Westminster Hall

Thursday 31st October 2024 Westminster Hall

Thursday 31 October 2024

[Sir Mark Hendrick in the Chair]

SEND Provision: Hampshire

Thursday 31st October 2024 Westminster Hall

13:30

[Luke Murphy (Basingstoke) (Lab)]

I beg to move,

That this House has considered SEND provision in Hampshire.

It is a pleasure to lead my first Westminster Hall debate under your chairship, Sir Mark, particularly on this important topic. I begin by recognising the parents, advocates and campaigners who have brought the issue into the public eye, especially the Kids nursery parent committee from Basingstoke, who are here today in the Public Gallery. Their dedication to advocating for inclusion and calling for urgent reforms to the special educational needs and disabilities system is inspiring, and their personal stories highlight the real impact of this crisis on children, young people and their families.

When I first stood as Labour’s candidate for Basingstoke, I knew that SEND support faced challenges, but it was not until I met families across Basingstoke that I truly understood the depth of the crisis. I spoke to two mothers on the campaign, who live just two doors apart, yet both said they felt alone in their struggles with an adversarial and confusing system. They had no idea that their situations were nearly identical. Both were battling to secure essential support for their children, believing that they were alone in that fight. A mother in my constituency, Michelle, perfectly summarised the struggle. She told me:

“Raising children with SEND is incredibly challenging, exhausting and stressful. There isn’t enough support for parents to cope. We face constant appointments, endless form-filling, and have to fight for the education our kids deserve. It shouldn’t be this hard, and it doesn’t need to be this hard.”

No family should be placed in Michelle’s position, having to fight tooth and nail for a fair, inclusive education for their children.

Just last week, the National Audit Office issued a report described by the Minister for School Standards as a “damning indictment” of the SEND system. The report highlighted that the system is not only financially unsustainable, but is failing to deliver the necessary outcomes for children. It is a broken system—a crisis we inherited, after 14 years of inaction. It is heartening to know, looking around this room, that the sentiment is shared across party lines. The last Conservative Education Secretary labelled the system she left behind as “lose, lose, lose” while current Tory shadow Ministers say that they did not do enough on SEND and should hang their heads in shame. We agree.

The NAO report underscores the reality that families and councils live with every day. The demand for SEND support has surged. Education, health and care plans have increased by 140% since 2014, with more than 576,000 individuals now needing that support. Local authorities are also struggling under a £4.6 billion deficit as high-needs funding, even at £10.7 billion, fails to meet demand. Tribunal appeals have risen by 334%, which is testament to a system where families must fight for basic rights rather than being supported to achieve them.

One parent shared her story with me recently. After waiting two and a half years following an initial needs assessment, her daughter finally secured a placement in a specialist school, but it is a 70-minute round trip for only two hours of schooling each day. That family’s experience reflects a system that feels combative rather than supportive—where councils, as this mum pointed out, spend public funds on solicitors and barristers to deny or delay access to services that children are legally entitled to.

The impact of the crisis on families is stark. Nationally, only 50% of EHC plans met the statutory 20-week timeline in 2023—down from 60% in previous years. That failure to meet deadlines has left parents understandably losing faith in the system. It is little wonder that parents who have children with SEND are significantly more likely to consider home schooling than parents who have children without SEND—a sad consequence of a system that is failing them.

[Chris Bloore (Redditch) (Lab)]

I congratulate my hon. Friend on securing this debate, and thank you, Sir Mark, for your chairmanship. I also thank the parents that my hon. Friend has brought along in support. I have the same situation in my constituency of Redditch in Worcestershire, and if it was not for the parents dotted around the country who fight for their children or grandchildren, we would not have such energy in the new Parliament to fight for the proper solutions for SEND. My hon. Friend talked about trust and the broken system; does he agree that it is essential, if we are to rebuild a system that is fit for purpose, to rebuild trust between local authorities and parents and grandparents, so that co-production can truly start again?

[Luke Murphy]

I completely agree with my hon. Friend: crucial to fixing the system will be rebuilding trust between parents, national Government and local authorities. There is much work to do, but I think yesterday’s Budget showed that this Government are making a downpayment on that commitment—and there will be more to come. As my hon. Friend mentioned, the lack of adequate support has lasting impacts on families. Many parents have had to reduce their work hours or even leave employment entirely to care for their children when the local authority fails to provide adequate support. I know, from hearing families’ stories, that many are reaching breaking point, and parents are exhausted from the constant battle against the system.

Hampshire county council, like many others, has been coping with a system in freefall. The number of EHC plans in Hampshire has nearly doubled, from just over 8,000 in 2019 to around 16,000 this year. Hampshire’s cumulative deficit for the dedicated schools grant is now at £86.1 million, representing 9.4% of its total dedicated schools grant income. To put that in perspective, for every £100 that Hampshire receives for schools and SEND provision, it has accumulated nearly £9.40 in debt. That deficit is expected to reach £250 million by 2025-26 if nothing changes. Hampshire also currently spends £47.2 million annually on independent school placements, due to the lack of available spaces in state-funded options, underscoring the urgent need for expanded state provision and the need to support mainstream settings in providing essential SEND support.

I am particularly concerned about the exploration of the statutory override in 2026, which currently allows the education deficits to be kept off councils’ balance sheets. When the override ends, councils like Hampshire could face financial insolvency, forcing them to declare a section 114 notice and request Government intervention. The situation is clearly untenable, and serious reforms are urgently needed, but this crisis is not just about budgets or statistics; it is about real lives and families.

Eleanor, a mother in my constituency, told me about her son. When he turned two, she sent him to the local nursery to be with his older sister, but there it quickly became clear that his development was delayed. On multiple occasions, Eleanor would go to pick him up and find him playing alone in the toilets unsupervised. Quite understandably, that is not what she wanted for her son, but without sufficient support from early years education, and because he could not talk, he was left to blend into the background and slip through the cracks. Eleanor describes the process of fighting for SEND provision as “just terrible”—a constant battle with the local authority in a system that she describes as completely broken.

Another parent, Kelly, shared her story with me. After multiple appointments where she raised concerns about her son’s development, she was told that he was simply the “lazy twin”. But Kelly did not give up. She described how, without clear guidance and support, parents go into the SEND system “blindfolded”, feeling their way through a complex maze that should be straightforward. Jodie, another mother from Basingstoke, told me that

“the only support you get consistently through the whole SEND journey is from other parents who are going through the same thing.”

