Moles: Histological Testing

Wera Hobhouse Excerpts

Thursday 30th October 2025 Westminster Hall

[Wera Hobhouse (Bath) (LD)]

It is a pleasure to serve with you in the Chair, Ms Jardine. I congratulate the hon. Member for Isle of Wight West (Mr Quigley) on securing this important debate—I call him a friend, because we are working on quite a lot of issues together. He told the courageous story of Zoe, her family and their courageous campaign so beautifully, and made the case that if we detect cancers like this early, we save money across the board, because expensive hospital treatment will be avoided. The cost of detection and testing is a fraction of the cost of treatment.

Stories like Zoe’s are truly heartbreaking. We cannot change what happened to her, but we must learn from it to make sure it is never allowed to happen again. I entirely welcome the call to make it mandatory for all excised moles to be tested, even if they are removed for cosmetic reasons. Performing histological testing on removed moles will help us to diagnose more cancers and, of course, save lives. We will also probably find out more about the extent of cancers that we would not have linked to other severe cancers if we did not do that testing.

Currently, the British Association of Dermatologists recommends that all removed skin lesions be tested, even if they are taken off for purely cosmetic reasons, but there is currently no specific requirement for those tests, despite that advice. The tests are often carried out when moles are removed in a medical setting by the NHS, but we must ensure that private cosmetic clinics also follow the requirement for testing. The introduction of Zoe’s check will ensure that every mole is tested, thereby making sure that early signs of skin cancer are never missed or overlooked and that heartbreaking stories like Zoe’s are never repeated.

Early detection is paramount. Too many people are slipping through the cracks in the system and not being diagnosed until it is too late. Catching cancer early allows it to be tested faster, thereby giving treatments a greater chance of being done quickly and succeeding. We have campaigned across the House for the earlier detection of cancers. I also have a campaign to detect breast cancer early through a better screening programme for younger women, because cancer is on the rise throughout all ages—it is not just an illness of older people.

Cancer is a terrible disease that tears families apart. We Liberal Democrats have long called for more to be done to improve the early detection and treatment of cancer, because we recognise that detecting cancer early and treating it faster is our most powerful weapon against it. It is not only about early detection; what follows it is crucial. Early detection is meaningless unless it is followed by direct treatment very quickly. Early detection and fast treatment go hand in hand.

The Government’s current target is for a patient to have received their first treatment for cancer within 62 days of an urgent cancer referral, but that target has not been met since 2015, leaving many patients waiting with the knowledge of their cancer diagnosis looming over them. The toll on their mental health is enormous. Once we have a diagnosis, treatment must follow fast on its heels. That is why we Liberal Democrats are calling for the target to be made law, so that patients can be confident that they will receive the treatment they urgently need.

Detecting cancer early saves lives, reduces treatment costs and spares families unimaginable pain. Every check, every screening and every test can make the difference by diagnosing a cancer before it spreads. Zoe’s check will help us to do this, and I support it every step of the way.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

It is a pleasure to serve under your chairship, Ms Jardine. I thank my hon. Friend the Member for Isle of Wight West (Mr Quigley) for this important debate and all hon. Members who have contributed. I thank my hon. Friend the Member for Neath and Swansea East (Carolyn Harris) for raising the report by the APPG for beauty and wellbeing; I look forward to considering it in the new year. I thank the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), for raising the issues of sun damage and sunbeds. I am exploring options with respect to those issues and will report to Parliament as necessary.

Let me say how sorry I was to hear about the heartbreaking circumstances of Zoe’s story. My sympathies are with her family. I was honoured to meet them and hear their story at first hand earlier this month, and I am glad to see some of them in the Public Gallery today. I commend their campaigning in Zoe’s name.

I would also like to take a moment to acknowledge the personal experience of my hon. Friend the Member for South Norfolk (Ben Goldsborough) with stage 2C malignant melanoma. I commend his courageous efforts to share Zoe’s story alongside his own. From awareness-raising, better regulation and improved diagnostics, all the way through to fundamentally reforming the NHS, we will seize every opportunity to learn from preventable and unnecessary tragedies like Zoe’s, to help to save the lives of others.

The last time that I checked, the petition for Zoe’s law had received almost 40,000 signatures and many more people will have seen Zoe’s story in the news. Just a couple of weeks ago, my right hon. Friend the Prime Minister paid tribute to Zoe’s family for their work. I commend all those who have raised awareness of skin cancers through Zoe’s story, because the faster and earlier that people are diagnosed with skin cancer, the faster they can begin treatment and the more effective that treatment can be.

The Government are taking steps to promote awareness of signs and symptoms through the NHS’s “Help Us Help You” campaigns, which aim to increase knowledge of cancer symptoms and encourage body awareness, helping people to spot symptoms earlier. Let me also take this opportunity to further promote the NHS’s clear and accessible information about how to check moles. That guidance is available to everyone on the NHS website and makes it easier for people to recognise when they should seek medical advice.

