National Cancer Plan
Tim Farron Excerpts(3 weeks, 3 days ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Andrew Gwynne
I absolutely do. That shift to analogue to digital, and the use of the latest advantages in technology, science and research, will push the boundaries of what is possible when it comes to diagnosing and treating some of the rarer cancers, on which we have made virtually zero progress in recent years. I think that, with the right direction, the right commitment and the right drive, we can really start to make inroads in this area.
Tim Farron (Westmorland and Lonsdale) (LD)
May I invite the Minister, and indeed everyone here, to join us in Room M after these exchanges, when Radiotherapy UK will have a drop-in session with—most important—our patron Bryan Robson, England’s Captain Fantastic? I thank him for mentioning radiotherapy in his statement, which is crucial step forward, but may I suggest that he and the Government need to show exponentially greater ambition to get this right? The UK spends 5% of its cancer budget on radiotherapy, while the OECD average is 9%, which is why the UK is at the bottom of the survival league for so many cancers. Will the Minister commit himself to putting that right?
Andrew Gwynne
I am not sure that I will be able to attend the hon. Gentleman’s meeting, but I will certainly be in Westminster Hall for his debate later this afternoon. I understand exactly the concerns of people who are championing the need for increased access to radiotherapy treatments. My dad benefited from radiotherapy at the Christie, which probably gave him an extra couple of years of life with his family—I will be forever grateful for that. I get it; I understand it; we need to make the case.
Accessibility of Radiotherapy
Tim Farron Excerpts(3 weeks, 3 days ago)
Westminster HallRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Tim Farron (Westmorland and Lonsdale) (LD)
I beg to move,
That this House has considered the accessibility of radiotherapy.
It is a great honour to serve under your guidance, Sir John, and it is a great privilege to have the opportunity to raise the issue of the accessibility of radiotherapy on World Cancer Day.
Three quarters of those in my communities in Westmorland live dangerously too far from radiotherapy treatment. It has been my privilege over the years to drive a number of my constituents to the Rosemere centre at Preston to get treatment, and I am always struck by the quality of the treatment and the warmth and professionalism of the staff, but also by the gruelling impact on my constituents, on whom the daily lengthy journeys take a terrible toll.
Daisy Cooper (St Albans) (LD)
I am grateful to my hon. Friend for giving way so early in his speech. He mentioned travel times. Travel times to radiotherapy for my constituents in St Albans and Hertfordshire would certainly be much reduced if the relocation of the Mount Vernon cancer centre to Watford General could proceed, and the only way for that to happen is if the new hospital programme goes ahead sooner than is currently planned. Would he agree with me that shortening the travel time would provide a much better service for local residents?
Tim Farron
Yes, I absolutely do agree with my hon. Friend. Travel times, which I will come on to in a moment, do have an impact on outcomes—in other words, whether people survive—because there is an impact on the extent to which a person will be referred for treatment depending on how close they are to the nearest site. What she says is absolutely right, especially for her communities.
For my constituents, the two, three or in some cases four-hour round trip to the excellent but distant Rosemere cancer unit at Preston is not just inconvenient, but debilitating and cruel. It means that many do not complete their treatment, and many choose not even to start such treatment. Some do not even get referred for radiotherapy in the first place, because clinicians understandably conclude that the patient is not strong enough to cope with the rigours of travelling such distances so frequently. For us in Westmorland, longer journeys mean shorter lives.
Steff Aquarone (North Norfolk) (LD)
I congratulate my hon. Friend on securing such an important debate, especially on World Cancer Day. In my constituency of North Norfolk, Radiotherapy UK found that nobody can access radiotherapy treatment within 75 minutes by public transport. Does he agree that we need a two-pronged approach to tackle this—to fix our broken public transport infrastructure and to make more services available closer to where people are, such as at Cromer hospital in my constituency?
Tim Farron
My hon. Friend is absolutely correct. Back at the time of the last Labour Government, the national radiotherapy advisory group recommended that it was bad practice for anybody to live beyond 45 minutes of a radiotherapy centre one-way, or a round trip of an hour and a half, yet so many people—7.5 million people—including his constituents and my constituents, live beyond that.
Anna Sabine (Frome and East Somerset) (LD)
On that specific point, I do not want to show off about who has the worst travel times for radiotherapy, but nobody in my constituency of Frome and East Somerset who does not own a car lives within that recommended 45-minute NHS travel time. Does my hon. Friend agree that reliable, quick and affordable public transport is key, and that the recent increase to the bus fare cap has not helped with the situation?
Tim Farron
Yes. By definition, almost all of the radiotherapy deserts—those places that are beyond sensible and safe travelling times—are rural communities. As a result, they have terrible public transport. It is not just about the cost. The increase in the bus fare cap is hugely damaging, but for many of our communities—my hon. Friend’s and mine alike—it almost does not matter what the bus cap is; if there is no bus to spend the fare on, people are stuffed, really. That has a huge impact on their cancer outcomes, which means whether they survive or not.
Rachel Gilmour (Tiverton and Minehead) (LD)
Could the reason that radiotherapy is used in only 35% of cases, rather than 50% of cases, be that local transport just does not exist to take people to have the treatments that they need?
Tim Farron
My hon. Friend makes a good point. There is a combination of reasons, which I will come on to in a moment, but distance from treatment is undoubtedly the critical point that decides whether people can access and take advantage of lifesaving and life-prolonging treatment.
