Secondary Breast Cancer

Clive Betts Excerpts

Thursday 11th June 2026 Westminster Hall

[Clive Jones]

I thank the hon. Member for putting his support on the record. This debate is very important: it gives us the opportunity to highlight the experiences of people living with secondary breast cancer and the action needed to support them.

One of the biggest challenges is the lack of reliable data. It is estimated that about 61,000 people in the UK are living with secondary breast cancer, but we do not know that for certain. The disease remains under-recognised, poorly tracked and inadequately recorded. People living with secondary breast cancer are still not consistently counted. Too often, they are invisible within the health system, making it harder to provide the tailored treatment, services and support that they need.

Some 20 years ago, data collection on metastatic breast cancer was identified as a priority by Breast Cancer Now’s secondary breast cancer taskforce. Progress was made in 2013 when mandatory data collection was introduced, and subsequent strategies have promised further improvements, but we are still flying blind. The first two national audits of metastatic breast cancer were unable to provide a complete picture, because recurrence data remains insufficient, both in quality and in completeness. The audit has demonstrated just how important it is that the issue be addressed: without accurate data, the NHS cannot properly plan services, allocate resources or understand the scale of need. Better data could also help to address continuing gaps in access to clinical nurse specialists for people with metastatic breast cancer.

Most importantly, people living with the disease are left feeling that they do not count, because the system cannot guarantee the support that they need. The reality is simple: if we do not know how many people have the disease, we cannot hope to support them effectively. This challenge is not unique to the UK; it is a global issue, and international collaboration can help us to learn from best practice elsewhere, but we should be leading the way. That is why the Government’s national cancer plan is so important. The plan commits to defining and counting recurrent cancers, starting with metastatic breast cancer in 2026. That commitment must now be delivered in full, and Parliament must hold the Government to account on achieving it. The ongoing work of the national disease registration service with NHS trusts to improve data collection is encouraging, but progress will require national leadership and accountability.

I am delighted that the hon. Member for West Lancashire is here today. Ashley Dalton was the Minister who drove the national cancer plan through Parliament.

[Mr Clive Betts (in the Chair)]

Order. Members must not refer to each other by name in the Chamber.

[Clive Jones]

I did mention the hon. Member’s constituency first, but I take your guidance, Mr Betts—my apologies for that.

I recently joined a meeting with the hon. Member and with charities including Breast Cancer Now, Breast Cancer Network Australia and Rethink Breast Cancer. Together those charities are working across the UK, Australia and Canada to improve metastatic breast cancer data and ensure that patients’ voices are heard. The message is clear: if we do not count people, we cannot support them. Collecting and publishing this data is essential, because people with metastatic breast cancer count.

Alongside better data, timely access to new treatments is critical. Secondary breast cancer may be incurable, but advances in medicine have transformed outcomes or many patients, giving them more time with the people they love. However, too many patients still struggle to access life-extending treatments on the NHS. One example is Enhertu, a treatment for people with HER2-low metastatic breast cancer. It has the potential to extend and improve lives, yet it was rejected for routine NHS use in England in 2024 on cost grounds. As a result, many patients have been unable to access the treatment that they need. Meanwhile, Enhertu is already available in 26 European countries, including Scotland. England is falling behind. Recent changes to the National Institute for Health and Care Excellence’s cost-effectiveness threshold provide an important opportunity to revisit that decision. I urge Daiichi Sankyo, AstraZeneca, NICE and NHS England to work together to reach an agreement so that patients can access and benefit from Enhertu.

More broadly, concerns remain about how NICE assesses medicines and about the impact on innovation and access to treatments, particularly following the introduction of the severity modifier in 2022. Even after recent changes, the threshold for approving some medicines for metastatic cancer remains lower than before 2022. NICE has estimated that the revisions may result in only three to five additional medicines being approved each year. It is the patients who pay the price. Life-extending treatments exist, but they are not always available to those who need them most. That cannot be right.

The commitments in the national cancer plan to streamline medicine approvals and accelerate clinical trials are welcome. The recent UK-US pharmaceutical agreements, including commitments to strengthen support for the life sciences sector, are likewise welcome, but without meaningful investment in innovative medicines for severe conditions, access will remain limited and patients will continue to miss opportunities for longer and better lives. Support services also remain inadequate.

Clinical nurse specialists play a vital role in guiding patients through complex treatment pathways and providing emotional support, yet many people with secondary breast cancer still do not have access to a clinical nurse specialist. Even among those who do, a quarter have not seen their specialist since diagnosis, and only 65% feel that their specialist has enough time for them. The reason is simple: caseloads are too high. We must recognise the profound emotional impact of secondary breast cancer. More than a quarter of patients say that they did not receive enough mental health support. Many need greater support for their family as well. The NHS long-term plan promised every cancer patient access to a clinical nurse specialist or support worker. That commitment must now be delivered for people with secondary breast cancer who need specialist expertise to navigate this complex disease.

People living with metastatic breast cancer do not have time to wait. They need to be counted. They need access to the support they deserve. They need rapid access to treatments that can give them more precious time with the people they love. I ask the Minister for two clear commitments. First, will she set out a timeline for delivering the national cancer plan’s commitment to define and count recurrent cancers, starting with metastatic breast cancer in 2026, and will she outline any plans to make the data that is currently held by the national disease registration service publicly available? Secondly, what are the Government doing to support metastatic breast cancer patients who may miss out on life-extending medicines because of pricing and access barriers?

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[Several hon. Members rose—]

[Mr Clive Betts (in the Chair)]

Order. I will call Mary Kelly Foy next, as the co-sponsor of the debate. After her speech, I will give hon. Members an indication of how long they may have to speak, to try to get us to the end of the debate in a reasonable fashion.