It is a sad reflection of the system when parents find that their only reliable support is each other.

My hon. Friend the Member for Aldershot (Alex Baker), who wanted to be here today, has heard similar experiences of a lack of suitable school places leaving parents with no option but home schooling for their children. That puts unacceptable pressure on parents, resulting in mental health issues and self-harm, while children miss out on vital opportunities to develop wider life and social skills

A parent in my constituency described the impact of finally receiving specialist provision for her daughter as having a “halo effect”. It brought a sense of normalcy and confidence back to her daughter’s life, sparking interests outside the classroom, but that positive impact should not just be the rare exception; it should be the standard experience for every family navigating the SEND system.

When I committed to a manifesto focused on building a truly inclusive, responsive and supportive education system, it was not just a pledge; it was a mission. Every child deserves an education system that meets their needs, especially those children with special educational needs and disabilities.

I am encouraged by the Government’s actions in taking the first steps towards real change. Yesterday’s Budget marked a significant commitment from the Chancellor, with a £1 billion increase in SEND and alternative provision funding. That is a 6% real-terms boost. The funding is a critical step towards improving outcomes for children and families, and guiding our SEND system towards much-needed financial stability, fixing the foundations to ensure that every child in England can achieve and thrive regardless of their background.

The children’s wellbeing Bill, which was announced in the King’s Speech, will mandate schools to collaborate with local authorities to improve SEND inclusion. That is a foundational step. Our commitment to expand early years support by investing in SEND-specific teacher training and establishing a framework for early intervention, such as the Nuffield early language intervention, is all part of a larger strategy to prevent children as soon as possible from slipping through the cracks. The Government have also said that they will ensure accountability in mainstream settings through bodies like Ofsted to guarantee that every school is equipped to meet the needs of students with SEND. More widely, the Government have committed to recruiting 6,500 new teachers to reduce class sizes, which I hope will also allow for more inclusive classrooms.

This crisis has stretched on for far too long and we must work on a cross-party basis to address it before the situation becomes truly unsalvageable. Every child, regardless of whether they have SEND or not, should have the support in place so that they can thrive in school and beyond.

Today, with the Kids parent committee from Basingstoke and the Minister both present in Westminster Hall, I want to amplify a clear message from families in my constituency: we need greater training and support for mainstream early years staff in SEND, because early intervention is crucial. By equipping early years staff with the skills to recognise and support children with additional needs, we can ensure that children receive timely help, giving both parents and children a solid foundation. I fully support that goal and will work alongside others to make it a reality.

In yesterday’s Budget, the Chancellor announced an additional £1.8 billion to expand Government-funded childcare and allocated £69 million to grow the network of family hubs. This funding represents a chance to provide essential support and early intervention for SEND families across the country.

I hope that this debate shines a light on the reality of SEND provision for families, not only in Hampshire but across the country. Today I urge the Minister and colleagues from all parties urgently to support a reformed SEND system that lifts up our young people and their families.

The Government have rightly committed to breaking down barriers to opportunity for all, which must include children and young people with special educational needs and disabilities. We know that there is no magic wand that can fix this broken system overnight, but I urge the Minister to collaborate with her colleagues across Government to urgently reform the SEND system, so that we can restore faith in SEND provision, and I am hopeful that this Government will lead the way in creating a system that truly works for every young person, every family and every community. As Michelle put it:

“It shouldn’t be this hard, and it doesn’t need to be this hard.”

[Sir Mark Hendrick (in the Chair)]

I remind Members that they should bob if they wish to be called in this debate.

13:44

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship, Sir Mark. As the hon. Member for Basingstoke (Luke Murphy) and I were walking down to Westminster Hall, I asked if he would be speaking and he said he was. I know that the debate is about Hampshire, but I always want to come along to support hon. Members who are bringing forward critical issues. I also want to add comments from a Northern Ireland perspective.

I am pleased to see the Minister in her place; I always look forward to meeting her and I know she clearly understands the issues that the hon. Member presented. I want to support him and his parents group, which has come here today. On the way here, he mentioned that those parents are the reason he secured the debate, and parents should be in everything that we do. These things are about our constituents and about what we can do to help them and give their perspective.

I spoke on this issue just last week; indeed, like almost everyone here, I have spoken in every debate on SEND education since we came back after the election. As I said, I want to give a Northern Ireland perspective, if I may.

I welcome the Budget, which allocated extra money to the SEND education system, as the hon. Member mentioned. I am always hopeful that some of that allocation will come our way through the Barnett consequential, which results in us gaining from investment here on the mainland.

[Sir Mark Hendrick (in the Chair)]

Order. The debate pertains to Hampshire. Although you raise issues that are common, the subject is aimed in the direction of Hampshire. Can you please make the main points and try not to veer off the subject in terms of specifics in your own part of the UK?

[Jim Shannon]

I will make sure that whenever I mention Northern Ireland, I mention Hampshire as well. That will hopefully keep the perspective right, because what the hon. Member said happens in Hampshire happens in my constituency as well. I want to illustrate that and make some suggestions on how we can provide better help in the system. What we do back home in Northern Ireland can help those in Hampshire with how they move forward.

We have a clear teacher funding issue, especially in the SEND sector. One of my questions to the Minister, which I hope will be helpful for the hon. Member for Basingstoke and for the wider debate, is this: what has been done to ensure that there are more adequately trained people to respond to this issue?

I also speak in this debate because this matter is personal for me. I have six grandchildren, and three of them unfortunately have some difficulties with autism, learning and speech issues. I will not mention their names, because it would not be appropriate, but that is why this is personal.

Whenever I come here to make a contribution, it is clear to me what I am asking for: for the same things that have already been done back home. I will give a couple of examples of how things have happened and, by doing so, show what has made the situation better. I know that the hon. Member has referred to that.

A teaching assistant back home told me that she did a level 3 qualification on specialist support for teaching and learning in schools. If she lived here in England, she would fully qualify as a substitute teacher; in Northern Ireland, further training is necessary. That is an example for us back home. With the same system here, someone qualifies, but with the system back home, they do not. That clearly highlights the issue.

