NHS Workforce Levels: Impact on Cancer Patients

Clive Jones Excerpts

Thursday 23rd October 2025 Westminster Hall

[Clive Jones (Wokingham) (LD)]

I beg to move,

That this House has considered the impact of NHS workforce levels on cancer patients.

It is a pleasure to serve under your chairship, Ms Hobhouse. I declare an interest as a governor of the Royal Berkshire hospital. Also, a family member has shares in a medical company.

Being a cancer survivor, cancer diagnosis, treatment and outcomes are important to me. I thank the 136 people who responded to my survey ahead of this debate, and the Chamber engagement team for helping to highlight the real experiences of cancer patients across the country. I also thank all the organisations that have helped me and my office to prepare for the debate.

Shortfalls in the NHS workforce are no secret. Consultants, nurses, radiologists and oncologists are all working flat out to deliver care but are being held back by staff shortages, limited equipment, outdated buildings and a lack of training. This is a legacy of the last Conservative Government. The new Labour Government must act swiftly to support our NHS workforce and deliver world-class cancer care.

I welcome the commitment to a new national cancer plan that was confirmed on 4 February 2025—World Cancer Day—after I called for a national cancer plan on 31 October last year. That plan must prioritise early diagnosis and improved treatment. Perhaps it could even be launched on World Cancer Day 2026, which is 4 February.

According to Lilly UK, only one third of NHS staff believe there are enough people for them to perform their roles effectively. The Royal College of Radiologists reports a 29% shortfall in radiologists, or 1,670 consultants, which is set to rise to 39%, or 3,112 consultants, in five years. An extra 346 radiologists are now needed to clear the diagnostic backlog—equivalent to 9% of the current workforce. The Royal College of Pathologists found that 60% of consultants said their departments lack adequate resources, including staff.

Clinical oncology faces a 15% shortfall, forecast to reach 19% by 2029, with smaller cancer centres suffering vacancy rates six times higher than larger ones. In genomics, only 60% of tests are delivered on time, mainly due to a shortage of pathologists. In 2022, NHS England reported a 12% mammographer vacancy rate, rising to 15% in the midlands and south-east, and 36% of the workforce are due to retire within the next 10 to 15 years. Mike Richards’ 2020 review found that histopathology activity had increased by 30% between 2018 and 2019, while consultant numbers rose by just 8%. The gap continues to widen.

The UK also has among the lowest numbers of MRI, CT and PET scanners per million of the population among comparable nations, with just 10 CT scanners, 8.6 MRI units and 0.5 PET scanners per million. Even when equipment exists, staff shortages mean it is often not used. One survey respondent arrived for a CT scan to find no staff available to operate the machine.

In August 2025, only 69% of patients began treatment within 62 days of urgent referral—far below the 85% target, which has not been met since December 2015. That is the fault not of this Government but of the last one, but this Government need to make some improvements.

Early diagnosis is key to survival, yet 73% of hospitals are failing to meet the 62-day target. Between January and July 2025, only 66.7% of breast cancer patients began treatment within 62 days of referral. According to data from Breast Cancer Now, if the 85% target had been met each month, 2,931 more people would have started treatment on time. Even under Labour we are continuing to struggle. The Government are not making enough of a difference yet. But I must say again that the problems in the NHS are down to 14 years of Conservative Governments.

Best practice recommends a triple assessment, a clinical exam, imaging and biopsy in a single appointment, yet between 2020 and 2022 only 68% of people received that, due to staff shortages. The failure to streamline diagnosis creates delays and backlogs. Nearly everyone who is diagnosed with bowel cancer early survives for five years, but only one in 10 survive if they are diagnosed late. Still, just 38% of patients in England are diagnosed at stages 1 or 2. One respondent shared how her daughter, who was diagnosed with stage 4 bowel cancer, waited months to start treatment due to delays caused by workforce issues.

In July 2025, only 50% of lower gastrointestinal cancer patients were treated within 62 days of referral, although 93% began treatment within 31 days of a decision to treat. That shows that the delays occur early in the diagnostic process. At the same time, 91,400 people were waiting for a colonoscopy or a sigmoidoscopy. Around 28% waited for more than six weeks and 13% for more than 13 weeks. The Government must increase endoscopy and pathology capacity, and that requires the improvement of staffing levels.

Less survivable cancers—lung, liver, brain, oesophageal, pancreatic and stomach—are most affected by workforce shortages. Only 35% of pancreatic cancer patients receive treatment within 62 days. Less survivable cancers account for 20% of cases but cause 42% of cancer deaths, with a five-year survival rate of just 16%, compared with 55% in more survivable cancers. A new national cancer plan must include a strategy specifically for less-survivable cancers.

Between 2015 and 2023, one in four leukaemia patients faced avoidable diagnostic delays. A Leukaemia UK survey found that insufficient phlebotomy capacity was the top reason for delays in basic full-blood-count tests—a simple, inexpensive diagnostic tool. Acute myeloid leukaemia patients who faced avoidable delays were 22% more likely to die within a year of diagnosis. The Government should audit and invest in phlebotomy services, as called for by Leukaemia UK and the Royal College of General Practitioners. The Government also need to establish a national register of available phlebotomy sites.

Cancer remains a leading cause of death from disease among teenagers and young adults, but it is too often missed. Around 46.3% of 16 to 24-year-olds saw a GP three or more times before diagnosis, according to the Teenage Cancer Trust. That diagnosis delay is exacerbated by a nationwide decline in GPs, meaning longer waits and reduced access to diagnostic services. The national cancer plan and workforce plan must ensure that all frontline healthcare professionals—from GPs to A&E staff and opticians—are trained to recognise cancer symptoms in young people. Services in deprived areas also need support. Those communities face heavier workloads, greater pressure and less funding. The Government must provide targeted support for those areas.

