Non-invasive Precision Cancer Therapies

Jeff Smith Excerpts

Thursday 18th July 2019 Commons Chamber

[Grahame Morris (Easington) (Lab)]

I beg to move,

That this House recognises the vital role that radiotherapy plays in cancer treatment across the UK with an estimated one in four people needing that treatment at some stage of their life; notes that there is a significant body of expert opinion that up to 24,000 people may be missing out on the radiotherapy they need, resulting in many hundreds of unnecessary or premature deaths; further notes that the UK spend on radiotherapy as a percentage of the overall cancer budget is approximately five per cent which compares badly with most other advanced economies where the percentage varies from nine per cent to 11 per cent; notes that the current commissioning system for radiotherapy is sub-optimal as exemplified by a tariff regime which discourages NHS Trusts from implementing advanced modern effective radiotherapy; calls on the Government to provide an immediate up-front £250 million investment in the service, an ongoing extra £100 million per annum investment in personnel and skills and IT, and to introduce a sustainably, centrally and fully funded rolling programme for Linac machine replacements; and further calls on the Government to appoint a single person to oversee the commissioning and implementation of radiotherapy services.

I thank the Backbench Business Committee and its Chair, my hon. Friend the Member for Gateshead (Ian Mearns), for granting this debate, and all the Members on both sides of the House who supported the application. I must declare an interest as one of the vice-chairs of the all-party group on radiotherapy, and also as a cancer survivor—[Hon. Members: “Hear, hear.”] Thank you. Thanks to early diagnosis, I was successfully treated with both chemotherapy and, crucially, precision radiotherapy.

I want to point out to the Minister that there is currently a crisis—there is no other word for it—in the management and funding of radiotherapy in the United Kingdom. Indeed, the charity Action Radiotherapy estimates that as many as 20,000 people across the UK may be missing out on the radiotherapy they need. Many of these patients will die prematurely or unnecessarily as a result of this shortfall. Given that one in four people receives some form of radiotherapy during their lives, and that almost half of us in the United Kingdom will be diagnosed with cancer at some point in our lifetimes, I hope the Government will realise just how important it is that we invest in modern and, importantly, accessible cancer diagnosis—and not just in diagnosis, but in cancer treatments.

[Jeff Smith (Manchester, Withington) (Lab)]

I am very proud to have the Christie Hospital in my constituency of Manchester, Withington. It has a fantastic proton beam therapy unit, which is going to be the future of cancer treatment. However, when I speak to the staff at the Christie, their biggest worry is the workforce. Does my hon. Friend agree with me that the challenge is not just funding for treatment, but actually investing in our cancer workforce as well?

[Grahame Morris]

Absolutely, and I am grateful to my hon. Friend for pointing that out. Indeed, that is one of the four basic requirements, as the all-party group, the charity Radiotherapy4Life and Action Radiotherapy have pointed out. That is clearly demonstrated in the “Manifesto for Radiotherapy”, which I commend to the Minister and to all hon. Members.

I appreciate that the Minister will want to refer to chapter 3 of “The NHS Long Term Plan”, particularly paragraph 3.62 on more precise treatments using advanced radiotherapy techniques. In anticipation of that, I would like to say, on investment, that the Government have promised to complete the £130 million investment in radiotherapy machines and, as my hon. Friend has just mentioned, to commission the proton beam machines at University College Hospital in London and the Christie Hospital in Manchester. However, I respectfully point out to the Minister that that is not a new announcement of additional resources, but the recycling of previous announcements. The money has already been spent or committed, so it is not part of the comprehensive 10-year plan for radiotherapy that we advocated for in the “Manifesto for Radiotherapy”.

The £250 million for proton beam facilities, while welcome, will only treat 1,500 patients a year. I accept that many of them will be children with brain cancers, but the number represents only 1% of patients needing radiotherapy. As indicated in the manifesto, we recommend that the same sum that was spent on proton beam facilities—a relatively modest sum given the size of the budget as a whole—is all that is needed to renew radiotherapy centres and to ensure that all patients, not just those who live in London or near to major conurbations, can receive treatment within the recommended 45-minute travel time. I know that other hon. Members will say a little more about that.

We are also asking for an additional £100 million a year, increasing the cancer funding for radiotherapy from the current 5% a year to 6.5% a year, to ensure sufficient funding for workforce planning, including ensuring that there is suitable training, and ensuring that there is an effective IT network, equipment upgrades and a rolling programme to ensure that all radiotherapy machines across the UK are up to date. According to analysis of freedom of information requests made by Action Radiotherapy, more than 40% of NHS trusts in England—all bar six responded to the requests—that provide radiotherapy have machines that are past their recommended lifespan, leading to less efficient and effective care.

The current system of commissioning for radiotherapy often incentivises trusts not to use their most modern precision radiotherapy machines to their full capability. That means that some patients are treated more often and less effectively, even though there are modern stereotactic ablative radiotherapy machines that could treat them more effectively. Precision radiotherapy is needed to cure 40% of cancers, and all that we want is to ensure that all patients can get to a radiotherapy machine and that the professionals are allowed to switch on the machines and provide the appropriate treatment. However, chronic underfunding and the complications of radiotherapy commissioning and delivery are preventing that from happening.

Radiotherapy receives only 5% of the cancer treatment budget. At £383 million a year, that represents 0.025% of the total NHS budget, and I want to compare that with the cost of just two cancer drugs. The NHS budget for Herceptin—an effective drug that is used to treat about 15% to 20% of breast cancer patients—is £160 million. A recent UK trial showed that only six months, not 12 months, of adjuvant Herceptin may be needed for adjacent therapy, which is when the drug is used in combination with radiotherapy. In financial terms, the NHS could therefore save up to £80 million a year, offsetting much of the additional radiotherapy costs.

It is time to put radiotherapy back at the top of the NHS agenda, and we need someone to advocate for that. We are urging the Department to appoint a radiotherapy tsar who will ensure that the NHS has a world-class radiotherapy service. Many other MPs want to speak in the debate, so I will keep my remarks short. I am pleased that the Government have accepted that advanced precision radiotherapy is more effective and has fewer side-effects.

In summary, I want to see a modest increase in the budget for advanced radiotherapy, rising from 5% to 6.5% of the cancer budget. That would enable large numbers of cancer patients to live longer and more fulfilling lives and would achieve better outcomes and more positive economic benefits. I am keen to ensure that Members have an opportunity to participate in the debate. There are many issues that we need to highlight, including in relation to commissioning, workforce planning and IT networks, so I will leave it at that to allow others to participate.