Lord Taylor of Warwick (Non-Afl)

My Lords, I also thank the noble Lord, Lord Patel, for securing this timely debate. One of the lessons of history is that, so often, we fail to learn the lessons of history. I say this particularly in relation to prostate cancer. It is the most diagnosed cancer in men aged over 45 in England. There are higher risks of prostate cancer linked to ageing, black men and family history. Early diagnosis is critical. Survival is nearly 100% when detected early, but it drops to around 50% at stage 4. Yet one in five men—that is 10,000 annually—is still diagnosed too late. Despite these earlier warning signs, there is still no UK-wide screening programme for prostate cancer. This is a cancer that affects men from every social and professional class. Some of the most well-known names in the world have spoken of their prostate cancer diagnosis. Some of them are still with us; others are not. They include Robert De Niro, Warren Buffett, Colin Powell and Nelson Mandela. Closer to home, this cancer has affected Ian McKellen, Stephen Fry, Rod Stewart, Andrew and Julian Lloyd Webber, and, another knight of the realm, Chris Hoy. I mention these names because the fact that these famous men have been prepared to discuss their personal diagnosis has helped expose the need for more active screening. Although prostate cancer is the most frequently diagnosed cancer among men in 112 nations, the testing procedures vary greatly from country to country. For example, some nations, such as Sweden, have trialled organised screening programmes involving PSA—prostate-specific antigen blood tests—and subsequent MRI, or magnetic resonance imaging, tests for men of a certain age. But America and Australia have elective individual decision-making approaches. My first question to the Minister is: what analysis of other nations’ prostate cancer treatment strategies are the Government carrying out? Have they come to any conclusions about the way forward for the United Kingdom? Organisations such as Prostate Cancer UK, Prostate Cancer Research and the British Association of Urological Surgeons all support the introduction of a screening programme. The Telegraph has been campaigning in recent months for men with the highest risk of the disease to be offered a test. According to Prostate Cancer Research and Deloitte, targeted screening is not only life-saving but cost-effective. Their modelling shows that it could deliver a £14,000 net socioeconomic benefit for every high-risk man diagnosed. Bearing in mind the reluctance of some men to submit themselves to rectal examinations, what assessment have the Government made of the BARCODE 1 study on the early detection of prostate cancer using saliva samples to identify high-risk patients? I am pleased that the UK National Screening Committee has now recommended national screening for men aged 45 to 61 with certain confirmed gene mutations, but when will it next be considering whether to extend this to other men at risk of prostate cancer? As for cancer more generally, NHS England has advised caution when making comparisons between historic and latest available data on cancer. This is because cancer registrations in England can take up to five years after the end of a given calendar year to reach 100% completeness due to continuing late registrations. If we cannot get the data right, how can we have confidence in the information being provided? Additionally, diagnoses of cancer are registered for each separate cancer, so this means that a person diagnosed with more than one type of cancer would appear more than once in the total data. As the noble Lord, Lord Kakkar, said, data is vital. I am a vice-chairman of the All-Party Parliamentary Group on Artificial Intelligence. Can the Minister indicate what plans there are to improve medical data collection, because this is key, perhaps by using more AI technology? Also, what plans do the Government have to invest more in AI and robotics to help spot cancers earlier and increase access to innovative cancer treatments as soon as they become available? Regarding international comparisons, the UK has lagged behind other countries on mortality rates. According to the Organisation for Economic Co-operation and Development—OECD—data on deaths from cancer in developed countries showed that we presently rank 26th out of 36 countries for cancer mortality rates. It is against that background that I welcome the Government’s publication on 4 February of this year of their 10-year National Cancer Plan for England, but I note that some cancer and public health academics have been critical. For example, the London School of Hygiene and Tropical Medicine has raised concerns with the plan’s delivery model, arguing that it lacks clarity on what additional resources and leadership capacity would be required to achieve its ambitious goals. A relevant issue is the Terminally Ill Adults (End of Life) Bill. An important factor in end-of-life management is palliative care and pain relief, yet in the UK some independent hospices rely on charity to fund up to 70% of their costs. The quality of palliative care is very much a postcode lottery. Will the Government consider putting more funding into palliative care? The good thing is that, on average, we are all living longer, but our life should be measured on its quality, not only on its length. So much of cancer care depends on the power of the purse, but we also need more emphasis on prevention and early detection. As the saying goes, cancer can be a dark place to be in, but we can bring light.