Lord Bethell (Con)

My Lords, I echo the praise of other noble Lords for the report. Professor Peter Johnson has done an enormously worthwhile job, and there is so much richness and so many good things in the report. I will put a spotlight on the unfortunate framing that catching cancer is, largely speaking and for the majority of people, simply a matter of bad luck. The report says quite clearly, under prevention: “As much as a third of cancers are preventable”. That is a very conservative estimation of the proportion of cancers that are preventable. Modern analysis would point to systemically preventable exposure to multiple risk factors, which are entirely clustered around class. This framing is incredibly important, because it leads to consequential decisions in the Treasury, among health colleagues and in the rest of government about what we should and could be doing as a society and as a Government to try to reduce the prevalence of cancer. In Europe, the European Code Against Cancer puts prevention absolutely at the centre of the cancer plan. In countries such as Malta, Portugal and Spain, cancer reduction is not seen as something that is relegated to a paragraph in the introduction: it is absolutely front and centre of the whole cancer plan. It embraces all of health. The noble Baroness, Lady Walmsley, mentioned screening and vaccines, but it is a shame that those are not much more front and centre and that the Government’s ambitions are not greater. Where are the targets on things such as obesity and clean air? These are the kinds of things that one would expect to see built into a cancer plan. In terms of the “all of government” approach, where is taxation and the planning system, mentioned in the plan as important levers for reducing cancer? The bad-luck attitude to cancer is an old-fashioned clinicians’ bias that is no longer supported by the epidemiology. So, I ask the Minister, first, is it possible to perhaps review the research framework that has led to that kind of understatement of the preventability of cancer? Coming out of that, secondly, I ask the Minister whether she could perhaps consider looking at a cancer prevention plan, as they have in other countries?