[Mary Kelly Foy (City of Durham) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Betts. I am grateful to have had the opportunity to work with the hon. Member for Wokingham (Clive Jones) to secure this important debate. I thank the campaigners who work to ensure that people living with secondary breast cancer are seen, heard and supported. I am thrilled that my hon. Friend the Member for West Lancashire (Ashley Dalton), who has spoken so openly about her diagnosis, is here today: I am sure that her remarks will be invaluable.

I speak not only as a Member of Parliament, but as someone who has been through breast cancer. I was fortunate: my cancer was picked up through screening and caught early. I received timely treatment and am now cancer-free, but I am forever grateful to the teams at the QE hospital in Gateshead, the Maggie’s centre and Future Dreams for their support. Whenever I can, I encourage people to attend screening appointments and to check themselves. In fact, on 14 July I will be hosting an event alongside leading breast cancer advocates and sporting ambassadors, focusing on raising awareness of the importance of women prioritising their breast health. I would love the Minister to join us.

I know that my personal experience was not that of someone living with secondary breast cancer. For people whose cancer has spread and can be treated but not cured, time is everything. In 2026, it is unacceptable that we do not know with confidence how many people are living with secondary breast cancer. We know that around 60,000 people in the UK are living with it, but that remains just an estimate. More than a decade after data collection was made mandatory, it is still not being consistently or accurately recorded across the country, and if people are not properly counted, their needs are too easily overlooked. The NHS cannot plan the right number of specialist nurses, oncology appointments, palliative care services, mental health support services or clinical trials if the true scale of need is not known.

I welcome the work of the national disease registration service, with NHS trusts, to improve data returns on metastatic breast cancer, but I am concerned that no data has yet been published. I also welcome the Government’s commitment to the national cancer plan, to define and count recurrent cancers, starting with metastatic breast cancer, and to ensure that patients have named primary contacts, but patients need delivery now, not just commitment. The NHS must routinely capture data on not only diagnosis but treatment and support needs. That is how we can move from counting people in theory to improving the services available to them in practice.

In Durham, trust was shattered when failures were identified in breast services at County Durham and Darlington NHS foundation trust. The concerns went way beyond isolated mistakes, and patients wondered whether the care that they received was truly in line with the standards that they should expect. Patients place their lives in the hands of the system, so they deserve to know that decisions about their care are evidence- based, properly scrutinised and made through strong, multidisciplinary teams. When that trust is broken, it is difficult to rebuild. I pay tribute to those who spoke out, such as my constituent Jackie, who did so on behalf of her sorely missed daughter, Michaela, and Amelia, Cat and Nadeen, who formed the Pink Justice Network. I do also recognise the efforts of the new senior leadership team at the trust, who are working to reform services and repair patient confidence.

On access to treatments, everyone living with secondary breast cancer deserves to have access to new, effective life-extending treatments, but there are serious concerns that the way in which NICE currently assesses some drugs limits access for people living with incurable metastatic breast cancer. Campaigners have warned that since the introduction of the severity modifier, some advance cancer treatments have been disadvantaged compared with the previous system. Breast Cancer Now reports that only a minority of end-of-life treatments assessed under the new approach received the same level of priority as they would have before.

The clearest example is Enhertu, which could give people with HER2-low metastatic breast cancer more time, yet was not recommended for routine NHS use in England in 2024, as a cost-effective pricing agreement could not be reached. Since then, eligible patients have missed out, and people have asked why a life-extending treatment should be available in Scotland but not in England. The Government’s decision to increase the NICE cost-effectiveness threshold for new medicines is welcome, and I hope it will create an opportunity to reach an agreement on Enhertu. I also welcome the fact that discussions between AstraZeneca, Daiichi Sankyo, NHS England and NICE are understood to have begun. More than 50,000 people have signed a petition calling for urgent agreement on Enhertu. They are asking for something very simple: that all parties come together to find a way to give eligible patients more time.

I must also mention the work of our hospices, such as St Cuthbert’s hospice in Durham, which are supported by charities such as Marie Curie, in providing people who are living with secondary breast cancer with the services that they need. Marie Curie reports that one in three people do not receive the care and support they need at the end of life, so I welcome the fact that the Government are developing a palliative care and end-of-life care modern service framework. I hope that the framework will address the lack of support available outside of normal working hours, embed palliative care in neighbourhood health and ensure that the palliative care workforce is fit for the future.

Will the Minister set out how the Government will ensure three things: first, that secondary breast cancer data is collected and published consistently across every trust, with clear accountability for delivery; secondly, that every patient has meaningful access to a specialist named contact with the time and capacity to support them properly; and thirdly, that people living with secondary breast cancer are not left behind when life-extending treatments become available?

Secondary breast cancer is not just a diagnosis. Mothers miss milestones, daughters face uncertain futures, partners become carers and families must live with a clock that they never asked to hear ticking. We do not ask for kind words today, but for action on research, access to treatment, support and giving people more time not just to survive, but to live—because behind every diagnosis is a person who still has dreams, plans and a life worth fighting for.

[Mr Clive Betts (in the Chair)]

Order. We have four Members who want to come in, so I will issue a guideline of nine minutes each for speeches, if Members could stick to that, please.

[John Milne (Horsham) (LD)]

It is a pleasure to serve under your chairmanship, Mr Betts. I want to focus on something that sits at the heart of improving outcomes for people living with secondary breast cancer: data, research and recognition. That especially applies to people suffering from lobular breast cancer.

Last year, my office asked the Government whether the new national audit of metastatic breast cancer would provide a breakdown by breast cancer subtype and hormone receptor status. The response from the Department of Health and Social Care was striking. The Government have effectively admitted that the data is simply not there in any complete or meaningful form. There is still no clear national picture of how many people are living with different forms of secondary breast cancer, what treatments they receive or the outcomes they face. That matters because, if we cannot accurately count metastatic breast cancer patients, we cannot properly plan services, understand needs, target research funding or develop treatments. We cannot fix what we do not measure.

