Wales for that.

We also had the announcement about the King’s health. I was surprised and I immediately prayed for him, as I do every day. But the announcement about the Princess of Wales, a young woman in her prime, goes back to what the right hon. Member for Herne Bay and Sandwich (Sir Roger Gale) said: many people do not see cancer as a disease of younger people. The Princess of Wales, who was apparently so healthy and vibrant, has caused many of our young people to remember that cancer is not a disease that is a respecter of person, age, religion or background. All are brought to their knees by this disease that is ravaging the nation.

In Northern Ireland the target is that at least 98% of patients diagnosed with cancer should begin their first definitive treatment within 31 days of a decision to treat. At least 95% of patients should begin their first definitive treatment for cancer within 62 days. The problem is that those timescales here on the UK mainland and for us back home in Northern Ireland are not always met—indeed, they are rarely met. That means that that first definitive treatment, which is so important, does not happen at the time it should, and the figures are not getting any better. With the £22 billion that has been set aside for the NHS, I am hopeful that, through the Barnett consequential for Northern Ireland, we will get additional money that we can use specifically for cancer treatment.

I want to make a point about research and development and make a plea for Queen’s University Belfast and the partnerships it has with companies. It brings students from all over the world to find treatments and cures for cancer. I know that happens in many other parts of the United Kingdom, which is good. Research and development is so important, so perhaps the Minister will give us some ideas about research and development when he sums up. I am pleased see him and welcome him to his place.

The question should not be about lowering the target, but about how we deliver and meet the target of curing cancer. Having spoken to cancer specialists, I know that the need for more staff in radiology and in labs to provide a quicker turnaround, as well as the need to ensure that there are trained specialist cancer nurses and staff in place, is a long-term issue that needs to be dealt with not with words but with action. We need to spend the budget in a much better way throughout the UK—perhaps the Minister will indicate how that will happen. I believe the answer lies in the recruitment of staff in all facets of the cancer machine—labs, radiology, pharmacy and care. Every area needs specialist training. We need to keep staff in place with better working conditions, rather than the wonderful staff that we have simply burning out due to the pressure.

The father of my constituent, Eli Martyr, has been diagnosed with bowel cancer. Despite a difficult time, his father is being looked after amazingly well by NHS staff. If the Government commit to a national cancer strategy, will they ensure that the second biggest cancer killer, bowel cancer, is given sufficient attention? Can we address the staff and kit shortages and ensure that we improve the bowel cancer screening programme to improve the chances of survival?

I am of an age—I am not sure many others are in this Chamber—where I get a test for bowel cancer every year. A kit is sent out to do the job. Thankfully, every time I have done a bowel cancer test it has come back negative. To be fair, the NHS has a good system for that. When someone reaches 60, they are sent a test. They do the test and the NHS comes back very quickly. If something is wrong, they will hear right away. Although we sometimes criticise the NHS—rightly so—we should always recognise the good things that the NHS does. The hon. Gentleman was right to bring that up; I thank him for that.

The questions regarding cancer care in England are the same as for Northern Ireland: “How can we get the best outcome with what we currently have?” and “How can we plan to do better in the future?” Neither are easy questions, but the fact that some 9,000 new cancer diagnoses are made every year in Northern Ireland—these are drastic figures—in a population of 1.85 million, equating to one in two people developing cancer in their lives, means this issue must be a priority for us all.

I know that in his response the Minister will give us some positives in relation to where we are—I expect that, knowing the nature of the Minister—but it would also be helpful if we could have some idea about how we can better address this issue together, across this whole United Kingdom of Great Britain and Northern Ireland.

It is a pleasure to serve under your chairship, Mr Betts. I thank my hon. Friend the Member for Wokingham (Clive Jones) for securing the debate. Some 2.2 million people are expected to be diagnosed with cancer during this Parliament, and almost one in two of us will get cancer in our lifetimes, so we should all be concerned about the crisis in cancer care that was highlighted by the Darzi report.