Across Northern Ireland—the hon. Member’s contribution has convinced me that this is similar to what is happening in Basingstoke and Hampshire—we have autism assessments, and some 66,000 pupils have some form of SEND. That is 20% of the population—the figures are similar to what the hon. Member referred to. Children fight for a diagnosis from the day they enter school, but unfortunately there are detrimental educational psychology delays, which coincide with delays in our health service. Even though we are focusing on SEND and education, will the Minister, when she responds, consider that there must also be a tight relationship between education and health? That is important and I hope she will respond in a positive fashion.

As I said, this issue is a personal one: three of my six grandchildren unfortunately have autism and speech therapy needs. I want to give an example of what has happened. I have mentioned diagnosis; get the diagnosis done early and we can change the child’s life—wow! I will give an example that is personal, because it happened in our family. One of the grandchildren—one of the boys—was quite boisterous and seemed to have difficulty expressing himself. Unfortunately, the result was that when he was at nursery and early school, he was hitting out at other children and became quite a difficult child. It was nobody’s fault; it was just that he was not able to express himself in the way he wished to.

We got the early diagnosis, and with the early diagnosis came the speech therapy, and with the speech therapy came an absolute change in that wee boy. When we were going to my son’s house for Christmas, I said to my wife, “Sandra, there’ll be some goings-on the day, when we get there,” and she said, “You’ll see a difference.” I had not seen my grandson for a while, and what a difference there was in that wee boy because he had got the diagnosis and the speech therapy—you could not have kept him quiet. What a change in that wee fella because the system had worked and helped him.

I give that as an example of what can happen if we have the right strategy and the right way forward. The opposite is now true of the wee boy: he never keeps quiet. It is lovely to have a wee boy in the corner who is so boisterous and alive and so respectful—we heard so many pleases and thank yous. There can be such a difference as a result of the system when it works. We now have two others coming through, and the provision of an early diagnosis has to be the same for them. The hon. Member for Basingstoke has asked for that, and I am sure the Minister will respond.

Another example is about how education can help. This is an example to help the Minister, because I think the great advantage of these debates is that we can give examples of where things have been going the right way and thereby exchange ideas on ways forward and how we can do things better. Movilla high school in my constituency increased its enrolment from 401 to 600, because the education authority enabled it to extend the special provision for pupils with autism to include 10 and 11-year-olds, and it has established what are called nurture classes. It is not a novel idea, but it is a good idea in terms of helping to move forward education and mainstream education in particular.

Those are just two of the points I want to raise: early diagnosis and the nurture classes that we have in my constituency of Strangford. I do not know what the reason is, but in the last number of years—the last 10 to 15, in particular—I have certainly seen more children there who have difficulties with autism and other issues. More should be done to create specialist nurture units within mainstream schools and to support specialist training for teachers of all ages. There must be the capacity for us to do our best for pupils who require additional support; they should not have to suffer because of a funding crisis.

I look forward very much to hearing the Minister’s thoughts and those of the shadow Minister, the hon. Member for North West Norfolk (James Wild). Around this room, we have people with incredible knowledge, and I look forward to all their contributions. I hope the Minister can undertake further discussion with the devolved nations on this matter. I said earlier—I mean it, and it is true of any debate I come to—that there are always lessons that can be learned regionally, and we can then share them in this great United Kingdom of Great Britain and Northern Ireland. There is that benefit that comes from regional knowledge, which may be specific, but which can help us all to do things better. With that, I commend the hon. Member for Basingstoke for bringing the debate forward. I hope my contribution kept exactly to the line that you asked me to keep to, Sir Mark. Thank you so much.

13:54

[Darren Paffey (Southampton Itchen) (Lab)]

It is a pleasure to serve under your chairship, Sir Mark. I am still learning about these things, but I believe I may need to refer to my interest as a member of the Education Committee.

I thank my hon. Friend the Member for Basingstoke (Luke Murphy)—my childhood home—for securing this important debate for our county. I fully recognise the picture that he so comprehensively and eloquently set out. As a former council cabinet member for education in Southampton and a proud dad to an amazing SEND child, both my professional and personal experience move me to take part today. I am grateful for the opportunity to do so representing the people of Southampton Itchen— I did move further south in the county a few years ago.

The debate could not have come at a better time. Not only is the need for SEND reform at its greatest after being overlooked by the Conservative Government for 14 years, but the debate follows the announcement of £1 billion of extra SEND funding in yesterday’s Budget, as my hon. Friend mentioned. I do not intend to repeat the points he made, but I will take this opportunity to share three reflections from my experience that hopefully contribute to a way forward for SEND children and their families in Southampton and across the county.

I will start by saying as clearly as I can that inclusion in mainstream schools is the right approach for many. However, the metrics around schools must change. I can tell Members what inclusion is not: it is not just putting a child with SEND in a mainstream classroom and then, “Job done!” It is not just a box to tick or a target to meet; it is a fundamental shift in how we think about education—not only how we define school success but, far more importantly, each child having the opportunities they deserve opened up to them.

Our current metrics of attainment 8 and progress 8 often fall short in recognising a school’s full achievements. In Southampton Itchen, and I am sure in other parts of the county, we have seen promising improvements in school performance, and schools are making remarkable strides towards inclusivity, but the performance metrics often do not reflect that. Teachers are working incredibly hard to meet the needs of students with special educational needs and disabilities, tailoring their classroom approach to ensure that those students are not left behind in their learning journey. Yet those efforts—that dedication, adaptability and commitment to inclusivity of our teaching staff—are somehow not considered a measure of a school’s success. I want to argue that they absolutely are and should be.

In our very welcome Ofsted reforms, will the Minister consider how we might ensure that not just statistics, but inclusive practices that open up opportunities for SEND children, count towards the new report cards? In that way, we can expand measures from just academic achievement to educational practice that makes a difference to whether SEND children have the opportunity they need and deserve.

My second point is on the National Audit Office report mentioned by my hon. Friend the Member for Basingstoke. Some 1.7 million young people are identified as having special educational needs and disabilities in UK schools, but the report notes that there have been no consistent improvements since 2019 in outcomes for those children and young people. That is a huge swathe of our children—our future—that cannot, should not and must not be left behind.

In Southampton Itchen, the rate of growth in the number of children with SEND is outpacing the national average. Dealing with that increased need inclusively in mainstream schools relies on adequate teacher training and teachers’ preparedness for future trends. Yet the current national standards require teacher trainees to spend just one day of their placement in a SEND setting. Contrast that with what they face in the mainstream classroom, where one in five school pupils in England has identified special needs. There needs to be much more attention to the needs of those children and much more preparation in teachers’ professional development.