That is especially true for lobular breast cancer. Invasive lobular carcinoma is the second most common form of breast cancer. Twenty-two people are diagnosed with it every day in the UK, yet it remains chronically under-researched and poorly understood. Unlike ductal breast cancer, lobular cancer often does not form a distinct lump. It grows in thin, single-file patterns, making it much harder to detect on standard mammograms and often leading to delayed diagnosis.

Secondary lobular breast cancer also presents further challenges because it tends to be found in untypical places, such as the liver, lungs, brain, bladder and even the eyes, whereas other types of breast cancer spread mostly to the bones. Despite those key biological differences, there is still no specific treatment pathway designed for lobular breast cancer patients. That is extraordinary, considering how many women are affected.

For too long, secondary and metastatic lobular breast cancer has existed in a blind spot. Historically, cancer registries have focused on primary diagnoses and have often failed to track recurrence or progression properly. Mandatory reporting has improved matters somewhat over the last decade, but huge gaps remain. That is why the work of campaigners and researchers has been so important.

I especially want to recognise and pay tribute to Dr Susan Michaelis, founder of the Lobular Moon Shot Project. She was one of my Horsham constituents, and she sadly died of lobular breast cancer almost a year ago. Susan was relentless in pushing this issue into public view. She understood that, without data, dedicated research and recognition that lobular breast cancer is different, progress would remain unacceptably slow. Her work has already helped encourage NHS England to release the first dedicated statistics on lobular breast cancer, but much more needs to happen.

This is about more than statistics. It is about people living for years with secondary breast cancer while feeling invisible within the system. Better subtype data would help us understand metastatic disease properly. Better research would improve diagnosis and, ultimately, dedicated treatment pathways for lobular breast cancer could help us move closer to what patients want to hear most of all: that their cancer is not just treatable, but curable.

The Lobular Moon Shot Project is looking for just £20 million over five years to fund research into the basic biology of lobular breast cancer. Researchers at the Manchester Breast Centre are ready and willing to take on the mission—they could start tomorrow. The Lobular Moon Shot Project is supported by more than 460 sitting MPs, more than can be found on any other single issue. All it needs now is for the Government to press the button. While we wait for that, women face poorer outcomes and require medications that were actually designed for other types of cancer, which cost upwards of £3,000 per month. Now is the time for the Government to commit to front-loaded funding to save lives, save money for the NHS and, most of all, demonstrate to those women that they matter. I ask the Minister for her support in finding the modest investment required to find answers for this very common but, sadly, much-neglected disease.

[Mr Clive Betts (in the Chair)]

I am supposed to be neutral in the Chair, but I think I am allowed to give a particularly warm welcome to Ashley Dalton.

[Hon. Members]

Hear, hear!

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[Mr Clive Betts (in the Chair)]

Before I call Wendy Chamberlain, let me say that the hon. Member for Strangford (Jim Shannon) has indicated to me that he has to leave at about quarter past 4. He has a plane to catch; I accept that as a reason, and he has given advance notice, which I thank him for. We will begin the wind-ups by 4.05 pm at the latest.

[Wendy Chamberlain (North East Fife) (LD)]

It is a pleasure to serve under your chairmanship, Mr Betts. Some people, both in this place and outside of it, say that politicians are out of touch, that they do not care and that they do not bring their lived experience to the Chamber. I want to thank the hon. Member for West Lancashire (Ashley Dalton) for everything that she did in her role as Health Minister and for her powerful speech. It should be essential watching for those who say otherwise about politicians’ intentions in this place.

I congratulate the hon. Member for City of Durham (Mary Kelly Foy) and my hon. Friend the Member for Wokingham (Clive Jones) on securing this debate, and I thank them for telling their own cancer experiences. Like most Members, I have been impacted by breast cancer in that my mother is a survivor. She was diagnosed when I was away from home for the first time at university. It was difficult for the family to receive that diagnosis and difficult for me, knowing that my mum was going through treatment while I was far away from home. I am pleased to say that she is still with us.

My colleague and friend in the Liberal Democrats in North East Fife, Councillor Fiona Corps, is currently stable after undergoing treatment for lobular breast cancer. She messaged me today to say she started her new meds yesterday. It is only two years since her daughter’s leukaemia fight. Fiona and her family have been through a lot. Her diagnosis brought me to speak to the lobular breast cancer campaign and I, like others, want to focus my remarks on that cancer in particular. Part of that is because, in relation to secondary breast cancer, the unmet clinical need of lobular breast cancer means the chances of it spreading are incredibly high. Indeed, for many who are diagnosed it has already spread by the time of their diagnosis.

It is important to note that this year marks 50 years since doctors first knew that lobular breast cancer was a distinct condition. I had not been born—just—we did not yet have Sony Walkmans, personal computers or mobile phones, “Don’t Go Breaking My Heart” was No. 1 for six weeks, and “Rocky” won best picture. I know it has been a long time since Scotland were in the World Cup, but this really was a long time ago. Here we are 50 years later in a world with advances that were unimaginable back then, but we have made painfully little progress on the diagnosis and treatment of lobular breast cancer.

As others have referenced, it is not like we think breast cancer is. As a woman, I have been taught to check for lumps—my mother’s experience made that more acute—but lobular cells grow in single lines that spread out over tissue. If a somebody did a lump check today, the chances are they would not spot it. Even more worryingly, if somebody goes for a mammogram, it will probably not show up there either. As others have referenced, 22 people are diagnosed with lobular breast cancer every day, but the reality is that we do not know how many people might be living with the disease and getting progressively more ill without treatment.