In my constituency of Thornbury and Yate, just over half of cancer cases are diagnosed early—that is around 2,500 people a year—but just over two thirds of those diagnosed are able to start treatment within two months after being referred. That is far lower than the 85% NHS target. This Government have promised to do more to tackle the delays in cancer diagnosis and treatment, and I think a specific cancer strategy is the way to achieve that. I will illustrate that with two examples from my constituency.

The first constituent suffers from a rare cancer condition and sought treatment at Cheltenham general hospital, where they received immunotherapy treatment. However, they have since been informed that their treatment will cease on 31 January 2025, due to financial considerations. It simply is not acceptable to have a situation in which a patient is told that they need a particular treatment and then has it halted part way through, not because it needed to stop for their own best interests but because of financial constraints. That is absolutely appalling, and it is a glaring example of where the system is failing. Everyone who has cancer deserves timely and consistent treatment. That is the first thing I highlight for Ministers: when they are looking at producing a cancer strategy, will they look at the treatment and how it is delivered, to make sure that decisions are being made in the best interests of patients, rather than the accountants?

My second example shows how early treatment can save lives. This constituent told me how, in 2021, they were diagnosed with cancer in their eyes. They are one of the lucky ones: it was caught early by their optician and they got an urgent referral. Because they got treatment quickly, they are still cancer-free today. However, it is fair to say that they are not out of the woods; there is a high chance of recurrence and possible metastasisation in the coming years. They told me how that is hanging over their head every day, and made the point that one small change could have meant that, instead of living their life, they would no longer be with us.

That shows exactly why identifying and treating cancer as early as possible is vital. It highlights, in particular, the importance of professionals who are not specialists in cancer but play vital roles in identifying possible signs of cancer at the early stage. There are probably people up and down the country who can give examples of how pharmacists, opticians, dentists and so forth have been the ones who set them on the road to that all-important diagnosis. As we know from other debates in Parliament, all those professions are under strain. We know that people cannot get dental appointments, yet we know how important that is for identifying oral cancers. As I raised in the Chamber this morning, we also know about the issue of pressures on community pharmacists. When the strategy is drawn up, will Ministers look at the importance of non-cancer specialists in referring people for diagnosis, and ensure that that forms part of the strategy?

My hon. Friend the Member for Wokingham identified Denmark as a good example of a country that had been where this country is, but has managed to race ahead. The point is that it had a series of cancer strategies. Reference has been made to delays, or to the idea that we should make this part of a wider strategy. Let us get something done, as a starting point, and then it can be an iterative process. The strategy can be looked at again, and gradually we can make the improvements we need.

A dedicated cancer strategy would complement the Government’s 10-year health plan by offering a clear road map for an integrated approach to improving outcomes across cancer prevention, diagnosis, treatment, research and care. That is why we need a dedicated cancer strategy and a wholesale review of the system, to ensure that everyone gets an early diagnosis and the treatment that they need, when they need it, and are fully supported in their journey with cancer.

I thank my hon. Friend the Member for Wokingham (Clive Jones) for securing this debate on the urgent need for a comprehensive cancer strategy, and particularly for his moving personal story, which I think touched us all. In Woking, my constituency, and Surrey, my county, the situation is increasingly concerning, in a similar way to the situation he presented.

Woking does not have a dedicated cancer centre, meaning my constituents have to travel outside of the area to receive specialist care. This adds to the burden of those already facing the weight of a life-changing diagnosis. My constituency, like the rest of England, really wants a strategy that actively meets the needs of our patients and improves access to timely, high-quality cancer treatment.

This year, 2024, is projected to be the worst year on record for cancer care since the NHS last met its 62-day target in 2015. Already, more than 72,000 patients across the country have not been treated within the NHS’s 62-day window from referral to treatment. If those trends continue, we could see more than 107,000 patients treated outside the standard by the year’s end. That is simply not acceptable.

To put that into perspective, the number of patients who did not start treatment within the 62-day timeframe in 2015 was just under 27,000. By the end of 2023, that figure had risen to more than 100,000, and it continues to climb this year. That near four-fold increase is staggering. Each of those statistics represents real people—our constituents—facing unnecessary delays at the most critical time for them and their families.

