Cancer Outcomes in the UK
Baroness Bloomfield of Hinton Waldrist Excerpts(2 days ago)
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Baroness Bloomfield of Hinton Waldrist (Con)
My Lords, I, too, thank the noble Lord, Lord Patel, for securing this debate and for introducing it so powerfully in his usual inimitable fashion. I declare my interests as a trustee of the Royal Marsden Cancer Charity, as a former patient and as someone married to a current patient.
We all recognise the ambition behind the National Cancer Plan for England. It sets out a vision of earlier diagnosis, faster treatment and improved survival—goals that command universal support across this House. But ambition, however welcome, is not the same as delivery, and it is on delivery that this plan invites scrutiny.
First, on early diagnosis, the plan rightly emphasises catching cancer sooner, when outcomes are far better. The new 28-day faster diagnosis standard is a meaningful step forward and the UK is improving five-year survival rates across a range of cancers, with particularly strong performance in breast and some children’s cancers. Yet the plan leans heavily on expanding screening and awareness, without adequately addressing the capacity constraints already facing primary care and diagnostic services. General practitioners are overstretched and diagnostic hubs, though welcome and promising, remain unevenly distributed. Without a credible workforce strategy, radiologists, pathologists and specialist nurses, the aspiration of earlier diagnosis risks becoming little more than a slogan.
Secondly, on children’s cancer, we have seen important advocacy, including the Solving Kids’ Cancer response to the 10-year plan, which rightly highlights that childhood cancers are biologically distinct and require tailored approaches. Yet the national plan does not fully reflect that specificity. Children’s cancer should be treated as a dedicated priority, not simply folded into a general cancer narrative. Survival rates for some paediatric cancers have improved, but progress has stalled in others, particularly rare and aggressive forms. Families still face fragmented pathways, limited access to trials and inconsistent genomic testing. If we are serious about improving outcomes, this requires dedicated investment, co-ordinated research infrastructure and guaranteed access to specialist centres and innovative therapies.
On specialist centres, the plan must not blur the distinction between general cancer care and specialist excellence. The Royal Marsden and the Institute of Cancer Research remain among the world’s leading cancer institutions, with the Marsden identified as one of the top five cancer centres globally for research impact and the country’s only specialist NIHR biomedical research centre for cancer. That matters because a serious national cancer strategy must support both broad improvement across the NHS and world-leading specialist research that drives the next generation of treatments. We should not ask our flagship centres to carry international responsibility without giving them the sustained support that they need.
Thirdly, the plan speaks of reducing waiting times and meeting treatment targets. But we must be candid: the NHS has struggled to meet its existing cancer waiting time standards for several years. Simply restating targets does not make them achievable. What is missing is a clear funded pathway to recovery, one that accounts for workforce shortages, ageing equipment and the persistent backlog exacerbated by the pandemic. Targets without tools will not deliver results.
Fourthly, as many have mentioned, there is the question of inequality. Cancer outcomes in England vary significantly by geography, socioeconomic status and ethnicity. The plan acknowledges these disparities, but its remedies remain broad and underspecified. We hear of targeted interventions and community engagement, yet there is little detail on how these resources will be shifted to the areas of greatest need or how success will be measured. Without a sharper focus and accountability, inequality risks being noted but not narrowed.
Fifthly, on innovation and infrastructure, particularly the overlooked issue of medical radioisotopes, modern cancer care increasingly depends on nuclear medicine, both for diagnostics and targeted therapies, yet the UK remains heavily reliant on international supply chains for key medical radioisotopes, which are vulnerable to disruption. A serious national cancer plan should address this strategic gap. Developing a domestic supply, whether through research, reactors, cyclotrons or alternative production methods is not merely an industrial question but a matter of clinical resilience and patient safety.
We have a plan, project ARTHUR, to site a reactor at the old Trawsfynydd site in north-west Wales, supported by the Welsh Government and the local skilled population. I urge the Minister to look seriously at this plan. Without secure access to these materials, some of the very innovations that the plan champions cannot be reliably delivered.
Sixthly, on patient experience, the plan speaks of holistic care, mental health support, rehabilitation and survivorship, and this is welcome. Maggie’s, the independent charity that I know well, helps to provide this support across the country in its 24 centres sited alongside hospitals. Yet many patients today still report fragmented care, poor communication and insufficient support after treatment ends. These are not peripheral concerns; they are central to outcomes and quality of life. A truly patient-centred plan would embed these elements as core standards, not optional extras.
Finally, on accountability, the plan sets out ambitions over the coming years, but it lacks clear milestones and transparent reporting mechanisms. Parliament and the public must be able to track progress in real time to understand not only what is promised but what is delivered. Without this, there is the risk that the plan will become another well-intentioned document that fades from view.