The professional evidence is that when we get the inclusive approach right, the benefit is felt not just in the outcomes for SEND children, but by all children. Will the Minister consider revising the initial teacher training framework so that all new teachers coming to Hampshire and other parts of the country will have received training on how they can best support, draw out the best in, and provide the greatest strides forward for those who will be in their care in the classroom? We must ensure that teachers’ needs for comprehensive training and support are met to empower them to meet pupils’ needs.

Finally, no discussion of the issue can avoid money completely. Resourcing has been a key issue in recent years. In particular, independent SEND provision is growing. While we recognise that those places are needed, it means that councils are at the mercy of market prices set by market providers. No one in their right mind would deny those children the provision they need, but it puts a significant strain on council budgets dedicated to SEND children. Yesterday’s announcement of £1 billion in extra funding is a welcome and much-needed step but, if we are to make the most of the investment, we need to ensure that it supports state-funded special schools and mainstream schools with inclusive practices, so that every child can make the strides they need and deserve, and gets the support that they are due.

We are not just talking about more money. Schools in my constituency tell me that they need certainty about what will happen with the proposed national funding formula and top-ups. Can the Minister give a timeline of when we can expect that certainty to come? Can she also confirm what will happen to the statutory override for the dedicated schools grant?

We must get this right if the Labour Government are to achieve our mission of breaking down the barriers to education and opportunity that too many SEND children face. I am aware of the scale of the challenge, and no one is more aware of it than the families in the Public Gallery today. It is my belief that the Government will deliver the long overdue changes for families here and in my constituency seeking support for their children with SEND.

14:02

[Alex Brewer (North East Hampshire) (LD)]

I thank the hon. Member for Basingstoke (Luke Murphy) for securing this debate and it is a pleasure to see you in the Chair, Sir Mark. In North East Hampshire, as in many other places, special educational needs and disabilities come up repeatedly in casework, constituency surgeries and local council meetings. The system, frankly, is broken. I welcome the calls from the hon. Member for Basingstoke to work across parties on a solution.

Children are frequently not getting the support that they need, schools do not have the funding for further provisions, and Hampshire county council is running at an £86-million deficit trying to meet the need. As a result, children and their families suffer, despite the hard work of headteachers, teachers, teaching assistants and parents. I have met constituents to talk about these challenges, as well as meeting charities that support families in the local area and local councillors to talk through the concerns. I pay tribute to all those who support our children with additional needs, despite the complexity of the system as it stands.

Raising a child with additional needs is hard. We cannot deny that there is an additional parenting burden, although parents, of course, bear it willingly. There is also an additional administrative burden, and council budgets are squeezed so hard that they cannot meet that need.

The number of parents who have to make appeals for SEND support has more than trebled since 2014. When provision is scarce and parents have to fight for it, it becomes an exhausting battle just to have their child’s needs met. The increasingly cited narrative—that pushy parents are just trying to get a bit of extra help for their child—is utterly nonsensical given how much work it is to ensure even the most basic provision.

North East Hampshire is a beautiful place to live, but as a largely rural area with many small villages, hundreds of children have to travel a long way to their nearest school. Those families who live a long way from their nearest suitable provision have to deal not only with the stresses of the system, exclusion, lack of academic progression, high levels of anxiety and the opaqueness of the process, but with transport. Due to the severe lack of public transport, they often have to take private taxis.

According to the Department for Education, the net planned expenditure on SEND transport in Hampshire for the ’24-25 financial year is £56,795,000, yet I hear time and again from my constituents about the failure to secure transport in time for the start of the school year. The lack of a secure transport route can have a huge impact on a child’s relationship with school and their real and perceived safety. It also increases the pressure on working parents, who frequently must leave work or reduce their hours due to the lack of accommodation for their child’s needs. The result? A postcode lottery in access to support.

One of my constituents had SEND transport approved in June. We are now on the last day of October and they have not received any further information—two months of the school year have been missed. That is not good enough, and the situation is not unique in my constituency. Another child in North East Hampshire has been told to use a bus stop a mile away from her home, but because of her disability, she and her parents are understandably anxious about the safety of this journey each morning, given the challenges and dangers she faces when crossing roads.

Prior to being elected this year, I was the chief executive of a charity that supports children and young people with Down’s syndrome and their families. I saw at first hand what those families must grapple with to secure the right educational support for their child. The charity provides specialist support throughout a child’s education —a service that used to be provided by many county councils across the UK.

Charities are often left to pick up the pieces. I recently met Special Needs Jungle, which analyses the sector, provides recommendations and supports families. The Hampshire Parent Carer Network is also a helpful source of support and information. But these organisations cannot find additional services out of thin air.

In the Budget yesterday, the Chancellor stated that she wants

“to improve outcomes for our most vulnerable children”,—[Official Report, 30 October 2024; Vol. 755, c. 822.]

but she also announced that VAT will be charged on private schools. That is highly concerning for North East Hampshire: we have at least four independent schools, each of which has explicit provision for SEND pupils, and our state schools not only are full but are telling us clearly that they cannot meet the needs of many children with additional needs under the current funding models. There is a budgetary disincentive to including children with additional needs in mainstream schools, which the Liberal Democrats have said we would halve.

The announcement of a £1-billion funding uplift for SEND in the Budget yesterday was welcome, but we must go further to clean up this mess. The system needs a complete overhaul, not just an increase in funding. We must undo the damage inflicted on our wider education system by the previous Conservative Government. We must ensure that early help is restored so that children develop the tools to navigate the school system as early in their lives as possible. We must rebuild play into our early years programme and dispense with testing at age five. We must build outdoor learning into our core curriculum and much more besides.

One school in my constituency is building a new room. It is not for teaching and it is not a classroom; it is a welcome room where children who are refusing to go to school can come and feel safe, secure and welcome. It is a bridge between school refusal and school acceptance. It is a great idea, but it should not be needed.

SEND provision must be flexible, tailored and suitable for all communities, both urban and rural. Most of all, it must be available, and that includes the transport required to get to the school gate. I close with a sentiment from an assistant headteacher in North East Hampshire, who said:

“Parents and families shouldn’t have to fight against systems that are meant to be helping their children.”

