Accessibility of Radiotherapy

Tuesday 4th February 2025 Westminster Hall

16:31

[Tim Farron (Westmorland and Lonsdale) (LD)]

I beg to move,

That this House has considered the accessibility of radiotherapy.

It is a great honour to serve under your guidance, Sir John, and it is a great privilege to have the opportunity to raise the issue of the accessibility of radiotherapy on World Cancer Day.

Three quarters of those in my communities in Westmorland live dangerously too far from radiotherapy treatment. It has been my privilege over the years to drive a number of my constituents to the Rosemere centre at Preston to get treatment, and I am always struck by the quality of the treatment and the warmth and professionalism of the staff, but also by the gruelling impact on my constituents, on whom the daily lengthy journeys take a terrible toll.

[Daisy Cooper (St Albans) (LD)]

I am grateful to my hon. Friend for giving way so early in his speech. He mentioned travel times. Travel times to radiotherapy for my constituents in St Albans and Hertfordshire would certainly be much reduced if the relocation of the Mount Vernon cancer centre to Watford General could proceed, and the only way for that to happen is if the new hospital programme goes ahead sooner than is currently planned. Would he agree with me that shortening the travel time would provide a much better service for local residents?

[Tim Farron]

Yes, I absolutely do agree with my hon. Friend. Travel times, which I will come on to in a moment, do have an impact on outcomes—in other words, whether people survive—because there is an impact on the extent to which a person will be referred for treatment depending on how close they are to the nearest site. What she says is absolutely right, especially for her communities.

For my constituents, the two, three or in some cases four-hour round trip to the excellent but distant Rosemere cancer unit at Preston is not just inconvenient, but debilitating and cruel. It means that many do not complete their treatment, and many choose not even to start such treatment. Some do not even get referred for radiotherapy in the first place, because clinicians understandably conclude that the patient is not strong enough to cope with the rigours of travelling such distances so frequently. For us in Westmorland, longer journeys mean shorter lives.

[Steff Aquarone (North Norfolk) (LD)]

I congratulate my hon. Friend on securing such an important debate, especially on World Cancer Day. In my constituency of North Norfolk, Radiotherapy UK found that nobody can access radiotherapy treatment within 75 minutes by public transport. Does he agree that we need a two-pronged approach to tackle this—to fix our broken public transport infrastructure and to make more services available closer to where people are, such as at Cromer hospital in my constituency?

[Tim Farron]

My hon. Friend is absolutely correct. Back at the time of the last Labour Government, the national radiotherapy advisory group recommended that it was bad practice for anybody to live beyond 45 minutes of a radiotherapy centre one-way, or a round trip of an hour and a half, yet so many people—7.5 million people—including his constituents and my constituents, live beyond that.

[Anna Sabine (Frome and East Somerset) (LD)]

On that specific point, I do not want to show off about who has the worst travel times for radiotherapy, but nobody in my constituency of Frome and East Somerset who does not own a car lives within that recommended 45-minute NHS travel time. Does my hon. Friend agree that reliable, quick and affordable public transport is key, and that the recent increase to the bus fare cap has not helped with the situation?

[Tim Farron]

Yes. By definition, almost all of the radiotherapy deserts—those places that are beyond sensible and safe travelling times—are rural communities. As a result, they have terrible public transport. It is not just about the cost. The increase in the bus fare cap is hugely damaging, but for many of our communities—my hon. Friend’s and mine alike—it almost does not matter what the bus cap is; if there is no bus to spend the fare on, people are stuffed, really. That has a huge impact on their cancer outcomes, which means whether they survive or not.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

Could the reason that radiotherapy is used in only 35% of cases, rather than 50% of cases, be that local transport just does not exist to take people to have the treatments that they need?

[Tim Farron]

My hon. Friend makes a good point. There is a combination of reasons, which I will come on to in a moment, but distance from treatment is undoubtedly the critical point that decides whether people can access and take advantage of lifesaving and life-prolonging treatment.

[Jim Shannon (Strangford) (DUP)]

rose—

[Tim Farron]

I feel that the hon. Member has a point to make.

[Jim Shannon]

First, I commend the hon. Member for championing this issue for all the years I have known him in this House. He deserves credit for that, he has got this debate in Westminster Hall today, and we are looking to the Minister for a response. Does the hon. Member agree that the issue goes more widely, and is also about recruitment? Training and retention of clinical oncologists is needed, with only seven in 10 training places filled in 2024. Does he agree that there is a way forward—bursaries for students, which could begin to fill the training needs in the long term? Students would understand that they will not live under the burden of student debt if they pick a career for life—in other words, help them with a bursary and the NHS will have them forever.

[Tim Farron]

I completely agree with the hon. Member. Many people watching the debate today, whether physically in the Gallery or on television outside, are part of that outstanding workforce, and we are massively grateful to them. What a career for someone to be in, where you are saving lives every day and alleviating pain. That is a wonderful thing, yet there are not enough of them. The workforce is part of the solution, as well as the challenge, to the problem that we face.

