Non-invasive Precision Cancer Therapies

Paula Sherriff Excerpts

Thursday 18th July 2019 Commons Chamber

[Paula Sherriff (Dewsbury) (Lab)]

I thank the hon. Member for Westmorland and Lonsdale (Tim Farron) and my hon. Friend the Member for Easington (Grahame Morris) for securing this debate and the Backbench Business Committee for allowing the time for it.

As my hon. Friend the Member for Blackburn (Kate Hollern) said so poignantly this afternoon, cancer is a disease that touches us all. In my case, it was my lovely dad who was diagnosed with bowel cancer in his 50s. Thankfully, due to early diagnosis and amazing NHS expertise, he survived. I am truly blessed that he is still with us. However, not everyone is that lucky.

I also pay tribute to my hon. Friend the Member for Rhondda (Chris Bryant), who, with his typical fortitude, eloquence and courage, spoke about how important it is that people seek all-important help upon noticing symptoms.

Of those of us born in the UK after 1960, almost half of us will be diagnosed with cancer at some point in our lifetime, and around a quarter of us will receive some form of radiotherapy. These are scary statistics. Radiotherapy is not some obscure treatment that is easy to ignore because it only happens to someone else. Statistically, every fourth person in this room will have had or will at some point need radiotherapy. If nothing else, from a purely self-preservation perspective, it is in all our interests to ensure that the provision of radiotherapy is exemplary.

Although the UK has a long history of being active in radiotherapy research due to having a much higher radiotherapy machine capacity and a larger workforce than elsewhere, access to radiotherapy in many parts of northern Europe is now superior to that in the UK. Radiotherapy need in the UK is expected to rise by a further 25% by 2025, but as things stand and as has been demonstrated today, the provision of radiotherapy across the country is patchy at best. Indeed, it is widely held by the experts that up to 24,000 people may be missing out on the radiotherapy they need, resulting in thousands of unnecessary or premature deaths each year. This is simply not good enough.

The advanced radiotherapy techniques of today are the standard techniques of tomorrow, and we need to invest in ensuring that these treatments are easily accessible for all patients across the country as soon as possible. There have been major breakthroughs in radiotherapy in the last 10 years. Technological advances have made radiotherapy treatments safer and more effective, improving cure rates with fewer short and long-term side effects—often to the point where patients can even continue working during the course of their treatments.

Advanced radiotherapy is now an extremely effective treatment in curing cancer when the disease is detected early enough and for palliating symptoms when a cancer has spread. However, this advanced radiotherapy is not currently available across all the UK, with many advanced radiotherapy techniques available at only a small number of centres, as the hon. Member for Westmorland and Lonsdale pointed out.

Radiotherapy centres across the UK are unevenly distributed, and although it is estimated that radiotherapy is needed to treat more than half of all diagnoses of cancer, access to it in England varies between 25% and 49% of cases, depending on the region. The charity Action Radiotherapy reports that patients understandably want to be able to access the best-quality radiotherapy as close to home as possible. Only 57% of the people surveyed said that they would be willing to travel as far as was necessary to get the best radiotherapy treatment available, with many opting for shorter travel times and convenience over quality. It is vital, therefore, that we ensure that the best possible treatment is available consistently across the UK, so that every patient is able to access the best high-quality radiotherapy for their individual cancer, without needing to worry about the added stress and inconvenience of lengthy travel times and distances and the associated costs.

However, tackling barriers to access is not only about travel and distance. Having radiotherapy can be very tiring, so greater consideration needs to be given to the quality of support that people receive throughout their treatment—for example, the provision of free parking and accommodation where needed or allowing people to book all their appointments in advance. Different types of radiotherapy techniques are not always available in the UK centres that are willing and able to deliver those treatments, and evidence suggests that some patients are missing out due to a failure of appropriate commissioning of the specific therapies they require.

One story I have heard about is Robert’s. When examining the surgery versus radiotherapy option, Robert was offered the opportunity to take part in a trial that explored whether, by using stereotactic ablative radiotherapy, or SABR—a type of non-invasive therapy—the number of radiotherapy treatments he would receive could be condensed to just five sessions, as opposed to the 20 currently recommended. For obvious and understandable reasons, the chance to have a short course of radiotherapy treatment appealed to Robert, and he underwent five sessions in just one week. It is disappointing, then, that such advanced techniques are available at only a small number of centres, reducing patient access.

As the cross-party “manifesto for Radiotherapy” outlined, £100 million a year is needed to catch up and provide the advanced modern radiotherapy currently needed in the UK. A one-off £250 million would be required to secure equal access for all radiotherapy patients over the next 10 years, with cutting-edge technology. Unfortunately, the commitment that we have from the Government thus far falls far short. As we have heard this afternoon, current spending levels on radiotherapy fall well short of our comparable international partners, and UK cancer survival rates lag behind the European average for nine out of 10 cancers.

As we have heard from my hon. Friends the Members for Heywood and Middleton (Liz McInnes) and for Rhondda and the hon. Member for Chichester (Gillian Keegan), a further clear and pressing concern is that our current oncology workforce is simply not large enough to meet current demand. There are inadequate plans to increase the workforce to ensure that it will have the capacity for our future needs.

Without drastic and immediate action to remedy the chronic, NHS-wide staffing crisis, we are in no position to deliver the improved radiotherapy treatments that we both deserve and have been promised. Per head of population, the NHS now ranks among the lowest in the western world when it comes to the number of doctors, nurses and hospital beds, according to King’s Fund analysis of OECD health data. Analysis from the Health Foundation showed that the number of personnel leaving the NHS because of a poor work-life balance has trebled in the last seven years.

The NHS workforce remains overstretched, overworked and undervalued. Much like the rest of our NHS, our radiotherapy services and staff need transformative actions, not words, to provide the world-class care that patients deserve. To address that, we would like a national plan for the funding of radiotherapy equipment, to enable every patient to have access to the appropriate treatment. Funding models should act to support innovation and research and should incentivise new and novel ways of working, but the current tariff funding of radiotherapy per fraction is clearly not fit for purpose. It can disincentivise novel ways of working, such as delivering a smaller number of fractions with a more complex technique.

As I said at the start of my speech, as many as 24,000 people are not receiving the radiotherapy they need. That cannot be allowed to continue. We must do more, today, to ensure that all those who need it are able to access not only radiotherapy but the best, high-quality radiotherapy available for their specific cancer. With sufficient investment and development, the UK can develop a world-class, patient-first radiotherapy service. I will do all I can to ensure that we achieve that goal.