14:09

[James Wild (North West Norfolk) (Con)]

It is a pleasure to serve under your chairmanship again, Sir Mark. I congratulate the hon. Member for Basingstoke (Luke Murphy) on securing his first Westminster Hall debate on such an important topic for children and parents in Hampshire—it is good to see a number of them in the Gallery listening to the debate. This is the third debate on SEND that I have taken part in since the election, which reflects the importance of the issue to hon. Members in Hampshire and across the whole county, including in Northern Ireland, who all see the challenges and demands facing the sector.

Those problems are familiar to us all. As has been mentioned, last week’s National Audit Office report into support for children and young people with special education needs highlighted the 140% increase in the number of children with education, health and care plans since 2015, and there has been a 93% increase in Hampshire since 2019 alone. Overall, half of those EHC plans are not delivered within the 20-week timeframe, although, in Hampshire, around three quarters are issued on time, a timeframe that my own county of Norfolk aspires to. The NAO also recognised the significant increase in high-needs funding to £10.7 billion put in place by the last Government, but demand continues to grow and there are still big deficits in local authorities that need to be addressed.

That report highlighted the need for whole-system reform; an integrated approach to improve outcomes, which has rightly been mentioned; and the financial sustainability of funding. It also recommended research to understand the root causes driving the increase in SEND and in the demand for EHC plans. I know that the Department is funding some work—I think through the University of Newcastle, and others—to look into those issues, and that there is action to put the budgets of local authorities on a sustainable footing.

I was a member of the Public Accounts Committee a few years ago when another NAO report looked at the SEND system and identified similar problems. The report that we as a Committee put forward helped to inform the SEND and alternative provision improvement plan that the last Government came forward with. We all recognise and accept that the system needs to be reformed; it is not working at the moment.

First, we need a national framework and standards to address the inconsistent support across the country. The previous Government’s plan set out a blueprint for a unified system for SEND and AP that would be driven by new national standards. The first area that we were going to bring forward was around speech and language therapy, and, in a recent written answer to me, the Minister confirmed that the Government are still considering doing that, which we welcome. The hon. Member for Strangford (Jim Shannon) referred to the powerful impact that early diagnosis and access to speech and language therapy can have. It is great to hear such stories, and they should be told far more often.

We also need to improve the EHCP process because, as the constituent of the hon. Member for Basingstoke said, it shouldn’t be this hard. As constituency MPs, we see the families who have had to battle. We help them to get through the system, but they should not have to come to us. Our plan also committed to improving the timeliness of those plans through a standardised and digitised approach. I would like to hear from the Minister whether the Government will proceed with those proposals as well.

The second area where we need reform—again, there is a lot of consensus—is around building capacity and expertise in mainstream schools, with a focus on early help. As I said in the Chamber last week during an urgent question, we wholeheartedly support the focus on inclusivity. That means improving skills and training in the SEND workforce, with a particular emphasis on early intervention, and sharing the real expertise in specialist schools with those working in mainstream settings. I have mentioned in previous debates that I have been to specialist schools where the teachers are desperate to get into mainstream schools and talk about the activities and expertise they have to support children with those needs in mainstream settings.

Some people clearly do need specialist school support, however, and I understand that Hampshire has been expanding such provision with three new schools, including one that I think was approved shortly before the election. I hope that the Minister will confirm that that school is not part of the review of free schools, but will be proceeding and will be funded.

Hampshire, like my own county of Norfolk, is one of the counties that spends a huge amount of money on transporting children to schools with specialist provision. The hon. Member for Basingstoke referred to the impact on children of being stuck in taxis or buses, and travelling long distances for learning. The hon. Member for North East Hampshire (Alex Brewer) also talked about the impact on parents and their ability to work—and, importantly, on the safety of children, who have to get to bus stops far from their homes.

The third area on which we need to focus is partnerships between education and health groups; we need to ensure that they are working together to lead the change. The NAO said the current system has

“misaligned incentives, accountabilities and priorities across the system”.

That creates challenges in a whole-system approach. Collaboration between key partners is important, and the last Government proposed measures for SEND and AP partnerships. We look forward to proposals in the children’s wellbeing Bill that look to achieve the same outcome.

We all want to see a bit more leg from the Government about their plan for reform and inclusivity. We know that the SEND team in the Department has been moved into the schools unit to help bring greater focus. That sounds perfectly sensible. In yesterday’s Budget, as has been referred to, there was also an additional £1 billion for SEND and AP funding.

Additional funding for SEND is needed and welcome, but I suspect that hon. Members and families listening to the Budget would expect that to be used to provide additional support to their children and the inclusive practices to which the hon. Member for Southampton Itchen (Darren Paffey) referred. Can the Minister confirm, however, that the Government actually expect £865 million of the £1 billion to be used by local authorities to reduce their deficits in SEND? Clearly, financial sustainability and addressing deficits—including the statutory override, which a number of Members mentioned and which I have referred to in every other debate we have had on the subject—is important, but we should be clear about where the extra £1 billion of funding is going and what we are going to see on the ground as a result.

Beyond funding, the Minister has regularly said that we need significant change, but despite last week’s urgent question, we are still lacking clarity on what that change looks like, although one thing that the Minister did say in response was that the Government would be looking at

“any legislation that needs to be amended or brought in to achieve our vision for an inclusive mainstream education”.—[Official Report, 24 October 2024; Vol. 755, c. 419.]

Can the Minister confirm that she was referring to the Children and Families Act 2014, which established EHCPs, and what is her timeframe for potentially reviewing that legislation? Is her intention that the number of EHCPs required will be reduced, and will she consult widely before implementing any such changes?

In yesterday’s Budget, the Government put up taxes by £42 billion, but one area where they were actually honest with the electorate that they would put up taxes was the 20% education tax. We now have the Office for Budget Responsibility assessment, which says that up to 37,000 pupils will leave or not enter the independent schools sector as a result of the new tax; and many of them may be in independent schools that offer specialist support for children.

More than 100,000 children in specialist schools do not have an EHCP. Those are children whose parents have decided that that is the best place for their child to be educated. However, in response to the technical consultation, the Government have refused to exempt them from the new tax, as they believe that there must be a formal independent assessment that a child’s needs cannot be met in the state sector. I repeat a question that I have asked before, because I do not think I have had an answer: how many extra EHCP applications do the Government expect local authorities will have to assess?

Since the election, the Minister has said that the Labour Government are absolutely committed to fixing the SEND system. I know that she means that, and the Opposition want to work with her to achieve that. Every hon. Member wants to ensure that families get the support that their child deserves to realise their potential, so our offer is: let us work together to improve outcomes and give children the best start.

