Cancer Outcomes in the UK

Lord Kakkar Excerpts

Tuesday 21st April 2026 Grand Committee

[Lord Kakkar (CB)]

My Lords, I join other noble Lords in congratulating and thanking my noble friend Lord Patel for having secured this important debate and having introduced it, as he always does, in such a thoughtful and sensitive fashion. In so doing, I remind noble Lords of my own interests as the chairman of King’s Health Partners and of the King’s Fund.

I start by congratulating, through the Minister, His Majesty’s Government for having established such a thoughtful, comprehensive and forward-looking national cancer plan, and for having described a substantial ambition extending, as we have heard, over 10 years. It covers so much of what is essential in ensuring that we have a joined-up strategy that can potentially achieve the impact and ambition so rightly described.

In its initial description, the ambition covers the problem that we currently face: we experience, as a nation, untimely delays in diagnosis, access to imaging and access to a proper histopathological evaluation of biopsy samples; and an inability, therefore, to apply advanced diagnostic and characterisation techniques to targeting therapeutic intervention in an increasingly precise fashion. There are delays in establishing treatment for patients and in ensuring that patients are able to participate in clinical trials. We have done little of what needs to be done to drive a proper national programme for prevention in the area of cancer. It is of course vital, and there is a necessity—because, actually, we are making substantial progress and we must not be too gloomy—to start focusing on survivorship and how we are able to help patients beyond that initial therapeutic intervention when they are potentially not cured and have to continue to live with their cancer.

As we have heard, it is also very clear that previous Administrations have made substantial efforts to secure improved clinical outcomes for patients with cancer. Much of that innovative and imaginative approach to improving clinical outcomes in cancer has happened at a time in our national history when the NHS has benefitted, as have many other public services, from the so-called peace dividend—the period since the end of the Cold War. In 1990-91, NHS spending was some 4% of GDP, and in the year 2023-24, it was some 8%: a near doubling from £1 in every £25 of public expenditure some 30-odd years ago to £1 in every £12 of public expenditure.

That was a period of substantial plenty, when strategies and plans were presented but, regrettably, did not achieve absolutely what was intended and expected. As a result, this new cancer plan now lands at a time when our fiscal situation in the country, with the demands for increased defence expenditure, makes it highly unlikely that the substantial increases in public funding that have previously been devoted to healthcare will be available in the future.

It is therefore right that in this Grand Committee debate so many noble Lords have identified the question of how this plan will be implemented. What are the potential restrictions, not only financial but organisational and structural, that are likely, regrettably, to ensure that much of this great ambition that is absolutely necessary for the future health and well-being of our fellow citizens will not come to pass?

In this respect, it is very important, as we heard from the noble Lord, Lord Patel, to look at examples from other national experiences. The International Cancer Benchmarking Partnership has looked at these questions. As we have heard, the jurisdiction of Denmark represents an important example of what can be achieved: the clear lesson is that there has been consistency after a national cancer plan was adopted. That consistency manifests itself over many decades in political consensus. At a time when there was substantial opportunity for various Administrations to make further and increasing commitments to healthcare expenditure, it was possible that our country could live without consensus about the long-term delivery of health strategies, but we are no longer in that luxurious position.

I would therefore be interested to hear from the Minister how, in taking forward this impressive plan, His Majesty’s Government propose to achieve the substantial consensus—not only political but professional and, more generally, among the general public—that will see this strategy live through its 10 years, modified if it requires modification, but without wholesale dismissal. Those who deliver have to be in a position to do so with some certainty.

Secondly, in the circumstance we find ourselves with the economy and our fiscal constraint, how do His Majesty’s Government propose to find the substantial additional investment that is inevitably required when one looks at the ambition of this plan? As we have heard from other noble Lords, there are so many areas that we would all support, but each will require substantial investment—beyond the investment that is already made in delivering the day-to-day care that is required for cancer patients today and the increasing demands on that care through the adoption of already available innovation—to be provided at scale and pace across the entire country. Therefore, we need clarity about the approach to funding, the approach that will be taken in the Department of Health and Social Care now that it has incorporated the functions of NHS England back into the department and the approach that will be taken to prioritise funding on cancer over other priorities that will inevitably be identified for other disciplines and for the management of other clinical conditions.

Finally, so much of what is described in this impressive plan is predicated on the basis of ensuring that research is no longer an adjunct to the delivery of cancer care, but central to it. One of the points that we have heard, which is absolutely correct, is about accelerating the opportunity for clinical trials. We know that patients managed on clinical trial protocols, or in the clinical environment where they can access clinical trial protocols, have improved clinical outcomes. There is a need to drive broader equity in access to those clinical trials.

In addition, it will be vital to ensure that there is consensus on the use of data. Data will be critical to drive the innovation agenda and the implementation agenda. Can the Minister give a view on the approach of His Majesty’s Government to ensure that there is broad societal consensus on the use of data, on a routine and regular basis, to achieve so much of this ambition?

