Radiotherapy: Accessibility

Margaret Ferrier Excerpts

Tuesday 18th July 2023 Westminster Hall

[Selaine Saxby (North Devon) (Con)]

I beg to move,

That this House has considered the accessibility of radiotherapy.

It is a privilege to serve under your chairmanship, Dame Maria. I thank the Backbench Business Committee for granting this important debate, all colleagues who supported the application, and Professor Pat Price for her tireless work in supporting the all-party parliamentary group for radiotherapy and championing this vital treatment.

We all know that the cancer backlog was affected by the pressures of covid-19, but in May this year there were 7.47 million people waiting for cancer treatments and 3 million of those have been waiting for over 18 weeks. Only 61.7% of patients receive their first treatment within two months, far below the operational standard of 85%. Radiotherapy is a key part of cancer care. It is the second most effective treatment for cancer and is needed in four out of every 10 cancer cures.

Radiotherapy targets the cancer with radiation. The cancerous cells are more affected than the healthy cells, which are better at repairing themselves. Modern radiotherapy has come on leaps and bounds, and within the last 10 years breakthroughs have increased the accuracy and focus of the treatment to within millimetres, significantly reducing collateral damage to healthy cells.

Surgical treatments require intensive care, with all of the hospital resources and emotional trauma that that entails, and chemotherapy has a significant impact on the immune system. In contrast, radiotherapy is an out-patient treatment that requires fewer patient visits to care centres. It only costs between £3,000 and £7,000 per patient, despite being incredibly high tech.

The international recommendation is that 53% to 60% of cancer patients receive radiotherapy treatments. However, in the UK only 27% of cancer patients received radiotherapy treatment in 2019. In my North Devon constituency, only 4.7% of my constituents live within the recommended 45-minute travel time for radiotherapy treatment. The other 95.3% are among the 3.4 million people in England for whom distance from a radiotherapy service effectively limits the availability of treatment.

[Margaret Ferrier (Rutherglen and Hamilton West) (Ind)]

As the hon. Member said, radiotherapy is the second most effective cancer treatment and is required by half of all cancer patients. However, the ability to access treatment has been described as a postcode lottery, with 3.4 million people unable to access radiotherapy without travelling more than 45 minutes. Does the hon. Member agree that it is unacceptable that there should be such significant disparities in access to radiotherapy?

[Selaine Saxby]

I do indeed agree with the hon. Member. In my case, North Devon is the fourth worst constituency in the country for access to radiotherapy services. North Devon is home to the smallest and most remote hospital on the UK mainland—and possibly the most loved. An exceptional team works tirelessly to deliver the best care, despite the challenges of rurality and the availability of staff, mostly linked to the availability of affordable housing, which is currently at its most extreme.

Radiotherapy is usually a series of daily treatments over a number of weeks. Far too many of my constituents choose not to have radiotherapy because the 120-mile round trip each day is too much to consider on top of the understandable pressures that patients with a cancer diagnosis already experience.

Radiotherapy is a far less invasive treatment than many others. With such an elderly population in North Devon it is often the best treatment for patients. A further complication that has been brought to my attention by the wonderful volunteer drivers we have in North Devon who help patients to their appointments across the expansive county, often to Exeter—a 120-mile round trip—for many different treatments, including radiotherapy. I do not want to discourage anyone from reaching out for those services, it will be clear to everyone that a daily radiotherapy session involving a journey of that length is a significant undertaking for patients and volunteer drivers alike. We have a declining number of volunteer drivers, which restricts driver availability for other patients.

It is hard to explain to those who have not visited North Devon the remoteness and the distances involved in undertaking all sorts of treatments. We benefit hugely from the merger of our hospital trust with Exeter’s, but that does not bring Exeter any closer. While it is positive that the backlog of patients waiting longer than 62 days for a GP referral is improving, the 62-day wait to start treatment is not. We know that every four weeks of delay in starting cancer treatment can increase the risk of death by 10%. To ensure everyone receives timely cancer care, radiotherapy needs to be an accessible treatment for every patient.

--- Later in debate ---

[Grahame Morris (Easington) (Lab)]

It is a pleasure to serve under your chairmanship, Dame Maria, and I congratulate the hon. Member for North Devon (Selaine Saxby) on securing this important debate. Unusually, I agree with absolutely everything that a Conservative MP said, and I hope the Minister is making copious notes.

I hope you will forgive me if there is a bit of repetition, Dame Maria, because we have been trying hard to address this issue. In effect, this is the radiotherapy lobby. Although we do not have the big guns and finances of the pharmaceutical industry, we are the Members of Parliament who argue for the very small, dedicated and highly skilled radiotherapy workforce to be given the tools and facilities to deliver what they want, which is an improvement in cancer outcomes.

I would like to declare an interest: I am a cancer survivor and have had it twice. I have undergone various treatments, including cancer drugs, chemotherapy, surgery, and radiotherapy on three occasions. I am also privileged to be a long-standing vice-chair of the all-party parliamentary groups for radiotherapy and on cancer. Given the current economic climate, characterised by fiscal conservatism and a reluctance to commit to new spending—that is not a criticism of just the governing party, because it is an issue that my own party is addressing—it is crucial that we optimise the opportunities that present themselves to improve cancer outcomes, and the hon. Member for North Devon raised the issue of IT networks and the use of AI software.

[Margaret Ferrier]

AI technology is proving to be an asset in improving cancer treatment outcomes, and Radiotherapy UK has outlined the fact that a £4 million investment in AI technologies, which equates to £15 to £40 per patient, would immediately enhance NHS workforce capacity and reduce wait times. Does the hon. Member agree that further investment in AI could be vital in increasing access to radiotherapy?

[Grahame Morris]

That is a really important point, and I hope the Minister is taking note. I do not know whether the term is “low-hanging fruit”, but here is an opportunity to get some synergies from the new technologies that are available now but perhaps were not available even a couple of years ago. I will return to that theme, but AI is potentially a force multiplier, if that is the appropriate term: it can improve the productivity of the small radiotherapy workforce. As the hon. Member for North Devon mentioned, AI can save a consultant oncologist two hours in planning a patient’s treatment. As a couple of hon. Members have said, it is wonderful to have centres of excellence—some of the best hospitals not only in the United Kingdom, but in the world—such as the Royal Marsden in London and the Christie Hospital in Manchester. Now we have the opportunity, through IT networks and AI, for doctors and clinicians, even in remote locations, to access highly qualified oncology specialists, who can plan the treatment to be delivered in satellite centres. There is a huge opportunity here.

As we have heard, almost half of individuals experience cancer at some point in their lives, and about a quarter require radiotherapy. It is quite a disturbing statistic that only 27% of cancer patients in the UK access radiotherapy. The international recommendation is that between 50% and 53% should. Only half the people who would benefit from radiotherapy are accessing it at the moment.