Grahame Morris is the MP for Easington in County Durham and vice-chair of the All-Party Parliamentary Group on radiotherapy.
It is not rocket science: in the United Kingdom, radiotherapy accounts for just £383 million, or 5%, of the NHS cancer budget, even though one in four of us will need it at some point in our lives. The Government has committed to invest in new diagnostic equipment. And while I very much welcome that, the penny doesn’t seem to have dropped that there’s an important link between diagnosis and treatment.
I must declare an interest: I am vice-chair of the All-Party Parliamentary Group on radiotherapy. I am a cancer survivor myself and have benefited from this particular treatment. About 50% of people develop cancer at some time in their lives, and I am sure that even those fortunate enough to be spared the disease will all have had a loved one who has been touched by cancer. I am not arguing from a completely selfish point of view, here –putting a case for me, my constituency or my region – as a magnanimous person, I am arguing that we should improve cancer services across the whole country. Access to world-class cancer treatment really matters to every single one of our constituents in every constituency in the United Kingdom.
I want to take issue with a statement that the Secretary of State for Health has made on more than one occasion about cancer survival rates. Although our cancer survival rates are improving – the Secretary of State is not lying – we still have some of the worst cancer outcomes in Europe. Figures comparing nine comparative countries were published in The Lancet in November last year, just before the election. These showed the United Kingdom had the lowest survival rates for breast cancer and colon cancer, and the second lowest for rectal cancer and cervical cancer. Some 24% of early-diagnosed lung cancer patients are not getting any treatment at all.
I welcome the Government’s commitment to considering ways to improve cancer diagnosis, with a plan to set new targets so that patients receive cancer results within 28 days. That is great. But we still need to address issues of staffing and capacity: there is a desperate need for more radiologists and diagnostic radiographers, as well as skilled people to address shortages in endoscopy, pathology and the vital IT networks.
Unlike chemotherapy (which I have also had on a couple of occasions), which impacts the entire body with chemicals, advanced radiotherapy targets tumours precisely, to within fractions of millimetres, limiting damage to healthy cells in close proximity to the tumour. Improved radiotherapy technology allows us to treat cancers previously only treatable with surgery, chemotherapy or a combination of both. Radiotherapy is also cost-effective; the NHS is obviously very keen to ensure we get value for money. A typical course of radiotherapy costs between £3,000 and £6,000 – much less than most chemotherapy and immunotherapy cures – and patients experience fewer side effects.
The problem is that access to radiotherapy centres and this life-saving treatment is not evenly distributed across the United Kingdom. A 2019 audit showed that 32% of men with locally advanced prostate cancer in the United Kingdom had been potentially undertreated, with 15% to 56% of trusts in the survey not offering the sort of radical radiotherapy those patients really required. In England, advanced curative radiotherapy is actively restricted for no good reason, with only half the 52 Trusts having been commissioned by NHS England to deliver advanced radiotherapy: stereotactic ablative radiotherapy, or SABR. That is despite the fact its use is specifically recommended by the National Institute for Health and Care Excellence.
It is World Cancer Day on 4 February 2020. I want the Minister for Health to make a commitment on behalf of the Government that the UK will become a world-class centre for patient-first radiotherapy so that we can improve our cancer survival rates.
That will require an increase in investment. Currently, radiotherapy gets 5% of the cancer treatment budget; we need this to be closer to the European average of 11%. There is an immediate need for £140 million of investment to replace the 50 or so radiotherapy machines – the old linear accelerators – which are still in use despite being beyond their recommended 10-year life at the end of 2019. We also need investment in IT and to help establish the 11 new radiotherapy networks.
The All-Party Parliamentary Group’s manifesto for radiotherapy is calling for a modest increase in the annual radiotherapy budget– from 5% to 6.5% of the cancer budget– and for the Government to establish some basic standards to secure our vision for radiotherapy. We need to recruit and train highly skilled oncologists, radiographers, medical physicists and other healthcare professionals, and to guarantee that every cancer patient has access to a radiotherapy centre within a 45-minute travel time. In 2020, the Government should set themselves a 2030 target for the United Kingdom to go from having the worst cancer outcomes to the best cancer survival rates in the world. We could do that, and we could make a start by delivering a world-class radiotherapy service.