Accessibility of Radiotherapy

Debate between Caroline Johnson and John Hayes

Tuesday 4th February 2025 Westminster Hall

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

It is a great pleasure to serve under your chairmanship this afternoon, Sir John.

As we discuss the future of radiotherapy services, it is essential that we acknowledge the vital role our radiographers, medical physicists and oncologists play, along with all the nursing staff and others, in the delivery of care.

The professionals are the backbone of any successful radiotherapy service, and without them progress is impossible. However, it is clear that Governments have faced significant challenges in both staffing and infrastructure. I will take this opportunity to scrutinise the current state of radiotherapy services and the plans to address those concerns. The demand for radiotherapy has increased substantially in recent years, driven primarily by one factor: our ageing population, and the fact that as we grow older our chances of being diagnosed with cancer increase significantly. However, radiotherapy is and remains one of the most cost-effective treatments available within the NHS. Previous Governments recognised that fact, and between 2016 and 2021 they invested £162 million to enable the replacement or upgrade of approximately 100 radiotherapy machines.

Since April 2022, the responsibility for investing in new machines has sat with local integrated care boards in England, supported by the 2021spending review, which set aside money for the purpose. As hon. Members have said, to keep up with increasing demand and the need for cutting-edge care, there must be significant sustained investment in radiotherapy services. Radiotherapy is one of the most technologically advanced areas of healthcare, so it is incumbent on us to keep up with the latest scientific developments.

It is welcome that the Government have announced £70 million for new radiotherapy machines, but Radiotherapy UK has said that that is not enough and has suggested that the Government invest five times that amount to upgrade out-of-date machines. I would appreciate clarification on that point. The Government have consistently stated in written answers that funding for new radiotherapy machines will be allocated by ICBs using criteria set by NHS England, but how will they monitor the upgrading of the machines across ICB areas to ensure that that takes place and to prevent the postcode lottery that Members have described? Furthermore, NHS England has confirmed that it will give high-performing local systems greater freedom around capital spending. Will such freedoms include capital retention, which can be used to invest in new radiotherapy equipment?

One of the most pressing issues is the need for a comprehensive long-term strategic plan for radiotherapy from the Government. The absence of such a plan hinders the ability to think strategically about the future of cancer care and to make the necessary investment to meet growing demand. I am glad that today, World Cancer Day, the Government have committed to produce a new cancer plan. We are told that it will include details about how outcomes for cancer patients, including waiting times, will be improved. Will the Minister indicate whether it will provide specifics on the roll-out of radiotherapy machines in the short, medium and long term?

In response to a written question last month, the Minister clarified:

“NHS England does not hold any data on the effectiveness of radiotherapy machines relative to the number of doses that they deliver.”

Hon. Members have said that newer machines will be able to deliver more doses more quickly. I would be interested to know whether the Department has any plans to collect such data.

Of course, any strategic plan should focus not just on the machines, but on the people who operate them—the radiotherapy workforce. What steps are the Government taking to improve the recruitment and retention of the radiotherapy workforce?

In a written question, the hon. Member for Westmorland and Lonsdale asked the Government whether they had consulted or planned to consult with clinical experts, the radiotherapy industry, patients or charities about how best to allocate the funds announced in the Budget for the new radiotherapy machines. The Minister responded by saying:

“The Department has no plans to consult on this matter”,

and reiterated that the funding would be allocated using NHS England criteria. The Minister today announced the plan to produce a cancer strategy. Will that include radiotherapy? Will he commit to working with Radiotherapy UK and providers to improve access to radiotherapy treatment where it is currently lacking?

The hon. Member for Westmorland and Lonsdale (Tim Farron) made a very compelling case about long journeys. He spoke about a service in his constituency, and there are others that are similarly affected. We know that earlier treatment affects survival rates. I asked the Minister a question in the main Chamber earlier about the 62-day target, and I did not hear him answer. Will he confirm that he intends to stick to the Health Secretary’s previous commitment to reaching the 62-day target by the end of this Parliament?

In addition to Government investment, the private sector plays a role in ensuring the future success of radiotherapy services. The NHS has signed a significant partnership agreement with the independent sector to increase capacity for diagnostic and elective procedures, which will help to reduce waiting times, but it is not clear whether that agreement includes treatment equipment such as radiotherapy machines. Will the Minister confirm whether the Government will work with the independent sector to upgrade equipment such as radiotherapy machines? A partnership that includes capital investment in radiotherapy equipment could ease the burden on the NHS and speed up access to treatment for patients.

I know the Minister is hugely motivated to do all he can to improve cancer care, as we all are. This debate should have helped to give him a steer on how that can be achieved.

[Sir John Hayes (in the Chair)]

I ask the Minister to leave a few moments for Mr Farron to say a final word of wind-up, and Mr Farron, in turn, to leave me a few moments to put the question.

Tobacco and Vapes Bill

Debate between Caroline Johnson and John Hayes

2nd reading
Tuesday 26th November 2024 Commons Chamber

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

Prevention is better than cure. As we have heard, smoking is a cause of many premature deaths and much serious ill health. That was why the previous Government introduced legislation to tackle it and restrict access to tobacco purchases for those born after 1 January 2009. This Bill builds on many measures in the previous one.