14:19

[The Minister for School Standards (Catherine McKinnell)]

It is a pleasure to serve under your chairmanship, Sir Mark. I congratulate my hon. Friend the Member for Basingstoke (Luke Murphy) on securing a debate on this incredibly important subject. I know that he, like every Member here, has been supporting families in his constituency to navigate the SEND system. He has raised this issue in the main Chamber regularly, particularly during oral questions. In his opening speech, he spoke incredibly passionately on behalf of his constituents, and I am sure that it will be a huge comfort to them to have their voices heard in such a powerful way in this Chamber.

Improving the special educational needs and disability system across the country is a priority for this Government. We want all children, regardless of where they are in the country, to get the right support to succeed in their education and lead happy, healthy and productive adult lives. Every child deserves the opportunity to achieve and thrive, but far from every child is getting that chance and, for far too long, families have been let down by a system that is not working. As my hon. Friend the Member for Basingstoke highlighted, a National Audit Office report last week echoed that, finding: a system that has totally lost the confidence of families; that children with special educational needs and disabilities are being failed on every measure; and that, despite the high-needs funding for children and young people with complex special educational needs and disabilities rising to higher and higher levels, the whole system is not delivering and is clearly in need of reform.

I want to give a sense of light at the end of the tunnel. Our promise to families is that we are completely committed to improving the SEND system and rebuilding the confidence that the education system will provide for every child. I know that there are families in the Gallery today, and I am glad that they are here to hear this message. Last week, we published independently commissioned insights showing that if the system was extensively improved, using early intervention and better resourcing in the mainstream schools, it could lead to tens of thousands more children and young people having their needs met without an EHCP and in a mainstream setting, rather than in a specialist placement.

To do that, we need to urgently improve the inclusivity and expertise in mainstream schools while ensuring that there are special schools that can cater to those with the most complex needs. As my hon. Friend the Member for Southampton Itchen (Darren Paffey) said, this requires a holistic approach to reform: getting more teachers into our schools; creating a voice for support staff, who we know are so crucial in supporting children with special educational needs and disabilities, through the school support staff negotiating body that we will bring forward in legislation; and improving training for support staff, teachers and leaders to ensure that we have a curriculum and assessment system that truly serves every child and enables them to thrive, with a broad curriculum that gives them the opportunity to have a rich education that taps into their skills and talents.

Of course, we also need to look at Ofsted and how it is motivating the school system to be as inclusive as possible. We want to see all schools co-operating with their local authorities on admissions, strengthening the accountability of the mainstream system to be more inclusive through Ofsted and supporting the mainstream workforce to have that SEND expertise.

We want to see early intervention and identification improved and supported, which is why—as the shadow Minister, the hon. Member for North West Norfolk (James Wild), said—we have announced that the ongoing funded support for schools registered with the Nuffield early language intervention programme will continue. It is so important that children get speech and language intervention support at the earliest stage possible, so that they can find their voice and we can identify challenges at the earliest stage possible.

As hon. Members have highlighted, improving the SEND system is vital to fulfilling our opportunity mission to break the unfair link between background and opportunity, and that starts with giving every child with SEND, along with all children in our system, the best start in life. But this is huge, complex reform: there is no magic wand or quick fix, and the Government cannot do it alone. That is why we will work with the sector. It is essential that we work with valued partners to ensure that the approach is planned and delivered together with parents, schools, councils and expert staff, who we know already go above and beyond to support children. We ask for patience, but we will work as fast as we can to make the changes that we know families are crying out for.

Following the Budget announcement yesterday, high-needs funding will increase by almost £1 billion in 2025-26 compared with 2024-25, which brings the total high-needs funding to £11.9 billion. The funding includes £90 million to increase the high-needs element of the 2024-25 core schools budget grant to the full-year equivalent, which will be incorporated with the other teachers’ pay and pension grants for 2025-26 to make sure that they are fully funded.

We are now in the process of calculating the high-needs national funding formula, which will provide local authorities with their indicative allocations for 2025-26. We expect to publish that by the end of November. The structure of the high-needs national funding formula remains largely unchanged in 2025-26 because we want to take time to consider what changes are needed to make sure that we establish a fair education funding system that directs funding to where it is needed and to support the special educational needs and disability reforms that we want to take forward. That will take time, so we ask for patience.

My hon. Friend the Member for Southampton Itchen asked specifically about the statutory override. We recognise the unprecedented pressures that local authorities find themselves under. We are providing almost £1 billion more for high-needs budgets in 2025-26, as I mentioned. The impact on individual local authorities’ deficits will be variable, and the statutory override is a temporary accounting measure that separates local authorities’ dedicated schools grant deficits from their wider financial position so that they can manage their deficits.

It remains important that every local authority continues to look at what it can do within the current system to manage its high-needs budget while continuing to provide the support that children with special educational needs and disabilities need. We are working to consider how we can help councils manage the impact of the dedicated schools grant deficits on their accounts within a SEND system that is in desperate need of longer-term reform.

With reference to Hampshire specifically, Ofsted and the Care Quality Commission jointly inspect local area SEND provision to ensure that there is a joined-up approach for children and young people. The inspections enable the Department to intervene in cases of significant concern and to work with local areas and professional advisers to try to address weaknesses that have been identified.

The last joint local area SEND inspection in Hampshire took place in March 2020. Inspectors visited a range of providers and spoke to leaders, staff and governors to determine strengths and weaknesses in the local area’s SEND provision. The inspection found that leaders in Hampshire at the time were highly ambitious for children and young people with SEND, and although the inspection did identify areas for improvement, it did not identify areas of significant weakness. Since that inspection, the Department for Education and NHS England have stayed in regular contact with Hampshire local special educational needs and disabilities officials to discuss the local area’s strategic direction and to offer support where needed.

As the hon. Member for Strangford (Jim Shannon) rightly pointed out in his characteristically constructive contribution, there is a significant need for the Department for Education and Department of Health to work closely together at a local level on this issue. Hampshire will be inspected under the new area SEND inspections framework, which came into effect in 2023, in due course

[Jim Shannon]

The Minister has very kindly given us some hope about the way forward. I should have mentioned the Department for Work and Pensions earlier. It is important that parents are aware of all the help in the system—for instance, there is disability living allowance. Whenever somebody comes to me with a child who has experienced educational issues, I always ask them, “Are you aware that there is a system set up to help you?” Is that something we should emphasise a wee bit more strongly?