The causes are clear, and so are the consequences. Each delay not only impacts the outcome for patients, but places strain on the healthcare system and the wider employment system. What we need now is a long-term, well-resourced cancer strategy, exactly as outlined earlier, that prioritises investment in early diagnosis, improves treatment infrastructure and supports the research needed to make real progress in combating cancer. Patients in Woking and across the whole country deserve nothing less. A national cancer strategy would help to reduce the postcode lottery for cancer care, ensure prompt treatment and provide patients with the security of knowing that our health system is equipped to meet their needs. I urge the Government, and particularly the Minister, to work with us to reverse this distressing trend and deliver the strategy that we desperately need.

I thank my colleague, my hon. Friend the Member for Wokingham (Clive Jones), for calling this timely and critical debate. It is good to see the Minister for Care in his place. I would like to mark the passing of many friends and some of my family who have lost their lives in a battle with cancer—a dreadful disease.

When I arrived here in 2010, my team and I started a five-year project tracking the use of radiotherapy in England, using freedom of information requests every six months to gather data on the availability and frequency of the use of stereotactic ablative radiotherapy in England’s then 51 cancer centres. It was not a pretty picture.

It is a pleasure to return to the subject of radiotherapy, about which many of my constituents in Wells and Mendip Hills care deeply, as do I. I recall that the hon. Member for Easington (Grahame Morris) and I had common cause. He represented a constituency in the north-east and I one in the south-west of England, the two areas with the greatest incidence of cancer per head of population. I hope and trust that every one of us is persuaded that when confronted with a serious problem or challenge, the odds of successfully tackling it are immeasurably improved if one has a plan. Without a plan, there is a serious risk of misguided or confused action. Benjamin Franklin, one of America’s founding fathers, reportedly said, “If you fail to plan, you plan to fail.” That phrase is as relevant now as when he said it nearly 300 years ago.

In England we are in a battle royale against this deadly disease of cancer, which will directly affect one in two of us and indirectly affect almost every one of us through our connections to friends or family. The evidence is absolutely clear: countries with a dedicated cancer control plan show a better overall five-year cancer survival rate. That is not anecdotal; it is the clear result of an international cancer benchmarking partnership study published in The Lancet Oncology.

A report in The Lancet Oncology by 12 leading cancer experts published a blueprint for a national cancer plan. Those experts were from Imperial College London, #CatchUpWithCancer and Radiotherapy UK, the Faculty of Public Health and Policy at the London School of Hygiene and Tropical Medicine, and the Institute of Cancer Policy at King’s College London. Their blueprint consolidates four reports published separately in The Lancet Oncology over two years, clearly outlining the necessary steps—a plan—to improve cancer outcomes.

The need for a plan is urgent. We had a 10-year one, which ran out in 2022. The then Health Secretary promised a new one. There was a five-month consultation, and then the next Secretary of State binned the whole idea. We are in a dire situation on the cancer front. Cancer mortality in this country is among the highest in the OECD. The key 62-day target to start treatment has not been met in England since 2015. When we consider that international research shows that a four-week delay in cancer treatment can increase the risk of death by 10%, this failure to meet that 62-day target has potentially fatal consequences.

If the Government are in any doubt about the consensus across the cancer care community on the need to get back to having a dedicated cancer plan, they need make only a cursory scan of all the charities and other stakeholders. Almost without exception, every organisation of any standing is in favour of getting a cancer plan and getting it fast. As is widely known, there are several main cancer cure pathways: surgery, chemotherapy and radiotherapy. Any cancer plan would obviously need to include all these pathways, but I would like to say a few words about radiotherapy in the context of any such cancer plan.

For clarity, I am talking about radiotherapy, not radiography. Radiography is vital. It is the use of techniques to scan an image to detect potential issues such as cancer. Radiotherapy is the use of high-energy radiation to kill cancer cells. If anyone is perplexed by my need to clarify that, they may understand when I say that some former Secretaries of State for Health and Social Care have been heard to confuse the two. I am confident that this Minister and the current Secretary of State will not suffer a similar confusion.

