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House of Lords Hansard
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20 October 2020
Volume 806

Question

Asked by

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To ask Her Majesty's Government how the new cancer taskforce will operate; and what funding that taskforce will be able to direct towards reducing any backlog in identifying and treating cancer patients.

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My Lords, the Cancer Recovery Taskforce’s role is advisory, to oversee the development of a national cancer delivery plan due to be published later this autumn. The task force is chaired by Professor Peter Johnson, the national clinical director for cancer. It met for the first time in September and is due to meet again on Thursday. Membership is drawn from across the cancer community, and I thank all of those involved. NHS Improvement has recently confirmed annual funding allocations of £153 million for 2021 to the cancer alliances in England.

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My Lords, I refer to my interests as in the register. Cancer Research UK and Macmillan have reported that 2.4 million people are now waiting for screening, tests and treatments for cancer services. The Commons Health Select Committee has reported that the number of MRI and CT scans to diagnose the disease has plummeted by 75%. Given that the Government spend on average half as much on capital in healthcare compared to similar countries, what is the scale of the investment over the next year that will be specifically allocated for the latest technologies and additional staff to deal with the backlog of cancer diagnosis and treatment?

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My Lords, the situation raised by Cancer Research UK and others causes concern, but I reassure the noble Lord that we are doing more than a million routine cancer appointments and operations per week to catch up with the backlog. Urgent two-week waits for GP referrals are back to almost 85% of pre-epidemic levels and we have a massive plan to address this, which includes the creation of Covid-secure environments, switching to new drugs for those who cannot make it to hospital, the judicious use of radiography, targeted messaging to those who may suffer from the symptoms of cancer, the use of rapid health diagnostics, an alliance with charities, a cancer recovery plan and enhanced monitoring on a single version of truth basis of our progress on this important issue.

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My Lords, I would like to follow up on the Question of the noble Lord, Lord Rennard, which was about investment. The UK spends on average half as much on capital in healthcare compared with similar countries, so the average number of MRI and CT scanners is well below the OECD average per million of population. Does the Minister agree that to tackle the cancer backlog and improve survival outcomes the Government must also implement the recommendations of Sir Mike Richards’s recent review into diagnostics and significantly invest in the necessary diagnostic equipment?

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The noble Baroness is right to raise the excellent report by Professor Sir Mike Richards into cancer diagnostics. We have taken that report on board and are studying it very carefully; it will inspire us tremendously. As I mentioned earlier, £153 million has been allocated to cancer alliances. The investment in capital is an extremely important part of that. I want to flag a few immediate developments: diagnostic capability at the Harrogate and Exeter Nightingale hospitals, the community diagnostic hubs and the rapid diagnostic centres are all in focus for this investment.

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My Lords, with radiotherapy being needed for over 50% of cancer patients and involved in 40% of cancer cures, what is being done to ensure that patients can continue to access this life-saving treatment throughout the Covid-19 pandemic? Are there plans to improve access to radiotherapy for the 2.5 million people currently living over the recommended 45-minute travel time to bring cancer treatment closer to people’s homes?

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My Lords, during the Covid pandemic, radiotherapy services have continued. We are working to ensure that the need to travel to hospital is kept to a minimum, using drugs where they present an alternative to radiotherapy. The recovery of our radiotherapy services is massive and we are using the latest technology to ensure that this is delivered as impactfully as possible.

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My Lords, is the cancer task force, now in the fifth year of its five-year programme, to become a permanent organisation? What is the basis for allocating funding and research?

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My Lords, the Cancer Recovery Taskforce I refer to is the group of people focused specifically on the recovery from the Covid pandemic. The overall cancer recovery programme will be published later in the autumn, and it will have budgets associated with it.

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My Lords, the whole thrust of the Covid pandemic has been to make sure that the NHS stays in one piece. As we have fewer people referring to their GPs and fewer people being referred into the system, are we not creating a backlog that will affect the NHS’s capacity to deal with problems? With that in mind, what will the Government do to ensure that people know that it is safe, or at least that the risk is low, to go to a GP in the first place and then go on to hospital?

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The concern is serious. However, I reassure the noble Lord that although those waiting longer than 62 days for an urgent GP referral increased to about 21,000 between the end of March and the end of May this year, it now stands at about 8,000, which represents a dramatic decrease in the backlog. We have invested in the “Help Us Help You” campaign, which is directed specifically at those who are most at risk from cancer. It is a massive campaign that we are rolling out shortly, and we will continue to invest in it if that is needed.

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My Lords, calculations by the charity Action Radiotherapy suggest that the cancer treatment backlog may cost more lives than the coronavirus itself—indeed, it estimates that it could be as high as 100,000. Can the Minister give us details—and if not, can he place them in the Library—of the investment in and expansion of radiotherapy services that is being considered and of the aim to reduce the number of machines that are beyond their 10-year lifespan?

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My noble friend is entirely right. The impact on cancer from Covid is extremely concerning. However, the backlog is being dealt with more quickly than the immediate figures perhaps suggest. The investment in radiotherapy is incredibly important; we have new treatments coming in all the time, and I reassure my noble friend that we will be retiring redundant machines as soon as they reach the end of their natural lifespan. I want to mention in particular stereotactic ablative body radiotherapy for small cell lung cancer and oligometastatic indications: I am told that this is a particularly exciting radiotherapy treatment

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Following on from that, does the Minister recognise that about half the machines in the country are currently beyond their 10-year lifespan and urgently need replacing—including upgrading to provide stereotactic radiotherapy, which has lower side effects and better outcomes—and that there therefore needs to be at least £230 million ring-fenced for innovation in radiotherapy, quite apart from the other investments?

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The noble Baroness puts her case extremely well. We have a massive investment in the NHS that spans physical infrastructure and staff, hospitals and investment in nurses. This will have a big impact on the diagnosis of cancer, which we are committed to getting as early as possible, as well as on treatment for cancer. Treatment with radiotherapy will form an important part of that.

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As there has been much more exposure to the sun this summer, there will be a greater incidence of melanoma. Does the Minister agree that screening is essential to detect melanomas before they spread rapidly and are fatal? If they are detected while they are less than 0.6 millimetres deep, they can be cured by a simple removal under local anaesthetic. Does he agree that this ought to be a priority for the task force?

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My Lords, I completely and utterly agree with my noble friend.

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I am pleased to hear of the arrangements made for treating the backlog of patients suffering from cancer. However, that is not the only backlog that exists; other conditions require urgent attention. I disclose the position of my 24 year-old grandson, who is studying for a doctorate in epidemiology. He was born with a condition which meant that, at a very early age, he had to be fitted with a pacemaker. Unfortunately, when changing his pacemaker, the wiring was found to have become embedded in his heart. It was therefore decided to leave the wiring in that position and to fit a second pacemaker. Towards the end of last year, his health deteriorated. He was eventually admitted to the Brompton hospital, and by that time was in a very serious condition. Fortunately, after five weeks in an induced coma, his condition dramatically improved and he should make a full recovery. However, it was touch and go. I make no criticism of anyone, but it is important that it is not only cancer that is regarded as important; other patients should also be regarded as important.

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I thank the noble and learned Lord for sharing that moving testimony. The broad point that he makes is entirely right—that Covid has an impact on our healthcare system that goes way beyond those who have Covid. It has an impact on the care and outcomes of all sorts of people who need important places in the healthcare system. That is why this Government are committed to the suppression of the virus and to protecting the NHS, and it is why, on behalf of everyone, we wish both the noble and learned Lord and his grandson well.

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My Lords, the time allowed for this Question has elapsed.