Cancer Care

Helen Whately Excerpts

Tuesday 14th March 2023 Westminster Hall

[The Minister for Social Care (Helen Whately)]

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

I thank my hon. Friend the Member for West Bromwich East (Nicola Richards) for securing this debate on cancer care. According to Cancer Research UK, one in two people—half of us—will develop cancer at some point in their lives. There are around 290,000 new cancer diagnoses a year, or nearly 800 every day.

When we cite statistics such as these—as is the case with NHS waiting lists, for instance, across the board—I always remember that every one of the figures is about a human being. Whether it is a parent, a child or a grandparent, they are someone’s loved one. And every one of them will be worried, or even scared, about their diagnosis; their lives are disrupted and they may be living in pain.

My hon. Friend brought that to life in her speech from her own personal experience. May I express my very sincere condolences to her for the loss of her mother? Such a loss is so sad, especially as it came too soon; I believe that her mother was only in her 50s when she died last year. My thoughts are also with her staff member Bradley, who she mentioned, whose mother would have been 58 today. Also, the hon. Member for Westmorland and Lonsdale (Tim Farron) mentioned his mother, who very sadly died of cancer. So this is a moment to think about mothers, perhaps particularly with mother’s day coming up. My best friend in childhood lost her mother to cancer when we were in our teens, and I clearly remember how that was for her. And there are so many other people who have lost loved ones to cancer, too often before their time. That is why diagnosis and treatment of cancer is so important to so many of us.

My hon. Friend rightly spoke about the importance of early diagnosis and prompt treatment. They are important for everybody. However, she particularly talked about areas with higher rates of cancer and the above-average levels of cancer in her own area. As she said, health disparities are part of the problem and they must be tackled, too.

Clearly, and rightly, my hon. Friend keeps a close eye on the performance in her area. I see my job as a Minister to look across the whole country and to help our healthcare system to tackle variation in performance, and indeed to level up where there are inequalities, because everybody should have access to early diagnosis of cancer and effective treatment for it.

Right now, I have three priorities for cancer: one is to recover from the pandemic and reduce the pandemic backlog; the second is to improve early diagnosis and treatment, using the tools and technologies that we have; and the third is for there to be investment in research and innovation, and for those innovations to be developed to make a difference to people’s lives and to the diagnosis and treatment of cancer. We know that technologies such as genomics and artificial intelligence, for instance, have the potential to truly transform our ability to diagnose and treat cancer effectively as a society.

[Peter Dowd]

Yesterday, I received an email from Sarah Taylor on behalf of the #CatchUpWithCancer and Radiotherapy4Life campaign. Among other things, she indicated that in May 2022 over half the heads of radiotherapy departments wrote to the Health Secretary and warned that

“radiotherapy is at crisis point”.

However, to our knowledge, so far they have not had a reply from the Department. Will the Minister try to chase that up if I provide her with further information?

[Helen Whately]

I will come on to talk about radiotherapy, but I can say to the hon. Gentleman here and now that I will indeed look into what has happened to the response to that letter.

However, I will start by talking about the waiting times, recovery from the pandemic and reduction of the pandemic backlog. Our elective recovery plan included the ambitious target to return the number of people waiting for more than 62 days for an urgent cancer referral back to pre-pandemic levels by this month. Since the publication of that recovery plan, the NHS has seen enormously high demand for cancer checks. More than 2.8 million people were seen in the 12 months to January 2023—up by 19% compared with the same period before the pandemic. The return in demand, with people coming forward for cancer checks, is very positive after the falls we saw in the pandemic.

When giving evidence to the Health and Social Care Committee last week, Dame Cally Palmer, NHS England’s national cancer director, said that

“we are not going to meet the pre-pandemic target by the end of March, simply because of those record levels of demand.”

That is already in the public domain. However, I assure hon. Members that we are working closely with NHS England to reduce the time people are waiting to receive a diagnosis, or an all-clear, and to start treatment, and we are making progress on that. The latest published figures show that the 62-day cancer backlog for the week ending 26 February stood at just over 22,000, which is a fall of 35% since its peak in the pandemic. However, that is 22,000 people too many who have had to wait 62 days, and many of them will have had to deal with the anxiety of waiting for a diagnosis or an all-clear, which is why we are working so hard on this issue with NHS England.