Jim Shannon
First, I commend the hon. Member for championing this issue for all the years I have known him in this House. He deserves credit for that, he has got this debate in Westminster Hall today, and we are looking to the Minister for a response. Does the hon. Member agree that the issue goes more widely, and is also about recruitment? Training and retention of clinical oncologists is needed, with only seven in 10 training places filled in 2024. Does he agree that there is a way forward—bursaries for students, which could begin to fill the training needs in the long term? Students would understand that they will not live under the burden of student debt if they pick a career for life—in other words, help them with a bursary and the NHS will have them forever.
Tim Farron
I completely agree with the hon. Member. Many people watching the debate today, whether physically in the Gallery or on television outside, are part of that outstanding workforce, and we are massively grateful to them. What a career for someone to be in, where you are saving lives every day and alleviating pain. That is a wonderful thing, yet there are not enough of them. The workforce is part of the solution, as well as the challenge, to the problem that we face.
For us in Westmorland, longer journeys mean shorter lives. The answer is clear for us in Westmorland, and that is to build a satellite radiotherapy unit at the Westmorland general hospital in Kendal as part of the Rosemere unit, following the model of the many excellent satellite units around the UK. The number of cancer patients travelling from south Cumbria each year for radiotherapy provides demand for at least one linear accelerator at the Westmorland general hospital. If the experience of other new satellite centres around the country is replicated, such as at the new Hereford site, which is a satellite of Cheltenham, a satellite centre in Kendal would attract at least 20% more patients than existing demand, because people who would not have had radiotherapy treatment at all beforehand would now be able to access it, simply because it is closer to them. That a satellite unit in Kendal has not already happened is an indictment of the lack of responsiveness to the obvious need from NHS England, and of a lack of concern for cancer patients and their families who live in rural communities.
Sorcha Eastwood (Lagan Valley) (Alliance)
I commend the hon. Member for his advocacy on this subject over a long time. The satellite centres are one thing. I represent Northern Ireland and my constituency of Lagan Valley, and I note that there are people in the Gallery involved in the All-Island Cancer Research Institute. Does he agree that geography is important and that cancer knows no boundaries, so our efforts to tackle it should also know no boundaries?
Tim Farron
The hon. Member makes wonderful points, and it is absolutely right that in every corner of the United Kingdom we need to ensure that we have the staffing, the kit and the level of technology to meet need close enough to where people live for people to be kept safe and treated in a convenient way.
In Westmorland, we successfully campaigned to bring chemotherapy, greater amounts of surgery and a new diagnostic hub to Kendal. All of that is welcome, and all of that has saved lives. I am unbelievably grateful to all those in our communities who campaigned alongside us, and to the wonderful NHS professionals who deliver and run those services, but the failure of successive Governments, including the one I was a part of, and NHS management to take the people of Westmorland out of the radiotherapy desert is utterly inexcusable given the multiple opportunities to do so over the last 30 or so years.
So my first ask of the Minister is that he takes a personal interest in the call for a satellite radiotherapy unit at the Westmorland general hospital in Kendal, and that he meets with me and with oncologists, commissioners and patients, to kickstart that bid.
Adam Dance (Yeovil) (LD)
Does my hon. Friend agree that we must also do more to help local groups providing clinical and non-clinical support for radiotherapy patients after treatment, such as the Macmillan radiotherapy late effects service and the Cancer Connect group in my constituency of Yeovil?
Tim Farron
My hon. Friend makes a great point and does a great service to his community by standing up for those groups who support people after cancer, and their families. I know that personally in my own family, so I congratulate him on making a really important point.
My second ask—the Minister should be delighted to hear that I only have two—is that he separately meets with the all-party group on radiotherapy and the leading fantastic clinicians who support us, to look at how the Government and NHS England can turn the tide on radiotherapy nationwide, because the problems of access do not just affect Westmorland; they affect the whole country.
Although in Westmorland our issue is unacceptable distance from services, the problem across the country is that we lack sufficient capacity, lack up-to-date technology, and lack an effective workforce plan. Britain is behind our neighbours on the number of radiotherapy machines, and we are behind our neighbours in how advanced that machinery is. In France, for example, there are twice as many linear accelerators per head as we have in the United Kingdom. Across the OECD, roughly 9% of cancer budgets are spent on radiotherapy; in the UK we spend a paltry 5%. One in two of us will have cancer at some point, and one in two people with cancer should have radiotherapy—to be precise, 53% of us should—yet only 35% of cancer patients in the UK had radiotherapy as their primary treatment. In fact, the regional variation in access to radiotherapy ranges from the lowest of only 29.8%—by the way, that is in my constituency—up to 50%.
There are shocking variations based on tumour type, too. Only 11% of lung cancer patients in some regions receive radiotherapy, compared with 43% in other regions. Only 18% of rectal cancer patients receive radiotherapy in some areas, compared with 62% in others. People’s chances of surviving should not depend on their postcode. Inadequate and inequitable radiotherapy capacity is costing lives. Over the past decade, more than 500,000 patients have waited more than two months for their first cancer treatment. Yet the chilling reality is that for every four weeks of delay in treatment we have a 10% reduction in our chances of surviving.
The Royal College of Radiologists reminds us that in 2024 only 38% of patients starting radiotherapy did so within two months of an urgent referral for cancer. The national target is 85%. Let us compare that with other forms of cancer treatment: 68% of patients had surgery for their cancer in that time, and 64% started chemotherapy within that two months. That means that over 10,000 patients requiring radiotherapy received their treatment after the recommended timeframe. In 2023 some 92% of cancer centres reported delays in patients starting radiotherapy. That is one of the main reasons why the UK is near the bottom of the OECD cancer outcome rankings, which is a sanitised way of saying that people with cancer in Britain are more likely to die sooner than in other equivalent countries. So longer journeys mean shorter lives, and longer waiting times also mean shorter lives.