For us in Westmorland, longer journeys mean shorter lives. The answer is clear for us in Westmorland, and that is to build a satellite radiotherapy unit at the Westmorland general hospital in Kendal as part of the Rosemere unit, following the model of the many excellent satellite units around the UK. The number of cancer patients travelling from south Cumbria each year for radiotherapy provides demand for at least one linear accelerator at the Westmorland general hospital. If the experience of other new satellite centres around the country is replicated, such as at the new Hereford site, which is a satellite of Cheltenham, a satellite centre in Kendal would attract at least 20% more patients than existing demand, because people who would not have had radiotherapy treatment at all beforehand would now be able to access it, simply because it is closer to them. That a satellite unit in Kendal has not already happened is an indictment of the lack of responsiveness to the obvious need from NHS England, and of a lack of concern for cancer patients and their families who live in rural communities.

[Sorcha Eastwood (Lagan Valley) (Alliance)]

I commend the hon. Member for his advocacy on this subject over a long time. The satellite centres are one thing. I represent Northern Ireland and my constituency of Lagan Valley, and I note that there are people in the Gallery involved in the All-Island Cancer Research Institute. Does he agree that geography is important and that cancer knows no boundaries, so our efforts to tackle it should also know no boundaries?

[Tim Farron]

The hon. Member makes wonderful points, and it is absolutely right that in every corner of the United Kingdom we need to ensure that we have the staffing, the kit and the level of technology to meet need close enough to where people live for people to be kept safe and treated in a convenient way.

In Westmorland, we successfully campaigned to bring chemotherapy, greater amounts of surgery and a new diagnostic hub to Kendal. All of that is welcome, and all of that has saved lives. I am unbelievably grateful to all those in our communities who campaigned alongside us, and to the wonderful NHS professionals who deliver and run those services, but the failure of successive Governments, including the one I was a part of, and NHS management to take the people of Westmorland out of the radiotherapy desert is utterly inexcusable given the multiple opportunities to do so over the last 30 or so years.

So my first ask of the Minister is that he takes a personal interest in the call for a satellite radiotherapy unit at the Westmorland general hospital in Kendal, and that he meets with me and with oncologists, commissioners and patients, to kickstart that bid.

[Adam Dance (Yeovil) (LD)]

Does my hon. Friend agree that we must also do more to help local groups providing clinical and non-clinical support for radiotherapy patients after treatment, such as the Macmillan radiotherapy late effects service and the Cancer Connect group in my constituency of Yeovil?

[Tim Farron]

My hon. Friend makes a great point and does a great service to his community by standing up for those groups who support people after cancer, and their families. I know that personally in my own family, so I congratulate him on making a really important point.

My second ask—the Minister should be delighted to hear that I only have two—is that he separately meets with the all-party group on radiotherapy and the leading fantastic clinicians who support us, to look at how the Government and NHS England can turn the tide on radiotherapy nationwide, because the problems of access do not just affect Westmorland; they affect the whole country.

Although in Westmorland our issue is unacceptable distance from services, the problem across the country is that we lack sufficient capacity, lack up-to-date technology, and lack an effective workforce plan. Britain is behind our neighbours on the number of radiotherapy machines, and we are behind our neighbours in how advanced that machinery is. In France, for example, there are twice as many linear accelerators per head as we have in the United Kingdom. Across the OECD, roughly 9% of cancer budgets are spent on radiotherapy; in the UK we spend a paltry 5%. One in two of us will have cancer at some point, and one in two people with cancer should have radiotherapy—to be precise, 53% of us should—yet only 35% of cancer patients in the UK had radiotherapy as their primary treatment. In fact, the regional variation in access to radiotherapy ranges from the lowest of only 29.8%—by the way, that is in my constituency—up to 50%.

There are shocking variations based on tumour type, too. Only 11% of lung cancer patients in some regions receive radiotherapy, compared with 43% in other regions. Only 18% of rectal cancer patients receive radiotherapy in some areas, compared with 62% in others. People’s chances of surviving should not depend on their postcode. Inadequate and inequitable radiotherapy capacity is costing lives. Over the past decade, more than 500,000 patients have waited more than two months for their first cancer treatment. Yet the chilling reality is that for every four weeks of delay in treatment we have a 10% reduction in our chances of surviving.

The Royal College of Radiologists reminds us that in 2024 only 38% of patients starting radiotherapy did so within two months of an urgent referral for cancer. The national target is 85%. Let us compare that with other forms of cancer treatment: 68% of patients had surgery for their cancer in that time, and 64% started chemotherapy within that two months. That means that over 10,000 patients requiring radiotherapy received their treatment after the recommended timeframe. In 2023 some 92% of cancer centres reported delays in patients starting radiotherapy. That is one of the main reasons why the UK is near the bottom of the OECD cancer outcome rankings, which is a sanitised way of saying that people with cancer in Britain are more likely to die sooner than in other equivalent countries. So longer journeys mean shorter lives, and longer waiting times also mean shorter lives.