As we have heard, this is a Bill of two parts: tobacco and vapes. Those two parts have been received differently, a bit like Marmite and chocolate spread—part controversial, part pretty universally liked. The section on smoking and tobacco has proved to be a bit like Marmite—some people have liked it. My hon. Friend the Member for Harrow East (Bob Blackman) spoke eloquently of his passion for stop-smoking measures, his successful campaigning, and the previous Government’s success in reducing rates of smoking. My hon. Friend the Member for North Dorset (Simon Hoare) spoke eloquently about the balance between libertarianism and choice, and the need for order, societal norms and the protection of others in society. The hon. Member for City of Durham (Mary Kelly Foy) spoke about the dangers of smoking and the difficulties and challenges for people trying to quit.

On the other hand, other Members expressed concern about the Bill. The hon. Member for Lewes (James MacCleary) talked about how the Secretary of State might use powers relating to outside places where people may smoke. The hon. Member for Newbury (Mr Dillon) shared his concerns about how measures on the age of sale will work in practice. Those will indeed be clunky measures for shopkeepers to try to enforce, and will have an effect on the cohort of individuals who are just either side of the threshold, who will require ID throughout their lives. The hon. and learned Member for North Antrim (Jim Allister) spoke about how that measure will work in Northern Ireland, and although he received some assurances from the Minister, I am not sure that they were completely effective.

Although I confess that I do not like Marmite, it is a free vote this evening for Conservative Members, and I will support the Bill. The Secretary of State said in opening that 350 young people will start smoking today, most of whom will regret it, so why was 1 January 2009 chosen? I appreciate that that was the date in the previous Bill, but why did he choose it for his Bill too?

Let me move on to the area of chocolate spread—the part of the Bill on vaping. I think it was universally welcomed, and was supported by the hon. Members for Newcastle upon Tyne East and Wallsend (Mary Glindon) and for North Shropshire (Helen Morgan) among others. It includes measures to tackle vaping among children, on which I have personally campaigned. As others have said, the chief medical officer has been clear that for someone who smokes, vaping may be better, but if they do not smoke, they should not vape. As a Member of Parliament and a children’s doctor, I have been increasingly concerned about the sharp increase in children addicted to vaping and, more recently, to other nicotine products such as pouches. Schoolteachers have reported that children are unable to concentrate, or even complete a whole lesson, without visiting the bathroom to vape.

[Sir John Hayes]

I very rarely disagree with my hon. Friend. She is of course right about vaping, the effect that it has on children and the difficulty that schools have in managing it, as headteachers will no doubt have told Members across the House, but can she really go into the Division Lobby to support the Bill with this nonsense about age? The idea that someone aged 30 could smoke and someone aged 29 could not, and the idea that that could be policed or managed in any practical way, is just nonsensical. It was daft when the last Government introduced it, and it is daft now this Government have done so.

[Dr Johnson]

The challenge is that if we were to ban it altogether, we could risk criminalising people who were already addicted to tobacco products—adults who had made that choice. That is the reason why both present and past Governments put forward a measure to increase the age gradually, but I understand the points that have been made about the difficulties for shopkeepers and others in enforcing it over time.

I return to vaping. Doctors report a growing body of evidence suggesting that children may be having difficulty in school and suffering health problems as a result of vaping. A report from Healthwatch said that 31% of the more than 4,000 under-18s it surveyed were regularly vaping. Nicotine is a powerfully addictive product. Young people are particularly susceptible to it, so it is very important that we protect children from vaping and other nicotine products. After all, vaping is an adult activity; it is apparently designed to help smokers quit. While the industry may argue that the flavours and colours are enjoyed by adults—and they may well be—I struggle to understand why adults would want a vape flavoured like a unicorn milkshake, whatever a unicorn’s milk tastes like. The Healthwatch survey showed that fruit flavours are very popular with children, and the same has been repeated by various teaching unions, the British Medical Association, of which I am a member, Cancer Research UK and even a Government report from last year. I also do not see why an adult stop-smoking device needs to be disguised in the form of a highlighter pen, which could perhaps be hidden in a child’s pencil case, or created in the shape of a children’s cartoon character. Enticing and luring children into a lifetime of unwanted and potentially harmful addiction is immoral.

The Secretary of State is taking powers to regulate the flavours, colours and packaging of vapes, but how will he ensure that he stays one step ahead of an industry whose income depends on a new generation of addicts? He has taken quite extensive powers, which I know is of concern to some hon. and right hon. Members, but how and when does he intend to use them? What support will be given to children who are already addicted to vaping to help them quit?

Finally, while this is a free vote issue, I am pleased on a personal level to see some of the proposals that I put forward on the last Bill being incorporated into this one, particularly on the sponsorship and advertising of vending machines. Whatever our views on this Bill, it is a bold piece of legislation of good intention. It aims to improve the health of our nation and of our children in particular and to reduce smoking and prevent nicotine addiction in the young. It is not clear whether it will work, but we have to hope, for the health of all of us and our children, that it does.