The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, I congratulate the noble Lord, Lord Patel, on securing this excellent debate. I thank him for bringing his considerable expertise and careful consideration—as he always does, as other noble Lords have said—to these matters. He has assembled a pretty daunting selection of noble Lords, for which I am also grateful.
I thank all noble Lords for their contributions, which have been incredibly well informed, personally felt and thoughtful. There is much that I will share and examine further with my ministerial colleagues. Sharon Hodgson, the Minister for Public Health and Prevention, is driving forward the implementation of the cancer plan. To pick up the specific point about GPs, I note that Stephen Kinnock, the Minister for Care, is the responsible Minister for that area; I will raise the searching comments from the noble Baroness, Lady Gerada, with him.
I appreciate how personal and affecting the debate is for so many—if not everybody—whether they have said it or not, either directly or indirectly. That has inspired us much. By using the word “inspired”, I am quoting the noble Earl, Lord Howe; I was delighted to hear him talk about the cancer plan as an “inspiring read”—he really should review books—and “excellent”. The noble Earl’s assessment of it being a jigsaw is absolutely spot on, and that has been acknowledged throughout.
I will do my best to respond to a number of points. I suspect that I will not manage to do so entirely, but I hope noble Lords will be assured that their comments and questions will be taken up.
For me and noble Lords here today, strategy is one thing but implementation is the main thing. Many noble Lords, including the noble Baronesses, Lady Bottomley and Lady Bloomfield, the noble Lord, Lord Patel, and others challenged the point about implementation, so I will speak briefly about that. There will be a reformed national cancer board. It will be accountable for delivery and include cancer experts. It will track progress, update Ministers and monitor the impact, including—following the points raised by my noble friend Lady Nargund—by dealing with inequalities; that will be key in its monitoring. Updates will be published annually on the national cancer plan’s progress. I look forward to more challenge and engagement from noble Lords in relation to that.
On outcomes, as we have heard, the best way is to diagnose and to treat early to improve outcomes, which is why the cancer plan sets an ambitious goal to meet all cancer waiting times standards by 2029. We are already making strides towards this goal—not least by reducing the NHS waiting list overall by 405,000 since July 2024—but we have a very long way to go in this area of cancer.
The point about inequalities—whether we are talking about race, deprived communities or any other significant factor—came up so much, and rightly so. The noble Baronesses, Lady Redfern, Lady Bottomley and Lady Nargund, and the noble Lord, Lord Patel, among others, referred to this. As was said, the improvement of care for deprived, disadvantaged or less equal communities will be monitored through the NHS cancer waiting time standards. Data is published at integrated care board and provider level, and the NHSE acute provider table of all 134 providers supports this transparency. It is about getting attention to where it is needed most.
The cancer plan’s central ambition is to transform survival rates, committing to 75% of patients diagnosed from 2035 being cancer-free or living well within five years. What an ambition that will be to achieve. It will be the fastest rate of improvement in cancer outcomes this century and lead to an additional 320,000 lives saved over the course of this plan—and of course, for every life saved, many more are affected.
On diagnostics, one way in which we can achieve our ambitions is by improving cancer diagnosis in the community—the noble Lord, Lord Taylor, spoke to this point. As noble Lords have acknowledged, last week we announced plans to open four new community diagnostic centres in England over the next year, while also announcing that a further 32 of the 170 CDCs that are currently providing valuable diagnostic capacity will be expanded and enhanced. They are a major move towards a neighbourhood health service.
By extending new capacity—which was referred to by the noble Baroness, Lady Bloomfield—we are also optimising our cancer screening programmes to catch it earlier. I make particular reference to HPV, which was raised by the noble Baronesses, Lady Watkins and Lady Walmsley, and the noble Lord, Lord Patel. From this year, young people who missed out on the vaccination at school can have it administered from a pharmacy. That is to help us move to the elimination of cervical cancer by 2040. I really welcome that. It is about recognising that some people have missed out and providing the service easily and locally in the trusted pharmacy.
My noble friend Lady Ramsey and the noble Lord, Lord Stevens, referred to the national lung cancer screening programme. This will be fully rolled out by 2030, inviting more than 6 million people and identifying at least 23,000 cancers at an earlier stage. I am glad that the noble Lord, Lord Stevens, made the point that those who are more disadvantaged are benefiting from this to a greater degree. Disadvantage is being matched with greater and disproportionate—as in the right amount of—care and attention, and I hope we will see more of that.
On the matter of treatment, I say to the noble Baroness, Lady Redfern, that we will be taking a new approach: more patients will be able to access specialist training centres; by 2028 the NHS app will be the front door for managing our healthcare, and it will have a particular resonance for cancer care; and by 2035 we will bring together genomic and lifestyle data with the all-important single patient record, which will provide the kind of joining up that noble Lords have referred to.
I turn to the important matter of workforce, which was referred to by many noble Lords, including the noble Baroness, Lady Walmsley. I share the frustration of the noble Earl, Lord Howe, about the effect of industrial action on the service to patients and the kind of progress that we seek to make.