Radiotherapy offers technologically-advanced, cost-effective, personalised and precise solutions to treat more patients more quickly, more accurately and better. We have about 270 radiotherapy machines in England. Of those, 70 will pass their 10-year recommended life this year, and replacing them would cost £150 million. The Minister will know that this will be money well spent, as it takes people off the waiting lists and straight into treatment and gives them a life chance that is longer, and many will return to work, just like my hon. Friend the Member for Wokingham.

Until recently, radiotherapy has been overlooked in both priority and investment, so I would like to pay testament to the impressive work of Professor Pat Price of Radiotherapy UK, the charity she founded and still leads. I also thank the Secretary of State for Health and Social Care for agreeing to meet Professor Price, representatives of Radiotherapy UK and me, so that we can all do what we can to help. I am sure that the Minister for Care will also be involved in that conversation. Professor Price’s relentless campaigning is putting radio- therapy back at the heart of the political debate. This was reflected in the recent Budget announcement of £70 million for new radiotherapy machines. That money is not enough, but it is a really positive start.

The recent Radiotherapy UK productivity report shows that smart investment in the sector could create 87,000 new cancer appointments, and the need for a new national cancer plan including measures to boost radiotherapy is clear. Only 27% of cancer patients in the UK can access the radiotherapy that they need, compared with the international recommendation of 52% to 53%. In total, 7.4 million people in the UK live in radiotherapy cancer treatment deserts. Lord Darzi’s independent review of the NHS revealed that more than 30% of patients are waiting too long for their radio- therapy cancer treatment.

Radiotherapy cannot be used on all cancers, but where it is appropriate a typical radiotherapy cancer cure can cost as little as £3,000 to £5,000, which is dramatically less than chemotherapy. The case for a national cancer plan is well made. I urge the Minister to bring the experts in and to produce such a plan.

I thank all hon. Members for adhering to the time guidance; that is really helpful. We now move on to the Front-Bench speakers, who will have 10 minutes each—

Sorry; please take just three minutes.

We move on now to the Front Bencher. If they could just leave a minute at the end of the debate for the hon. Member for Wokingham to respond to the debate, that would be really helpful.

It is a pleasure to serve under your chairmanship, Mr Betts. I thank my hon. Friend the Member for Wokingham (Clive Jones) for securing this important debate.

As so many have said, and as Lord Darzi has confirmed, our NHS is in crisis. Spiralling waiting lists, crumbling infrastructure and demotivated staff are symptoms of the mismanagement that was all too common under the previous Government. The current state of cancer diagnosis and treatment is a testament to their failure: a lack of vision and of strategic thinking has let patients and families down. Under NHS guidelines, 85% of cancer patients are expected to wait no longer than 62 days between referral and the start of treatment, but last year the figure was less than 65% and this year is shaping up to be even worse. On current trends, in excess of 100,000 patients are failing to begin treatment within that timeframe. That is simply not good enough.

The UK is a global hub for life sciences research, yet we lag behind many countries without that expertise when it comes to applying the very research that we have often pioneered. Cancer research is a top priority for the UK, but we must aim to lead the world in outcomes too. As the Health and Social Care Committee made clear earlier this year, that requires

“a long-term strategy…which has innovation at its core.”

We need a more integrated, forward-looking approach to cancer that ensures that research, policy and delivery pull in the same direction, not opposite directions. The current system is much too fragmented.

In my constituency of Wimbledon, there are concerns around breast cancer, for which early diagnosis and treatment is critical. Across Merton, the London borough within which most of my constituency lies, breast cancer screening rates are significantly below both NHS targets and the national average. In 2022, less than 57% attended a screening when invited, which is significantly lower than the 70% national standard required to make screening truly effective. Behind those statistics are lives and families. When breast cancer is diagnosed and treated at stage 1, survival rates are close to 100%, but lower uptake of screening inevitably leads to later diagnosis and a commensurate decline in survival rates. That is why my council colleagues and I have been campaigning for NHS England to provide a breast cancer screening site in Wimbledon, which lacks the screening infrastructure necessary to meet national screening targets.