As I said, it is good that more people have come forward for cancer checks but, in response, we must increase our capacity to diagnose and treat cancer. That is one reason why we have been investing in community diagnostic centres, and we have more than 93 centres open and operational. That is why the NHS is rolling out what we call fit tests to speed up diagnosis for people who may have, for instance, bowel cancer. That is why the NHS is rolling out teledermatology to speed up diagnosis for people who may have skin cancer, and speeding up access to MRI scans for people who might have prostate cancer. Those are the three types of cancer with the most people waiting for a diagnosis or an all-clear or, if they have a diagnosis, to start treatment, and I am determined to reduce those waits.

When I meet charities and clinicians, the one message I consistently hear is how important early diagnosis is for improving patient outcomes and care, and that was something my hon. Friend the Member for West Bromwich East referred to. She talked about the ambition in our long-term plan to be diagnosing 75% of cancers at stages 1 or 2 by 2028. As part of achieving that, we are extending targeted lung health checks, with more than double the number of community lung truck sites. The targeted lung health checks programme had diagnosed 1,625 lung cancers by the end of December 2022, with 76% of those diagnosed at an earlier stage.

To help people get a cancer diagnosis or an all-clear more quickly, since November GPs have been able to directly order diagnostic tests such as CT scans, ultrasounds or brain MRIs for patients with concerning symptoms who fall outside the National Institute for Health and Care Excellence’s guideline threshold for urgent referral. Alongside that, community pharmacists in pilot areas are helping to spot signs of cancer in people who might not have noticed symptoms or realised their significance, and we continue to see non-specific symptom pathways rolled out. As of December 2022, more than 100 are live across the 21 cancer alliances.

To encourage people to contact their GP if they notice, or are worried about, symptoms that could be cancer, NHS England has run the “Help Us, Help You” campaign, which seeks to address the barriers deterring patients from accessing the NHS if they are concerned they might have cancer. In March and June 2022, we saw a 1,600% increase in the number of visits to the NHS website’s cancer symptoms landing page, so the campaign had a huge impact on the number of people looking to see whether they might have cancer symptoms. NHS England is in the process of planning “Help Us, Help You” activity for 2023-24, to make sure we continue the momentum and continue to encourage people to come forward if they have worrying symptoms of something that might be cancer.

However, we all know that diagnosis is just the first step on a patient’s journey, so we are also taking steps to improve cancer outcomes by rolling out innovative new treatments, such as the potentially life-saving drug pembrolizumab for one of the most aggressive forms of breast cancer, and mobocertinib to treat a specific form of lung cancer. The National Institute for Health and Care Excellence has made positive recommendations in all 18 of its appraisals of breast cancer medicines since March 2018, and those medicines are now available to NHS patients. NICE is also able to make recommendations to the cancer drugs fund, which has benefited more than 88,000 patients, with 102 medicines receiving funding for treating 241 different cancers.

My hon. Friend the Member for West Bromwich East mentioned radiotherapy equipment, as did the hon. Members for Westmorland and Lonsdale and for Bootle (Peter Dowd). Since 2016, more than £160 million has been invested in radiotherapy equipment so that every radiotherapy provider has access to modern, cutting-edge radiotherapy equipment. That investment enabled the replacement or upgrade of around 100 radiotherapy treatment machines and in some cases the roll-out of new techniques, such as stereotactic ablative radiotherapy. On top of that, £260 million has been invested in establishing two services to deliver proton beam therapy in London and Manchester.

On the workforce, from 2016 to 2021, the number of therapeutic radiotherapy staff grew by more than 17%, and the number of clinical oncologists by more than 24%. From 2021, there has also been an uplift in the number of entry-level places available, with 108 in clinical oncology, up from an average of around 60 per year in previous years.

I want to pick up on the claim that only 27% of cancer patients are treated with radiotherapy. That claim is outdated and incorrect, as it includes radiotherapy only as part of a patient’s primary treatment for cancer and does not capture a substantial proportion of patients who receive radiotherapy as a subsequent treatment. Also, I am told that the data is from 2013-14, so that is also out of date. NHS England has assured me—I have looked into this—that those who need radiotherapy treatment can access it.