[Alex Easton (North Down) (Ind)]

Thank you, Sir John, for your chairmanship today. In Northern Ireland, one in two people who need radiotherapy do not get it at an early stage. Does the hon. Member agree that a strong focus on awareness and early diagnosis is needed?

[Tim Farron]

That is a good point. Early diagnosis is vital. We are getting a bit better at it, but it would be a tragedy if we diagnosed people but then did not treat them early enough to cure them. The hon. Gentleman makes a good point on behalf of his communities.

If we cannot cope with treating the number of cancer patients we are seeing now, how will we deal with the projected 30% increase in cancer cases by 2040? The good news—the very, very good news—is that it does not need to be this way. The upcoming cancer plan, of which we have heard an outline today, is an opportunity to supercharge cancer services and transform a culture of normalising unacceptable delays into one that drives continuous cancer care improvements. However, without decisive and radical action and leadership, lives will continue to be lost needlessly.

[Torcuil Crichton (Na h-Eileanan an Iar) (Lab)]

It is a pleasure to serve under your chairmanship, Sir John. I was very struck by the hon. Gentleman’s comment about longer journeys meaning shorter lives. There is no competition on journeys, of course, but my constituents in Na h-Eileanan an Iar and the Western Isles face some of the longest journeys in Britain to get cancer treatment, outwith and within the constituency. Somebody from Barra, for example, faces a three-day journey to Stornoway by boat, taxi and aeroplane for therapy and then a return journey over three days. I hope that that can be changed by sending people directly to Glasgow or, perhaps even better, by implementing a public service order to restore flights between one end of the island and the other. I commend the hon. Gentleman for securing the debate and for his very telling comment about longer journeys meaning shorter lives.

[Tim Farron]

I am extraordinarily fond of the hon. Gentleman’s constituency, which he represents well. He makes an important point about travel times. In some parts of my constituency, people need to take a ferry to get from one place to another, but it is not quite as common as in his constituency.

At the heart of the radical, lifesaving transformation that we need through the cancer plan must be the elevation of the unsung hero, the Cinderella of our cancer services: radiotherapy. Lord Darzi found that 30% of patients are waiting more than 31 days for radical radiotherapy. As the incidence of cancer grows, the urgent need for quicker and more efficient treatments such as radiotherapy is only increasing.

As things stand, the replacement and updating of linear accelerators is left to the 52 separate cancer units in England—52 separate procurement operations, 52 different finance officers trying to balance the books and 52 different heads of service all trying to meet increasing demand, often without the time and space to look beyond the horizon. It is time, then, to centralise the commissioning of the technology to ensure a constant focus on updating and expanding radiotherapy. That would immediately start saving lives everywhere.

Radiotherapy UK estimates that simply replacing all the out-of-date LINACs could free up 87,000 additional appointments every single year. Modern radiotherapy is quicker and more accurate than other treatment. It is also by far the cheapest, costing between £3,000 and £7,000 per patient—several times less expensive than equivalent cancer treatments. The Government’s £70 million commitment to radiotherapy services was welcome, but in reality, as the Minister says, that money would cover the cost of only 26 LINAC machines, fewer than half the number that are currently operating beyond their sell-by date. Erratic one-off rounds of funding do not address the need for a sustainable rolling programme of machine replacement to enable planning, support procurement and improve access for patients. Even the new machines are often old technology. What a terrible waste.

In my years of campaigning on this matter, I have found that radiotherapy lacks funding and prominence. Britain therefore lags behind our neighbours, so people tragically die when they do not need to—all because of a lack of leadership and drive from the centre. On more than one occasion, I have almost seen the penny drop on the faces of Ministers of all parties when it comes to our failure on radiotherapy, but every time so far, I have seen that zeal founder on the rocks of bureaucratic sluggishness, indifference and resistance to change within the NHS. If they show the leadership that we desperately need, the Minister and the Secretary of State will have the enthusiastic and active support of the all-party parliamentary group on radiotherapy, and of the army of outstanding clinicians who are out there saving lives.

Professor Mike Richards is a name that many people remember. He was the cancer tsar in the early noughties, under the previous Labour Government; he did great work and his achievements were tangible. If the Government will forgive me for using shorthand, we basically need a Mike Richards for radiotherapy, and we need them, like, yesterday. Failing that, tomorrow morning would just about do. Every day we delay, my constituents—as well as yours, Sir John, and those of the Minister and of all Members present—are dying unnecessarily.

We need new technology as we plan treatments, too. Last May, £15.5 million was announced for AI technology that would save clinicians time and reduce radiotherapy waiting lists. However, we have heard from cancer units around the country that this funding may be withdrawn or diverted, which would be a hammer blow to trusts in the face of the ongoing workforce crisis. Will the Minister take the chance today to reassure our cancer units and confirm that this funding will go, as promised, to radiotherapy departments in full? I hope the Minister will also act swiftly to tackle the perversities of the tariff payments for radiotherapy, which effectively punish trusts for treating cancer patients in the most effective and modern ways.