At a recent Radiotherapy4Life session in Parliament, I heard similar concerns about the lack of investment across England in radiotherapy. Only half of those who could benefit from radiotherapy are accessing it, because—in the words of the medics I spoke to—this country lacks a cancer strategy. The entire set-up is far too fragmented. To take one depressing example, even though integrated care boards are responsible for radio- therapy, some 30% of them, when subjected to a freedom of information inquiry, did not even know that.

In contrast, when the cancer referral system works well, the approach is transformational. Two weeks ago, in the wake of an elevated prostate-specific antigen level, I was put on a two-week cancer pathway; two days ago, I had an MRI and received a clean bill of health. It took just 10 days to give me peace of mind. Not everyone will be so fortunate, but everyone deserves that alacrity. A more integrated approach to cancer will speed up diagnosis and treatment and improve cancer outcomes. Consequently, I echo my colleagues’ calls for the Government to introduce a cancer strategy.

For the Opposition, I call Ben Spencer.

It is a pleasure to serve under your chairmanship, Mr Betts. I thank the hon. Member for Wokingham (Clive Jones) for securing this important debate on what is clearly a difficult subject, given how much cancer affects people: as several hon. Members have said, it affects all of us, not just those who are directly affected. I listened carefully to the powerful speeches that he and the hon. Member for Cheltenham (Max Wilkinson) made about the direct impact that they have experienced.

I pay tribute to all the people who work in our NHS, the charity sector, the research sector and all parts of our community that are active in prevention and in supporting, treating and helping people through the journey with cancer. My speech cannot cover every cancer in the limited time I have, but I will focus on the major cancers, so to speak, in terms of prevalence and mortality rates. That is not to diminish the importance of the range of cancers: it is critical that we focus on rare cancers as well as the major ones.

I thank the hon. Member for Wokingham again for his speech and for sharing his personal experience. He did not mention the fact that he has raised more than £800,000 for cancer charities in his work following his diagnosis. It is important that we pay tribute to him for bringing forward this debate.

I was deeply concerned by the story told by the hon. Member for Thornbury and Yate (Claire Young) about the impact on her constituent of the cessation of their treatment as a result of financial measures. I hope that the Minister can meet her or take up the case; I would be interested to hear how that decision was taken. I hope that the family and the individual affected are doing okay with their treatment. My right hon. Friend the Member for Herne Bay and Sandwich (Sir Roger Gale) made important points, to which I will return later, about childhood and teenage cancer.

I was pleased that the hon. Member for Woking (Mr Forster), my constituency neighbour, raised the impact on his constituents in terms of seeking direct cancer care. As he knows, both of our constituencies are served by Ashford for broader cancer support. I would welcome the chance to meet him to discuss how we can help our constituents, particularly with journey times to access cancer care locally.

It is important to focus on data, so I will refer to data from the NHS and from Cancer Research UK. I have a series of questions for the Minister; I know that a lot may not be in his portfolio, but if he cannot answer today I will be grateful for a written response.

Fundamentally, the things that the state can do about cancer strategies break down into prevention, diagnosis, care and treatment, and research. All the major cancers have modifiable risk factors. Of the 44,000 bowel cancer cases a year, 54% are deemed to be preventable, with 11% linked to obesity, 28% linked to diet and fibre, 13% linked to processed meat and 5% linked to physical activity. Breast cancer is the most common cancer in the UK: of the 56,800 cases a year, about 8% are believed to be linked to or caused by obesity. Lung cancer is the third most common cancer: of the approximately 50,000 cases a year, about 80% are preventable and 72% are linked directly to smoking.

Overall, tobacco is the largest preventable cause of cancer. Some 50,000 cancer cases per year are attributable to smoking. In the last Parliament, we introduced the Tobacco and Vapes Bill because we recognised the importance of reducing smoking. Can the Minister tell me when his Government plan to reintroduce that Bill, so that we can start to see its health benefits? Obesity is the UK’s second biggest cause of cancer, after smoking. It is believed to cause about one in 20 cases: 20,000 cases of cancer per year are attributable to obesity. We brought forward an obesity strategy. Will the Minister review it and bring forward an obesity strategy in this Parliament?