The noble Baroness, Lady Walmsley, almost asked me, “When is spring?”, and my noble friend Lady Blake whispered, “It’s still quite cold outside”. But there is indeed to be the publication of the 10-year workforce plan, which will set out a multi-disciplinary approach and will pay greater attention to the role of the workforce. I very much look forward to it supporting this cancer plan, as well as others.
My noble friend Lady Rafferty asked about the training of clinical staff. We will establish new national training standards for surgeons, in particular surgeons in robotic surgery. Over the first three years of the cancer plan, we seek to create some 5,000 learning and training opportunities for people per year in cancer-critical roles. That shows its importance in our approach.
As noble Lords have said, we have to take steps to seize and embrace research breakthrough. I am sure that the noble Lord, Lord Stevens, will take this back, but Cancer Research UK has rightly pointed out that, if we shift the dial on outcomes, that requires us to target rarer cancers, which noble Lords have referred to, where progress has often been slow. As your Lordships will know, we are fully implementing the Rare Cancers Act and are glad to do so. That will make it easier for patients to take part in cutting-edge clinical trials, the importance of which my noble friend Lady Paul spoke to. I can tell my noble friend Lady Warwick that we will appoint a national specialty lead who will advocate for rare cancer patients and oversee the delivery of research in England.
A new cancer trials accelerator will increase the speed and reach of trials. Up to 10,000 personalised cancer vaccine doses will be delivered through clinical trials by 2030. To respond to my noble friend Lady Paul, the Government have committed to reducing the set-up time for clinical trials to under 150 days, to earn the UK the real honour and practicality of being a world leader. We will streamline the implementation of proven technology, as well as boosting access via our new national healthtech access programme.
Just as we are targeting rarer cancers, we will also target specific groups—to which I have already referred—to ensure greater progress. That requires the use of data and data collection, which the noble Lord, Lord Kakkar, spoke about. The national cancer plan includes, for example, real-time pathway analytics, streamlined cancer metrics to expose unwanted variation, which is absolutely crucial, and providing trusts and cancer alliances with more granular and actionable data. Without data we cannot target where we need to go.
As noble Lords know, April is not just part of spring; it also marks the publication, last week, of our renewed women’s health strategy, in which we set out actions to expand genomic testing for those with a lifetime risk of breast and ovarian cancers. We will also look to improve the detection of endometrial cancer. I am grateful to my noble friend Lady Nargund, who spoke to the important matter of gynae cancers.
On linking women’s health to AI, I hope noble Lords will recall that we now have the EDITH—Early Detection using Information Technology in Health—trial, which will see nearly 700,000 women take part in a world-leading trial to test whether AI can increase the number of cancers detected in the national breast screening programme. To the point on workforce, this will also mean that the radiographers will be key, but we will need not two but one for each case—that is how we can harness AI. I agree with the noble Lord, Lord Evans, about the great improvements that AI can make, including in back-office functions. My noble friend Lord Drayson also spoke to the importance of harnessing the benefits of AI, and I assure noble Lords that we will continue to do that.
I will make a couple of final comments on innovation, productivity and funding, but, before I do, I will comment on prevention. Noble Lords have referred to this. We will stop as many cancers as we can by—these are just examples—cracking down on illegal underage sunbed use, eliminating cervical cancer through HPV vaccination, tackling obesity and creating the world’s first smoke-free generation. I am grateful to noble Lords, including the noble Baronesses, Lady Ramsey and Lady Walmsley, for welcoming the Tobacco and Vapes Bill. It is a step change in our work and will save thousands of lives.
On productivity, and on a point raised by the noble Lord, Lord Patel, we estimate that we will see up to a 21% gain in productivity as we invest in digital and robotic automation-enabled histopathology—pronouncing that is where I need the noble Lord, although it is also my writing—pathways, with further capability enhancement by AI. So we are not standing still on productivity and workforce, and I agree with the noble Baroness, Lady Finlay, about the importance of bringing together strategies and approaches. We will achieve in the cancer plan only by doing that. The noble Baroness rightly raised the issue of palliative care.
On funding and resources—the noble Lord, Lord Kakkar, raised this—there are significant commitments, and I will mention just some of them: £10 million a year for children and young people to be able to access their treatment without financial penalty; £200 million for cancer alliances to improve performance; and £2.3 billion in diagnostics, which should deliver 9.5 million additional tests by 2029. I think that gives a sense of our commitment.
My noble friend Lady Ritchie asked about resourcing for innovation. I assure my noble friend that we are working with education colleagues in the way that she asked, and there will also be a plan in place, which we are developing, for how we resource innovation. I am grateful for her comments.
This was such a rich debate. I feel I have picked out themes, and I will reflect, as will my ministerial colleagues, on the very real and informed points that noble Lords have made. The thing I did sense is that we all want this national cancer plan to work. I look forward to continued scrutiny, contribution and expertise from noble Lords. Lastly, I once again thank the noble Lord, Lord Patel.