I ask the Minister to guarantee that radiotherapy will be at the centre of the NHS 10-year cancer plan, and that that plan will be led by people empowered and determined to deliver it. The technology is vital, but the people matter just as much. Our specialist and highly skilled radiotherapy workforce numbers only 6,400 people, yet the survey conducted by Radiotherapy UK shows that one in five cancer doctors may leave the profession in the next five years. We have a 15% shortage in clinical oncologists—set to rise to 21% by the end of this Parliament—and 30% of oncologist training posts were vacant last year. On top of that, 50% of clinical technologists are over 50 years old, and 84% of heads of cancer services reported that they were concerned that workforce shortages affected the quality of patient care.

I ask the Minister to agree that the 10-year cancer plan will include a renewed investment in workforce and infrastructure. A 10-year vision already exists, by the way—drawn up by the experts, via Radiotherapy UK. I simply urge the Minister to consider their findings and borrow the proposals detailed by leading oncologists and cancer experts.

I have asked for two separate meetings today. The first is on the need for a satellite radiotherapy unit at Kendal; the second is a first meeting for the Minister with the all-party parliamentary group on radiotherapy, to look at the national picture. I hope he will grant me both.

The radiotherapy lobby is tiny: 6,400 dedicated professionals within our health service; a compact but awesome group of charities and volunteers; a handful of companies building the technology, many of which are based in the United Kingdom; England’s captain fantastic, Bryan Robson; and a small band of MPs of all parties, seeking to be a voice not just for the radiotherapy sector, but for the thousands and thousands of people living with cancer in our country, who deserve the best treatment that we can give them. For the last generation or more, the UK has let those people down, and so often with tragic consequences. Yet radiotherapy is a cost-effective, easily deliverable technology that will save lives in every community in this country.

We are way behind where we need to be, yet it would be so easy, with the right leadership from Ministers, to catch up with and go beyond our neighbours. Cancer no longer needs to be seen as a death sentence; it is a disease that can be treated and cured, but we cannot do that if our systems and practices prevent us from deploying the best treatments available. Please save lives, Minister, and become our radiotherapy champion.

[Sir John Hayes (in the Chair)]

This is a short debate. I intend to call the first Front-Bench speaker at 5.08 pm.

16:53

[Clive Jones (Wokingham) (LD)]

It is a pleasure to serve under your chairship, Sir John. I thank my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron) for securing this debate and for his dedication on this issue. I declare an interest as a governor of the Royal Berkshire hospital. I also have a family member who has shares in a medical company.

Radiotherapy access suffers from geographical constraints, and this issue cannot be solved until the significant workforce challenge is addressed alongside it. The Royal College of Radiologists states that in England the NHS faces a 30% shortfall in radiologists. That figure is projected to rise to 40% by 2028, yet more than a fifth of NHS trusts have implemented recruitment freezes. Shortfalls in recruitment mean that consultants, faced with burnout and impossible workloads, retire earlier. That is made especially clear as the average age of retirement is just 54.

The Royal College of Radiologists highlights the absurd situation whereby newly trained consultants may struggle to find jobs, forcing invaluable radiologists and oncologists to go for locum jobs, move abroad or leave the healthcare sector altogether at a time when their skills are best placed in our NHS to fix our cancer care crisis—a crisis in which not a single integrated care board is currently meeting its cancer waiting time standards.

The impact of the recruitment freezes on patients is tangible and is not limited to radiotherapy. Some 80% of patient pathways in the NHS are reliant on radiology. Delays in scan reporting result in delayed treatment. Delayed treatment results in worse outcomes. Worse outcomes may be the deciding factor in whether someone fails to recover.

How will the Government ensure that when my Wokingham constituents visit the Royal Berkshire hospital, the oncology and screening departments are fully staffed? Can the Minister explain his understanding of the recruitment freezes that are taking place across NHS trusts? I am aware that the Minister has a very, very busy diary: he told me so earlier today in the main Chamber.

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

I suspect that my diary will be a little busier with the two requests from the hon. Member for Westmorland and Lonsdale (Tim Farron).

[Clive Jones]

The Minister’s diary will be a little busy, but I am sure it can cope. I ask him to meet me and representatives of the Royal College of Radiologists to discuss the Government’s plan for workforce reform.

[Sir John Hayes (in the Chair)]

I am delighted to be able to call the Front-Bench spokesmen early, although that does not necessarily mean that they have to go on at immense length. I call the Liberal Democrat spokesman.

16:57

[Helen Morgan (North Shropshire) (LD)]

Thank you very much, Sir John. It is a pleasure to see you in the Chair. I promise that I will not go on at great length, partly because—

[Tim Farron]

Because I did!

[Helen Morgan]

Well, my hon. Friend did go on at great length. He has secured a really important debate for World Cancer Day; it is an honour to speak in it for the Liberal Democrats. He outlined the issues comprehensively; I am not sure that I could improve on what he said. I welcome the Government’s announcement earlier today on the national cancer strategy and I highlight the excellent work of my hon. Friend the Member for Wokingham (Clive Jones), who campaigned for it.

