Cancer Outcomes in the UK

Lord Kakkar Excerpts

Tuesday 21st April 2026 Grand Committee

[Lord Kakkar (CB)]

My Lords, I join other noble Lords in congratulating and thanking my noble friend Lord Patel for having secured this important debate and having introduced it, as he always does, in such a thoughtful and sensitive fashion. In so doing, I remind noble Lords of my own interests as the chairman of King’s Health Partners and of the King’s Fund.

I start by congratulating, through the Minister, His Majesty’s Government for having established such a thoughtful, comprehensive and forward-looking national cancer plan, and for having described a substantial ambition extending, as we have heard, over 10 years. It covers so much of what is essential in ensuring that we have a joined-up strategy that can potentially achieve the impact and ambition so rightly described.

In its initial description, the ambition covers the problem that we currently face: we experience, as a nation, untimely delays in diagnosis, access to imaging and access to a proper histopathological evaluation of biopsy samples; and an inability, therefore, to apply advanced diagnostic and characterisation techniques to targeting therapeutic intervention in an increasingly precise fashion. There are delays in establishing treatment for patients and in ensuring that patients are able to participate in clinical trials. We have done little of what needs to be done to drive a proper national programme for prevention in the area of cancer. It is of course vital, and there is a necessity—because, actually, we are making substantial progress and we must not be too gloomy—to start focusing on survivorship and how we are able to help patients beyond that initial therapeutic intervention when they are potentially not cured and have to continue to live with their cancer.

As we have heard, it is also very clear that previous Administrations have made substantial efforts to secure improved clinical outcomes for patients with cancer. Much of that innovative and imaginative approach to improving clinical outcomes in cancer has happened at a time in our national history when the NHS has benefitted, as have many other public services, from the so-called peace dividend—the period since the end of the Cold War. In 1990-91, NHS spending was some 4% of GDP, and in the year 2023-24, it was some 8%: a near doubling from £1 in every £25 of public expenditure some 30-odd years ago to £1 in every £12 of public expenditure.

That was a period of substantial plenty, when strategies and plans were presented but, regrettably, did not achieve absolutely what was intended and expected. As a result, this new cancer plan now lands at a time when our fiscal situation in the country, with the demands for increased defence expenditure, makes it highly unlikely that the substantial increases in public funding that have previously been devoted to healthcare will be available in the future.

It is therefore right that in this Grand Committee debate so many noble Lords have identified the question of how this plan will be implemented. What are the potential restrictions, not only financial but organisational and structural, that are likely, regrettably, to ensure that much of this great ambition that is absolutely necessary for the future health and well-being of our fellow citizens will not come to pass?

In this respect, it is very important, as we heard from the noble Lord, Lord Patel, to look at examples from other national experiences. The International Cancer Benchmarking Partnership has looked at these questions. As we have heard, the jurisdiction of Denmark represents an important example of what can be achieved: the clear lesson is that there has been consistency after a national cancer plan was adopted. That consistency manifests itself over many decades in political consensus. At a time when there was substantial opportunity for various Administrations to make further and increasing commitments to healthcare expenditure, it was possible that our country could live without consensus about the long-term delivery of health strategies, but we are no longer in that luxurious position.

I would therefore be interested to hear from the Minister how, in taking forward this impressive plan, His Majesty’s Government propose to achieve the substantial consensus—not only political but professional and, more generally, among the general public—that will see this strategy live through its 10 years, modified if it requires modification, but without wholesale dismissal. Those who deliver have to be in a position to do so with some certainty.

Secondly, in the circumstance we find ourselves with the economy and our fiscal constraint, how do His Majesty’s Government propose to find the substantial additional investment that is inevitably required when one looks at the ambition of this plan? As we have heard from other noble Lords, there are so many areas that we would all support, but each will require substantial investment—beyond the investment that is already made in delivering the day-to-day care that is required for cancer patients today and the increasing demands on that care through the adoption of already available innovation—to be provided at scale and pace across the entire country. Therefore, we need clarity about the approach to funding, the approach that will be taken in the Department of Health and Social Care now that it has incorporated the functions of NHS England back into the department and the approach that will be taken to prioritise funding on cancer over other priorities that will inevitably be identified for other disciplines and for the management of other clinical conditions.

Finally, so much of what is described in this impressive plan is predicated on the basis of ensuring that research is no longer an adjunct to the delivery of cancer care, but central to it. One of the points that we have heard, which is absolutely correct, is about accelerating the opportunity for clinical trials. We know that patients managed on clinical trial protocols, or in the clinical environment where they can access clinical trial protocols, have improved clinical outcomes. There is a need to drive broader equity in access to those clinical trials.

In addition, it will be vital to ensure that there is consensus on the use of data. Data will be critical to drive the innovation agenda and the implementation agenda. Can the Minister give a view on the approach of His Majesty’s Government to ensure that there is broad societal consensus on the use of data, on a routine and regular basis, to achieve so much of this ambition?