Clive Jones

I beg to move, That this House has considered the national lung cancer screening programme. It is a pleasure to serve under your chairship, Sir Alec. I declare an interest as a governor of the Royal Berkshire hospital. A family member also holds shares in a medical company. Lung cancer is a rapidly fatal disease that kills nearly 33,000 people in the UK every year. Fortunately, targeted lung cancer screening has become one of the NHS’s real success stories, with Lord Darzi highlighting it as the only initiative across all cancers that has improved rates of early-stage diagnosis in recent years. Screening is without doubt the single biggest intervention in improving lung cancer survival. When the UK Lung Cancer Coalition was launched in 2005, five-year survival stood at around 8% which was among the lowest rates in Europe. The UKLCC has now set an ambition of 35% of patients surviving five years after diagnosis by 2035—a target once thought to be impossible, but now within reach thanks to screening. The Government’s decision to roll out fully the targeted national lung cancer screening programme in England for people aged 55 to 74 with a smoking history was a major milestone. To date, that programme has identified more than 10,600 lung cancers, with over 75% diagnosed at an early, treatable stage, compared with just 28% before screening was introduced. Without doubt, lung cancer screening is saving lives. It is cancer prevention in action and exemplifies the shift toward earlier diagnosis set out in the NHS 10-year plan. I place on record my thanks to the NHS cancer programme team, lung cancer advisers and the lung cancer screening clinical expert group for delivering the fastest roll-out of lung cancer screening anywhere in the world. The benefits of screening extend beyond lung cancer. Screening is also identifying conditions such as chronic obstructive pulmonary disease and cardiovascular disease, potentially saving even more lives. Since I applied for this debate, the Department has committed in the national cancer plan to a timetable for the full roll-out of the programme. That is a significant achievement. The inclusion of screening in the NHS app is another welcome step, but we cannot be complacent simply because a roll-out is promised in a plan. Will the Government reaffirm their commitment to a national roll-out timetable and ensure that the programme continues at pace? The national cancer plan commits to reaching 100% of the eligible population by 2030. That timetable matters because any slowdown risks reversing progress on early diagnosis. Unlike other national screening programmes, lung cancer screening does not yet have guaranteed funding beyond 2030. If this programme is to remain stable and effective, it needs protected long-term funding. We must also continue to evaluate reporting systems, national databases, turnaround times, workforce capacity and how screening is tailored to local populations. Importantly, screening is helping to reduce health inequalities by focusing on areas of deprivation. That progress should continue, supported by investment in community engagement and communications to ensure that hard-to-reach populations are not left behind. Given the importance of reducing inequalities, will the Minister confirm whether lung cancer screening will move to section 7A arrangements with ringfenced funding beyond 2030? There is also concern about maintaining political momentum. With both drivers behind the national cancer plan no longer in post and Cabinet changes expected in the next few weeks, many in the cancer community are understandably concerned about whether the commitment will continue. I am sure the Minister will reaffirm his commitment. England is leading the way, but early detection must not become a postcode lottery across the UK. Wales is preparing to launch a programme in 2027, but Scotland and Northern Ireland remain significantly behind. The UK Lung Cancer Coalition is supporting discussions in both nations later this year to understand the barriers and encourage implementation. Lung cancer is the UK’s biggest cancer killer. Every eligible person, regardless of where they live, should have access to the same opportunities for early diagnosis. I urge the devolved Governments to learn from England’s experiences and introduce screening as quickly as possible. Will the Minister engage with counterparts in Scotland and Northern Ireland to encourage progress towards UK-wide implementation? There are several threats to the programme’s success. First, there are growing concerns about integrated care board interference and the lack of ringfenced funding. Cost-cutting pressures on ICBs threaten to undermine progress. There are reports that high-performing screening teams—some seeing 55 patients a day—are being disrupted, and that screening resources are being diverted elsewhere. The variation in delivery across the country is striking. Lung cancer screening funding should be used for lung cancer screening, and local structures should not be allowed to dilute a programme that is demonstrably working well. Will Ministers issue clear guidance to ICBs to prevent interference in delivery? Will they guarantee that screening funding is to be ringfenced and used solely for its intended purposes? Will they ensure that ongoing ICB restructuring does not weaken accountability or performance? Secondly, the abolition of NHS England raises legitimate concerns. The programme’s roll-out, data systems and clinical governance arrangements require continuity, and many charities and organisations across the cancer sector are concerned about potential loss of expertise during organisational change. What safeguards are in place to ensure continuity of leadership, data management and programme oversight throughout the transition? Thirdly, workforce pressures remain one of the greatest threats to the programme being sustained. Screening increases demand across radiology, pathology, thoracic surgery and genomics, yet workforce planning has not kept pace. The Royal College of Radiologists has warned that there will not be enough radiologists to support the programme by 2030. Timely diagnostic and treatment services must be available so that patients diagnosed with early-stage disease can access potentially curative treatment. Demand for thoracic surgery is also rising, as early-stage lung cancers are often best treated surgically. Without sufficient capacity, opportunities to cure may be lost. Greater awareness among GPs remains important too. Around one in five lung cancers occur in people who have never smoked—indeed never-smoked lung cancer is now the eighth most common cancer in the UK and the seventh most common worldwide—but smoking cessation remains a vital part of the screening programme. Smoking causes around 72% of lung cancer cases in the UK, making cessation support one of the most cost-effective interventions available. The British Thoracic Society has called for at least one specialist tobacco adviser in every hospital. As the Government pursues its smoke-free 2030 ambitions, the NHS has a critical role to play in helping people to quit smoking. The Institute of Clinical Research has highlighted workforce challenges in biomarker testing and molecular diagnostics, both of which are increasingly important for personalised cancer treatment. As I have repeatedly argued in this House, the national cancer plan can succeed only if its ambitions are matched by investment in the workforce needed to deliver them. When will the Government publish their delayed workforce plan and how will they support the continued expansion of lung cancer screening? Will Ministers commit to increase training places in radiology, pathology and thoracic surgery? Lung cancer screening is one of the most effective public health interventions introduced in recent years. It is saving lives, reducing inequalities and shifting diagnosis toward earlier, more treatable stages of the disease, but its future success depends on stability, protecting funds, a sustainable workforce, robust Government and UK-wide implementation. The Government have an opportunity to secure the future of a programme that is already transforming outcomes for thousands of people. The UK Lung Cancer Coalition believes that doing so is essential if we are to achieve the ambition of a 35% five-year survival rate by 2035.