On screening and treatment, while cancer outcomes continue to improve in comparison with the OECD, it is worth looking at the data in the Darzi report. One of the most interesting slides shows that over the past 14 years, we have improved relative to the gradient of cancer outcomes, but we started at a very low point. There are lots of questions to be asked about why we started at such a low point back in 2004. The NHS is still recovering from the disruption to cancer care caused by the covid pandemic, but thanks to the hard work of NHS staff, waits of more than 62 days declined between September 2022 and August 2024. Obviously there is still more work to be done.

Community diagnostic centres and surgical hubs made a difference. They were backed by a £2.3 billion investment, the largest cash investment in MRI and CT scanning in the history of the NHS; those scans, tests and checks are now being delivered in 170 CDC sites.[Official Report, 11 November 2024; Vol. 756, c. 6WC.] (Correction) As the independent Health Foundation recently pointed out, surgical hubs have helped to build capacity and reduce waiting lists over the past few years. Although it was not mentioned in Lord Darzi’s report on NHS performance, I welcome the Government’s intention to expand surgical hubs. Will the Minister provide more details on how many new surgical hubs will be established? What plans have the Government to expand the CDC network further?

There is clearly more work to be done to improve cancer waiting times and outcomes. The major conditions strategy developed under the last Government was designed to provide more impetus for improving cancer outcomes, alongside those for other major conditions. Developing the strategy involved significant consultation and engagement with cancer charities and professional bodies. Since the election, the Government have decided to scrap the strategy. Can the Minister explain why he made that decision?

Given the time that cancer charities and organisations have put in, can the Minister explain how their contributions will be used to develop the 10-year plan for the NHS? Can he explain why, in the NHS consultation that is now being run, there are no cancer-specific questions? We heard earlier that eight people in 10 want a cancer strategy. Will he respond if similar results emerge from the consultation?

The Government scrapped the children and young people cancer taskforce, and we have yet to hear an alternative approach to improve of outcomes in that area. Will the Minister provide clarity on the Government’s plans on children’s cancers and the reasons why they discontinued the children and young people cancer taskforce?

Research is most relevant to some of the rarer cancers that are often not talked about. We very much welcome the protection of Government investment in R&D, with £20 billion allocated to 2025-26 and core research spending protected. That includes a £2 billion uplift for the National Institute for Health and Care Research. I should mention that my doctoral research fellowship was funded by the NIHR, although it was mental health research rather than cancer research. It is great that we support that fantastic institution.

I am pleased that the Government have kept the current rate of research and development tax relief. However, the Minister will know that a lot of support and research is provided by or directly commissioned from charities, which are a critical part of the cancer care and treatment infrastructure. My understanding is that in yesterday’s Budget, public services were protected from the rise in employers’ national insurance contributions. Can the Minister explain what the impact of national insurance employer contributions will be on charities that provide care and treatment in this area? What conversations has he had with those charities, and what concerns have they raised with him?

In the Darzi report and elsewhere, there is rightly a focus on the diagnostic pathway and on the time it takes to diagnose and treat someone following a query as to whether someone has cancer. When does the Minister expect the huge £22 billion injection in the NHS to produce outcomes? Or does he agree with the comments in Lord Darzi’s report that the NHS does not necessarily need more money for outcomes? It has had a lot of money from the former Conservative Government over the past few years. Does the Minister think that reform is the best way to ensure improvement?

I call the Minister. It would be helpful if he could finish by 4.28 pm to allow the mover of the motion a couple of minutes to respond.

It is a real pleasure to serve under your chairship, Mr Betts. I thank the hon. Member for Wokingham (Clive Jones) for raising this vital debate about the future of cancer care and the potential merits of a cancer strategy. I am aware of the impressive work he has done on access to primary care on behalf of his constituents in Wokingham and that, as he very movingly set out in his speech, he is a cancer survivor. I welcome and commend his efforts in campaigning for cancer charities. I understand that he has raised a mind-boggling £800,000 for charity, so I pay huge tribute to him. I also thank and pay tribute to every Member who has spoken today. They have spoken with such clarity and passion, and it became clear that many present have personal experiences of cancer, which adds a poignancy to our discussion that makes it even more powerful.