As of today, we still understand very little about it and there are no dedicated treatments for it. I am conscious that health is a devolved issue. I am standing here as a Scottish MP, but given the Minister’s responsibilities, I will note that the Government’s recent cancer action plan for England did not mention lobular breast cancer. We can say that other treatments are available, and Fiona and others are taking other treatments, but they are hit and miss. I have engaged with the Lobular Moon Shot Project and with Tristan—a constituent of my hon. Friend the Member for Horsham (John Milne)—and the story of his wife, Susan. She had eight different generic breast cancer treatments, none of which worked. Frankly, that lack of treatment kills people.

That is why lobular breast cancer is so relevant to the debate on secondary breast cancer. Not enough people know what to look for because it does not show up on tests, it is diagnosed late, and when it is diagnosed, there is not a dedicated treatment pathway for it. It is a recipe for a cancer spreading and we heard very powerfully from the hon. Member for West Lancashire what a diagnosis of secondary breast cancer means.

Unsurprisingly, there is still a lot that we do not know about what happens when the cancer spreads. We know it can spread to areas where other cancers do not like to, such as the outside membrane of the spine. We also know that the cells can lie dormant for years before starting to spread again. What we do not know is why any of that happens, how it can be identified, or how it can be stopped.

There could be hope. As others have referenced, researchers across this country are ready to take on this challenge. Importantly, there is cross-party support for getting this done; it is probably one of the most bipartisan campaigns in the history of this place. The Liberal Democrats are behind it; our leader, my right hon. Friend the Member for Kingston and Surbiton (Ed Davey), asked the Prime Minister about funding last summer. Indeed, I recently asked the then Secretary of State for Health and Social Care, the right hon. Member for Ilford North (Wes Streeting), about the project. He suggested that the money was there to fund the project, but work was needed on the programme of research. I say to the Minister: that is not how those involved with the project see it. This is a campaign that almost every Opposition MP supports, as well as huge numbers of those in the governing Labour party. Outwith this place, 84% of Labour voters surveyed in 2024 wanted lobular breast cancer research to be funded.

As others have said, £20 million over a five-year settlement equates to £238 per person for every person diagnosed over the next 10 years. Although I do not believe that life-changing research should be about a cost-benefit analysis, £238 is nothing compared with the costs of patients being out of the labour market and being treated over several years with the wrong thing—successfully or not.

I know that the Lobular Moon Shot Project is calling on devolved Governments to step up as well and provide £1 million per year for research to be carried out in their countries; the hon. Member for Strangford (Jim Shannon) referred to that, too. I call on the new Scottish Government and the new Cabinet Secretary for Health and Care to take this ask incredibly seriously.

I am sure that the Minister will refer to the current National Institute for Health and Care Research funding round. I do not want to pre-empt that—it is, of course, important— but it is not the same funding as is needed for the Lobular Moon Shot Project, which is research into the underlying biology of lobular breast cancer. Such research will remain weak until we know what it is we are trying to treat. We need funding for research into the underlying biology, so that lobular breast cancer can be identified, diagnosed and treated. That will improve outcomes drastically, including reducing the number of people with secondary breast cancer, which is the topic of this debate.

I will conclude by saying that my hon. Friend the Member for Wokingham has demonstrated very visibly that breast cancer is not simply a female issue, so I will end today by reflecting on the fact that anyone can get cancer. Many of those who do get cancer will make a full recovery. For some, cancer is something they will live with for the remainder of their life, but it will not be the condition from which they die. However, we have heard today that secondary breast cancer is decisive in terms of people’s life expectancy. We must let those women and men know that they are not alone.

[Mr Clive Betts (in the Chair)]

We now move on to the Front Benchers.

[Helen Maguire (Epsom and Ewell) (LD)]

It is a pleasure to serve under your chairmanship, Mr Betts.

I thank both my hon. Friend the Member for Wokingham (Clive Jones) and the hon. Member for City of Durham (Mary Kelly Foy) for securing this important debate, and for sharing their experience with cancer. I also thank the hon. Member for West Lancashire (Ashley Dalton) for her frankness and openness in describing her own experience.

Secondary breast cancer is now the leading cause of death in the UK for women between 40 and 49. Each month, around 1,000 people lose their lives to secondary breast cancer. That is one person every 45 minutes, so two lives will be lost to this disease in the short span of this debate.

Secondary breast cancer is incurable; treatment can slow down the disease, but it cannot cure it. Nevertheless, 13 years after data collection on secondary breast cancer became mandatory for all NHS trusts, the true number of people living with this disease remains unknown. It is estimated that the number is around 61,000. However, the lack of accurate data makes thousands of people who are in need of care invisible to the healthcare system. That is simply unacceptable. Those people count and we must count them. Collecting and publishing this data is essential. Without it, how can the NHS accurately assess the scale of need and appropriately plan services to ensure that support is available where required?

The Government’s commitment within the national cancer plan to define and count all secondary cancers, beginning with breast cancer, and the target to meet all cancer wait-time standards by 2029, are steps in the right direction. But to achieve those ambitions in full, we must be bolder and do so much more.

The Liberal Democrats are clear: quality and speed of treatment are vital to increase the survival rates for secondary breast cancer. The results of the research conducted by Breast Cancer Now in 2019 are damning. They make the lack of quality and the poor speed of treatment and care undeniable. They showed that 23% of respondents had to see their GP three or more times before they were diagnosed, and 53% of respondents said that they had not been given enough information about clinical trials by healthcare professionals. Just 30% of respondents said that they saw a cancer nurse specialist regularly and only 13% of respondents who had previously had breast cancer felt that they had been given enough information to recognise the signs and symptoms of secondary breast cancer.

Those figures show a healthcare system that is creaking under the strain after years of neglect by the previous Conservative Government. They highlight that professionals lack the time and capacity to effectively diagnose, offer follow-up care and share sufficient information, for which patients ultimately pay the price.

