Lord Stevens of Birmingham Portrait Lord Stevens of Birmingham (CB)
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My Lords, I declare my interest as chair of Cancer Research UK and wholeheartedly endorse all the previous contributions on this group, which have been outstanding. The purpose of these probing amendments is simply to make sure that cancer remains very firmly on the Government’s agenda. The cancer plan, published in February, has a range of really welcome proposals, but the key thing will be putting them in place. In the cancer plan, there was a commitment to delivering the cancer waiting time standards by 2029. It would be fantastic if the Minister could confirm at the Dispatch Box that that remains the game plan the Government and the NHS have embarked on.

In doing so, can the Minister briefly comment, in the context of the three headline cancer waiting times targets, on the faster diagnosis standard for urgent referral of 28 days? We are seeing a bit of a bifurcation opening up between the faster experience that patients who do not have cancer are having—with cancer being ruled out for 79% of people, against an 80% target, which is great—and maybe only 55% of people who actually have cancer getting their diagnosis within that 28-day period. If we are interested in the outcomes improvement that will come from early diagnosis, it will be crucial to keep a beady eye on the waiting times for diagnosis for people who actually have cancer.

Lord Tarassenko Portrait Lord Tarassenko (CB)
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My Lords, I will speak very briefly in support of Amendment 250 in the name of the noble Baroness, Lady Finlay, to which I have added my name. I come to this debate as the husband of a cancer survivor. My wife was diagnosed with Hodgkin’s lymphoma 30 years ago, and I am very glad to say that she was successfully treated with radiotherapy.

I realise that, for lymphoma, the role of radiotherapy has decreased as chemotherapy has improved. But for some cancers, as we have heard, radiotherapy remains the treatment of choice. Chemoradiotherapy for cancer of the larynx cures patients while, very importantly, preserving their voice. For anal cancer, it has replaced an operation that once meant a permanent colostomy for every patient. For locally advanced cervical cancer and early lung cancer in patients too frail for surgery, it is the curative option.

Radiotherapy, of course, also works in partnership with other treatments. A study of more than half a million cancer survivors in England found that three-quarters of five-year breast cancer survivors and two-thirds of head and neck survivors had received radiotherapy. In the ProtecT trial, led by my Oxford colleague Professor Freddie Hamdy, which followed more than 1,600 men with localised prostate cancer for 15 years, radiotherapy matched surgery on survival but fewer men were left with long-term incontinence.

So, the problem is not the evidence but delivery. As the noble Baroness, Lady Finlay, has said, only four in 10 patients start radiotherapy within the 62-day standard against a target of 85%—far behind surgery and chemotherapy. More than half of cancer patients would benefit from radiotherapy, yet in England only around a third receive it. Some 60,000 patients a year miss out, and that is often because of where they live.

That is why a national delivery programme is important. First, we should think about equipment: the linear accelerators which generate the high-energy radiation of radiotherapy last around 10 years. A national programme can plan a replacement as a rolling cycle and buy at scale instead of trusts bidding for capital one machine at a time. In May 2025, the Government invested in 28 new machines, which is very welcome, but a plan is needed to go beyond one-off funding. Secondly, satellite centres such as Oxford’s, at Swindon’s Great Western Hospital, bring treatment closer to the patient’s home, but they need to be planned nationally once the gaps have been identified. Thirdly, a national programme can collect national data, including performance data, and have a co-ordinator responsible for delivery.

Radiotherapy is curative, cost effective and preserves organs. Patients deserve timely access to it wherever they live.

Lord Evans of Rainow Portrait Lord Evans of Rainow (Con)
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My Lords, I apologise for interrupting the noble Lord; the House always enjoys hearing from him. I am speaking in an incredibly important and delicate debate. I thank all the noble Baronesses for tabling such amendments which address some of the most pressing challenges facing cancer patients and their families. Cancer is a disease for which time is so often the difference between life and death. Too many patients face delays in diagnosis, uncertainty over treatment and unacceptable inequalities in access to care. These amendments speak to a fundamental principle: improving cancer outcomes must remain a clear and measurable national priority.

I welcome the amendments tabled by the noble Baroness, Lady Pidgeon, particularly Amendment 41, which seeks to ensure that cancer outcomes, including survival, remain a priority for the Secretary of State. Removing the existing statutory requirement risks weakening accountability at precisely the moment we need greater ambition.

That ambition must extend to cancers with the poorest survival rates. I was encouraged to hear last week from the noble Baroness, Lady Merron, that the Government have commissioned an expert review into brain cancer research and that findings will be expected within just three months. This is welcome, but patients and families have heard promises before. What will be different this time? Can the Minister explain how the review will translate into tangible improvements in research funding, clinical trials and, ultimately, survival?

The Government have also released a national cancer plan to support new clinical trials and increase research participation, coupled with an ambition to reduce clinical trial set-up times to 150 days by March 2026. These are positive steps, but they must be matched by the capacity to deliver them. Does the NHS have the workforce, infrastructure and resource necessary to turn this ambition into concrete results for patients? Research is essential, but so is timely treatment. What targeted funding do the Government further envisage for clinical trials?

I will now address the amendment from the noble Baroness, Lady Pidgeon, which would strengthen patients’ rights to begin cancer treatment within 62 days of referral. This should be a reliable standard. Can the Minister explain why this target is not being met and what steps they are taking to do so?

The urgency is particularly apparent in radiotherapy. As the noble Baroness, Lady Finlay, powerfully highlighted, radiotherapy is one of the worst performing cancer treatments. Only 62% of radiotherapy patients begin treatment in 62 days in comparison to 71% for surgery and 67% for chemotherapy—all fall short of the target of 85%. These figures should concern us all. Delays and geographical inequalities continue to undermine access to treatment. Can the Minister tell us whether the Government have begun to design a nationally co-ordinated programme addressing workforce shortages, equipment capacity and access to modern techniques?