NHS: Heart Valve Disease

Lord Kakkar Excerpts

Thursday 12th March 2026 Lords Chamber

[Baroness Merron (Lab)]

My noble friend is right and, certainly, as we move through our 10-year health plan, the opportunity to make every contact count is very important. I refer my noble friend to the advances that we have made in services available in community pharmacies, because measuring blood pressure is hugely important. Our pharmacies, I am glad to say, have delivered nearly 4.2 million blood pressure monitoring checks since October 2021. We have more than 7,500 pharmacies now available in our high streets delivering this service. That is the kind of thing that my noble friend is looking for.

[Lord Kakkar (CB)]

My Lords, I declare my interest as chairman of King’s Health Partners. The Minister made reference to AI stethoscopes aiding in the diagnosis of patients with heart conditions. The evidence for this was established in a very large trial—the TRICORDER trial—involving some 1.5 million patients and more than 200 general practices in our country. What it demonstrated was, compared to the use of the ordinary standard of care, a doubling of the rate of diagnosis for heart failure and a tripling of the rate of diagnosis for heart arrhythmias. The problem was that, subsequent to the trial, the diagnostic rate did not increase, suggesting that it is necessary to invest in training and the establishment of new working pathways to ensure that innovation can be properly established in routine clinical practice. Is His Majesty’s Government funding such activity?

[Baroness Merron (Lab)]

The noble Lord is right to make the point that innovation research is one part of it, but it is actually its implementation that matters. However, the faster and more frequent detection of cardiovascular conditions is the key thing and training is certainly a part of that.

Rare Cancers Bill

Lord Kakkar Excerpts

2nd reading
Friday 16th January 2026 Lords Chamber

[Lord Kakkar (CB)]

My Lords, it is a great pleasure to follow the noble Baroness, Lady Browning. In so doing, I congratulate the noble Baroness, Lady Elliott of Whitburn Bay, on the very thoughtful way in which she has introduced this important Bill. I must remind noble Lords of my own registered interests as chairman of King’s Health Partners, chairman of UK Biobank and chairman the Office for Strategic Coordination of Health Research.

We have heard that rare and less common cancers represent a substantial burden of disease—some 47% of diagnoses and some 55% of deaths. This is striking, because the poor clinical outcome has been attributed to a lack of research, a lack of co-ordination in care and a lack of application of resources to ensure that clinical outcomes can be improved. The Bill before your Lordships today addresses all these matters by ensuring that there is greater accountability, that regulation is improved and, most importantly, that we can drive forward a meaningful research effort for a series of cancers that represent, by themselves, small numbers of patients but collectively represent, as I have said, a substantial burden.

It is very important, and indeed we have heard it this morning, that the appointment of a national specialty lead for rare cancers is achieved quickly. We have seen in other areas and domains of clinical practice the impressive results achieved through the appointment of such leadership. For instance, the appointment of a national specialty lead for cardiovascular disease some 20 years ago was attended by a substantial reduction in cardiovascular mortality. We have also seen the impact that such individuals can have on the research agenda.

Regulation is vital in incentivising innovation. Numerous reviews and assessments have determined that, in many areas, our regulation is wanting. In this area, the regulation has the potential for a substantially negative impact on innovation, and it is innovative therapies that are going to improve clinical outcomes, so review of regulation is critical. I share the view of my noble friend Lord Patel that the three-year window for delivery of the review of the regulatory framework appears far too long and should be addressed by His Majesty’s Government.

The final part of the Bill is to enhance and promote the research effort. This is critical. The mandate that the National Institute for Health Research, as part of its Be Part of Research initiative, establishes special opportunities for registers for rare cancers is critically important.

However, beyond that, as we heard from my noble friend Lord Patel, it is important that we go beyond just knowing where the patients are and providing patients with the opportunity to participate in clinical research. The register should go beyond and provide the opportunity for appropriate genotyping and phenotyping of rare cancers as a resource to drive future research effort.

In that regard, the sharing of data within the NHS for research purposes is critical. We saw the benefits of that during Covid, when the Secretary of State issued a COPI notice that allowed the sharing of primary care data with UK Biobank and allowed researchers therefore to use that important resource to identify many treatment options and a better understanding of Covid-19.

The sharing of data that will be facilitated as part of this Bill is probably one of the most important elements that will drive forward the opportunity for improving clinical outcomes for those suffering from rare cancers.

Breast Cancer

Lord Kakkar Excerpts

Monday 15th December 2025 Lords Chamber

[Baroness Merron (Lab)]

Part of the 10-year plan, as we move from analogue to digital, will be ensuring that digital exclusion will not be a barrier. As I mentioned in response to my noble friend, it is indeed the case that women aged 71 and over can have screening every three years, and that can happen by women calling their local breast screening service to ask for an appointment. In other words, analogue is still possible, not just digital.