None of this is to dismiss the importance of having a national cancer plan. On the contrary, it is precisely because cancer care is so vital that we must hold such plans to the highest standard. We need a strategy that is not only ambitious but credible, not only comprehensive but deliverable, and not only forward-looking but grounded in the realities of today’s NHS. If this plan is to succeed, it must be strengthened with a robust workforce strategy and a serious commitment to children’s cancer; securing domestic capabilities in critical technologies, such as radioisotopes; realistic funding; targeted action on inequality; equitable access to innovation; and clear mechanisms for accountability. Without these, we risk raising expectations that cannot be met, and that is something that neither patients nor clinicians can afford. The challenge before us, as ever, is not to write plans but to make them work.
Medical Nuclear Radioisotopes
Baroness Bloomfield of Hinton Waldrist Excerpts(5 months ago)
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Baroness Bloomfield of Hinton Waldrist
To ask His Majesty’s Government what steps they are taking to enable the domestic manufacture of medical nuclear radioisotopes.
Baroness Bloomfield of Hinton Waldrist (Con)
My Lords, it is always a privilege to be allocated a slot in the ballot for Questions for Short Debate. While I am disappointed with the small number of speakers, I feel sure that had more noble Lords been aware of the challenges facing the supply of these clever little chemical elements, this debate might have generated a bit more interest. My contribution seeks to address this issue of both national and personal significance. I declare my interest as a trustee of the Royal Marsden Cancer Charity.
Radioisotopes have transformed science, medicine and industry. Their ability to emit radiation makes them both powerful and, when handled safely, invaluable to modern society. In medicine, they are the backbone of modern diagnostics, innovative therapies and clinical trials. They are vital for the early detection and treatment of cancer, heart disease and many neurological disorders. Every year, more than 700,000 NHS procedures rely on medical isotopes and yet, despite their critical importance to world-class patient care, we face an acute and growing crisis in their supply. Currently, around 60% of our medical radioisotopes are imported. For the isotopes that we use in therapeutic treatment, almost 100% comes from overseas. The UK produces radioisotopes domestically only for PET-CT scans, and even that capacity is very limited.
Recent disruptions, triggered by overseas reactor shutdowns and global manufacturing shortfalls, have already led to the delay and cancellation of critical diagnostic tests. Delays can cost lives. Molybdenum-99, a critical isotope for cancer testing, was acutely limited in late 2024, forcing health leaders to ration supplies and to prioritise only the most urgent cases. Between January and May this year, dozens of cancer patients in the Nottinghamshire and east Midlands trusts experienced delays in PET-CT scans due to radioisotope shortages.
This fragility of supply has a very human cost. The root causes are clear: our dependence on ageing foreign reactors, transport hurdles and Brexit-related trade barriers all converge to create a precarious, expensive pipeline for these life-saving elements. The majority of them are produced by an ageing global network: 64% of current production capacity, in 11 reactors, is expected to be decommissioned by 2030. Shutdowns, such as that of the Belgian BR2 reactor, are more likely to occur as global demand increases, reactors age and more research reactors come offline.
The situation is unsustainable but, luckily, neither inevitable nor unfixable. However, it requires the Government and the scientific community to explore and pursue long-term solutions—not an easy ask in times of serious budget constraints—where cross-departmental co-operation is key. I note that it is the noble Baroness, Lady Merron, responding as Minister for Health, but it could as appropriately have been a Minister from the Department for Science, Innovation and Technology, the Department for Business and Trade or indeed the Department for Energy Security and Net Zero.
Any long-term solution must have at its core a vision for a secure, sovereign supply chain anchored in world-leading research, agile infrastructure and a skilled workforce. As well as direct benefits, research reactors have been demonstrated to create technological clusters that attract investment as industry benefits from proximity, which reduces the loss of radioactivity due to decay, and highly skilled expertise is built up in a local workforce. But the supply chain challenges for molecular radiotherapy stem from the fact that the radioactive component—the radionuclides—are short lived, so must be made continuously and cannot be stockpiled.
Where could we build a reactor where there is already a suitable nuclear site, owned by the Nuclear Decommissioning Authority, with a highly skilled local workforce in the relevant nuclear and medical sciences, a welcoming population well educated in the advantages of living in close proximity to a nuclear site, and an airfield almost adjacent to export the radionuclides with short half-lives—more likely to be counted in hours, not days—to the UK and beyond? Extensive research by the Snowdonia Enterprise Zone, backed by the Welsh Government, assessed long-term economic uses for the Trawsfynydd site in south Gwynedd. Given the site’s heritage, it concluded that it is most suited for nuclear development. Following detailed assessments of a number of different options, two projects were confirmed as having the greatest potential to deliver socioeconomic benefits, namely SMRs and a medical research reactor to produce radioisotopes for cancer diagnostics treatment and research.