Alex Easton (North Down) (Ind)
Thank you, Sir John, for your chairmanship today. In Northern Ireland, one in two people who need radiotherapy do not get it at an early stage. Does the hon. Member agree that a strong focus on awareness and early diagnosis is needed?
Tim Farron
That is a good point. Early diagnosis is vital. We are getting a bit better at it, but it would be a tragedy if we diagnosed people but then did not treat them early enough to cure them. The hon. Gentleman makes a good point on behalf of his communities.
If we cannot cope with treating the number of cancer patients we are seeing now, how will we deal with the projected 30% increase in cancer cases by 2040? The good news—the very, very good news—is that it does not need to be this way. The upcoming cancer plan, of which we have heard an outline today, is an opportunity to supercharge cancer services and transform a culture of normalising unacceptable delays into one that drives continuous cancer care improvements. However, without decisive and radical action and leadership, lives will continue to be lost needlessly.
Torcuil Crichton (Na h-Eileanan an Iar) (Lab)
It is a pleasure to serve under your chairmanship, Sir John. I was very struck by the hon. Gentleman’s comment about longer journeys meaning shorter lives. There is no competition on journeys, of course, but my constituents in Na h-Eileanan an Iar and the Western Isles face some of the longest journeys in Britain to get cancer treatment, outwith and within the constituency. Somebody from Barra, for example, faces a three-day journey to Stornoway by boat, taxi and aeroplane for therapy and then a return journey over three days. I hope that that can be changed by sending people directly to Glasgow or, perhaps even better, by implementing a public service order to restore flights between one end of the island and the other. I commend the hon. Gentleman for securing the debate and for his very telling comment about longer journeys meaning shorter lives.
Tim Farron
I am extraordinarily fond of the hon. Gentleman’s constituency, which he represents well. He makes an important point about travel times. In some parts of my constituency, people need to take a ferry to get from one place to another, but it is not quite as common as in his constituency.
At the heart of the radical, lifesaving transformation that we need through the cancer plan must be the elevation of the unsung hero, the Cinderella of our cancer services: radiotherapy. Lord Darzi found that 30% of patients are waiting more than 31 days for radical radiotherapy. As the incidence of cancer grows, the urgent need for quicker and more efficient treatments such as radiotherapy is only increasing.
As things stand, the replacement and updating of linear accelerators is left to the 52 separate cancer units in England—52 separate procurement operations, 52 different finance officers trying to balance the books and 52 different heads of service all trying to meet increasing demand, often without the time and space to look beyond the horizon. It is time, then, to centralise the commissioning of the technology to ensure a constant focus on updating and expanding radiotherapy. That would immediately start saving lives everywhere.
Radiotherapy UK estimates that simply replacing all the out-of-date LINACs could free up 87,000 additional appointments every single year. Modern radiotherapy is quicker and more accurate than other treatment. It is also by far the cheapest, costing between £3,000 and £7,000 per patient—several times less expensive than equivalent cancer treatments. The Government’s £70 million commitment to radiotherapy services was welcome, but in reality, as the Minister says, that money would cover the cost of only 26 LINAC machines, fewer than half the number that are currently operating beyond their sell-by date. Erratic one-off rounds of funding do not address the need for a sustainable rolling programme of machine replacement to enable planning, support procurement and improve access for patients. Even the new machines are often old technology. What a terrible waste.
In my years of campaigning on this matter, I have found that radiotherapy lacks funding and prominence. Britain therefore lags behind our neighbours, so people tragically die when they do not need to—all because of a lack of leadership and drive from the centre. On more than one occasion, I have almost seen the penny drop on the faces of Ministers of all parties when it comes to our failure on radiotherapy, but every time so far, I have seen that zeal founder on the rocks of bureaucratic sluggishness, indifference and resistance to change within the NHS. If they show the leadership that we desperately need, the Minister and the Secretary of State will have the enthusiastic and active support of the all-party parliamentary group on radiotherapy, and of the army of outstanding clinicians who are out there saving lives.
Professor Mike Richards is a name that many people remember. He was the cancer tsar in the early noughties, under the previous Labour Government; he did great work and his achievements were tangible. If the Government will forgive me for using shorthand, we basically need a Mike Richards for radiotherapy, and we need them, like, yesterday. Failing that, tomorrow morning would just about do. Every day we delay, my constituents—as well as yours, Sir John, and those of the Minister and of all Members present—are dying unnecessarily.
We need new technology as we plan treatments, too. Last May, £15.5 million was announced for AI technology that would save clinicians time and reduce radiotherapy waiting lists. However, we have heard from cancer units around the country that this funding may be withdrawn or diverted, which would be a hammer blow to trusts in the face of the ongoing workforce crisis. Will the Minister take the chance today to reassure our cancer units and confirm that this funding will go, as promised, to radiotherapy departments in full? I hope the Minister will also act swiftly to tackle the perversities of the tariff payments for radiotherapy, which effectively punish trusts for treating cancer patients in the most effective and modern ways.
I ask the Minister to guarantee that radiotherapy will be at the centre of the NHS 10-year cancer plan, and that that plan will be led by people empowered and determined to deliver it. The technology is vital, but the people matter just as much. Our specialist and highly skilled radiotherapy workforce numbers only 6,400 people, yet the survey conducted by Radiotherapy UK shows that one in five cancer doctors may leave the profession in the next five years. We have a 15% shortage in clinical oncologists—set to rise to 21% by the end of this Parliament—and 30% of oncologist training posts were vacant last year. On top of that, 50% of clinical technologists are over 50 years old, and 84% of heads of cancer services reported that they were concerned that workforce shortages affected the quality of patient care.
