Cancer Outcomes in the UK

Baroness Paul of Shepherd's Bush Excerpts

Tuesday 21st April 2026 Grand Committee

[Baroness Paul of Shepherd’s Bush (Lab)]

My Lords, like many before me, I thank my noble friend Lord Patel for securing this debate and other noble Lords for the excellent contributions that have been made so far. I beg your Lordships’ indulgence—my comments are of a more personal nature than some of the others we have heard. I hope that noble Lords will accept that. The themes and targets in the cancer plan are among the many things I will touch on in my more personal remarks.

I want to focus on clinical trials, one of the great engines of medical progress. They underpin the medicines that extend lives, relieve suffering, and in many cases deliver cures that would have been unthinkable a generation ago. They also support the UK’s ambition to be a global leader in clinical research and can be an engine for much-needed economic growth in our country.

But today I draw attention to a group of patients for whom the current clinical trial system does not really work properly: those who are diagnosed with life-limiting conditions and for whom time is short. I know that rare cancers are for the first time mentioned in the cancer plan. I also know that there is a significant commitment to clinical trials. I want to make certain that those who have rare cancers that are diagnosed late have access to those clinical trials. For those individuals, time is not abstract—it is measured in months, not years—and it is about the quality of life, not just the length of it. Our trial infrastructure is not really built for that reality. Normally, you have to fail standard treatments and then navigate complex rules in order to participate in any of the trials.

As I speak today, I remember our much-missed colleague Baroness Margaret McDonagh. She was my great friend, and watching her die from glioblastoma, a rare and devastatingly aggressive cancer, brought home to me the reality of what a rapidly progressing, life-limiting illness can be. It exposed the gap between the urgency faced by patients and their families and the pace at which our systems operate.

The brutal truth is that a patient diagnosed with glioblastoma today will, in almost all cases, be offered the same treatment, delivering the same average expectancy of nine months, as they were offered 40 years ago. That stasis cannot be explained by lack of scientific promise, because we have seen extraordinary advances in medicines, diagnostics and data in that time. Yet far too few of the solutions reach patients with the most aggressive and rare cancers.

Since Margaret’s death, her sister Siobhain McDonagh and her outstanding clinician, Dr Paul Mulholland, based in UCLH, have worked tirelessly to improve outcomes for glioblastoma patients, raising funds for trials when the NHS has not been able to pay for them, championing research and repeatedly confronting the many barriers that stand in the way of progress. Their experience shows a culture stacked against urgency and innovation, with long lead-in times for decisions, inertia, caution and conservatism in the system, slow processes and obstacles that deter clinicians from pushing the frontier of treatment and offering patients new and innovative treatments.

Dr Mulholland has been running immunotherapy trials using medicines that have transformed outcomes in other cancers to test whether they can help with glioblastoma too. Immunotherapy, as many noble Lords know much more than me, works by triggering the body’s own immune system to fight cancer, and it has transformed outcomes in conditions once considered untreatable. Dr Mulholland is trialling a new approach in which some glioblastoma patients receive immunotherapy before tumour removal, when their body is at its strongest, to see if that produces better outcomes. One patient who has been widely reported in the press, Ben Trotman, who was part of that trial, has lived for more than two years beyond his nine months’ diagnosis of glioblastoma, and his cancer remains under control. During that two-year period, he and his wife have had a baby, Mabel. I regard her as a miracle made possible by this innovative trial.

But such breakthroughs require patients to reach trials early enough and a system willing to test new approaches with urgency and ambition. We need to be honest about risk. Many of these patients are already dying, so why not let them, with full consent and proper safeguards, try promising new treatments where there is a scientific case to give them a go? The potential benefits for them are more time and a better life, and increased knowledge for us about what does or does not work. What greater legacy could there be than that?

I ask the Minister: what specific steps are the Government going to take under the cancer plan to ensure that the increased clinical trials are also available to those with the shortest timescales and in the most urgent period of need?