[Tim Farron]

Will the hon. Lady give way?

[Helen Whately]

If the hon. Gentleman will allow me, I want to move on to the major conditions strategy, which my hon. Friend the Member for West Bromwich East mentioned as well. I want to talk about going beyond the immediate action we are taking here and now to improve people’s access to cancer diagnosis and treatment and about what we are doing looking further ahead.

In January, we announced that we will publish a major conditions strategy, which will tackle the conditions that contribute most to morbidity and mortality across the population in England, one of which is cancer. Many people now experience major conditions as part of a wider set of illnesses or needs, known as multi-morbidity. A 2020 academic study of cancer patients in England found that most had at least one co-morbidity and nearly one in two had multiple co-morbidities, so many people with cancer also have another long-term condition. We want to support individuals by diagnosing them earlier, helping conditions to be better managed and improving the overall co-ordination of treatment and care for those who have cancer and other major conditions.

The strategy will draw on the previous work on cancer, and hon. Members mentioned the long-term plan on that. It includes more than 5,000 submissions that were provided as part of our call for evidence last year. I can assure hon. Members that we will continue to work closely with stakeholders, the public and the NHS, including those involved in cancer care, in the coming weeks and months as we work up the details of that strategy. We will look at the health of people at all stages of life and, in reference to the point my hon. Friend the Member for West Bromwich East made on health disparities, focus on the geographical differences in health that contribute to variations in health outcomes.

[Tim Farron]

Will the hon. Lady give way?

[Helen Whately]

I just want to spend a little time on research, and I am conscious of the clock ticking.

[Tim Farron]

She mentioned a couple of points about the figures.

[Helen Whately]

If the hon. Gentleman will allow me to proceed, I want to talk briefly about the third priority—research—which is so important to improving cancer outcomes.

The Department of Health and Social Care invests £1 billion a year in health and care research through the National Institute for Health and Care Research. The NIHR spent almost £100 million on cancer research in 2021-22. I should also say that, among other charities, Cancer Research UK makes a huge contribution to funding research. Thanks to the generosity of the British public, it spent £388 million in 2021 on research activity.

There is a huge amount of research for us to be excited about. For example, the NHS-Galleri trial looks for markers in blood to identify signs of more than 50 cancers, and a vaccine taskforce-style approach is being taken to invest over £22 million in cancer research as part of the life sciences cancer mission. A memorandum of understanding that the Secretary of State for Health and Social Care signed with BioNTech SE will aim to deliver 10,000 doses of personalised therapies to UK patients by 2030.

As another example, just last week I visited Imperial College London. I saw some truly exciting research that could help us to diagnose pancreatic cancer and other upper gastrointestinal cancers early through a relatively simple breath test. It is in its early stages, but it could make a huge difference for cancers such as pancreatic cancer, which can be so hard to diagnose early.

Before I close, I will mention the hospital that my hon. Friend the Member for West Bromwich East talked about. The exciting rebuild of the Midland Metropolitan University Hospital, as part of our new hospital programme, will bring together urgent care centres from three hospitals across the region into one state-of-the-art site, providing services to 500,000 people. As my hon. Friend said, construction has already commenced, and the hospital should be completed and open for patients in 2024.

The hospital will introduce a new model of care, which means that out-patient clinics, day case surgery and routine diagnostics will be provided from the Sandwell and City Hospital sites, while maternity services, emergency care, general surgery and medical wards will all be based at the Midland Metropolitan University Hospital. The new hospital will be a centre of excellence for clinical care and research. The new therapeutic model of care will encourage patients to maintain mobility and independence during a hospital stay. I spend a lot of time looking at the downside of people having long stays in hospital. Maintaining independence and mobility is an important thing for us to try to achieve. I share my hon. Friend’s excitement about the forthcoming opening of the new hospital.

To conclude, I once again thank my hon. Friend for raising this issue. Improving cancer care is a priority for the Government, and I assure her and other hon. Members that we will continue to work hard to beat this terrible disease.