Most importantly, however, Zoe’s story demonstrates that even when someone does the right thing and raises concerns with their GP, accurate referrals to cancer services need to be in place. Let me stress that every patient should receive the thorough, compassionate and safe care that they deserve. Our GPs also need support to catch potentially deadly illnesses, including skin cancer, sooner. That is why, as a number of hon. Members mentioned, we recently introduced Jess’s rule, a new patient safety initiative designed to support GPs in making timely diagnoses. In practice, it means that if a patient returns to their GP three times with symptoms that are either worsening or still undiagnosed satisfactorily, GPs are asked to reflect, review and rethink. The aim is to make sure that no warning sign is missed and that every patient receives the attention they deserve.

I want to reassure hon. Members and others that the Government are committed to ensuring the highest standard of patient care by equipping healthcare professionals with the latest best practice clinical guidance. The National Institute for Health and Care Excellence provides evidence-based guidance for the NHS on best practice. NICE has published several guidelines that include recommendations related to the diagnosis, assessment and treatment of skin cancer, including a guideline on referrals for suspected cancer, which was updated in May.

Our commitment to best practice means that histological testing on excised moles is already routine practice in the NHS. There is not NICE guidance for the cosmetic industry, because it is not NHS-funded, but I know that the safety of the cosmetic sector is of significant interest to colleagues. Many Members will no doubt be all too aware of the devastating consequences of a wide range of unsafe cosmetic practices. Since I met Zoe’s family, my office has written to colleagues at the Department for Business and Trade to get a better sense of practice and to explore what it is possible for us to do in this space.

My Department will also consider whether Zoe’s story can be incorporated into action that we are taking to improve the safety of the cosmetic sector as a whole. We are prioritising developing legal restrictions on high-risk cosmetic procedures, to ensure that they can be performed only by suitably qualified and regulated healthcare professionals who are working for providers registered with the Care Quality Commission. Additionally, we will introduce a local authority licensing scheme in England for lower-risk cosmetic procedures. Licensing will enable us to embed rigorous safety training and insurance standards in the sector, and enable action to be taken against practitioners who fail to comply with the requirements. These measures will allow people to be confident that the practitioner they choose to perform their procedure has the skills to do so safely.

It is important to note that for the majority of skin cancer patients, diagnosis and treatment occur in a timely manner. To ensure that we continue to improve our strong performance and survival rates, we are spending £600 million of capital funding this year on diagnostics. That sum includes, for the first time, funding for the automation of histopathology laboratories to improve productivity. Thanks to the hard work of NHS staff, we exceeded the faster diagnosis standard for skin cancer in August, when more than 80% of patients received an all-clear or a cancer diagnosis within 28 days. The 62-day cancer waiting time for skin cancer was 84.9%—the standard is 85%, so it was just shy—and the five-year survival rate for melanoma is now around 92%.

However, we know there is more to be done. In the longer term, as part of our 10-year health plan, we are ensuring that the NHS is able to harness the power of technological innovation to improve the prevention, diagnosis and treatment of all cancers, including skin cancer. By using innovative technologies such as teledermatology, in which a high-resolution photograph is taken of the skin and sent directly to a dermatologist, we are increasing diagnostic productivity and reducing waiting times for skin cancer patients. We will ensure that no one waits longer than they should.

[Wera Hobhouse]

I called for teledermatology on another occasion because it absolutely works. Does the Minister have any figures on how many GPs are using that as the basis of their diagnosis? My husband recently went to our GP and he was still referred to the hospital, so I am not confident that a lot of GPs are making use of it.

[Ashley Dalton]

The majority of those services are provided through community diagnostic centres. I do not have any figures to hand but I am more than happy to write to the hon. Member with whatever figures we have available.

Within those services, we have recently begun testing AI-based platforms to triage patients following referral from primary care. I have seen at first hand how useful AI can be in flagging potentially risky images so that the consultant can prioritise and explore them. I know that my hon. Friend the Member for South Norfolk takes a keen interest in those developments. Further roll-out of AI in the NHS for this purpose will be subject to assessments of clinical effectiveness and cost-effectiveness, which are ongoing, but I can say from first-hand experience that it offers a very exciting opportunity and falls distinctly within our ambition for the shift from analogue to digital.

Although immediate action is essential, we recognise that bold reform is needed if we are to rise to the growing challenge that cancers of all types present. We will publish the national cancer plan in the new year to reduce the number of lives lost to cancer over the next 10 years. We have received over 11,000 responses to our call for evidence from individuals, professionals and organisations, and we are reviewing the submissions from skin cancer partners. Publication has been delayed by about six weeks to ensure that all the responses are properly considered in the plan. Our expansive engagement will allow the national cancer plan to have patients at its heart. The plan will cover the entirety of the cancer pathway, from referral and diagnosis to treatment and ongoing care.

I thank my hon. Friend the Member for Isle of Wight West again for bringing this important matter to the House, and I thank all Members who have contributed. I am pleased to assure them that we are undertaking immediate actions to learn from Zoe’s story. Combined with our bold reforms to create a health service that is fit for the future, we will reduce the number of lives lost to the biggest killers, including skin cancer.