I ask the Minister to agree that the 10-year cancer plan will include a renewed investment in workforce and infrastructure. A 10-year vision already exists, by the way—drawn up by the experts, via Radiotherapy UK. I simply urge the Minister to consider their findings and borrow the proposals detailed by leading oncologists and cancer experts.
I have asked for two separate meetings today. The first is on the need for a satellite radiotherapy unit at Kendal; the second is a first meeting for the Minister with the all-party parliamentary group on radiotherapy, to look at the national picture. I hope he will grant me both.
The radiotherapy lobby is tiny: 6,400 dedicated professionals within our health service; a compact but awesome group of charities and volunteers; a handful of companies building the technology, many of which are based in the United Kingdom; England’s captain fantastic, Bryan Robson; and a small band of MPs of all parties, seeking to be a voice not just for the radiotherapy sector, but for the thousands and thousands of people living with cancer in our country, who deserve the best treatment that we can give them. For the last generation or more, the UK has let those people down, and so often with tragic consequences. Yet radiotherapy is a cost-effective, easily deliverable technology that will save lives in every community in this country.
We are way behind where we need to be, yet it would be so easy, with the right leadership from Ministers, to catch up with and go beyond our neighbours. Cancer no longer needs to be seen as a death sentence; it is a disease that can be treated and cured, but we cannot do that if our systems and practices prevent us from deploying the best treatments available. Please save lives, Minister, and become our radiotherapy champion.
Sir John Hayes (in the Chair)
This is a short debate. I intend to call the first Front-Bench speaker at 5.08 pm.
Helen Morgan (North Shropshire) (LD)
Thank you very much, Sir John. It is a pleasure to see you in the Chair. I promise that I will not go on at great length, partly because—
Helen Morgan
Well, my hon. Friend did go on at great length. He has secured a really important debate for World Cancer Day; it is an honour to speak in it for the Liberal Democrats. He outlined the issues comprehensively; I am not sure that I could improve on what he said. I welcome the Government’s announcement earlier today on the national cancer strategy and I highlight the excellent work of my hon. Friend the Member for Wokingham (Clive Jones), who campaigned for it.
Cancer services in general have declined to an unacceptable level, as I think everyone would agree. I hope that the Government stick to their word on addressing that issue and ensuring that everybody can access the care they need, when they need it and—as my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron) pointed out so eloquently—where they need it.
In the UK, over 100,000 cancer patients receive radiotherapy treatment each year from a specialist workforce of 6,400 professionals. Cancer is one of the most difficult diseases—it is difficult for individuals and it is difficult for their families—and yet the number of patients who have waited over four months to receive cancer treatment has more than doubled since 2020.
Like so many areas of NHS care, the time people have to wait and the quality of care that they receive depends hugely on where they happen to live. That has to change; I hope that the Government will make that one of their urgent missions. People’s chances of surviving should not depend on their postcode.
NHS data shows that the west midlands had over 150,000 radiotherapy attendances in 2022, which is the most recent available data. That is the highest of all regions, yet hospitals such as Shrewsbury and Telford hospital in my constituency have had some of the worst waiting times. In September 2024, at the Shropshire, Telford and Wrekin trust, only just over half of patients requiring radiotherapy met the 62-day treatment standard. The target for treatment is 85%.
It is important to acknowledge that the situation at Shrewsbury and Telford hospital trust is improving—I welcome that—and that it was impacted by the staff shortages that many hon. Members have outlined today. But it is not just about numbers and statistics; it is about the impact on people’s lives. I think my hon. Friend the Member for Wokingham has pointed out the importance of scans, and some of my constituents who are undergoing cancer treatment have waited a long time for scans and say that sometimes they have not had the result of a scan until their next treatment was due. That is due to staffing shortages.
Waiting times are important, but so too are distances, particularly when somebody is poorly and finding it difficult to travel a long way. People in Shropshire are served in Shrewsbury, so I am glad to say that the distance issue is perhaps not as acute as it might be in other rural areas in the country, but the public transport issue remains so. Many people rely on friends and family to drive them to appointments, as there is no other reliable way of getting there and a taxi is simply too expensive for them to consider. For that reason, some will not be accessing the care that they need. Across the country, 3.4 million people live further away than the target of 45 minutes from a radiotherapy centre, so it is important that we address those radiotherapy deserts and ensure that people can access the care that they need.
In addition to the outdated, sparse machines and low morale, we found that 65% of staff felt that they did not have enough machine capacity and 93% felt that workforce numbers were too low. Therefore, in addition to the long distances involved, we must put an end to the problem of people being unable to be treated not just because they live a long way from the equipment, but because the equipment, when it is available, is outdated or because there is nobody to staff it properly and interpret what needs to be done.
My hon. Friend the Member for Westmorland and Lonsdale has said all this before, so I will draw my remarks to a conclusion. The Liberal Democrats would boost cancer survival rates by introducing a guarantee that 100% of patients would start treatment within 62 days of their urgent referral. We need to replace the ageing radiotherapy machines and increase the number of machines, so that no one has to travel too far for treatment. We need to recruit nurses, cancer nurses and the specialist staff required to staff the radiotherapy machines. We would also like to see a cancer survival Bill, requiring the Government to co-ordinate and ensure funding for research into those cancers with the lowest survival rates. I hope the Minister will be making cancer a top priority for the new Government and push to reinstate the UK as a global leader in cancer research and, most importantly, in cancer outcomes.