Cancer services in general have declined to an unacceptable level, as I think everyone would agree. I hope that the Government stick to their word on addressing that issue and ensuring that everybody can access the care they need, when they need it and—as my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron) pointed out so eloquently—where they need it.

In the UK, over 100,000 cancer patients receive radiotherapy treatment each year from a specialist workforce of 6,400 professionals. Cancer is one of the most difficult diseases—it is difficult for individuals and it is difficult for their families—and yet the number of patients who have waited over four months to receive cancer treatment has more than doubled since 2020.

Like so many areas of NHS care, the time people have to wait and the quality of care that they receive depends hugely on where they happen to live. That has to change; I hope that the Government will make that one of their urgent missions. People’s chances of surviving should not depend on their postcode.

NHS data shows that the west midlands had over 150,000 radiotherapy attendances in 2022, which is the most recent available data. That is the highest of all regions, yet hospitals such as Shrewsbury and Telford hospital in my constituency have had some of the worst waiting times. In September 2024, at the Shropshire, Telford and Wrekin trust, only just over half of patients requiring radiotherapy met the 62-day treatment standard. The target for treatment is 85%.

It is important to acknowledge that the situation at Shrewsbury and Telford hospital trust is improving—I welcome that—and that it was impacted by the staff shortages that many hon. Members have outlined today. But it is not just about numbers and statistics; it is about the impact on people’s lives. I think my hon. Friend the Member for Wokingham has pointed out the importance of scans, and some of my constituents who are undergoing cancer treatment have waited a long time for scans and say that sometimes they have not had the result of a scan until their next treatment was due. That is due to staffing shortages.

Waiting times are important, but so too are distances, particularly when somebody is poorly and finding it difficult to travel a long way. People in Shropshire are served in Shrewsbury, so I am glad to say that the distance issue is perhaps not as acute as it might be in other rural areas in the country, but the public transport issue remains so. Many people rely on friends and family to drive them to appointments, as there is no other reliable way of getting there and a taxi is simply too expensive for them to consider. For that reason, some will not be accessing the care that they need. Across the country, 3.4 million people live further away than the target of 45 minutes from a radiotherapy centre, so it is important that we address those radiotherapy deserts and ensure that people can access the care that they need.

In addition to the outdated, sparse machines and low morale, we found that 65% of staff felt that they did not have enough machine capacity and 93% felt that workforce numbers were too low. Therefore, in addition to the long distances involved, we must put an end to the problem of people being unable to be treated not just because they live a long way from the equipment, but because the equipment, when it is available, is outdated or because there is nobody to staff it properly and interpret what needs to be done.

My hon. Friend the Member for Westmorland and Lonsdale has said all this before, so I will draw my remarks to a conclusion. The Liberal Democrats would boost cancer survival rates by introducing a guarantee that 100% of patients would start treatment within 62 days of their urgent referral. We need to replace the ageing radiotherapy machines and increase the number of machines, so that no one has to travel too far for treatment. We need to recruit nurses, cancer nurses and the specialist staff required to staff the radiotherapy machines. We would also like to see a cancer survival Bill, requiring the Government to co-ordinate and ensure funding for research into those cancers with the lowest survival rates. I hope the Minister will be making cancer a top priority for the new Government and push to reinstate the UK as a global leader in cancer research and, most importantly, in cancer outcomes.

I welcome the commitment already made to invest £70 million in replacing ancient machines and delivering new ones, but I hope the Minister will consider where that investment is distributed so that we can address the urgent problem of treatment deserts. I hope that he will also consider that this is a spend-to-save issue—radiotherapy treatment is both effective and cost-effective, and a worthwhile investment for the NHS to consider from a financial perspective.

I also want the Minister to commit to introducing a 10-year workforce plan for radiotherapy as part of the national cancer strategy to which the Government are already committed, to ensure that people get the care they need, when they need it, with the appropriately qualified professionals necessary to deliver it.

Finally, we must address the problem of building space. Many of our hospitals, as we all know, are crumbling. Care must be delivered in an appropriate setting, as my hon. Friend the Member for Wokingham has outlined on a number of occasions. In conclusion, we welcome the Government’s steps so far, but I would like to push them to go further.

[Sir John Hayes (in the Chair)]

Thank you, Helen; as you predicted, your speech was pointed and not too long. I now call the shadow Minister.

17:03

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a great pleasure to serve under your chairmanship this afternoon, Sir John.

As we discuss the future of radiotherapy services, it is essential that we acknowledge the vital role our radiographers, medical physicists and oncologists play, along with all the nursing staff and others, in the delivery of care.

The professionals are the backbone of any successful radiotherapy service, and without them progress is impossible. However, it is clear that Governments have faced significant challenges in both staffing and infrastructure. I will take this opportunity to scrutinise the current state of radiotherapy services and the plans to address those concerns. The demand for radiotherapy has increased substantially in recent years, driven primarily by one factor: our ageing population, and the fact that as we grow older our chances of being diagnosed with cancer increase significantly. However, radiotherapy is and remains one of the most cost-effective treatments available within the NHS. Previous Governments recognised that fact, and between 2016 and 2021 they invested £162 million to enable the replacement or upgrade of approximately 100 radiotherapy machines.