Access to cancer care is an important issue for many people, and it is at the heart of this Government’s health mission to build an NHS that is fit for the future and to reduce the number of lives lost to the biggest killers. Our work will focus on three shifts: from hospital to community, from analogue to digital, and from sickness to prevention. On cancer services, I reassure the hon. Member for Wokingham and other hon. Members that the Government are absolutely committed to fighting cancer on all fronts, from prevention to diagnosis, from treatment to research. The NHS can be world-leading on cancer care as part of a wider health system that incorporates innovation and technology. It also benefits from access to world-class research and medicines, and we will look to realise the potential of both.

Nearly a third of patients are waiting more than two months for their referral before starting treatment. That is unacceptable, and the Government have made reducing those waiting times a core part of our health mission. Thanks to the hard work of NHS staff, we are now meeting the faster diagnosis standard so that more than 75% of patients get an all-clear or cancer diagnosis in 28 days. However, we know that there is much more to be done. The Chancellor set out yesterday how we will invest in the NHS to deliver 40,000 additional operations, scans and appointments per week as part of our commitment to cut waiting lists, and how we will invest in new radiotherapy machines so that cancer patients have access to the most effective treatment. NHS England is also working to make cancer diagnosis and treatment faster and more efficient through the use of innovative approaches such as teledermatology and faecal immunochemical test kits for risk stratification in bowel cancer.

The NHS has made historic strides in cancer care. Ten-year survival has doubled since the early 1970s—but that rate of improvement slowed in the 2010s, and there is still a lot of work to be done. Early diagnosis and innovative treatments are key to enhancing survival rates and quality of life for cancer patients, so we will ensure that the Government and the NHS work hand in hand with life sciences research institutions and industry to drive the development of new treatments and diagnostics. Members of all parties have rightly raised some of the deadliest cancers, including pancreatic and bowel cancers and cancers affecting children and teenagers. We recognise that different tumours have different diagnostic and treatment pathways, and will consider that as part of our cancer strategy.

Since taking office, this Government have wasted no time in taking steps to accomplish our vision. Earlier this month, we announced funding for a raft of new UK-created therapies for cancer that will be trialled in the UK. Developing early diagnosis technologies is a key aim of the National Institute for Health and Care Research funding. The potential to find cancers earlier will give patients more choice of treatment and enable us to save lives.

We also commissioned an independent investigation of the health service in England, carried out by Lord Darzi. Published in September, Lord Darzi’s report set out in stark terms the profound challenges faced by the health service, and he was honest about the scale of the work that will be needed. He highlighted that people in the UK are more likely to die from cancer than in any other European and English-speaking country, and that improvements to survival rates have slowed. He also pointed to the need to improve waiting times for cancer treatment—particularly curative radiotherapy—and expand access to the most sophisticated treatment options, such as genomic testing. Not enough progress has been made on increasing the number of patients diagnosed at stages 1 and 2—the best way to improve survival. However, Lord Darzi said that there are signs of hope, thanks to the success of initiatives such as the targeted lung health check programme. We are not daunted by the scale of the challenge; we know that we need to roll up our sleeves and get to work.

In response to the Darzi report, and as part of our mission to build an NHS fit for the future, we have launched an extensive programme of engagement to develop a 10-year health plan. The plan will set out a bold agenda to deliver on the three big shifts that I outlined earlier. This will be a team effort. We will listen to, and co-design the plan with, the public, the health workforce, charities, academics and other partners. I encourage every parliamentarian, in this Chamber and right across the House, to get involved in this big national conversation—the biggest conversation we have had about our healthcare and care system since the NHS was founded in 1948. Please go to change.nhs.uk and get involved. There will also be approximately 100 deliberative events around the country so that Members and their constituents can get involved in the big conversation, which will lead to the publication of our 10-year plan strategy in spring 2025.

Organisations such as Cancer Research UK have been at the forefront of advocating for a robust cancer strategy. Their reports highlight the importance of dedicated cancer strategies in driving efforts and impact towards improving cancer research, diagnosis and care. We have launched the Change NHS online portal to facilitate that national conversation and help develop the 10-year health plan. The journey of developing a plan is as important as the plan itself. We want the public and healthcare staff in England, and all other stakeholders and people who care about the future of our health and care system, to share their views, experiences and ideas. The portal opened on 21 October and will run for several months.