I welcome the commitment already made to invest £70 million in replacing ancient machines and delivering new ones, but I hope the Minister will consider where that investment is distributed so that we can address the urgent problem of treatment deserts. I hope that he will also consider that this is a spend-to-save issue—radiotherapy treatment is both effective and cost-effective, and a worthwhile investment for the NHS to consider from a financial perspective.
I also want the Minister to commit to introducing a 10-year workforce plan for radiotherapy as part of the national cancer strategy to which the Government are already committed, to ensure that people get the care they need, when they need it, with the appropriately qualified professionals necessary to deliver it.
Finally, we must address the problem of building space. Many of our hospitals, as we all know, are crumbling. Care must be delivered in an appropriate setting, as my hon. Friend the Member for Wokingham has outlined on a number of occasions. In conclusion, we welcome the Government’s steps so far, but I would like to push them to go further.
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
It is a pleasure to serve under your chairmanship, Sir John. I thank the hon. Member for Westmorland and Lonsdale (Tim Farron) for bringing this important debate to Parliament on World Cancer Day, and other Members for their contributions on this really important topic. I am happy to meet the hon. Member and his colleagues from the all-party parliamentary group on radiotherapy to discuss these issues further. I suspect that my diary is going to get busier, but I am more than happy to meet the hon. Member for Wokingham (Clive Jones) as well, to ensure that we get this aspect of the national cancer plan absolutely right.
To answer one of the questions put by the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), the national cancer plan will include radiotherapy—it would be odd if it did not, given the importance of radiotherapy—and I will work with Radiotherapy UK and others with an interest in this area. That is partly why we have launched our call for evidence today: to get the views and opinions of as many people and organisations as possible, so that we get the plan right. It has to be fit not just for 2025, but for 2035 and the years in between, so there is a lot of work to be done.
We know that cancer patients are waiting too long for treatment. That is why we are taking immediate action to kick-start the recovery of the NHS with a commitment to cut waiting times that will benefit all, including those with cancer. In our 10-year plan for the NHS, we committed to return our national health service to constitutional standards, including on cancer.
By investing in our workforce, a point made by several hon. Members, and allocating £70 million for new radiotherapy machines, we will reduce cancer waiting times and give more patients access to state-of-the-art treatments. Fixing the NHS also requires reform. This year, we will publish our 10-year health plan to help build a health service fit for the future and, as I have already mentioned, we are today announcing the launch of a call for evidence for a dedicated national cancer plan, another step towards unleashing our country’s potential as a world leader in saving lives from this deadly disease. I encourage everyone to have their say by responding to the national cancer plan call for evidence.
I assure hon. Members that the priority of this Government is to ensure that radiotherapy is available quickly to those who need it. Radiotherapy is a crucial treatment for many cancer patients, as it can shrink tumours very effectively. Although the vast majority of the population are located within reasonable distance of where they would go for treatment, I am very aware that that is not always the case, particularly in rural communities.
I can give a family example. My dad, who sadly died two years ago from a very rare and aggressive form of rectal cancer, benefited from superb treatment at the Christie in Manchester, which is our local cancer hospital. He had chemotherapy, immunotherapy and radiotherapy. The radiotherapy shrank his tumours, and that almost certainly gave him an extra two years of quality life with his family, including his great-grandson. I will forever be grateful that he received that.
One day, though, we took him to the Christie and he got chatting to somebody who was also receiving radiotherapy. This is pertinent to the hon. Member for North Shropshire (Helen Morgan), who leads on these matters for the Liberal Democrats, because this person was from Shropshire. My dad is Salopian born—he was born in Shrewsbury and brought up in High Ercall, before being dragged to Manchester in the 1950s when my grandad got a job as the chief accountant at Manchester education committee—and they got talking. “You’re really from Shropshire and you’re coming to Manchester for radiotherapy?” It was the nearest place that had that treatment available at that time. It really hit me then how sporadic these things are, and how some people have to travel unacceptably long distances. We need to make sure that in our national cancer plan, we look at the deserts and the accessibility issues.
Tim Farron
I would not be doing my job at all well if I did not pursue the Minister on this point. Earlier, he very kindly talked about meeting the all-party group to talk about the national picture, and I want to press him on our local bid to tackle the problem he has just spoken about. Will he meet me and local oncologists to talk about how we can deliver a radiotherapy satellite centre in Kendal?
Andrew Gwynne
I was just coming to that—the hon. Gentleman has obviously started to read my notes from a distance. I am aware that he met representatives of the previous Government to discuss the possibility of a satellite unit in his local area. The situation is the same now as it was then: it is the responsibility of the integrated care board, but if the hon. Gentleman thinks it would be helpful for us to have a meeting and see if we can push that case, my door is open. I absolutely recognise that people in that part of Cumbria would prefer to have those services closer to where they live. If we can impress that on his local ICB, let us see if we can make progress.
The Government aim to ensure that each treatment centre is accessible to the highest possible number of patients, as well as easily reached by the staff who work there. That is another consideration—it is not just the patients who have to physically get to these units, but the staff. We recognise that for those in rural communities, machinery may not be available at their local hospital, meaning that the only option is travel to specialist centres to receive the best possible care. Radiotherapy service provision is agreed by local systems, and each patient’s care needs and treatment location are decided on a case-by-case basis by their clinicians. We are giving local systems greater flexibility and control, as they are best placed to understand and meet the needs of their communities, but to drive the national cancer plan forward, we have to tackle this postcode lottery and the deserts head-on.
Accessibility is also about making sure that we have the right workforce available to deliver the treatment in the right places and at the right time. That is why the number of training places has increased, and it is why we are improving the quality of education for assistant practitioners, diagnostics and therapeutic radiographers. NHS England is also working to improve the retention of radiographers and radiologists through initiatives such as increasing investment in career development. By ensuring our workforce feels supported, we put ourselves in a better position to deliver the care that people need.
