National Lung Cancer Screening Programme Debate
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Main Page: Clive Jones (Liberal Democrat - Wokingham)Department Debates - View all Clive Jones's debates with the Department of Health and Social Care
(1 month, 1 week ago)
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Clive Jones (Wokingham) (LD) [R]
I beg to move,
That this House has considered the national lung cancer screening programme.
It is a pleasure to serve under your chairship, Sir Alec. I declare an interest as a governor of the Royal Berkshire hospital. A family member also holds shares in a medical company.
Lung cancer is a rapidly fatal disease that kills nearly 33,000 people in the UK every year. Fortunately, targeted lung cancer screening has become one of the NHS’s real success stories, with Lord Darzi highlighting it as the only initiative across all cancers that has improved rates of early-stage diagnosis in recent years. Screening is without doubt the single biggest intervention in improving lung cancer survival. When the UK Lung Cancer Coalition was launched in 2005, five-year survival stood at around 8% which was among the lowest rates in Europe. The UKLCC has now set an ambition of 35% of patients surviving five years after diagnosis by 2035—a target once thought to be impossible, but now within reach thanks to screening.
The Government’s decision to roll out fully the targeted national lung cancer screening programme in England for people aged 55 to 74 with a smoking history was a major milestone. To date, that programme has identified more than 10,600 lung cancers, with over 75% diagnosed at an early, treatable stage, compared with just 28% before screening was introduced. Without doubt, lung cancer screening is saving lives. It is cancer prevention in action and exemplifies the shift toward earlier diagnosis set out in the NHS 10-year plan. I place on record my thanks to the NHS cancer programme team, lung cancer advisers and the lung cancer screening clinical expert group for delivering the fastest roll-out of lung cancer screening anywhere in the world.
The benefits of screening extend beyond lung cancer. Screening is also identifying conditions such as chronic obstructive pulmonary disease and cardiovascular disease, potentially saving even more lives. Since I applied for this debate, the Department has committed in the national cancer plan to a timetable for the full roll-out of the programme. That is a significant achievement. The inclusion of screening in the NHS app is another welcome step, but we cannot be complacent simply because a roll-out is promised in a plan. Will the Government reaffirm their commitment to a national roll-out timetable and ensure that the programme continues at pace? The national cancer plan commits to reaching 100% of the eligible population by 2030. That timetable matters because any slowdown risks reversing progress on early diagnosis. Unlike other national screening programmes, lung cancer screening does not yet have guaranteed funding beyond 2030. If this programme is to remain stable and effective, it needs protected long-term funding.
We must also continue to evaluate reporting systems, national databases, turnaround times, workforce capacity and how screening is tailored to local populations. Importantly, screening is helping to reduce health inequalities by focusing on areas of deprivation. That progress should continue, supported by investment in community engagement and communications to ensure that hard-to-reach populations are not left behind. Given the importance of reducing inequalities, will the Minister confirm whether lung cancer screening will move to section 7A arrangements with ringfenced funding beyond 2030? There is also concern about maintaining political momentum. With both drivers behind the national cancer plan no longer in post and Cabinet changes expected in the next few weeks, many in the cancer community are understandably concerned about whether the commitment will continue. I am sure the Minister will reaffirm his commitment.
England is leading the way, but early detection must not become a postcode lottery across the UK. Wales is preparing to launch a programme in 2027, but Scotland and Northern Ireland remain significantly behind. The UK Lung Cancer Coalition is supporting discussions in both nations later this year to understand the barriers and encourage implementation. Lung cancer is the UK’s biggest cancer killer. Every eligible person, regardless of where they live, should have access to the same opportunities for early diagnosis. I urge the devolved Governments to learn from England’s experiences and introduce screening as quickly as possible. Will the Minister engage with counterparts in Scotland and Northern Ireland to encourage progress towards UK-wide implementation?
There are several threats to the programme’s success. First, there are growing concerns about integrated care board interference and the lack of ringfenced funding. Cost-cutting pressures on ICBs threaten to undermine progress. There are reports that high-performing screening teams—some seeing 55 patients a day—are being disrupted, and that screening resources are being diverted elsewhere. The variation in delivery across the country is striking. Lung cancer screening funding should be used for lung cancer screening, and local structures should not be allowed to dilute a programme that is demonstrably working well. Will Ministers issue clear guidance to ICBs to prevent interference in delivery? Will they guarantee that screening funding is to be ringfenced and used solely for its intended purposes? Will they ensure that ongoing ICB restructuring does not weaken accountability or performance?
Secondly, the abolition of NHS England raises legitimate concerns. The programme’s roll-out, data systems and clinical governance arrangements require continuity, and many charities and organisations across the cancer sector are concerned about potential loss of expertise during organisational change. What safeguards are in place to ensure continuity of leadership, data management and programme oversight throughout the transition?