Every patient must get the care and support they need, when and where they need it. We must support the specialist cancer workforce, as well as GPs, to deliver the standard of care they would like and we expect. I therefore urge the Minister to take forward the Liberal Democrats’ proposals to introduce a guarantee that 100% of patients will be able to start treatment within 62 days from urgent referral; to recruit more cancer nurses so that every patient has a dedicated specialist supporting them throughout their treatment; and to expand the Medicines and Healthcare products Regulatory Agency’s capacity to halve the time for new treatments to reach the patients who desperately need them.

I think of the two people who will have lost their lives to secondary breast cancer in the 90 minutes of this debate. For them, and all the secondary breast cancer patients past, present and future, I implore the Minister to consider many of the calls raised by me and my colleagues here today.

[Mr Clive Betts (in the Chair)]

We move on to the shadow Minister, Dr Caroline Johnson, who has 10 minutes to make her contribution.

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[Mr Clive Betts (in the Chair)]

If the Minister allowed a couple of minutes before 4.30 pm for the mover to make some further comments, that would be really helpful.

Disability Equipment Provision

Clive Betts Excerpts

Wednesday 11th March 2026 Westminster Hall

[Mr Clive Betts (in the Chair)]

Order. Six Back Benchers want to speak in the debate, so I suggest about five minutes each as a guideline.

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[Jim Shannon (Strangford) (DUP)]

It is again a pleasure to serve under your chairship, Mr Betts—it has been a long afternoon for you and for me. We have been here together all this time.

I thank the hon. Gentleman for Aberdeenshire North and Moray East (Seamus Logan) for leading the debate. Debates in Westminster Hall give us a chance to recollect things that we sometimes forget about. The hon. Gentleman bringing this issue forward has, all of a sudden, flooded our minds with examples from the last year of our constituents’ needs.

I hope the Minister will know that I will give a Northern Ireland perspective of where we are, to add flavour to the debate and highlight some of the problems that we have. Provision of disability equipment is of paramount importance to many disabled people across the United Kingdom. When equipment works well, it can significantly improve independence and quality of life. The Northern Ireland Statistics and Research Agency has concluded that, according to the 2021 census data, 24.3% of the population of Northern Ireland—almost quarter, or some 463,000 people—had a long-term health condition or disability that limited day-to-day activities. I regularly see those people in my office back home. The hon. Gentleman for Aberdeenshire North and Moray East reminded me of the particular problems that we have.

A significant majority of people will require adaptations and equipment to help support them. It is crucial that they have access to the support that they need. The hon. Member for West Dorset (Edward Morello) mentioned equipment that is unused because someone passes away or they have to go into a home. That includes disabled beds, commodes, walking frames, crutches and sometimes even stairlifts. Stairlifts are there for people to get up to their bed and they might still be workable. If they are compatible and useable, they should be collected. It is not just a problem in the hon. Gentleman’s constituency, but a problem in mine as well.

I want to make a wee plea for wheelchairs. Many of the people who come into my office have acute, complex and severe disabilities. They need a modern wheelchair. I am not being critical—it is never my form to be so—but the ordinary wheelchair was probably okay years ago when it was just a matter of getting about. Today, for people to have a decent life, they need to have a wheelchair that is compatible, workable and gives them freedom.

I know the Government cannot fund it all, but many people have crowdfunded or have done charity drives to acquire those wheelchairs. I am going to age myself with this example, but when I was younger my first pair of glasses were what they called the Milky Bar Kid glasses; they were the round ones, and I can well remember them. We progressed on from that and, to be fair to the Government, they will keep that progress going. People deserve to have a quality of glasses that they are happy with and can relax with, and the same applies for wheelchairs.

My office is contacted weekly, or even daily now, by constituents who are awaiting occupational therapist assessments to adapt their homes to their needs. Most recently, people have been waiting for up to a year for assessments, and for further years for works to be carried out. I am sure that it is the same on the mainland, including in Scotland.

We dealt with a recent case where a constituent’s occupational therapist had done the assessment and said that her bathroom was in no way suitable for her needs. To make it accessible, they needed to take the bath out, put a shower in, put a stool in the shower and make the doors wide enough—I am not smarter than anybody else, but I am involved with these cases regularly, so I understand fairly quickly what people need.

The lady is in pain daily and is struggling to do the bare minimum, from showering to using the toilet. After two years, she heard from her contractors last Friday—this is a fresh story—who agreed the plans, got things measured up and said that they would see her the next week. They were due back at 8 am yesterday to commence the work, but they never showed up. I understand that making adaptations for disabilities is not always a profitable job for contractors, but if they commit to something, they should turn up and do it, for goodness’ sake. I am not one to blame anyone, as issues arise and priorities shift, but there must be a level of accountability for the completion of works.

Furthermore, we must take the extra step to ensure that in businesses and work places, adaptations for those who are disabled are prioritised. For example, businesses across the United Kingdom have automatic doors for people who are disabled and in wheelchairs. They are not just a convenience but a vital accessibility feature that ensures that all customers, including those with disabilities, can enter and navigate premises safely and independently. That is just a small point, but it is one that I have noticed, as have Members across this Chamber, I am sure. Automatic doors support people using wheelchairs or mobility aids, as well as parents with pushchairs, and they create a more inclusive environment that meets both legal accessibility standards and modern expectations of equal access.

These are all things we should talk about, but it is all well and good for us to talk about it. I understand the issues; we are here not to criticise the Minister or the Government, but to try to find a constructive and helpful way forward. More often than not, funding is the critical issue. I would gently suggest that the Government need to ensure that physical support can be accessed, and the reasons for the delays must be tackled at their root cause. I believe that the UK Government, and the Minister, will collaborate closely with the Northern Ireland Executive to tackle backlogs for assessments for disability equipment by co-ordinating funding, and by streamlining procurement, which is also important—if the Government buy 10,000 disability beds to distribute across all the United Kingdom, there must be a better way of doing that procurement. Again, I am trying to be helpful with that. I am sure that they will also share best practices.