Turning to investment in machines, I agree with the hon. Member for Westmorland and Lonsdale that we should be ambitious in our plans to ensure that patients are treated as quickly as possible. Lord Darzi’s report highlighted the scale of the challenge we face: under the previous Government, waiting times for treatment increased, and more than 30% of patients waited longer than 31 days for radical radiotherapy.
In response to Lord Darzi’s findings, we have taken urgent action to get the NHS back on its feet. At the recent Budget, my right hon. Friend the Chancellor supported our commitment to end the backlogs by announcing £70 million of investment in new radiotherapy machines in 2025-26. Replacing older radiotherapy machines with newer, more efficient and more technically advanced ones will ensure that patients can be seen more quickly. By doing so, we will improve access and speed up cancer treatment. Making more advanced machines available means that patients will have fewer trips to receive their treatment.
Hon. Members may be aware that NHS England has now allocated funding to trusts across the country to purchase the new radiotherapy machines with the £70 million investment. NHS England invited trusts to express interest in receiving funding to purchase a new machine. Allocation criteria focused on the age of the machine being replaced, the proportion of older machines in use in the trust and the trust’s performance on radiotherapy. We expect to fund at least 27 new machines, which should be available to treat patients by spring 2026.
Those steps will ensure that we can improve cancer waiting times as soon as possible, helping us to put an end to the last Government’s neglect and underinvestment. I reassure the hon. Member for Westmorland and Lonsdale, and other hon. Members, that we will continue to make the case for additional funding, so that we can continue to upgrade machines and push the advances of the latest technological developments, for the benefit of patients with cancer.
I turn to the national cancer plan. Beyond immediate actions, we know that bold reform is required to rise to the growing challenge that cancers of all types represent. Lord Darzi found that cancer survival in this country is worse than in comparable countries, and that improvement slowed greatly during the 2010s. To help us to develop more targeted actions, my right hon. Friend the Secretary of State has announced the development of a national cancer plan, which was the subject of the statement I gave in the House just a few hours ago. The overarching aim of the plan is to reduce the number of lives lost to cancer. It will detail how we will improve outcomes for cancer patients, ensuring that patients have access to the most effective treatments and technology, including radiotherapy.
Today, we launched our national cancer plan call for evidence. We welcome views from all hon. and right hon. Members, as well as from clinicians, patients and their families—it is critical that we get the views of people who have lived experience of accessing cancer care—charities, researchers, members of the public and, of course, the excellent all-party parliamentary groups that champion cancer treatment and outcomes in this House.
In closing, I thank the hon. Member for Westmorland and Lonsdale for bringing this crucial matter to the House. I thank hon. Members, whose contributions have, in the spirit of this year’s World Cancer Day, put places and people at the centre of care. I am pleased to assure hon. Members that we are undertaking both immediate actions and bold reforms to improve access to radiotherapy. There is a lot more that we need to do, and we will do it in partnership. This work is part of our effort to rebuild the NHS and deliver world-class cancer services for everybody—something that will always be a top priority for this Government and that is personal for me—so let’s get on and achieve it.
Tim Farron
First of all, Sir John, thank you for your oversight of this debate and for keeping us in order. I also thank everybody who has contributed from the Front and Back Benches. Members from all sides of the House have contributed so knowledgably and passionately on behalf of their communities, so I am really grateful to them all.
I especially thank the Minister for his response and for agreeing to my two requests. That is great—I appreciate it very much indeed. I also appreciated his statement in the main Chamber earlier, when he spoke very movingly about his own family experiences. We share an experience: my mum also passed away from ovarian cancer, at a similar age to his mum. We begin to see the impact that cancer has on the lives of just about every single family, so when we get to a position where we can do something about it, what a privilege that is and what an opportunity, which we absolutely must not miss.
Since I still have a few moments left, I encourage Members who are not already members of the all-party parliamentary group on radiotherapy to join up, please: we will not overburden you. I have discovered over time that decisions are so often made in the interest of the people who are in the room, so we need to be in the room. Chemotherapy is a really vital part of cancer treatment and the pharmaceutical industry that goes with it has tons of resource to lobby us; that is good, and it is entitled to do that. Radiotherapy is a very different industry. This is the lobby—so we need to be in the room to make sure that we are equally heard and that radiotherapy is part of the armoury to tackle and defeat cancer.
Money is vital, but leadership is key. Having people who will be “on it” constantly within NHS England at the senior levels—who want this to happen, who are dissatisfied with how things are and who are hungry for change—is essential, but, without meaning any disrespect to anybody, I do not see that at the moment. I am, though, encouraged by what the Minister said about trying to instil it.
Radiotherapy is non-invasive. It is increasingly targeted and accurate. In the time that I have been involved in this area of campaigning, I have seen an exponential increase in how targeted it is and therefore how strong the doses, so to speak—the fractions—can be. I have seen the damage that can be done to a tumour without seriously damaging the healthy tissue around it. If the Minister is trying to convince his right hon. Friend the Chancellor to give us more money, he should argue that radiotherapy is so beneficial for the economy, because people will go back to work healthy, earn money and pay taxes.
I thank the Minister very much again for responding to points made in the debate. My final point is to make again the case for satellite radiotherapy units around the country, not just in my patch. His civil servants might want to look into this more deeply. Among the wonderful people I met today was a young clinician, James, who works in a radiotherapy unit in London. He used to work in Cheltenham, which then of course branched out to have a satellite unit at Hereford. He was able to demonstrate and vouch for the fact that that new satellite unit ended up with getting on for 25% more patients than it had originally planned for. That was for one obvious reason: people who would not have had radiotherapy at all were able to get it because it was closer to them. The important thing to remember is that satellite units are not just about convenience—in fact, they are not even about convenience; they are about saving people’s lives and returning people to normal life if possible.