Thirdly, workforce pressures remain one of the greatest threats to the programme being sustained. Screening increases demand across radiology, pathology, thoracic surgery and genomics, yet workforce planning has not kept pace. The Royal College of Radiologists has warned that there will not be enough radiologists to support the programme by 2030. Timely diagnostic and treatment services must be available so that patients diagnosed with early-stage disease can access potentially curative treatment. Demand for thoracic surgery is also rising, as early-stage lung cancers are often best treated surgically. Without sufficient capacity, opportunities to cure may be lost. Greater awareness among GPs remains important too.
Around one in five lung cancers occur in people who have never smoked—indeed never-smoked lung cancer is now the eighth most common cancer in the UK and the seventh most common worldwide—but smoking cessation remains a vital part of the screening programme. Smoking causes around 72% of lung cancer cases in the UK, making cessation support one of the most cost-effective interventions available. The British Thoracic Society has called for at least one specialist tobacco adviser in every hospital. As the Government pursues its smoke-free 2030 ambitions, the NHS has a critical role to play in helping people to quit smoking.
The Institute of Clinical Research has highlighted workforce challenges in biomarker testing and molecular diagnostics, both of which are increasingly important for personalised cancer treatment. As I have repeatedly argued in this House, the national cancer plan can succeed only if its ambitions are matched by investment in the workforce needed to deliver them. When will the Government publish their delayed workforce plan and how will they support the continued expansion of lung cancer screening? Will Ministers commit to increase training places in radiology, pathology and thoracic surgery?
Lung cancer screening is one of the most effective public health interventions introduced in recent years. It is saving lives, reducing inequalities and shifting diagnosis toward earlier, more treatable stages of the disease, but its future success depends on stability, protecting funds, a sustainable workforce, robust Government and UK-wide implementation. The Government have an opportunity to secure the future of a programme that is already transforming outcomes for thousands of people. The UK Lung Cancer Coalition believes that doing so is essential if we are to achieve the ambition of a 35% five-year survival rate by 2035.
Clive Jones
I would just like to mention a few of the things that hon. Members have spoken about. The hon. Member for Strangford (Jim Shannon) was absolutely right to pay tribute to the Government for their work on lung cancer screening. That is an outstanding success, but screening still needs more support from the Government because, as he says, screening saves lives.
My hon. Friend the Member for Didcot and Wantage (Olly Glover) talked about lung cancer being horrific and deadly, and he spoke about his constituent John, who probably thought, when he got his diagnosis, “This is going to be horrific and deadly for me.” Because of the lung cancer screening programme, it looks like he might have a few good years ahead of him, so that is really good. My hon. Friend also talked about the speed and quality of treatment, and how important it is that we are quick with our diagnoses, that we are quick with our treatment and that our cancer patients have the support of specialist nurses.
The hon. Member for Hinckley and Bosworth (Dr Evans) is absolutely right that early detection is crucial in lung cancer treatment, as he knows from being a junior doctor once upon a time. He is also right to say that the origin of the screening programme was under the Conservatives in 2023, and he is right to join other Members in asking for lung screening to be spread out to all parts of the United Kingdom.
I thank the Minister for coming to the debate today and for answering an awful lot of the questions that we asked him. I know that he is here on behalf of the Under-Secretary of State for Health and Social Care, the hon. Member for Washington and Gateshead South (Mrs Hodgson), who is, I know, a real champion for improving cancer care in this country. I think it is great that the Government are committing £650 million for lung cancer screening in England to be spent by 2030, but what about Scotland and Northern Ireland? Is the Minister able to make a commitment that the Department will speak to the devolved Governments of Scotland and Northern Ireland to try to get them to implement what has been done so well in England, or does he need to speak to the Under-Secretary of State? We did not get a guarantee that lung cancer—
I just want to briefly put on the record that I will discuss that with my hon. Friend the Under-Secretary of State and we will write to the hon. Gentleman with an update on the work we are doing across the regional Governments in Wales, Scotland and Northern Ireland.
Clive Jones
Thank you for your intervention, Minister, and your clarification. But you did not need to intervene because I am sure—
Order. The hon. Gentleman has been here for quite a while now and knows that I am not responsible for anything. Please address the Minister through the Chair.
Clive Jones
I apologise, Sir Alec. The Minister did not need to intervene. I am sure he will take that message back to his colleague.
What we would like to see, which was not mentioned in the Minister’s speech, is a guarantee that lung cancer screening funding will be ringfenced and used only for lung cancer screening. There was no comment on the changes in the integrated care boards and NHS England or on what safeguards are in place to ensure continuity of leadership, data management and programme oversight during the organisational changes. I am sure the Minister and other Ministers know that is a big concern for a lot of charities. There was no mention of expanding radiology. A lot of people who talk about cancer, including Members of Parliament and cancer charities, know that there has to be a big expansion of radiography sooner rather than later.
Finally, I would like to thank you for chairing the meeting, Sir Alec, and for pulling me up on my mistake. I shall endeavour to do better next time.
Question put and agreed to.
Resolved,
That this House has considered the national lung cancer screening programme.