Accessibility of Radiotherapy

Torcuil Crichton Excerpts

Tuesday 4th February 2025 Westminster Hall

[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.