[Catherine McKinnell]

The hon. Gentleman raises an important point. That should happen at the earliest possible point, because we know—I have mentioned this already—that children’s earliest years make the biggest difference to their life chances, and high-quality early years education can lead to much better outcomes for all children. Arrangements are in place to support early years providers and access to early education, including disability access funding and special educational needs inclusion funding, but he is absolutely right to highlight the ways in which we can help children and families to access support. If we do that at the earliest possible stage in a child’s life, we will be able to improve children’s outcomes and families’ experiences.

We want more children and young people to receive the support that they need to thrive in their local mainstream setting, which reduces the need for them to travel a long way to access a specialist placement. Many mainstream settings are going above and beyond to deliver specialist provision locally through resourced provision and special educational needs units.

We know that there will always be a place in the system for special schools and colleges for children and young people with the most complex needs, so the Department supports local authorities to provide those places for children and young people through annual high-needs capital funding, which can be used to deliver new places in mainstream and special schools as well as in other specialist settings. It can also be used to improve the suitability and accessibility of existing buildings, and we will set out plans for future high-needs capital funding in due course. The Government are committed to working with councils, school leaders and other sector partners nationally and in Hampshire to develop and improve inclusive education in the mainstream setting.

The hon. Member for North East Hampshire (Alex Brewer) raised concerns about transport. No child should struggle to get to school because of a lack of transport. Local authorities are obliged to arrange free travel for children of compulsory school age who attend their nearest school and cannot walk there because of the distance; because of a special educational need, disability or mobility problem; or because the route is not safe. There are additional rights to free travel for low-income households to help them exercise school choice, but we know how challenging home-to-school travel is for local authorities at the moment, in large part due to the pressures on the SEND system.

In our manifesto, we committed to improving inclusivity and expertise in mainstream schools, which will mean that fewer children have to travel long distances to a school that can meet their needs. It will also reduce the pressure on home-to-school travel. I am keen to understand how well the school travel policy is working to support children to access educational opportunities, and I will continue to work with officials in the Department and across Government to improve the situation, because transport is a cross-Government challenge.

I thank my hon. Friend the Member for Basingstoke again for bringing this matter forward and I thank all hon. Members who have contributed to the debate. We all care passionately about SEND outcomes in Hampshire and across the country.

[Jim Shannon]

I thank the Minister for her comprehensive and helpful response. In my contribution, I referred to “nurture” classes in a school in my constituency, which bring together and look after children with educational challenges in a big school. That is in the education system in Northern Ireland, of course, but I know the Minister always makes contact with the Education Authority there. As I said earlier, different regions have ideas that may be helpful elsewhere, so will the Minister consider that?

[Catherine McKinnell]

I thank the hon. Gentleman and I will take that away, because we are open to examples of good practice and ideas for reform that can be rolled out and used in other settings. We do not want the SEND system to work only in pockets; it must work everywhere and we must have a reformed system across the board.

[Luke Murphy]

Will the Minister give way?

[Catherine McKinnell]

I am glad that my hon. Friend has intervened, because it reminds me that I have still not answered a couple of his questions—I will come to them.

[Luke Murphy]

The Minister talked eloquently about how the Government intend to work with councils, providers and others on the reform of the system. How can parents like those I represent in Basingstoke and those represented by other hon. Members present inform and provide input into the future review and reform? Their experience and expertise would be incredibly useful.

[Catherine McKinnell]

My hon. Friend makes an important point, which the hon. Member for North West Norfolk also made. We are clear that the Government cannot deliver this work alone; it must be delivered with partners who are serving children in the community and in partnership with the families who we know are crying out for change. We are keen to consult and engage, and that must be done on as localised a basis as possible to get a real sense of the challenges in different areas. There are many common themes across the country, but there will be issues in particular areas that need to be addressed. I will take that point away and consider it.

Regarding the questions about education, health and care plans, figures released by the Department in September clearly show that children with special educational needs and disabilities are not having their needs addressed and are waiting far too long for action from a system that is currently creaking at the seams. Without further improvements, it is clear that it will just deteriorate further because a growing number of families need support. We know that local authorities have been affected by an increased demand for education, health and care plans, and that their workforce capacity to meet the demand has also been affected. A more efficient and effective service delivery, alongside communication with schools and families, is therefore central to improving the situation.

From this year, we are investing £21 million to train 400 more educational psychologists to support workforce capacity in local authority services, including for the delivery of statutory assessments. We will work as quickly as possible to ensure that there is more effective early identification, because, as I have already said, it is important to provide training to early educators so that we can identify the challenges that a child might face early in their life.

We will continue to monitor and work closely with any local authorities that have issues with their education, health and care plan timelines. Where we have concerns about a local authority’s capacity to make improvements, we will work with it to identify the barriers and to put in place effective recovery plans, which includes securing specialist SEND adviser support to help to identify the barriers to ECHP process timeliness and put in place plans for recovery.

There were questions about private schools and the VAT change. Private schools can provide choice, high-quality education, economic benefit and public benefit through partnerships, but most parents cannot choose private schools. We need to improve the provision for the 93% of pupils who are at state-funded schools—that is our focus. Parents who use private schools can pay to support that process by paying the VAT that would apply to other optional services. Ending the tax breaks that private schools currently enjoy will raise revenue to improve public services, including through the provision of 6,500 new teachers in our state-funded schools. Children whose place at a private school has been commissioned by a local authority—for example, under an education, health and care plan—will not be affected by the VAT change.

I absolutely acknowledge the hardship that too many families face when they try to secure the right support for their child with special educational needs and disabilities. I am determined that the situation will change, so I conclude by thanking all those working across the education, health and care systems in the interests of our children and young people with special educational needs and disabilities, both in Hampshire and across the country. We need to deliver the very best for all our children and young people, including children with special educational needs and disabilities, and the Government are determined to do that.

14:38

[Luke Murphy]

I thank all hon. Members who have contributed to the debate and I will conclude by referring to some of their remarks. I thank the hon. Member for Strangford (Jim Shannon) for highlighting the issue around early intervention, which many parents in my constituency have also recognised. I thank my hon. Friend the Member for Redditch (Chris Bloore) for recognising the great campaigning work of the parents who are here in Westminster Hall, and of parents in his constituency and across the country.