Forty-three per cent of brain tumour patients saw a healthcare professional three or more times before diagnosis, and 55% of parents said their child’s tumour was misdiagnosed. In 2020, 45% of brain tumours were diagnosed in emergency settings—double the 22.5% for all cancers.

According to the Brain Tumour Charity, shortages of neuroradiologists and limited imaging access, alongside GP training gaps, have caused these delays. GPs should be allowed to request neuroimaging directly for concerning symptoms. For prostate cancer, in July 2025, only 55% of men began treatment within 62 days—a 5% drop since January. Even this year, we are still heading in the wrong direction. Men are waiting weeks or months for MRI and biopsy results due to staff shortages. England also has one of the lowest numbers of radiologists per head of population in Europe, a situation that must be rectified.

Clinical nurse specialists are essential to patient support, yet in 2024, 31% of blood cancer patients did not know who their clinical nurse specialist was, and 22% did not know how to contact them. That information is from Blood Cancer UK. Among secondary breast cancer patients in 2019, 25% had not seen a CNS since diagnosis, and only 65% said their CNS had sufficient time for them. For leukaemia, just 9% were offered a holistic needs assessment, which CNSs help to deliver. The national cancer plan must ensure that every patient has access to a CNS, but instability is worsening.

The Royal College of Radiologists’ 2024 census found that colorectal oncology has the highest locum reliance, at 13%. One in five colorectal consultants will retire within the next five years. How are we going to replace those healthcare professionals? The British Association of Urological Surgeons reports that 12% of consultant roles are unfilled, with a growing reliance on costly locums.

In haematology, the east midlands has twice as many vacancies as filled clinical scientist roles, with 32% of haematology clinicians planning to reduce their working hours. Again, the Royal College of Radiologists reports that the median age of radiologists leaving fell from 56 in 2021 to 49 in 2024, and for clinical oncologists from 59 to 54 in one year. Around 20% of clinical oncology consultants will retire in the next five years.

The NHS is losing staff faster than it can replace them. What will the Government do to replace those doctors before they retire? People with less survivable cancers often have rapid disease progression and experience severe symptoms. Around 70% of pancreatic cancer patients receive no active treatment; many are too unwell or diagnosed too late.

Specialist symptom management and supportive care must be expanded to reduce emergency admissions and improve quality of life, yet the NHS cannot currently deliver this. Less survivable cancers must have their own section in the national cancer plan. Advanced treatments such as CAR T-cell therapy for leukaemia are not available everywhere due to a lack of trained staff and infrastructure, resulting in a postcode lottery for lifesaving treatment. The Government must invest in training, especially in primary care, and increase specialist training places in radiology and oncology, as called for by the Royal College of Radiologists. The Government must also end recruitment freezes. On research, only 12% of brain tumour patients have taken part in a clinical trial, and 42% say they were never informed about opportunities to be part of a trial. Investment is needed in research, nurses, radiographers and infrastructure, as well as in embedding research into routine care and protecting staff time to deliver trials.

The Royal College of Radiologists is clear that delays caused by staffing gaps are endangering patients. Without investment, waiting times will lengthen, treatment delays will worsen and costs will rise. I hope it is clear to all of us that workforce shortfalls are a massive barrier to early diagnosis and effective, timely treatment across all cancers. The Government must increase recruitment, training and retention, support primary care referrals, invest in diagnostic infrastructure and education, guarantee access to clinical nurse specialists and prioritise support for patients with less-survivable cancers. Those steps must underpin the national cancer plan and the 10-year workforce plan. Lives depend upon it.

[Several hon. Members rose—]

--- Later in debate ---

[Clive Jones]

I thank you, Mrs Hobhouse, and the Minister for leaving me time to sum up the debate. I thank my hon. Friend the Member for North Shropshire (Helen Morgan) for her contribution and her kind remarks, and I thank other Members for their kind remarks as well. I thank all hon. Members who have contributed so much to today’s debate, each having special stories to tell about the areas they represent. All of them are fantastic campaigners for the cancer community.

We can all agree with the hon. Member for Strangford (Jim Shannon): we all hate cancer. In fact, I am sure everybody in this room today hates cancer.

[Dr Caroline Johnson]

Will the hon. Gentleman give way?

[Clive Jones]

I will make some progress.

I must also say a big thank you to all the cancer charities and life sciences companies that have provided valuable insight into the state of the NHS workforce and its effect on cancer patients. The impact of NHS workforce levels on cancer patients is a serious topic that needs to be discussed, and the experience of patients needs to be highlighted. Today has raised key demands for the Government to address.

The Government must increase endoscopy and pathology capacity. They should audit and invest in phlebotomy services, as called for by Leukaemia UK and the Royal College of General Practitioners. They also need to establish a national register of phlebotomy sites. The Government need to provide targeted support for the most deprived areas of the country, which are under immense pressure, and they need to replace doctors who they know are likely to retire in the next few years.

The Government must up their game on cancer. They have been left a very difficult legacy, with no money and no enthusiasm to change the way we deal with cancer, which is a really sad indictment of the previous Conservative Government. Finally, the Government must increase recruitment, training and retention; support primary care referrals; invest in diagnostic infrastructure and education; guarantee access to clinical nurse specialists; and prioritise support for patients with less survivable cancers.

Question put and agreed to.

Resolved,

That this House has considered the impact of NHS workforce levels on cancer patients.