Cancer Therapies Access

Lord Evans of Rainow Excerpts

Monday 6th February 2023 Lords Chamber

[Lord Aberdare (CB)]

My Lords, I beg leave to ask the Question standing in my name on the Order Paper, and I declare my registered interest as a trustee of the UK Focused Ultrasound Foundation.

[Lord Evans of Rainow (Con)]

NHS England’s specialised commissioning team has been undertaking work to expand the number of providers offering minimally invasive cancer therapies such as selective internal radiation therapy. The market engagement and prior information notice aspects of this have now been completed, with regional teams now putting in place the necessary contractual arrangements with NHS trusts.

[Lord Aberdare (CB)]

My Lords, I thank the Minister for that Answer and welcome him to the Dispatch Box. Minimally invasive cancer therapies such as focused ultrasound, SIRT, which he mentioned, cryoablation and radioligand therapy, offer significant benefits both to patients to the NHS: faster recovery times; reduced pain; fewer side effects; and less pressure on NHS facilities and staff. How will the 10-year cancer plan reflect the need to increase awareness of these therapies among patients and clinicians and increase access to them? Will the Government’s proposed workforce plan ensure the availability of enough interventional radiologists to deliver MICTs at the scale needed?

[Lord Evans of Rainow (Con)]

My Lords, I pay tribute to the noble Lord and the work that he has done on the All-Party Parliamentary Group on Minimally Invasive Cancer Therapies. In 2022-23, Health Education England is continuing to take forward priorities identified in the cancer workforce plan phase 1 and is investing an additional £50 million in 2022-23 to further expand the cancer and diagnosis workforce. Spending plans for individual budgets in 2023-24 to 2024-25 inclusive are subject to a detailed financial planning exercise and will be finalised in due course.

[Lord Allan of Hallam (LD)]

My Lords, as the noble Lord, Lord Aberdare, has already pointed out, interventional radiologists are essential to being able to provide minimally invasive cancer therapies. What is the Minister’s response to the Royal College of Radiologists’ 2021 census report, which painted a picture of growing concerns about the availability of interventional radiologists, as supply is not keeping up with demand? Will this particular shortage also be covered in the workforce plan? We will keep going on about the plan until we see it.

[Lord Evans of Rainow (Con)]

My Lords, NHS England commissions selective internal radiation therapy as a treatment of choice for patients with unresectable advanced hepatocellular carcinoma in accordance with technology appraisals and metastatic colorectal cancer in accordance with the NHS England clinical commissioning policy. It should be noted that the market engagement and prior information notice process permitted any NHS trust that hosts a specialist liver service and multidisciplinary team to put themselves forward, either independently or in partnership with other NHS trusts.

[Lord Patel (CB)]

My Lords, Cancer Research UK published a report last week that shows that, by 2040, we will have half a million new cases of cancer. Considering that the UK has the worst record on cancer outcomes in western Europe and that we are not likely to meet the Government’s target of diagnosing 75% of new cancers at stage 1 or 2, why did the Minister in the other place state that the Government are to abandon the 10-year cancer plan, particularly when the previous Secretary of State wanted a new plan which was more challenging and robust?

[Lord Evans of Rainow (Con)]

My Lords, improving early diagnosis of cancer is a priority for the NHS. That is why one of the core ambitions of the NHS’s long-term plan is to diagnose 75% of cancers at stage 1 or 2 by 2028. November 2022 saw the highest number of urgent GP referrals for cancer ever, with nearly 265,000 patients referred, representing 125% of November 2019 levels on a per working day basis, compared to the pandemic low of 80,000 in April 2020. It is a priority of this Government for the NHS.

[Baroness Blackwood of North Oxford (Con)]

My Lords, I declare my interest as chair of Genomics England. Will the Minister join me in welcoming the announcement of the UK cancer vaccine launchpad? It aims to rapidly identify large numbers of cancer patients who could be eligible for trials and to explore the potential of cancer vaccines among multiple types of cancer. This is vital research if we want to have any hope of identifying and tackling the challenges mentioned by the noble Lord, Lord Patel.

[Lord Evans of Rainow (Con)]

My noble friend raises a very good point. One in two of us will develop cancer in the future, so we need to explore all therapies or vaccines wherever possible.

[Baroness Wheeler (Lab)]

My Lords, Cancer Research UK has shown that the annual rate of cancer diagnosis will increase by one-third over the next two decades, rising to nearly half a million. It takes 15 years to train an oncologist, pathologist or surgeon. In the light of previous questions, will the Minister assure the House that the long-awaited NHS workforce plan, when it is finally published, will address these particular shortages? How will the workforce plan dovetail with the also promised major conditions strategy, which the Government have announced that they are now putting in place of the 10-year cancer strategy, as we previously heard, which itself was long overdue?

[Lord Evans of Rainow (Con)]

My Lords, I can assure the noble Baroness that the new major conditions strategy will set out a strong and coherent policy agenda that sets out a shift to integrate whole-person care. Interventions set out in the strategy will aim to alleviate pressure on the health system as well as support the Government’s objective of increasing healthy-life expectancy and reducing ill-health-related labour market inactivity. We will cover the patient pathway from prevention to treatment and set out the standards patients should expect in the short term and over a five-year lifetime. Many stakeholders have already responded to the Government’s call for evidence on cancer.

[Baroness Meacher (CB)]

My Lords, we now know that there are drugs that attack cancer cells directly, without damaging the surrounding tissue. These literally non-invasive treatments are available to some, but can the Minister assure the House that these drugs are now available to every trust throughout the country?

[Lord Evans of Rainow (Con)]

My Lords, I do not have a specific answer to that question, but I can certainly respond in writing.

[Lord Hunt of Kings Heath (Lab)]

My Lords, behind this Question lies an even more worrying fact, which is that the NHS is very, very slow to adopt new medicines and new treatments. Does the Minister accept that our very poor outcomes for cancer in relation to many OECD countries are partly down to this lack of adoption of proven new treatments? What are the Government doing to turn this around?

--- Later in debate ---

[Lord Evans of Rainow (Con)]

My Lords, looking ahead, a number of specialised services will be delegated to integrated care boards, which in turn will want to work with and through local cancer alliances to plan and organise access to cancer services, including specialised services such as SIRT and non-specialised services such as highly intensive focused ultrasound. Following delegation, NHS England will remain the accountable commissioner for all prescribed specialised services and will continue to determine national standards, including new treatments.

[Lord Patel (CB)]

My Lords, I am sorry to come back, but the Minister did not answer my question, which was: why are the Government abandoning the 10-year cancer plan? Is it to be replaced with a new plan, or is it totally abandoned?

[Lord Evans of Rainow (Con)]

My Lords, we have not abandoned anything. It is all part of the Government’s strategy to improve cancer outcomes.