I thank my hon. Friend the Member for Southampton Itchen (Darren Paffey) for highlighting the fundamental shift that is needed in inclusive practices in schools, the issues around teacher training and the fundamental importance of resourcing a reformed system. I thank the hon. Member for North East Hampshire (Alex Brewer) for highlighting an important quote, which echoes the comments of many parents I have spoken to, suggesting that this should not be a fight against the system, but that the system should provide support. I also recognise the transport challenges that she highlighted.

I thank the hon. Member for North West Norfolk (James Wild) for recognising many of the issues I highlighted around early intervention training in mainstream schools and transport. Given how devastating the NAO report was, I gently suggest that he should acknowledge that that was a summation of where the system had got to over the last 14 years. None the less, I thank him for his contribution and the nature of the debate, which has been conducted in a cross-party manner. I also thank the Minister for recognising the challenges in the system and for her passion in committing to reforming the system and ensuring it works for parents and children in Basingstoke and across the country.

As other hon. Members have said, this is my first Westminster Hall debate and I thank the Minister and all hon. Members for contributing, as well as the Chair, the House officials and the officials from the Department. I also thank all the teachers and others in the education system in Basingstoke and beyond. I have had lots of conversations with primary and secondary school headteachers in my constituency who have talked about the challenges they face. I know that they struggle every day to do their best to provide opportunities for the kids who attend their schools. We must help them with that and ensure that it is not a struggle for them, the parents or the kids, but is instead a system that works and delivers for them.

Most of all, I thank the families and parents who have raised the issue with me. I look forward to continuing to campaign with them and to working with the Government and hon. Members on both sides of the House to ensure that we build a truly inclusive education system where every child has the opportunity to succeed.

Question put and agreed to.

Resolved,

That this House has considered SEND provision in Hampshire.

14:12

Sitting suspended.

Cancer Strategy for England

Thursday 31st October 2024 Westminster Hall

[Mr Clive Betts in the Chair]

15:00

[Clive Jones (Wokingham) (LD) [R]]

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.

[Ian Sollom (St Neots and Mid Cambridgeshire) (LD)]

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?

[Mr Clive Betts (in the Chair)]

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

[Clive Jones]

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.

[Rachael Maskell (York Central) (Lab/Co-op)]

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?

[Clive Jones]

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?

[Rachael Maskell]

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.

[Clive Jones]

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.

[Several hon. Members rose—]

[Mr Clive Betts (in the Chair)]

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.

15:23

[Tony Vaughan (Folkestone and Hythe) (Lab)]

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.

15:28

[Sir Roger Gale (Herne Bay and Sandwich) (Con)]

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.

[Mr Clive Betts (in the Chair)]

I call Noah Law.

[Noah Law (St Austell and Newquay) (Lab)]

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

[Mr Clive Betts (in the Chair)]

Jim Shannon probably will want to make a speech.

15:33

[Jim Shannon (Strangford) (DUP)]

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.

[Noah Law]

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?

[Jim Shannon]

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.

15:40

[Claire Young (Thornbury and Yate) (LD)]

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.

15:45

[Mr Will Forster (Woking) (LD)]

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.

15:48

[Tessa Munt (Wells and Mendip Hills) (LD)]

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.

[Mr Clive Betts (in the Chair)]

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—

[Max Wilkinson (Cheltenham) (LD)]

Sorry, Mr Betts— I wanted to speak.

[Mr Clive Betts (in the Chair)]

Sorry; please take just three minutes.

15:56

[Max Wilkinson (Cheltenham) (LD)]

It is an honour to serve under your chairmanship, Mr Betts, and I will be as brief as I possibly can be. I thank my hon. Friend the Member for Wokingham (Clive Jones) for securing this important debate.

Two days ago, it would have been my father’s 64th birthday, but sadly he died of lymphoma in 2018 aged just 57. Recently my family marked 18 months since my wife was given the all-clear after ovarian cancer. It is thanks to the skill of a highly-qualified surgeon, who removed an absolutely huge lump from her body, that she is with us today and I am very grateful to them every single day.

Much has been said about the need for a national cancer strategy. I will offer the Minister one local opportunity, and it is an opportunity because the previous Government, despite taking some political credit for it in Cheltenham, failed to offer very much money to the Big Space Cancer Appeal to revamp Cheltenham general hospital’s oncology centre. As a regional cancer centre, Gloucestershire hospitals NHS foundation trust treats thousands of patients each year, but many of its buildings are now at end of life, many of the rooms have no natural light, and the outdated design is unsuitable for the number of patients in need of treatment.

We know that identifying cancer early and beginning treatment soon afterwards is key to giving people the best chance of survival. The staff at the trust work very hard but they are working under huge pressure and it is no secret that, as others have mentioned, targets are routinely missed. Our local trust is not alone in that. Many staff in the trust feel that the current space is not fit for purpose, and that certainly will not help their best efforts. That is why the trust has launched the Big Space Cancer Appeal. That situation is representative of the challenge we face in not having a strategy for dealing with cancer. The last Government gave almost no money for the project, and the £17.5 million that is being raised in Cheltenham is almost the entire capital cost of the project.

The new centre will offer patients a modern space and a better environment for treatment, healing and recovery. It will have modern consulting rooms, allowing more patients to be treated every day. That will help to cut down waiting times, so that targets can be hit and patients get better outcomes. For some people, this will mean the difference between life and death.

You asked me to be brief, Mr Betts, so I will draw my remarks to a close by thanking Dr Sam Guglani, Dr Charles Candish and all the staff at the trust’s charity—the initiative is charity-led but backed by the trust, which does not itself have the funding to deliver it. I also thank Dr Diane Savory, who has been working extremely hard on the project.

If the Government are looking for opportunities to invest in cancer care—we have already heard about some of the consequences of not doing so in my area from my hon. Friend the Member for Thornbury and Yate (Claire Young)—I urge them to get in touch, because there is a real opportunity with this project to make a huge difference on the ground.

[Mr Clive Betts (in the Chair)]

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.

15:54

[Mr Paul Kohler (Wimbledon) (LD)]

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.

[Mr Clive Betts (in the Chair)]

For the Opposition, I call Ben Spencer.

16:03

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

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. 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?

[Mr Clive Betts (in the Chair)]

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.

16:15

[The Minister for Care (Stephen Kinnock)]

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.

16:25

[Clive Jones]

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.

16:29

Sitting adjourned.