Accessibility of Radiotherapy

Debate between Tim Farron and John Hayes

Tuesday 4th February 2025 Westminster Hall

[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Radiotherapy UK estimates that simply replacing all the out-of-date LINACs could free up 87,000 additional appointments every single year.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.

Farming and Inheritance Tax

Debate between Tim Farron and John Hayes

Wednesday 4th December 2024 Commons Chamber

[Tim Farron]

There is something in that, and I will come to that in a moment when I talk about poverty in our countryside, when it just does not look the way people in urban communities think it ought to look.

There is no doubt that family farms are under attack, but this did not start on 4 July, and I want to go through why we have ended up where we are now. The botched transition from the old farm payment scheme to the new one is the principal source of hardship among our farmers. Let us start with the fact that the environmental land management scheme—ELMS—budget saw a £350 million underspend under the last Government, and that was not an accident. It was blindingly obvious that that was going to happen. One hill farmer I spoke to just last month told me that, as a consequence of the transition, he will lose £40,000 a year in basic payment. To replace it, he will gain £14,000 under the sustainable farming incentive. By the way, it cost him £6,000 to go through a land agent in order to get in in the first place.

[Sir John Hayes]

The hon. Gentleman is making a profoundly important point. Not for the first time he is speaking as a Liberal Democrat, but also in a way that belies the fact that he is a Liberal Democrat, because he is genuinely committed to the countryside. He has made a point about family farms; the important thing about them is not only the arguments that he has already advanced, but the sense that they represent a continuum—an investment for the future. The reason this policy is so detrimental is because it impacts on that sense that farmers are investing now for generations to come.

[Tim Farron]

I am going to get to that, but the right hon. Gentleman will have to tolerate me accurately pinning blame on his side before I do so.

We were told by the last Government that they would maintain the amount of funding that we used to spend when we were in the European Union. In England, that was £2.4 billion. In one sense, and one sense only, they kind of kept that promise because it was £2.4 billion throughout that five years. However, they did not spend it, because they phased out the old scheme very rapidly, causing a great hardship, particularly to small family farms, and they brought in the new schemes far too slowly and made it very difficult for people to get into them. By the way, the people who were able to get into the new schemes were the big farmers. They were the landowners who had land agents to help them get into the schemes. So the large landowners with the bigger estates managed to get into those schemes. They are all right, broadly speaking. It is the smaller family farms—the farmers who own their own farms and the tenants—who have struggled.

It is also worth bearing in mind that there has been a little bit of inflation since 2019. The cost of running a farm has gone through the roof when it comes to feed, energy, fuel and all sorts of input costs. So the fact that we are at just £2.4 billion now, as we were five and a bit years ago, is absolute nonsense. It is important also to recognise that the grants that were available under the last Government, and now, are in reality often only available to those who have the cash flow to be able to get them in the first place.