Cancer Care

Debate between Tim Farron and Peter Dowd

Tuesday 14th March 2023 Westminster Hall

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

It is an honour to serve under your guidance today, Mr Paisley, and to follow the hon. Member for Bootle (Peter Dowd), who made some important points, for which I thank him. I express massive congratulations to the hon. Member for West Bromwich East (Nicola Richards) not just on securing an important debate, but on making an excellent speech. I commiserate, console and offer my condolences to her on the loss of her mother. I also lost my mum to cancer. The hon. Lady is a bit younger than I am, so I assume we lost our mums at about the same age.

My mum, Dr Susan Farron—she would like me to mention her title, I am sure—passed away from ovarian cancer 19 years ago. Although we are here to represent our constituents and do what is right, whether we are personally affected or not, there is an element of honouring our mothers in what we seek to do today. I am sure the hon. Lady’s mother would be massively proud of her, not just for what she has done today.

This is a huge issue. It is said that half of us will get cancer at some point in our lives, and 100% will be affected by it in one way or another. We deal at the moment with terrifying waiting times for cancer treatment. They are not quite as awful as they were a month or so ago. The Minister may say that, and we will grab some positives where they exist, but they are still deeply troubling.

In my constituency, in south Cumbria, 27% of people with cancer are not being seen within two months of being diagnosed. Someone who has cancer and has been told they have this dangerous thing within them that is potentially going to kill them then waits for two months for treatment. In north Cumbria, 44% of people diagnosed with cancer are waiting more than two months for their first intervention. What terror does that spark in an individual with cancer and all their loved ones? What frustration does that lead to within the clinical community, who desperately want to care for those people? To add substance to that terror, we know that on average—although there is no average cancer—for every four weeks that treatment is delayed, there is a 10% reduction in life expectancy. That is disastrous and massively worrying for everybody who faces that challenge.

Covid has played a part, with its massive impact on our health service. People perhaps did not come forward with symptoms during the pandemic as soon as they might have done. I have many disagreements with the Government about how they handled the pandemic, but it is important to say that, if they had not locked down, the situation would have been far, far worse. Let us remember that many of the pressures that we face are because we sought to protect the NHS to save lives, and we did just that. However, the waiting times are unacceptable. They are explicable but not excusable.

I want to focus my remarks on radiotherapy. I chair the all-party parliamentary group on radiotherapy. One reason for doing that is that I recognise that radiotherapy is one of an important range of tools that can be used to treat, and often cure, that terrible disease of cancer. Across the world, in countries with similar levels of GDP to ours, such as other European countries, Australia and New Zealand, there is an average international target that 53% of patients living with cancer should receive radiotherapy. In the UK, the proportion is 27%. One reason is the lack of investment from Governments of all colours represented in this room. I will point the finger at this Government for not taking the action they need to now, but I could point the finger inwards at the coalition Government and the Labour Government. We have collectively neglected this situation, I am afraid.

Only 27% of people with cancer who should or could receive radiotherapy are getting it. For a clue as to why that is the case, let us look at Australia, where the five-year survival rates for lung cancer are a third better than those in the UK. Australia spends around 10% or 11% of its cancer budget on radiotherapy; in the UK, we spend just 5%.

[Peter Dowd]

I am pleased that the hon. Gentleman raised that. Radiotherapy UK provided some figures indicating that

“by the end of 2024 there will be 74 out of date machines in the NHS,”

and that

“by 2025 it will be 90.”

Does he agree that that is a pretty grim statistic?

[Tim Farron]

It is, and in a moment, I will come on to how we might tackle that. It is a real problem, and not all of it is down to money—some of it is down to where and how the money is spent.

The all-party parliamentary group on radiotherapy has been working with the charity Radiotherapy UK, which the hon. Gentleman rightly referred to. We have been delighted with the coverage that we have received recently through the Daily Express, which has run a campaign alongside us calling for a £1 billion boost in radiotherapy. The Minister can read all about it not just in the Express, but in the manifesto put together by the all-party group, which details that.

To put it bluntly, in the run-up to the Budget this week, we know that the Chancellor has something like £30 billion more to spend than he thought because of underspend on energy support and an increase in tax revenues, not least because of people spending more money on goods due to inflation, and therefore spending more VAT. The Government therefore have that windfall to play with. I am asking for one thirtieth of that to be spent on radiotherapy, so that we can save thousands and thousands of lives.

What would we spend that money on? We would spend it on new kit. Not all of that would need to be new money; it could just be money that is spent more wisely. As the hon. Member for Bootle alluded to, part of the problem is that we have ancient kit. He mentioned the 74 machines—linear accelerators—that will be out of date by the end of next year. Why do we have so many out-of-date linear accelerators and other bits of radiotherapy kit? It is largely because the funding for those machines is feast and famine, and because it is devolved to 42 different specialist commissioners, when we actually need a central, national, well-funded rolling programme to replace and update linear accelerators. It is not rocket science—though it is science—and the Government could do that without spending an absolute fortune.

I want to ask the Minister again about the issue regarding tariffs. Many of our cancer centres are using second-division kit, to put it crudely. The tariff for using a second-division piece of kit means that centres can be paid for the 30 fractions a person might need to deal with their cancer, whereas with a first-division piece of kit, it might take only four, five or six trips to treat someone. Centres are paid per fraction, so there are perverse incentives whereby trusts are more likely to be rewarded if they use poorer kit more often than better kit less often. That has been fixed in part, but not for every cancer, not for every machine and not for every unit. That needs to be dealt with, and again, it could be done freely.

We talked about the workforce. The radiotherapy workforce is really small—about 6,400 individuals. There are 30% fewer entrants coming into the sector than there are places available, which has an impact on the morale of the people already working there. We are losing people as a consequence. Retention is becoming a problem because recruitment is such a problem. People feel under such weight. With such a small workforce, it would not involve an awful lot of effort to significantly increase that. We need to invest in training to bring clinical oncologists and clinical radiologists into the profession, and also to alleviate the pressure that staff are under now by supporting new admin staff up-front, which could be done very quickly, to allow people currently in the profession to be able to concentrate more on their frontline duties, rather than on admin.

I will make a final remark regarding radiotherapy, which is about access. Among the reasons why only 27% of people with cancer are getting radiotherapy in England—as opposed to the 53% who really should—is that many people, particularly in my community, are just too far away from the treatment. In our communities, the majority of patients using our nearest radiotherapy centre are making two or three-hour round trips every single day. The national radiotherapy advisory group says that it is bad practice for people to have to travel more than 45 minutes for treatment—never mind three-hour round trips every day for 30 days. As a consequence, some people do not get referred for treatment at all, or may even make the choice themselves not to finish that treatment. There is no doubt that that is having an impact on survival rates.

We have built a strong case, in our community, for a radiotherapy satellite unit from the Rosemere unit in Preston—our nearest unit—to be deployed at the Westmorland General Hospital in Kendal. A solid clinical and business case was put for that, and I would be grateful if the Minister might agree to meet with me, even for just 15 minutes, to review that and consider the extent to which the Department might be able get behind it and other satellite units around the country that could cut waiting times and save lives.

There are no silver bullets to many problems that we face in this place, but this is quite close to being one. For a relatively small amount of money, the UK Government could do something that would save lives, and do so quickly. I encourage them to do so.