[Lord Kakkar (CB)]

My Lords, I draw the House’s attention to my registered interest as chairman of King’s Health Partners. Is the Minister content that sufficient resources are applied to the molecular characterisation of screen-detected breast cancer in such a way that those over the age of 70 who have breast cancer detected are appropriately treated?

Genome Screening: Newborn Infants

Lord Kakkar Excerpts

Thursday 18th September 2025 Lords Chamber

[Baroness Merron (Lab)]

My Lords, the Generation Study is particularly designed to inform policy of the type that my noble friend is rightly concerned with. These are extremely important issues, and I am glad to have spoken to our noble friend Lord Winston about these matters. Perhaps I could give the assurance that the study will test only for treatable conditions, where there is robust evidence that the condition is highly likely to develop within the first five years of life, and suspected positive results are then reviewed and confirmed through further tests. If genomic testing is used within future screening programmes, informed consent will still be required.

[Lord Kakkar (CB)]

My Lords, I draw attention to my interest as chairman of UK Biobank. The value of large-cohort studies is not only in the collection of baseline data, and indeed, in this case, the genome sequences of the 100,000 newborns, but in the opportunity to secure the long-term longitudinal follow-up of participants, so that there is a broader understanding of the change in health and health dynamics.

The Minister mentioned the question of consent with regard to genetic testing, but there is another question of consent, with regard to long-term access to the primary care data of those individuals who have participated in the study. Is the Minister content that there are appropriate arrangements in place with regard to consent to ensure long-term access to primary care data for those individuals?

[Baroness Merron (Lab)]

The noble Lord raises a very good point. Certainly, it is part of how we develop the use of data. I am aware that he did not directly ask me this, but perhaps I might use the opportunity to say that data safety, which I know is a matter of concern to many noble Lords, is absolutely paramount here. We also have absolute regard to conducting studies ethically, but the point about primary care data, its use and its value, as well as its safety, is very well made and one which we are certainly developing still further.

Pharmacy Opening Hours

Lord Kakkar Excerpts

Thursday 20th March 2025 Lords Chamber

[Baroness Merron (Lab)]

I will of course discuss the right reverend Prelate’s request for publication of information with Minister Stephen Kinnock, who has been working very hard with the sector in resolving matters on funding.

On opening hours, as I have said, there are core hours, but there are also additional supplementary voluntary hours that community pharmacies can choose to do. There is also a whole range of ways in which people can access pharmacy services—notwithstanding the point the right reverend Prelate made about his personal experience—including being able to contact distance pharmacies, which can provide things through online contact, by telephone call or by other means.

Pharmacies are key to making healthcare fit for the future, but we want to make sure that they are completely accessible. We will work with them to make sure that they, as largely private businesses, do so.

[Lord Kakkar (CB)]

My Lords, I draw noble Lords’ attention to my interest as chairman of King’s Health Partners. Just to build on the point made by the right reverend Prelate, what assessment have His Majesty’s Government made of the impact on population health outcomes of the intersection between limited access to primary care services and diminishing availability of pharmacy services?

[Baroness Merron (Lab)]

I know the noble Lord talked about primary care more generally, but the assessment on pharmacies is that there is quite a good coverage. Some 80% of the population live within a mile of a pharmacy and, as I say, there are other online and not-in-person ways of contacting pharmacies. The Pharmacy Access Scheme provides financial support to pharmacies in areas where there are fewer pharmacies. Local authorities, along with ICBs, continue to monitor changes, look at provision and have the ability to intervene where necessary. On all these counts, in respect of primary care provided through pharmacy, which is so important, we continue to monitor the impact across ICBs. With regard to a particular assessment, I will gladly write with more details to the noble Lord.

NHS England Update

Lord Kakkar Excerpts

Wednesday 19th March 2025 Lords Chamber

[Baroness Merron (Lab)]

I am very pleased to give the reassurance that the noble Baroness seeks. When we reflect, the disastrous 2012 top-down reorganisation certainly did not depoliticise the NHS—it made it less efficient and less able to treat patients on time.

This is not about politicisation; this is about responsible government. I add—without embarrassing anybody—that a number of former Conservative Health Ministers have said to me, and to my colleague Ministers and the Secretary of State, how much they welcome this and how they wish that they had taken this step. That, for me, as well as the tone of the contributions from the Front Benches today, provides the reassurance the noble Baroness seeks.