The proposed ARTHUR—advanced radioisotope technology for health utility reactor—initiative envisages a dedicated medical reactor capable of producing a steady flow of radioisotopes for NHS use and research, and for export. The recommended reactor design for the ARTHUR project would use proven technology and is modelled on the ANSTO OPAL reactor, the world’s leading example for secure and efficient medical isotope production. The plan is supported by leading academic voices. Professor Simon Middleburgh of Bangor University’s Nuclear Futures Institute has stated that
“such a facility is not simply a Welsh inspiration—it is a UK wide imperative. Without it we remain at the mercy of foreign reactors, rising costs and global shocks”.
In 2022 the Government took a step in the right direction by announcing a £6 million medical radionuclide innovation programme. The commissioned report, issued by TÜV SÜD, warned of a supply vulnerable to technological failures, infrastructure delays and geopolitical upheaval, underscoring the conclusion that our current system is not future-proof. The recent review of molecular radiotherapy services produced by the Royal College of Radiologists, the Royal College of Physicians, the Institute of Physics and Engineering in Medicine and the British Nuclear Medicine Society made one key recommendation: that every devolved Government and every radiotherapy operational delivery network in England appoint a molecular radiotherapy champion, someone with the mandate and vision to drive the change we need. By investing in infrastructure using the existing workforce, as well as training the workforce of tomorrow, we can become self-reliant and once again lead the world in nuclear medicine innovation.
One in two UK citizens will be diagnosed with cancer in their lifetime. Many will see their quality of life and the efficacy of their treatments enhanced as a result of nuclear medicine. Every hospital in the UK uses it to help patients on a daily basis—700,000 patients a year and counting. We must act now. Let us not wait for another global shortage, another shutdown or another delayed shipment to force us into crisis mode. Let us choose instead to build a secure, resilient, sovereign supply of medical isotopes for the UK and, of course, I hope that will be in Wales.
NHS: Independent Investigation
Baroness Bloomfield of Hinton Waldrist Excerpts(1 year, 6 months ago)
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Baroness Merron (Lab)
I agree with the noble Baroness that that is unacceptable. There are just too many children and young people who are not receiving the care that they deserve. We know that waits for services are far too long and our determination is to change that—not least, as I am sure the noble Baroness has seen, given that children are at the heart of our opportunity and health missions, and rightly so. To ensure that every child has a happy and healthy start to life, among other measures we will train more health visitors and digitise the red book of children’s health records, so that parents and children can access the right support. We will be restricting vapes and junk food from being advertised to children, which will assist in the prevention of ill health, and we will ban the sale of high caffeine and energy drinks to under-16s. There will also be specialist mental health support in every school and walk-in mental health hubs in every community. I hope all of those will make a difference.
Baroness Bloomfield of Hinton Waldrist (Con)
My Lords, I draw attention to my entry in the register of interests as a trustee of the Royal Marsden Cancer Charity. The report of the noble Lord, Lord Darzi, discusses oncology services and life science research, both of which are at risk given NHS England’s planned closure of the paediatric oncology unit at the Royal Marsden in Sutton, cited alongside the Institute of Cancer Research as offering bench-to-bedside research and care. Does the Minister agree that such a closure would be devastating to the provision of paediatric cancer services, to research and to drug trials, and that it would undermine the recommendations of the report, which highlights the need to improve cancer survival rates and bolster our life sciences capability?
Baroness Merron (Lab)
I thank the noble Baroness for raising this important question, as she has done before with me. I know she is aware that I cannot comment on the individual case. What I can say is that research, diagnosis and treatment in all these areas, as we have heard from the noble Lord, Lord Darzi, are absolutely crucial to ensure that cancer patients are not being failed. We need to improve cancer survival rates, and we need to ensure that patients wait for no longer than they should. We have to research cancer, diagnose it on time and treat it faster.
NHS: Breast Screening Programme
Baroness Bloomfield of Hinton Waldrist Excerpts(1 year, 7 months ago)
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Baroness Bloomfield of Hinton Waldrist (Con)
I also begin by paying tribute to the noble Baroness, Lady Morgan, for her excellent work with Breakthrough Breast Cancer and more recently with Breast Cancer Now. Can the Minister reassure me that the Government will look again at the ceasing of breast cancer screening after the age of 70, when the incidence of disease occurring in that age group is still high, and would be higher were it not for the success of earlier breast cancer screening? This cohort of women should not be ignored.
Baroness Merron (Lab)
If a woman in the age group to which the noble Baroness refers has concerns, she may request follow-up and investigation. But it is the case that we follow the scientific advice, which is that going beyond that age as a matter of course will not give the rewards that we would hope. I can certainly reassure any woman in that age group that she will be seen should she have concerns, and she should present herself as soon as possible.