Contribution
My Lords, from these Benches, we very much welcome the national cancer plan and support its ambitions—and it is very ambitious. Many organisations and committees have called for an integrated, long-term plan, so it is very good that the Government have listened and, in particular, have taken note of the views of patients and their families—the people with lived experience of all these problems. However, may I reiterate Cancer Research UK’s response to the plan? It said:
“The key question that patients and their loved ones will ask, however, is how quickly will they see progress in cancer survival and outcomes? The improvements they are waiting for will depend on how this plan translates into delivery. Funding must match the ambition of what has been promised, or the NHS will struggle to expand its diagnostic capacity or introduce innovation at scale. And clear leadership and accountability are also crucial”.
Many of those points have also been mentioned by the noble Earl, Lord Howe, just now.
We know that outcomes in England have lagged behind comparable countries for decades, so it is positive to see improving cancer survival at the centre of the plan. However, it is going to be tough to achieve and will require much faster progress than what we have heard so far indicates. The key, of course, is improved diagnosis at an early stage, so I welcome the renewed commitment to earlier diagnosis and to meeting all cancer waiting time targets by 2029. It is outrageous that 92% of trusts do not reach the target for starting treatment. I welcome the full rollout of lung screening by 2030 and increasing the sensitivity of the tests used in bowel screening by 2028. However, what about breast screening? There have been problems in some parts of the country in getting that done. Can the Minister say whether these plans will be fully resourced? There is no point in doing the screening and tests unless an expert is there to interpret them. There are bold promises, but will they be matched with the resources and training required?
The plan talks about AI tools and liquid biopsy tests, which could certainly hold real potential for increasing productivity. However, before they are introduced, they must be robustly tested so that only safe and effective innovations reach patients and those that do not work can be dropped.
While there is a focus on diagnosis and treatment, I was pleased to see that the plan includes a commitment to increase action on lifestyle factors which we know cause cancer. Smoking tobacco, being overweight or obese, alcohol and UV exposure still cause many cancers that could be prevented. Fortunately, the Tobacco and Vapes Bill should certainly have a positive effect over the coming years in stopping people smoking in the first place. It is also positive to see action to strengthen protections on sunbed use and measures to drive HPV vaccination uptake, particularly in underserved groups. The new ad hoc committee on childhood vaccine rates is, I hope, going to contribute to that.
More action is needed to drive the shift from sickness to prevention, which is one of the Government’s core objectives in their 10-year health plan. There is still more to do to help millions of existing smokers quit smoking and to prevent someone becoming overweight or obese in the first place. Tightening regulation on alcohol through introducing minimum unit pricing, as implemented in Scotland and Wales, was a missed opportunity. Will the Government reconsider?
Rare cancers make up about 24% of cancers diagnosed in the UK and the EU every year. This includes cancers of children and young people, because they are less likely to suffer from the cancers caused by the lifestyle issues I have just mentioned. This is where research comes in, and the ability to implement research findings into the NHS. It is a sad fact that the NHS has been slow in the past to implement new cutting-edge treatments, so it is welcome that the plan has some important commitments in that respect. However, as with other aspects of the plan, the devil is in the detail.
The focus on ending delays in cancer treatment is a step forward, but funding 28 new radiotherapy machines is not enough when the treatment is so cost-effective and successful. We need to end the radiotherapy deserts. Will the Minister extend her ambition to the 200 extra radiotherapy machines that the Liberal Democrats have proposed? Another 28 will probably only replace the old machines that need to be replaced anyway—it will not take us forward. Can the Minister tell us about the plan to train the operatives for these new machines? Resources, training and accountability are at the heart of this. We have not had a lot of detail yet, so I look forward to getting more.