[Lord Kakkar (CB)]

My Lords, I draw the House’s attention to my registered interest as chairman of King’s Health Partners. In the announcement made by the right honourable Secretary of State for Health in the other place, there was particular emphasis on identifying that in this period of transition, NHS England will focus on ensuring that local providers are better able to cut waiting times and to organise their finances appropriately. But NHS England has many other functions beyond those two important ones, and they will need to be delivered in what is a substantial transformation in reabsorbing NHS England into the Department of Health and Social Care. What reassurance can the Minister give your Lordships’ House that functions such as the recently integrated Health Education England function into NHS England, the NHS Digital function and many others, are going to be properly supervised and delivered during this period? They are as essential, in many ways, as delivering on waiting times and organising finances.

[Baroness Merron (Lab)]

The noble Lord is right to talk about NHS England in all its functions. Bringing it together with the department will not diminish those functions but will allow them to be delivered rather more effectively than they are currently. At the head of the transformation team is Sir James Mackey, the new chief executive of NHS England, working with Dr Penny Dash as chair. Both individuals are well respected across the sector for their outstanding track records, not least on turning round NHS organisations, in Jim’s case, but also on balancing the books, driving up productivity and driving down waiting times—exactly what is needed. But I agree totally with the noble Lord, and we are going to ensure that the necessary functions are continued; it is the way they are delivered that we are changing.

Primary Healthcare Facilities

Lord Kakkar Excerpts

Monday 17th March 2025 Lords Chamber

[Baroness Merron (Lab)]

I can assure my noble friend that we are working closely with the Ministry of Housing, Communities and Local Government to raise the importance of primary care provision in the planning process, as my noble friend has highlighted. That is to influence the direction of local plans, as well as maximise contributions from developers. We very much support using existing community spaces, which is a creative solution to deliver primary healthcare services, and we are exploring through the 10-year health plan how to further support the integration of services into the wider public estate to improve access. Indeed, we will consider all solutions, including the ones that my noble friend highlights.

[Lord Kakkar (CB)]

My Lords, I draw noble Lords’ attention to my registered interests. The Minister will, I am sure, agree that, beyond physical infrastructure, one of the most important impediments to ensuring that there is effective integrated care between secondary and primary care settings is the question of regulation—professional and institutional regulation—which is quite different across those institutional boundaries. What plans do His Majesty’s Government have to look at the question of regulation to improve integrated care as part of their broader review of the delivery of healthcare in our country?

[Baroness Merron (Lab)]

The noble Lord is right to highlight regulation. Of course, there are many other aspects beyond physical infrastructure: for example, the use of technology, which also supports the subject on which we are speaking. All these matters are being considered as part of the 10-year plan and I am sure we all look forward to that reporting.

NHS: Electronic Patient Record Systems

Lord Kakkar Excerpts

Wednesday 12th February 2025 Lords Chamber

[Baroness Merron (Lab)]

The noble Baroness is quite right about the benefits. The electronic patient records programme provides a 4.5% reduction in length of stay, as well as a 13% lower cost in admitted patient spells, so there are great benefits as well as better productivity and outcomes for patients. Electronic patient record coverage is forecast to be at 96% of trusts by March 2026, and the remaining 4% of NHS trusts will be advanced in their plans for an electronic patient record. I emphasise that we are proactive in actively supporting hospitals and trusts to get to the right place.

[Lord Kakkar (CB)]

My Lords, I draw the House’s attention to my registered interests. Patients who are managed in research-active environments frequently have better clinical outcomes. For an environment, be it in the community or in the hospital, to be research active, it must be able to collect patient data; electronic records are therefore essential. Beyond that, there is a necessity to curate those data and present them in such a fashion that they can be used meaningfully and rapidly to drive our nation’s research effort and benefit all citizens. What plans do His Majesty’s Government have, as they move forward with the 10-year plan, to ensure that that area of development is properly funded?

National Cancer Plan

Lord Kakkar Excerpts

Monday 10th February 2025 Lords Chamber

[Lord Kakkar (CB)]

My Lords, I thank the Minister for bringing this Statement to the House today. I remind noble Lords of my interests as chairman of the Office for Strategic Coordination of Health Research and King’s Health Partners.

The Minister will recognise well that one of the most important determinants of achieving improved outcomes for cancer patients is access to innovative therapies. It has recently been suggested by the major pharma industry that there are fiscal and regulatory matters that impede the adoption of such innovative therapies across the NHS in England. Can the Minister confirm that, when His Majesty’s Government start to develop the cancer plan, they will look at matters of regulation and fiscal intervention to ensure not only the opportunity for broader support for clinical research but that a continued enthusiasm will be provided for those who have developed innovations to bring them to the UK and make them available to our fellow citizens?

[Baroness Merron (Lab)]

The noble Lord makes an important point about what I would call unnecessary obstacles to innovation and technology—something which the noble Lord, Lord Kamall, also raised. I assure the noble Lord, Lord Kakkar, that engagement with industry is extensive. We seek to identify blocks to improving healthcare provision in this country so that we can take the necessary steps. I agree that there are obstacles. We will continue to identify them—working with industry, which is crucial—and to seek to fix them.