Since April 2022, the responsibility for investing in new machines has sat with local integrated care boards in England, supported by the 2021spending review, which set aside money for the purpose. As hon. Members have said, to keep up with increasing demand and the need for cutting-edge care, there must be significant sustained investment in radiotherapy services. Radiotherapy is one of the most technologically advanced areas of healthcare, so it is incumbent on us to keep up with the latest scientific developments.

It is welcome that the Government have announced £70 million for new radiotherapy machines, but Radiotherapy UK has said that that is not enough and has suggested that the Government invest five times that amount to upgrade out-of-date machines. I would appreciate clarification on that point. The Government have consistently stated in written answers that funding for new radiotherapy machines will be allocated by ICBs using criteria set by NHS England, but how will they monitor the upgrading of the machines across ICB areas to ensure that that takes place and to prevent the postcode lottery that Members have described? Furthermore, NHS England has confirmed that it will give high-performing local systems greater freedom around capital spending. Will such freedoms include capital retention, which can be used to invest in new radiotherapy equipment?

One of the most pressing issues is the need for a comprehensive long-term strategic plan for radiotherapy from the Government. The absence of such a plan hinders the ability to think strategically about the future of cancer care and to make the necessary investment to meet growing demand. I am glad that today, World Cancer Day, the Government have committed to produce a new cancer plan. We are told that it will include details about how outcomes for cancer patients, including waiting times, will be improved. Will the Minister indicate whether it will provide specifics on the roll-out of radiotherapy machines in the short, medium and long term?

In response to a written question last month, the Minister clarified:

“NHS England does not hold any data on the effectiveness of radiotherapy machines relative to the number of doses that they deliver.”

Hon. Members have said that newer machines will be able to deliver more doses more quickly. I would be interested to know whether the Department has any plans to collect such data.

Of course, any strategic plan should focus not just on the machines, but on the people who operate them—the radiotherapy workforce. What steps are the Government taking to improve the recruitment and retention of the radiotherapy workforce?

In a written question, the hon. Member for Westmorland and Lonsdale asked the Government whether they had consulted or planned to consult with clinical experts, the radiotherapy industry, patients or charities about how best to allocate the funds announced in the Budget for the new radiotherapy machines. The Minister responded by saying:

“The Department has no plans to consult on this matter”,

and reiterated that the funding would be allocated using NHS England criteria. The Minister today announced the plan to produce a cancer strategy. Will that include radiotherapy? Will he commit to working with Radiotherapy UK and providers to improve access to radiotherapy treatment where it is currently lacking?

The hon. Member for Westmorland and Lonsdale (Tim Farron) made a very compelling case about long journeys. He spoke about a service in his constituency, and there are others that are similarly affected. We know that earlier treatment affects survival rates. I asked the Minister a question in the main Chamber earlier about the 62-day target, and I did not hear him answer. Will he confirm that he intends to stick to the Health Secretary’s previous commitment to reaching the 62-day target by the end of this Parliament?

In addition to Government investment, the private sector plays a role in ensuring the future success of radiotherapy services. The NHS has signed a significant partnership agreement with the independent sector to increase capacity for diagnostic and elective procedures, which will help to reduce waiting times, but it is not clear whether that agreement includes treatment equipment such as radiotherapy machines. Will the Minister confirm whether the Government will work with the independent sector to upgrade equipment such as radiotherapy machines? A partnership that includes capital investment in radiotherapy equipment could ease the burden on the NHS and speed up access to treatment for patients.

I know the Minister is hugely motivated to do all he can to improve cancer care, as we all are. This debate should have helped to give him a steer on how that can be achieved.

[Sir John Hayes (in the Chair)]

I ask the Minister to leave a few moments for Mr Farron to say a final word of wind-up, and Mr Farron, in turn, to leave me a few moments to put the question.

17:09

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

It is a pleasure to serve under your chairmanship, Sir John. I thank the hon. Member for Westmorland and Lonsdale (Tim Farron) for bringing this important debate to Parliament on World Cancer Day, and other Members for their contributions on this really important topic. I am happy to meet the hon. Member and his colleagues from the all-party parliamentary group on radiotherapy to discuss these issues further. I suspect that my diary is going to get busier, but I am more than happy to meet the hon. Member for Wokingham (Clive Jones) as well, to ensure that we get this aspect of the national cancer plan absolutely right.

To answer one of the questions put by the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), the national cancer plan will include radiotherapy—it would be odd if it did not, given the importance of radiotherapy—and I will work with Radiotherapy UK and others with an interest in this area. That is partly why we have launched our call for evidence today: to get the views and opinions of as many people and organisations as possible, so that we get the plan right. It has to be fit not just for 2025, but for 2035 and the years in between, so there is a lot of work to be done.

