Secondary Breast Cancer

Caroline Johnson Excerpts

Thursday 11th June 2026 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

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

I congratulate the hon. Members for Wokingham (Clive Jones) and for City of Durham (Mary Kelly Foy) on securing this debate, which I know is extremely personal to both of them. I also congratulate the hon. Member for West Lancashire (Ashley Dalton) on her speech. It is quite common in this place for people to say that an hon. Lady or hon. Gentleman has given an extremely powerful speech, but that was an extremely powerful speech. I was moved by it, and I am in great admiration of her courage and the frankness with which she speaks in this House about her illness. I was fortunate enough to be at a roundtable earlier in the week with the New Statesman about the cancer plan, with the hon. Member for Wokingham and others. I found it very insightful and thought-provoking, like the contributions we have heard in the Chamber today.

As has been said, for many people, primary breast cancer never comes back after treatment, and treatment for primary breast cancer has significantly improved. But sometimes the cancer cells spread to other parts of the body—commonly the bones, lungs, liver, brain or skin—which is called secondary or metastatic breast cancer. As we have heard, the best estimate we have is that there are around 61,000 people living with secondary breast cancer in the United Kingdom, but that statistic is uncertain and the data is unclear. One point in the cancer plan was that the Government would collect the data on secondary breast cancer from 2026. We are almost halfway through 2026, so I would be grateful if the Minister could provide an update on how that is going and when we will see that data. Also, how frequently does she expect it to be published—will it be published monthly, quarterly, every half year or every year? What are her plans for that? There needs to be definition in order to do that, so I wonder if she has settled on that too.

Another point in the cancer plan is the desire to improve screening. Again, I commend the hon. Member for West Lancashire on her work on the cancer plan, but there are women in Lincolnshire waiting five weeks and more for referral to their appointment when they discover a breast lump, and we know that the longer it takes for diagnosis, the more likely metastasis is to occur. Could the Minister give more detail on the promise to expand screening? What does it look like? What workforce will be necessary and when will that be in place? What mammography machines or ultrasound machines might be needed? Are they to be bought and installed, and how quickly does she expect that to happen? For those who need genetic testing, what plans does she have to expand the availability of genetic testing, and what will the timescale be?

The cancer plan, which I am glad is very ambitious—it should be—will work only if it is delivered. It was published just over four months ago, but it is not clear what progress is being made or that the work is continuing at the necessary pace to deliver the ambitions we all want to see achieved. One thing slowing progress is the reorganisation of integrated care boards in response to the cutting of their budgets by 50%, and the Health Bill’s abolition of NHS England. The people who would be organising and planning are organising and planning something else. Some of them are leaving, so we are losing expertise, while others are being made redundant—or leaving before they are made redundant. That is disrupting the planning of our health services. Will the Minister comment on that?

As has been said, there has not been the same progress for treatment of lobular breast cancer as for other forms of breast cancer. The previous Conservative Government committed £20 million to the Moon Shot project, to research ways of advancing treatment of that particular form of cancer, which needs more attention than it has had of late. Will the Minister tell us whether this Government are committed to providing that money for that research?

Hospices provide amazing services for people towards the end of their lives, but, as we have heard in other debates in this Chamber, they are struggling. They have a lot of staff because theirs is a very person-delivered service, and they accrue extra national insurance costs from employing all those members of staff. I appreciate that the Government have put a lot of money into hospices, but that is capital money to enable them to redecorate, build extra bits, provide extra equipment. That is lovely, but it does not help if there are no staff to run the service and provide the care that the patients so desperately need. What discussions has the Minister had about the effects of national insurance contributions on hospices? Has she considered an exemption? What are her plans to help to support the hospice movement?

The hon. Member for West Lancashire referred to what happens when a patient has run out of options. As a doctor, I am always told that a doctor never runs out of treatments. Palliative treatment is treatment, so even when they run out of treatments, they are still providing a treatment. However, what happens when we run out of treatment that is active or likely to be successful in prolonging life or curing disease? It is important that research is supported and able to continue. I look forward to the Minister’s words on what the Government are doing to support research so that new drugs can come online. During the pandemic, we saw how quickly vaccines were brought through the pathway. What is gumming things up now? How do we speed it up so that people can get the necessary drugs more quickly?

What happens in the grey zone, when a drug is going into trial and is sort of but not quite available yet? We have compassionate use schemes, about which I asked an urgent question in the main Chamber this morning. Such schemes are used when individuals have reached the end of the treatment options and perhaps do not qualify for any of the trials that are currently available—in paediatrics, that could mean that they are a few days out of the age bracket—or perhaps the trials are full. Those schemes are also used when a patient received the drug in a trial, but the trial is finished and negotiations about the drug are ongoing. In some cases, the drug companies will provide those drugs to patients for free to help them.

Unfortunately, towards the end of last year, the Government decided to charge VAT on the deemed value of such drugs. That means the companies have to pay sometimes quite significant charges to give those drugs to patients. One large pharmaceutical company has pulled out of the compassionate use scheme, which means that its drugs are not available for the people who need them—that issue was raised by my hon. Friend Member for Hornchurch and Upminster (Julia Lopez). The enforcement of that tax by His Majesty’s Revenue and Customs has been paused for review, but the liabilities remain.

We therefore have a situation in which some drug companies are pulling out and others are considering their position. People with secondary breast cancer, and those with other cancers and serious illnesses, cannot wait for the autumn Budget. They need the Government to make a decision to sort this problem out now. Only last month, the Government decided that they would take VAT off rides at Alton Towers. That is great, but if they can do that, they can sort this issue out as well, and they need to get on with it. Will the Minister raise the matter with her colleagues in the Department of Health and Social Care and in the Treasury to see what she can do to help people who have no option other than these new and special drugs to keep their hope alive?

In summary, the cancer plan is ambitious, which is great—it has some great targets that I hope can be achieved—but we need to see delivery. I am looking to the Minister for the detail on how the plan will be delivered.