Cancer Outcomes in the UK

Lord Evans of Rainow Excerpts

Tuesday 21st April 2026 Grand Committee

[Lord Evans of Rainow (Con)]

My Lords, I thank the noble Lord, Lord Patel, for securing this important debate. When I was a Minister, the noble Lord used to stand up and ask me extremely searching questions—well, they were searching questions to me—to which I did not always know the answer. Come to think of it, there are a couple of noble Lords in the House who used to do something similar: the noble Lord, Lord Sikka, and the noble Baroness, Lady Finlay. I used to go back to the department and ask for answers to these legitimate searching questions, but sometimes the answer was not forthcoming. So I used to press and stretch the civil servants to come back, because I had to come back and report to the noble Lord, Lord Patel.

But I started thinking for myself and looking into some of this, and the answer came down to technology. The noble Lord, Lord Drayson, has really made my speech—one of the problems with speaking at the end is that everything has been said. He is right that, two or three years ago, artificial intelligence was just starting to make an impact in certain industries. He made a very powerful point.

Time is short and I have a few things to say. I am speaking as a former Minister who looked into this matter and as a Member of Parliament to whom constituents used to come, pleading for treatment or to get assessment and diagnosis. Not knowing is a problem if you have a lump but you do not know what it is. They used to come to MPs’ surgeries, not just mine, to see if they could cut through the red tape to try to get an answer from the local NHS trust. I used to do my best to help, but it happened frequently.

As I say, I am a family man and have had two experiences of cancer. The first was my late sister, who died of pancreatic cancer. I was listening attentively to the comments of the noble Baroness, Lady Warwick, who mentioned a spray that can detect pancreatic cancer. That was not available until relatively recently. Pancreatic cancer is a terrible disease.

The second was my late mother, who lived to quite a good age. Ovarian cancer is not always easy to detect. I was surprised as a carer that it took a while for the GP to make a referral and, once you got the referral, to secure a scan and get communication from the hospital to the patient—that is, my mother, who had dementia. In a way, she could not understand that; they should talk to the carer. I thought it was old-fashioned to write a letter to someone who could not read it rather than dealing with them directly, perhaps using artificial intelligence, via the NHS app to speed things along.

My contribution to this is that early and timely diagnosis is important to ensure that the right treatment can be given at the right time to get the best possible outcomes, especially for children and young people, whose cancers are often more aggressive and faster growing and require specialist treatment. Despite this, young cancer patients regularly report needing multiple visits to doctors before a cancer diagnosis is given. Data shows that the median time for under-18s to be diagnosed after first symptoms is 4.16 weeks; it takes longer than this for half of them. Teenagers from 15 to 18 years of age have the longest time to diagnosis—a median of 8.7 weeks. Some 60% are diagnosed as an emergency. On average, 14 different healthcare professionals are consulted.

This is further reflected in the NHS cancer patient experience surveys, which show that more than two in five children and young people, 42%, see their GPs three or four times after their cancer symptoms before being told to go to hospital. This compares to the majority of adults, 62%, seeing their GP just once. Not only does this prolong receiving a diagnosis but it can impact trust and relationships with healthcare professionals throughout treatment and after. This experience can be worse for minoritised groups. Data on time to diagnosis is not routinely monitored for children and young people nationally, despite those issues. It is crucial that a diagnostic interval measure is introduced for young cancer patients, as was committed to in the national care plan, to consistently track and improve time to diagnosis.

I have a question for another special person, the Minister, whom we are very lucky to have in your Lordships’ House—she does a fantastic job as Minister. The noble Lord, Lord Stevens, talked about sweating NHS assets, but I am not asking about that. The noble Lord, Lord Patel, and others referred to the Danish model. Denmark has a population of 6 million. In London the figure is 10 million, in Manchester it is 3 million and England as a whole it is 60 million. The noble Lord, Lord Drayson, made a point about artificial intelligence—he talked about economic growth, wealth creation, NHS trusts not talking to one another and scaling up our own domestic industry—and he is exactly right.

My question is not original but is about a pilot scheme to implement artificial intelligence, in order to establish best practice and set international standards of early diagnosis for all cancers but particularly those of low survivability. There are 36 integrated care boards—there were 42 in my day, but I understand that they have been condensed. Not all are the same: we have different populations, rural areas, seaside communities, post-industrial towns and metropolitan areas. We should appoint the best and the brightest from the NHS or industry to implement artificial intelligence throughout the NHS.

What does success look like and how do you measure it? I respectfully say that the best survival rates in the G7 would be a good starter, but artificial intelligence is an opportunity for the NHS to modernise its back-office administrative processes. As noble Lords have pointed out throughout this debate, there is so much good research out there that AI has to have an impact. That is not about sweating the assets but about improving the current workforce, certainly in the back office, so that they can at least communicate with those hard-to-reach populations and communities in the country.

That is my question to the Minister: can we have a pilot scheme of hand-picked individuals and integrated care boards in select areas of the country, to see whether we can introduce this to the NHS to make a difference and the world-beating healthcare system that we all want?