I again thank the Minister for the attention he has given this issue, and I thank everybody else here today for taking part in this debate—not least yourself, Sir John.
Question put and agreed to.
Resolved,
That this House has considered the accessibility of radiotherapy.
New Hospital Programme Review
Tim Farron Excerpts(1 month, 1 week ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Wes Streeting
I can give my hon. Friend that assurance. I thank him for the very strong representations that he has made on behalf of his local trust since his election to this House. I am afraid that the extent to which promises were made about this scheme that could not be kept is shameful. I can reassure him that pre-construction work will take place between 2030 and 2035. As he knows, this is not a straightforward project, but it is one to which we are very much committed, with construction due to start around 2036. I am very happy to continue to work with my hon. Friend and with neighbouring right hon. and hon. Members to make sure that the trust is supported during that period, given the day-to-day challenges that it faces.
Tim Farron (Westmorland and Lonsdale) (LD)
The acute hospital that serves most of my constituency is the Royal Lancaster infirmary. It is an overcrowded Victorian hospital; parts of it are falling to bits, it has inadequate parking and it is at the wrong end of a one-way system. With the Secretary of State’s help, the local hospital trust has acquired an almost perfect site for a rebuild. The trust has designed the new hospital and even begun consulting the public on it, so today’s announcement that we face a 10-year wait until a spade is dug into the ground will come as something of a bombshell. Will he reconsider the timescale? The longer we leave it, the more the cost will spiral and, I am afraid, the less likely it is that people will have confidence that it will even happen at all.
Wes Streeting
On the hon. Gentleman’s final point, I can well understand why people across the country will be cynical about commitments made on hospitals, given the experience that they had under our Conservative predecessors. Even if not every decision that we are taking is universally popular, I hope that people will appreciate our up-front candour and honesty in not trying to pull the wool over their eyes, and in setting out in today’s report, in terms, the timetable for pre-construction work and for starting construction.
In the particular case that the hon. Gentleman raises, I hope that the fact that land was acquired by this Government in December 2024 signals our absolute commitment to the scheme. If we were not committed to the scheme, we would not have made the land purchase up front ahead of pre-construction works, which are planned for 2030. We did so because we absolutely accept the case that he makes about the desirability of the site and the need for investment and the new hospital locally. In addition to the representations from the hon. Gentleman, my hon. Friend the Member for Lancaster and Wyre (Cat Smith) wins the award for being the first MP to collar me straight after the election to say, “Buy this land and do it now.”
Oral Answers to Questions
Tim Farron Excerpts(1 month, 3 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Stephen Kinnock
My hon. Friend is absolutely right: the NHS dental contract simply is not working. We are working with the sector to reform the contract, with a shift to focusing on prevention and the retention of NHS dentists. We will deliver on our pledge to provide 700,000 more urgent dental appointments at the earliest possible opportunity, targeting areas that need them most.
Tim Farron (Westmorland and Lonsdale) (LD)
One in five social care jobs in Cumbria are currently unfilled, and the consequences are unbearable for those who are vulnerable; indeed, they are causing pressure on the rest of the NHS. Will the Secretary of State look carefully at the specific needs of rural communities such as ours, where it is so much harder to recruit and retain social care workers?
Wes Streeting
I was in Cumbria recently, and I was struck by the fact that the care home I visited in Carlisle is delivering great intermediate care for the NHS at half the price of a hospital bed—a really good example of how social care often delivers better value and better care. However, the hon. Gentleman is right about the recruitment challenges. We are determined to work with local training providers and the local university to make sure that we recruit social care workers, grow our own in Cumbria and keep them in Cumbria.
Hospice Funding
Tim Farron Excerpts(2 months, 1 week ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Karin Smyth
That is absolutely what we want to do, and today’s announcement is a step towards it. As my hon. Friend highlights, hospices are very special places, but most people want to die at home with their loved ones, in the place they know well, and many parts of the sector will be able to use this money to help more people to die peacefully at home.
Tim Farron (Westmorland and Lonsdale) (LD)
This additional funding will benefit hospices serving Westmorland communities—St Mary’s, St John’s, Eden Valley and the children’s hospice, Jigsaw—only if two things happen. First, the Government must provide additional funding to match the national insurance increases that those hospices will have to bear, and secondly, the Government must ensure that the integrated care boards in south Cumbria and north Cumbria pass on that money in full and on time. Will the Minister press them to do so? On the Morecambe bay end, will she press them on the closure of the Abbey View ward at Barrow hospital? The trust is planning to close that end of life ward, which will put additional pressure on our local hospices but without any additional funding to support them.
Children’s Hospices: Funding
Tim Farron Excerpts(3 months, 4 weeks ago)
Westminster HallRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Tim Farron (Westmorland and Lonsdale) (LD)
It is a pleasure to serve under your guidance today, Mr Twigg. I pay tribute to the hon. Member for Liverpool West Derby (Ian Byrne) for bringing this important debate to this place at this time and for making astonishingly good use of it. There is no doubt whatever that Zoe’s Place and the fundraising appeal will have been benefited materially from his putting this issue before this place, and therefore before the country and his community. I pay tribute to his community for their generosity.
