Health and Care Bill

Viscount Bridgeman Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Viscount Bridgeman (Con)]

My Lords, I add my congratulations to the noble Lord, Lord Stevens. His matchless experience of healthcare has been communicated to us with a pleasantly light touch.

I rise to speak to the proposed new subsection (2A) outlined in Clause 4(2) of the Bill, to which my noble friend Lord Bethell referred. This was one of three amendments made to the Bill in another place which were accepted by the Government. The mover of this amendment was my honourable friend John Baron who was for nine years the chairman of the APPG on cancer.

The OECD has confirmed that the survival rate for cancer in the United Kingdom ranks near the bottom of the table when compared with other major economies. For some cancer types, only Poland and Ireland were below us. As we have improved our survival rates, so have other countries, and there is very little evidence of our closing the gap with a better performance, despite the considerable increase in health spending in recent decades.

In their research, my honourable friend and his committee discovered that, once a cancer is detected, the NHS performs largely as well as other comparable health services. However, where our NHS falls down is in catching cancers at their crucial early stages. The APPG campaigned, with some success, for a one-year survival rate indicator to be adopted by the NHS at local level. The advantage of adopting this yardstick was that it gave local NHS bodies the opportunity to promote initiatives which boosted early diagnosis. It also gave them the flexibility to devise their own solutions. However, the APPG uncovered the tendency of local clinical commissioning groups to focus on process targets, with funds being released against performance against them.

In recent decades, the NHS has been beset by numerous process targets, of which waiting times is a high-profile example. As a result, these yardsticks have been used at the expense of front-line measuring of the success of the treatment of, among other things, early cancer. The new subsection (2A) proposed in Clause 4(2) addresses the problem by proposing that NHS England should be required to include

“objectives for cancer treatment defined by outcomes for patients with cancer”

and that these are to have

“priority over any other objectives relating to cancer treatment.”

The objective of the proposed new subsection is clear. Process targets may have their place, but it is the simple, clinical procedures of defining outcomes for patients with cancer which will hopefully concentrate resources on early diagnosis, which is currently the Achilles heel of the NHS.

I look forward to scrutinising in Committee this new amendment, which was initiated by John Baron in another place. It is the bedrock of a key change of emphasis in cancer treatment which has, I am happy to say, been adopted in principle by Her Majesty’s Government.