I thank you again, Mr Betts, for your patience and for your chairship—you have done incredibly well.

[Mr Clive Betts (in the Chair)]

We now move on to the Front Benchers. The Liberal Democrat and Opposition spokespeople will have five minutes, and the Minister will have 10. There is a bit of flexibility on that time, so we can be a little more generous if required.

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[Mr Clive Betts (in the Chair)]

Minister, it would be helpful if you could allow a couple of minutes at the end for the mover to respond.

National Cancer Plan

Clive Betts Excerpts

Thursday 5th February 2026 Commons Chamber

[Mr Clive Betts (Sheffield South East) (Lab)]

I really welcome this plan, and the efforts of my hon. Friend the Minister and right hon. Friend the Secretary of State in putting it together. I will just raise one credit and one request to go a bit further.

First, when I had my cancer treatment eight years ago, I thought I knew my way around the NHS, but it is a completely confusing organisation for anyone involved in it. One thing that really helped me was having a specialist nurse appointed at the beginning. That specialist nurse got my chemotherapy ready on a Monday before I came down to London, and then on a Thursday when I came back. That sort of organisation and help is vital, so I really welcome that proposal.

Secondly, when I had my stem cell transplant for myeloma, my own stem cells were harvested and used, but many young people with complicated blood disorders need stem cells to be donated. So will the Minister work with the Anthony Nolan trust—I am chair of the all-party parliamentary group on stem cell transplantation and advanced cellular therapies—to ensure that more young people donate their stem cells so that other young people can have a life to look forward to?

[Ashley Dalton]

I thank my hon. Friend for his question, for his expertise and for all that he has shared from his experience to help us develop this plan. I note how important specialist nurses are, but we are also doing more to help people navigate the NHS. I know exactly what it is like; I think I have in my Filofax—I am that retro!—about 38 email addresses and phone numbers of the various people I have to contact in order to project manage my treatment. We are going further and ensuring that the NHS app can handle all that information. Cancer patients will have the ability in their hands, or in their pockets, to manage scans, appointments and test results directly through the NHS app.

I am delighted to say that my hon. Friend the Minister for Technology, Innovation and Life Sciences is already looking at the issues that my hon. Friend the Member for Sheffield South East (Mr Betts) raises around blood products and donations, and is working with the Anthony Nolan trust on those. I will be more than happy to work with my hon. Friend further on those issues.

NHS 10-Year Plan

Clive Betts Excerpts

Thursday 3rd July 2025 Commons Chamber

[Wes Streeting]

I am grateful to the right hon. Gentleman for that question—[Laughter.] Given that the Bill is still passing through Parliament, assisted dying is not referred to in this 10-year-plan, but I assure both this House and the other place that regardless of different views among Ministers and across the House, we will abide by the law of the land. We will abide by the will of this House and the other place. If the Bill times out in the other place, I have no doubt that someone else will bring it back. I suspect it will not be a Government Bill.

It is important that we have the debate and that we scrutinise the legislation well. I am proud of the way the House has conducted the debate. My hon. Friend the Minister for Care, who is not in his place now, along with the Minister of State, Ministry of Justice, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), have done an exemplary job in supporting people on both sides of the debate to give the Bill the detailed scrutiny that it had here and that it will no doubt have in the other place. That is a credit to this House.

[Mr Clive Betts (Sheffield South East) (Lab)]

Let me say to the Secretary of State: well done. This is a really ambitious and excellent programme.

On the subject of cancer care, in the past few years we have both had good experiences of the NHS at its best, but it is important to improve services by getting the NHS to work with universities and the voluntary sector in local cancer alliances. Will he look at what I think is an unintended consequence of that? If a local cancer alliance is funded by an NHS trust, its funding continues; if it is funded by an ICB, as the South Yorkshire cancer alliance is, its funding will be cut in line with the rest of the ICB’s budget. That is not fair. Whether an alliance suffers cuts depends on which organisation funds it. Will he see if he can rectify that?

[Wes Streeting]

I am grateful for my hon. Friend’s support. Given his expertise, it means a lot. I am especially grateful to the GPs in his constituency with whom he and I spent time; that experience really had an impact on my thinking about neighbourhood health.

On cancer, I am happy to look at the issue he raises with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton). We want to get this right. Cancer alliances have played a valuable role, and we want to see that approach to joined-up working between research, diagnostics and treatment go from strength to strength, so I will happily pick that up.

Department of Health and Social Care

Clive Betts Excerpts

Wednesday 5th March 2025 Commons Chamber

[Mr Clive Betts (Sheffield South East) (Lab)]

It is a pleasure to follow the Chair of the Public Accounts Committee, the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown). Although we sit on opposite sides in the Chamber, we now spend most of our time in this place on the same side of the table in the Committee. I congratulate him on his appointment and the work he is doing as Chair.

The clear remit from the Secretary of State is to move to prevention, community care and digital services; that is how it is laid down. When we had the officials from the Department and NHS England before the Committee, we said that we thought they were complacent about the NHS’s finances. I thought that there was no sense of purpose or long-term strategy to deliver on the Secretary of State’s objectives; that was the worrying thing.

Let us look at the immediate problems. We have a service where trusts and others can run up deficits and seemingly there is no consequence. Unlike local government, which has to balance the books or go to the Government for approval to capitalise losses, that does not happen in the NHS. We have the problem in South Yorkshire that Doncaster hospital runs at a loss every year—I am not blaming the hospital, because it has an old building that needs massive refurbishment, or probably complete rebuilding, and it has not had the resources—and those losses go into the wider ICB system and put pressure on other hospitals and trusts not to distribute any surplus they might make to community services in Sheffield but to fund others’ losses. That is no way to incentivise a proper financial arrangement.