We know that cancer patients are waiting too long for treatment. That is why we are taking immediate action to kick-start the recovery of the NHS with a commitment to cut waiting times that will benefit all, including those with cancer. In our 10-year plan for the NHS, we committed to return our national health service to constitutional standards, including on cancer.

By investing in our workforce, a point made by several hon. Members, and allocating £70 million for new radiotherapy machines, we will reduce cancer waiting times and give more patients access to state-of-the-art treatments. Fixing the NHS also requires reform. This year, we will publish our 10-year health plan to help build a health service fit for the future and, as I have already mentioned, we are today announcing the launch of a call for evidence for a dedicated national cancer plan, another step towards unleashing our country’s potential as a world leader in saving lives from this deadly disease. I encourage everyone to have their say by responding to the national cancer plan call for evidence.

I assure hon. Members that the priority of this Government is to ensure that radiotherapy is available quickly to those who need it. Radiotherapy is a crucial treatment for many cancer patients, as it can shrink tumours very effectively. Although the vast majority of the population are located within reasonable distance of where they would go for treatment, I am very aware that that is not always the case, particularly in rural communities.

I can give a family example. My dad, who sadly died two years ago from a very rare and aggressive form of rectal cancer, benefited from superb treatment at the Christie in Manchester, which is our local cancer hospital. He had chemotherapy, immunotherapy and radiotherapy. The radiotherapy shrank his tumours, and that almost certainly gave him an extra two years of quality life with his family, including his great-grandson. I will forever be grateful that he received that.

One day, though, we took him to the Christie and he got chatting to somebody who was also receiving radiotherapy. This is pertinent to the hon. Member for North Shropshire (Helen Morgan), who leads on these matters for the Liberal Democrats, because this person was from Shropshire. My dad is Salopian born—he was born in Shrewsbury and brought up in High Ercall, before being dragged to Manchester in the 1950s when my grandad got a job as the chief accountant at Manchester education committee—and they got talking. “You’re really from Shropshire and you’re coming to Manchester for radiotherapy?” It was the nearest place that had that treatment available at that time. It really hit me then how sporadic these things are, and how some people have to travel unacceptably long distances. We need to make sure that in our national cancer plan, we look at the deserts and the accessibility issues.

[Tim Farron]

I would not be doing my job at all well if I did not pursue the Minister on this point. Earlier, he very kindly talked about meeting the all-party group to talk about the national picture, and I want to press him on our local bid to tackle the problem he has just spoken about. Will he meet me and local oncologists to talk about how we can deliver a radiotherapy satellite centre in Kendal?

[Andrew Gwynne]

I was just coming to that—the hon. Gentleman has obviously started to read my notes from a distance. I am aware that he met representatives of the previous Government to discuss the possibility of a satellite unit in his local area. The situation is the same now as it was then: it is the responsibility of the integrated care board, but if the hon. Gentleman thinks it would be helpful for us to have a meeting and see if we can push that case, my door is open. I absolutely recognise that people in that part of Cumbria would prefer to have those services closer to where they live. If we can impress that on his local ICB, let us see if we can make progress.

The Government aim to ensure that each treatment centre is accessible to the highest possible number of patients, as well as easily reached by the staff who work there. That is another consideration—it is not just the patients who have to physically get to these units, but the staff. We recognise that for those in rural communities, machinery may not be available at their local hospital, meaning that the only option is travel to specialist centres to receive the best possible care. Radiotherapy service provision is agreed by local systems, and each patient’s care needs and treatment location are decided on a case-by-case basis by their clinicians. We are giving local systems greater flexibility and control, as they are best placed to understand and meet the needs of their communities, but to drive the national cancer plan forward, we have to tackle this postcode lottery and the deserts head-on.

Accessibility is also about making sure that we have the right workforce available to deliver the treatment in the right places and at the right time. That is why the number of training places has increased, and it is why we are improving the quality of education for assistant practitioners, diagnostics and therapeutic radiographers. NHS England is also working to improve the retention of radiographers and radiologists through initiatives such as increasing investment in career development. By ensuring our workforce feels supported, we put ourselves in a better position to deliver the care that people need.

Turning to investment in machines, I agree with the hon. Member for Westmorland and Lonsdale that we should be ambitious in our plans to ensure that patients are treated as quickly as possible. Lord Darzi’s report highlighted the scale of the challenge we face: under the previous Government, waiting times for treatment increased, and more than 30% of patients waited longer than 31 days for radical radiotherapy.

In response to Lord Darzi’s findings, we have taken urgent action to get the NHS back on its feet. At the recent Budget, my right hon. Friend the Chancellor supported our commitment to end the backlogs by announcing £70 million of investment in new radiotherapy machines in 2025-26. Replacing older radiotherapy machines with newer, more efficient and more technically advanced ones will ensure that patients can be seen more quickly. By doing so, we will improve access and speed up cancer treatment. Making more advanced machines available means that patients will have fewer trips to receive their treatment.

Hon. Members may be aware that NHS England has now allocated funding to trusts across the country to purchase the new radiotherapy machines with the £70 million investment. NHS England invited trusts to express interest in receiving funding to purchase a new machine. Allocation criteria focused on the age of the machine being replaced, the proportion of older machines in use in the trust and the trust’s performance on radiotherapy. We expect to fund at least 27 new machines, which should be available to treat patients by spring 2026.