To build an NHS fit for the future, we first need to listen. To reduce the number of lives lost to the biggest killers, like cancer, we need to learn from people with lived experience, researchers and our NHS staff. We also recognise the need for leadership by the Government, and my right hon. Friend the Secretary of State has been clear that there needs to be a national cancer plan. We are now in discussions about what form that plan should take and what its relationship to the 10-year health plan and this Government’s wider health mission should be. However, we are clear that we must develop and publish the 10-year health plan in spring 2025, before we can publish a stand-alone cancer strategy. We will provide updates on that in due course. The sequencing is important; it is best to set the strategic framework through the 10-year plan, and then a stand-alone cancer plan will flow from that. I have absolutely heard the message about the need for a cancer strategy loud and clear from hon. Members, and I will convey it to my ministerial colleagues and to officials.

I thank the hon. Member for Wokingham for bringing this important matter to the House, and once again I thank all hon. Members who contributed. I also thank the hon. Member for Runnymede and Weybridge (Dr Spencer) for the constructive way in which he has engaged in this debate. He asked me a vast range of questions. It is probably better, in the short time that I have available, to say that I will write to him so that I can respond in the detail that is required, which I do not think I can today.

I am pleased to assure hon. Members that rebuilding our NHS and delivering world-class cancer services for every person remains a top priority for this Government. We have wasted no time in taking action, announcing funding that will make innovative treatments accessible to cancer patients. We have published an independent investigation of the health service in England, which has highlighted the challenges that cancer patients face and the scale of the work needed. With input from members of the public, researchers and NHS staff, we are now developing a plan to make the health service fit for the future and to reduce the lives lost to the biggest killers, including cancer.

The foundation of the NHS was, of course, one of the proudest achievements of the Labour Government of 1945 to 1951. We created a service that was right for the 20th century at that time. It now falls to the Labour Administration of 2024 to shape a health and care service that is fit for the 21st century, so let us work together to get our health and care service back on its feet and ready to tackle the scourge of cancer.

I thank you, Mr Betts, and the Minister for giving me a few minutes to sum up; that is very kind. I thank colleagues from all political parties who contributed to the debate. I made notes of what everybody said. I do not think that I can go through all of them, but I have to say that I agree with the hon. Member for Strangford (Jim Shannon): we have got from the Government another £22 billion for the NHS, and that has to be welcomed. I am also very pleased to say that I agree with everything that the right hon. Member for Herne Bay and Sandwich (Sir Roger Gale) said. Children should be included in clinical trials; I totally agree. I am very pleased that he also said that there should be a national cancer strategy. I am delighted that the wife of my hon. Friend the Member for Cheltenham (Max Wilkinson) has had successful treatment—the same that I had.

Both the Minister and the shadow Minister, the hon. Member for Runnymede and Weybridge (Dr Spencer), were kind enough to mention that I have helped to raise over £800,000. But it is not just me; many other people have been involved in the raising of that £800,000. My daughters and I did skydives. They went out of the plane first, and that really made me decide that I had to go out as well—I did not want to! We have had dinners, tea parties and golf days with friends, and the two very big events have been fashion shows in front of 1,000 people. If Members think that it is daunting to make their maiden speech in Parliament, they should imagine what it is like to walk out in front of 1,000 people, dressed in a ridiculous pink three-piece suit. That was not the easiest thing that I have ever had to do.

I was really pleased to hear the Minister say that he has heard loud and clear the request from all of us for a national cancer strategy. I hope that in the next few weeks, few months, or certainly by the end of the spring and beginning of the summer, he will have been able to persuade the Secretary of State that we need a national cancer strategy. It is a very popular policy. Eight out of 10 people want us to have a national cancer strategy. Many, many cancer charities want us to have a national cancer strategy. It would be really good if the Minister and the Secretary of State could help to deliver one.

Question put and agreed to.

Resolved,

That this House has considered the potential merits of a cancer strategy for England.