The hon. Member was absolutely right on moving towards community services, which is about not just getting people out of hospital but stopping them going into hospital in the first place. That certainly could be done. GPs hold 90% of appointments and get 10% of the funding. That is clearly wrong; we have got to switch that.

On social care, about eight years ago the Health and Social Care Committee and the Housing, Communities and Local Government Committee produced a joint report to which 22 Members of Parliament signed up, but we are still here talking about the funding. Louise Casey is a great appointment as she has a great “get up and go” attitude, but I am sure she could be asked to get up and go a bit before 2028, because that is a long time to wait for any response.

We should be looking a lot more at moving services out of hospitals. There is a proposal around—and I say “around” because the NHS does not tend to act quickly—a diagnostic centre at Crystal Peaks in my constituency. The south-east of Sheffield is a long way from the two teaching hospitals, so to put services such as MRI scans, ultrasound scans, X-rays and CT scans there and to have GPs working with consultants who come to see patients in their clinics in the community would save money and provide a better patient service. But that seems to get locked up in discussions about NHS financing and commissioning, and who gets paid what to see who and when. We have got to unravel that and recognise that services can be made to improve significantly.

On digitalisation, the example of fax machines is of course legendary, but the other week I had to change a hospital appointment a couple of times—the service was really helpful in changing it—and I got not merely three emails and three texts but three letters with a first-class stamp on them, all for one appointment. That is a complete waste of money. I have talked to the hospital in Sheffield, which is bringing in new IT systems to cover the whole of the hospital operation, but that does not link into the GP systems. It is just nonsense that in this day and age we have that sort of unjoined-up thinking.

I will raise a couple of other issues. The consultant who has been treating me for the last seven years—successfully at this stage—for my myeloma has got an idea. People have so much chemotherapy to go through—probably at least six different sessions, twice a week—and for those sessions they have to go into the day ward. That is all right for some people—my timetable was helpfully rearranged to suit me coming down here and going back—but for many that is not possible, particularly if they have to go to a specialist unit that is many miles away. He has developed an idea for home chemotherapy, which works and is good.

[Sir Geoffrey Clifton-Brown]

I am sorry to intervene on my deputy, who does an excellent job on the Public Accounts Committee. In the last Parliament, before he joined the Committee, we went to Denmark, where they do precisely what he is talking about: give chemotherapy treatment to people in their homes where they have a history of not reacting to it.

[Mr Betts]

Absolutely. Obviously, it is done with a clinician’s approval and with the patient’s agreement. The idea has been around for two years now, but again it is lost in the labyrinth of NHS discussions, boards and committees. Come on—let us do it now. It is a good idea, which is actually cheaper and benefits the patient. Why cannot these ideas be got up and moving much more quickly?

I absolutely agree with the comments made by the Chair of the Public Accounts Committee on public health. It is like an afterthought. The grant for public health comes out at least two, three or four months after the main grants for the NHS and local Government—it is like the money down the back of the sofa that the Treasury finds at the last minute—and over the years it has been cut significantly in real terms. Public health in Sheffield does an absolutely great job, working with NHS Sheffield Place. It has done some really good work in deprived communities to increase and improve community care in the north of Sheffield. That is the sort of initiative we ought to pursue, and we should give the ICB the wherewithal to support and engage with that.

Finally, we ought to build equality of treatment into our aspirations. In Sheffield, from one end of the city to another, life expectancy changes by 10 years. That is simply not acceptable. However, for child vaccinations, GPs get paid by the number of vaccinations they do, so those GPs with the easy patients to reach—probably those in the wealthier areas—get a lot more money for doing vaccinations than those struggling to engage with deprived communities. That sort of initiative from the NHS is wrong and we need to correct it.

--- Later in debate ---

[Dr Johnson]

If the hon. Gentleman looks back at the figures, he will see that there has been a substantial real-terms increase in NHS funding over the past 14 years. That cannot be said for this year, potentially, which is why I am asking the question.

[Mr Betts]

Perhaps I will ask the shadow Minister an easier question, then. She has just rejected the pay deals that this Government have agreed to give a proper reward to our nurses and doctors. By how much does she think that pay deal should be reduced to bring it in line with her policy? If she is opposed to the deal that has been agreed, she must have an alternative in mind.

[Dr Johnson]

One of the key things about the Government’s deal is that they have given in on money without asking for anything in return in terms of productivity. The Government needed to agree a pay deal that was sensible and affordable, not talk about the money that they are giving to the NHS while taking away with the other hand in taxes.

Let us hear what some healthcare providers have had to say about the implications of Labour’s NICs rises for their constituents’ healthcare. The Royal College of General Practitioners has warned that the NICs increase will force GP practices to choose between redundancies and closure. The hospice sector believes that the cost of national insurance rises could be £30 million a year. The Government have given that sector a capital grant worth £100 million, which is welcome and will improve facilities; however, if those facilities are empty and cannot be staffed, they will not deliver much in the way of improvement. Air ambulances are also under threat from the Chancellor’s rise in national insurance and taxes in last year’s autumn Budget, with the local service in my constituency, Lincolnshire and Nottinghamshire air ambulance—which is entirely charitably funded—needing to find another £70,000 just to pay for those national insurance rises.

The Independent Pharmacies Association estimates that the rises in employer national insurance contributions and the minimum wage will cost the average pharmacy over £12,000 a year, totalling more than £125 million for the sector as a whole. Nick Kaye, chairman of the National Pharmacy Association, has warned that

“Pharmacies face a financial cliff edge at the beginning of April, with a triple whammy of rising National Insurance, National Living Wage, and business rates all arriving at once.”