Those steps will ensure that we can improve cancer waiting times as soon as possible, helping us to put an end to the last Government’s neglect and underinvestment. I reassure the hon. Member for Westmorland and Lonsdale, and other hon. Members, that we will continue to make the case for additional funding, so that we can continue to upgrade machines and push the advances of the latest technological developments, for the benefit of patients with cancer.

I turn to the national cancer plan. Beyond immediate actions, we know that bold reform is required to rise to the growing challenge that cancers of all types represent. Lord Darzi found that cancer survival in this country is worse than in comparable countries, and that improvement slowed greatly during the 2010s. To help us to develop more targeted actions, my right hon. Friend the Secretary of State has announced the development of a national cancer plan, which was the subject of the statement I gave in the House just a few hours ago. The overarching aim of the plan is to reduce the number of lives lost to cancer. It will detail how we will improve outcomes for cancer patients, ensuring that patients have access to the most effective treatments and technology, including radiotherapy.

Today, we launched our national cancer plan call for evidence. We welcome views from all hon. and right hon. Members, as well as from clinicians, patients and their families—it is critical that we get the views of people who have lived experience of accessing cancer care—charities, researchers, members of the public and, of course, the excellent all-party parliamentary groups that champion cancer treatment and outcomes in this House.

In closing, I thank the hon. Member for Westmorland and Lonsdale for bringing this crucial matter to the House. I thank hon. Members, whose contributions have, in the spirit of this year’s World Cancer Day, put places and people at the centre of care. I am pleased to assure hon. Members that we are undertaking both immediate actions and bold reforms to improve access to radiotherapy. There is a lot more that we need to do, and we will do it in partnership. This work is part of our effort to rebuild the NHS and deliver world-class cancer services for everybody—something that will always be a top priority for this Government and that is personal for me—so let’s get on and achieve it.

17:24

[Tim Farron]

First of all, Sir John, thank you for your oversight of this debate and for keeping us in order. I also thank everybody who has contributed from the Front and Back Benches. Members from all sides of the House have contributed so knowledgably and passionately on behalf of their communities, so I am really grateful to them all.

I especially thank the Minister for his response and for agreeing to my two requests. That is great—I appreciate it very much indeed. I also appreciated his statement in the main Chamber earlier, when he spoke very movingly about his own family experiences. We share an experience: my mum also passed away from ovarian cancer, at a similar age to his mum. We begin to see the impact that cancer has on the lives of just about every single family, so when we get to a position where we can do something about it, what a privilege that is and what an opportunity, which we absolutely must not miss.

Since I still have a few moments left, I encourage Members who are not already members of the all-party parliamentary group on radiotherapy to join up, please: we will not overburden you. I have discovered over time that decisions are so often made in the interest of the people who are in the room, so we need to be in the room. Chemotherapy is a really vital part of cancer treatment and the pharmaceutical industry that goes with it has tons of resource to lobby us; that is good, and it is entitled to do that. Radiotherapy is a very different industry. This is the lobby—so we need to be in the room to make sure that we are equally heard and that radiotherapy is part of the armoury to tackle and defeat cancer.

Money is vital, but leadership is key. Having people who will be “on it” constantly within NHS England at the senior levels—who want this to happen, who are dissatisfied with how things are and who are hungry for change—is essential, but, without meaning any disrespect to anybody, I do not see that at the moment. I am, though, encouraged by what the Minister said about trying to instil it.

Radiotherapy is non-invasive. It is increasingly targeted and accurate. In the time that I have been involved in this area of campaigning, I have seen an exponential increase in how targeted it is and therefore how strong the doses, so to speak—the fractions—can be. I have seen the damage that can be done to a tumour without seriously damaging the healthy tissue around it. If the Minister is trying to convince his right hon. Friend the Chancellor to give us more money, he should argue that radiotherapy is so beneficial for the economy, because people will go back to work healthy, earn money and pay taxes.

I thank the Minister very much again for responding to points made in the debate. My final point is to make again the case for satellite radiotherapy units around the country, not just in my patch. His civil servants might want to look into this more deeply. Among the wonderful people I met today was a young clinician, James, who works in a radiotherapy unit in London. He used to work in Cheltenham, which then of course branched out to have a satellite unit at Hereford. He was able to demonstrate and vouch for the fact that that new satellite unit ended up with getting on for 25% more patients than it had originally planned for. That was for one obvious reason: people who would not have had radiotherapy at all were able to get it because it was closer to them. The important thing to remember is that satellite units are not just about convenience—in fact, they are not even about convenience; they are about saving people’s lives and returning people to normal life if possible.

I again thank the Minister for the attention he has given this issue, and I thank everybody else here today for taking part in this debate—not least yourself, Sir John.

Question put and agreed to.

Resolved,

That this House has considered the accessibility of radiotherapy.

17:28

Sitting adjourned.