I speak on behalf of the children’s hospice Jigsaw, which serves Cumbria, north Lancashire and the south-west of Scotland, and of Derian House in Chorley, which also serves some of my constituents. The scale of the heartbreaking reality of young people living with life-limiting conditions is mind-blowing. Nobody could fail to be moved by that reality and the impact on the families. It is worth also bearing in mind the immense compassion and professionalism demonstrated at Jigsaw and, indeed, all our hospices. It is true that there is a value in the hospice movement having independence and charitable status. It values that but there is a limit, and what we are looking at today is hospices, particularly children’s hospices, being stretched beyond the limit of their ability to raise the funds that they need to take care of the very poorly children whom they lovingly and so professionally do take care of.
The scale of the issue is worth bearing in mind. For the ICB that covers the southern part of my constituency, Lancashire and South Cumbria, there are currently nearly 3,500 people aged 0 to 24 years with life-limiting or life-threatening conditions. For the ICB for north Cumbria, which includes the whole north-east of England as well, the figure is more than 6,000. The money spent per head is £18.86 per child. If we think about the whole hospice movement serving Cumbria—St Mary’s at Ulverston, St John’s at Lancaster, Derian House, Eden Valley Hospice and Jigsaw—we are talking about the taxpayer, the NHS, being saved £33 million every single year because of the support that those hospices give in providing palliative and end of life care for people of all ages.
There is a particular thing that I want to raise about Jigsaw and the threat that it faces. It is a relatively small children’s hospice serving a very large rural county. The hon. Member for Strangford (Jim Shannon) talked about the importance of hospice at home, for example. The support that Jigsaw gives families outside the hospice is also massively important. But in recent years, of course, inflation has had an impact on fundraising. Look at energy bills: there has been an increase of something like 30% in overheads for most children’s hospices, including Jigsaw. Also, of course, hospices need and want to compete with the NHS on the pay that they give their excellent staff, but they are not funded. When the NHS has a pay rise, each part of the NHS, generally speaking, gets the funding to cover it, but not children’s hospices, so we are calling for ringfencing and central distribution of the money to hospices and for increases if at all possible.
I want to say a particular word about the complexity of our communities. I do not want to overly criticise our ICBs, but we have a children’s hospice that serves two, and as a result, getting the money out of them can be very difficult. It should not be for children’s hospices to work so tirelessly to drag money out of the public sector and to raise so much from voluntary services when what they are trying to do is to provide compassionate, professional, end of life care for children. It is time today for the Chancellor to step up and fund our hospices, including Jigsaw, in a way that is permanent, reliable and sufficient.
Access to Primary Healthcare
Tim Farron Excerpts(4 months, 1 week ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Helen Morgan
That is an important point. In my constituency, carers who go to pick up prescription medicines are finding that the pharmacists are not there because they are relying on locums. The pharmacy funding problem needs to be addressed as a matter of urgency, and I will say more about that later.
Growing the economy is so important that we need to get people off the waiting and referral lists and back into work. Liberal Democrats believe that people should be in control of their own lives, not “chained up” at home, unable to get out of bed, because they have no access to healthcare. They should be able to get the help that they need, when they need it, in their own homes and communities.
Let us start with GPs. The Liberal Democrat manifesto—it was well received, which is why there are so many Members sitting behind me on these Benches—called for the right to see a GP within seven days or 24 hours if the situation is urgent, and for those aged over 70 or with a chronic health condition to have access to a named GP. Those rights are extremely important. People who go to the same GP for more than 15 years have a 25% lower chance of dying than those who have seen a new GP in the last year. Primary care networks tell me that their inability to deliver continuity of care because of the shortage of GPs is one of the problems that worry them most.
Tim Farron (Westmorland and Lonsdale) (LD)
My hon. Friend is making a brilliant introductory speech. Is she aware that perhaps only a third of those leaving medical school and seeking to go into general practice are able to find jobs, partly because the additional roles reimbursement scheme—which does exist—cannot be extended to enable some of those would-be GPs to be recruited? Is it not mad that although we are creating enough potential GPs through medical school, we cannot give them jobs because of the funding mechanisms that this Government inherited from the last one? We are losing them from general practice, and, in some instances, losing them from the country altogether.
Helen Morgan
My hon. Friend is entirely right. I believe that the Government are taking steps to address that, but he has made an important point about the need for flexible GP funding. A general practice may have money to spend on professionals and need more fully qualified doctors to deal with its patient list, but can only spend that money on another pharmacist or another nurse. That is a ridiculous situation, and I am pleased that the Government are dealing with it.
Oral Answers to Questions
Tim Farron Excerpts(4 months, 1 week ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Stephen Kinnock
I thank my hon. Friend for raising that deeply tragic case. Words cannot express the heartbreak caused to Jamie Pearson’s friends and family. I hope it might be some small comfort to them to know that all acute hospitals should now have a 24/7 mental health liaison service in A&E, and we are looking at how best to take forward the Government’s suicide prevention strategy for England. We will do everything in our power to ensure that the tragic circumstances of Jamie’s untimely death are addressed, and that lessons are learned. I am happy to meet my hon. Friend to discuss that further.
Tim Farron (Westmorland and Lonsdale) (LD)
Those providing child and adolescent mental health services in south Cumbria do an outstanding job, but they are without a dedicated crisis team, unlike the rest of Lancashire and South Cumbria NHS Foundation Trust. That is devastating and dangerous for my constituents. Will the Minister use his power to intervene with the integrated care board and Lancashire and South Cumbria to make sure that young people in our communities have access to a crisis team?
Stephen Kinnock
I thank the hon. Gentleman for that question and the passion with which he put it. We are committed to rolling out Young Futures hubs across the country and, of course, we need to prioritise areas of particular need. I would be happy to meet him to discuss that further.