What impact will this have on our constituents’ health? The Government talk a good talk about bringing healthcare closer to the community, but actions speak louder than words, and putting extra pressure on community-delivered services is not a good way of delivering their aims.

The Nuffield Trust suggests that the national insurance rise alone will add a £900 million burden to the adult social care sector. With other new costs factored in, the care sector is believed to be facing a bill of an additional £2.8 billion, dwarfing the £600 million extra allocated to the local authorities responsible for providing social care. This will have a devastating knock-on effect: the amount of care that can be bought by local authorities will fall, the cost of private care will rise—so more people will be reliant on the state, rather than the private sector—and the waiting lists that the Government claim to prioritise will also rise. The Nuffield Trust warns that many small care providers will either have to increase prices, stop accepting council-funded patients, or go bust.

That will have a knock-on effect on the hospital sector, as people are unable to be discharged because there is not adequate social care for them. The Government talk about creating a new national care service, but they have managed to damage the existing one by hiking the costs borne by care homes through national insurance rises and other tax and wage increases.

In January, the Government announced a deal with private hospitals in an attempt to cut waiting lists. The deal, which sounded good to start with, would see private hospitals being paid for each patient that they treated, incentivising them to treat as many people as possible. However, The Times reported that NHS England has recently capped the amount that each hospital can be paid. The chief executive of the Independent Healthcare Providers Network has warned that the policy will actually lengthen waiting times. Will the Minister comment on that?

The Minister is focused on prevention, but when the Government announced that they would be cutting the overseas development aid budget by 40%, the Prime Minister said that the UK would continue to play a key humanitarian role on a range of issues, including global health and challenges such as vaccination. I would appreciate clarification from the Minister on whether the global health budget will be cut, or whether the cuts will be made from other aspects of the ODA budget.

Workforce is the key asset of the NHS, yet sickness levels are running at around 5.5%, which is a considerable cost to Government and drag on productivity. They vary considerably across trusts and professions, with consistently less than 2% of consultants off sick, but almost 8% of ambulance support staff. If those rates could be reduced, it would lead to improved productivity and patients being treated much faster. What is the Minister doing to look at that? Perhaps she will have another one of her reviews.

Community Pharmacies: Devon and the South-west

Clive Betts Excerpts

Tuesday 17th December 2024 Westminster Hall

[Adam Dance (Yeovil) (LD)]

I congratulate you on securing this vital debate. In my constituency of Yeovil, pharmacies provide vital services, including more than 6,700 prescriptions per month—not quite as many as in your constituency, Rachel.

[Mr Clive Betts (in the Chair)]

Order. “You” and “your” refer to the Chair.

[Adam Dance]

Sorry, Mr Betts. Since the launch of the Pharmacy First service this year, it is estimated that pharmacies in Yeovil have saved at least 556 GP appointments. However, a lack of investment and the rise in national insurance contributions threaten the amazing work done by pharmacies in Yeovil and across the country. I understand from the response I received to a parliamentary question—

[Mr Clive Betts (in the Chair)]

Order. Interventions should be brief and to the point for hon. Members to respond to. They should not be another speech.

[Adam Dance]

Will my hon. Friend join me in urging the Minister to provide a clear timeline for the consultation to start?

--- Later in debate ---

[Several hon. Members rose—]

[Mr Clive Betts (in the Chair)]

Order. Given the number of Back Benchers who wish to speak, you will probably have to keep to less than five minutes each. Also, at some point we may have to suspend the sitting for 45 minutes to vote, so please do not speak unless you are prepared to come back when the debate resumes.

--- Later in debate ---

[Several hon. Members rose—]

[Mr Clive Betts (in the Chair)]

Order. I am going to have to squeeze speeches down to no more than four minutes.

--- Later in debate ---

[Richard Foord]

I think the hon. Gentleman has come up with an absolutely brilliant idea. Community hospitals are potentially hubs where pharmacies might sit in the future. I pay tribute to my hon. Friend the Member for Tiverton and Minehead (Rachel Gilmour) for securing this debate; she has done a great thing by doing so.

[Mr Clive Betts (in the Chair)]

We now move on to the Front Benchers. The two Opposition spokespeople have no more than five minutes, and then the Minister will probably have about 10 minutes left.

National Insurance Contributions: Healthcare

Clive Betts Excerpts

Thursday 14th November 2024 Commons Chamber

[Karin Smyth]

As I have said, we have made a commitment to general practice and primary care by releasing extra GPs into the system. We recognise the situation in which GPs find themselves. I know this because I worked with GP practices in my previous career. We need those practices to be the foundation of our neighbourhood services, which is why we will talk in the normal process about the allocations over the next few months as part of the contract.

[Mr Clive Betts (Sheffield South East) (Lab)]

If we are to reform the NHS, we need to move resources over time into primary care. The reality is that GPs see at first instance 90% of patients, but receive only 8% of NHS funding. Will my hon. Friend ensure that, in the settlement that is agreed with NHS providers, particular attention is given to supporting GPs?

On the social care sector, when we help the hospices and social care providers, which are charities and small organisations in particular, can perhaps do so without subsidising some of the hedge funds that are now investing heavily in social care? We do not want to add to their profits while supporting the small charities involved.

[Karin Smyth]

My hon. Friend has led fantastic work in previous Parliaments on the health and social care system, which he understands very well. He makes an excellent point about ensuring that additional funding goes where we want it to, which is towards supporting our constituents, particularly with social care. We have all seen the situation over the last decade over so. Improving that is critical to the urgent and emergency care system, and to the dignity of those people who need the service. We will continue to talk to them, and to local systems, about the impact of any changes.

Cancer Strategy for England

Clive Betts Excerpts

Thursday 31st October 2024 Westminster Hall

[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.

--- Later in debate ---

[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.

--- Later in debate ---

[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.

--- Later in debate ---

[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.

[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.

[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.

[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.