Cancer Outcomes in the UK

Baroness Walmsley Excerpts

Tuesday 21st April 2026 Grand Committee

[Baroness Walmsley (LD)]

My Lords, I am very grateful to the noble Lord, Lord Patel, for giving us the opportunity to talk about cancer today, because I am a very lucky woman: like the noble Baroness, Lady Ritchie, I am a cancer survivor. My cancer was picked up by routine screening, so I am just as much of a fan as the noble Lord, Lord Stevens, of routine screening.

I am delighted to be able to talk about the National Cancer Plan, which covers improvements in targets for prevention, diagnosis, treatment, care and research. Yet, of course, all these are underpinned by a sufficient, properly trained workforce—with ongoing CPD, since the science is constantly changing. The Government have promised the NHS workforce plan by this spring, yet, despite the sunshine outside, for the Government, spring has not yet quite sprung. Will the Minister be able to confirm when we will get it, and can she say whether it will deal with not just clinicians but technicians, and not just initial training but a reliable system of CPD to keep practitioners up to date, as the noble Baroness, Lady Watkins, has also requested?

There are many areas where efficient workforce planning is vital for achievement of not just the cancer plan but the 10-year health plan, including, as it does, moving from hospital to community, and many examples have been raised by speakers today.

A couple of hours ago, I raised an Oral Question about the issue of newly qualified midwives being without a post despite the issues of unsafe staffing levels in maternity services. In Wales, paramedic students are being told there are no posts for them in Wales when they qualify; they will have to go and work somewhere else. The number of posts for health visitors has been halved over 10 years, leading to some having enormous case loads, which were highlighted in the media this week. These are just a few examples of poor workforce planning in the general NHS workforce, but I recognise that this is not easy.

There are of course many examples of shortages in the cancer workforce, including of GPs, as the noble Baroness, Lady Gerada, just told us. They are all vital to early diagnosis, which we know leads to better outcomes. Yet the role of some groups is underestimated: last week, I went to my local dentist for a check-up; she checked me for oral cancer, and for any swellings in the lymph nodes in my neck, which might indicate cancer. Thousands of people cannot get an NHS dentist and cannot afford to pay, as I did, and therefore do not get these cancer checks, as well as having their teeth fall out. Dentists also part of the cancer workforce.

The Government plan for 28 more radiotherapy machines, which—as the noble Baroness, Lady Redfern, said—are probably enough only to replace the outdated ones. My party has proposed that the ambition should be more like 200, but we are aware that this would have to go alongside training more technicians. Is there a plan to do so across the health service?

This brings me to diagnosis and the question of investment in haematology, pathology and several other sectors which noble Lords have mentioned. Many years ago, I worked as a cytologist in the pathology lab of a major cancer hospital in Manchester. I was screening cervical smears for cancer and pre-cancer cells so that patients could have further examination and timely treatment. Since then, productivity has vastly improved with mechanisation of slide preparation and AI-assisted interpretation of samples. There is even more potential for this sort of improved productivity today, so that patients can get their results quickly and proceed to treatment. The noble Lord, Lord Kakkar, talked about the importance of doing this kind of investment when we have a cash shortage.

However, while this requires some investment, it is certainly cost-effective, as indicated by many studies. Waiting for test results is very stressful for patients—as I am sure has been experienced by several noble Lords at some points in their lives—and can be dangerous, as mentioned by the noble Baroness, Lady Redfern. Consultants need these test results to aid early diagnosis, but most areas are unfortunately well behind the targets.

Turning to prevention, there are three major areas I will mention. First, there is a long list of cancers that could be prevented by lifestyle changes. Smoking tobacco has long been the most common cause of cancer, and we are grateful to the noble Baroness, Lady Ramsey of Wall Heath, for her speech on this. Over recent years we have had legislation which has helped to reduce smoking and secondary smoking, the most recent of which was the Tobacco and Vapes Bill which finally went through your Lordships’ House yesterday. I congratulate the Minister and the Government on this legislation, which will certainly protect young people from taking up smoking and increase the opportunity for smokers who wish to quit to get help, thereby reducing their risk of getting lung and mouth cancer.

However, it is vital that community-based stop-smoking services have sufficient resources to be able to offer the full range of help. For example, most do not have the funding to afford prescriptions for the drugs which are proven to help smokers for whom other methods have failed. Vapes have proved to be a very effective quitting tool and should be widely available as such, including on prescription. However, I am pleased that the Government have taken powers to restrict the opportunity of manufacturers to attract, through advertising and marketing, children and non-smokers to start vaping, and I look forward to the regulations to put these into practice. We do not yet have enough information about any long-term dangers of vaping, especially on young and developing lungs.

The second lifestyle factor is diet. In addition to diabetes and musculoskeletal problems associated with overweight, there is a very long list of cancers caused by bad diet and obesity. In response to an inquiry in your Lordships’ House in 2024, which I had the honour to chair, the Government have put a number of our recommendations in place—thank you very much—but a great deal more needs to be done, and more quickly. The effect on the economy of the lost years of life and the lost working years due to illness caused by obesity has been well documented. It is tempting for some to suggest that it is all down to willpower, but that is not the case. We make our decisions on diet in an obesogenic environment, and many people cannot afford a healthy diet, so they are susceptible to a whole list of cancers. My committee proposed a comprehensive cross-government, long-term strategy to improve the nation’s diet.

Last year, the Government set up a national food strategy led by Defra, but we are not hearing much about it. It should cover a whole raft of government departments, so can the Minister say how her department is contributing to that? It really affects the budget of the NHS in the long term. Legislation on healthy food is undoubtedly required, and the Government will no doubt soon hear proposals for a healthy food Bill in the debate on the King’s Speech.

Having formerly worked in the area of cervical cancer, I was thrilled when a vaccine against the human papillomavirus was developed. It is offered free to teenagers as part of the school-based vaccination programme. As chair of your Lordships’ current ad hoc committee on childhood vaccination rates in England, I have heard evidence that the uptake of the HPV vaccine has fallen from 90% when it was first offered to only 72% now, and this puts the Government’s objective of eliminating cervical cancer by 2040 in great danger—the noble Baroness, Lady Nargund, mentioned that. Therefore, what is the Minister’s department doing about that, and how is she working with the Department for Education to improve the situation? I am hearing that some schools are refusing to work with the vaccination services offered to their pupils, and some find getting parental consent very time-consuming. Perhaps the Minister will write to me about that when she has spoken to her colleague.

Finally, on research, as I mentioned, vaccines have already been developed to prevent or treat cancer, and there will be more. Only yesterday, the media reported a vaccine that considerably extends the survival of patients with pancreatic cancer. This raises the question as to what the Government are doing to enable more of this sort of work and the clinical trials that are basic to it, as mentioned by the noble Baronesses, Lady Bottomley and Lady Paul. Clinical trials are absolutely vital in order to bring treatments to patients, and we need to make them easier.

I served on another of your Lordships’ committees—the Science and Technology Committee—with the noble Lord, Lord Drayson, who mentioned some of the findings of one of its most recent reports. But, in addition to the report on the difficulties of scaling up small businesses in this country, including life science businesses and other scientific businesses, the committee wrote an urgent letter to the Secretary of State for Health about the missed opportunity of attracting more researchers from the United States to come here if they are unhappy with the situation there. I am hearing that it would cost an American researcher £18,000 to come with a spouse and one child, to get visas and to pay the NHS charge in advance. This is more of a barrier than an encouragement. The committee heard that other countries are being much more opportunistic than us on this matter. Why are we lagging behind, when other countries have managed to strengthen their cancer research workforce? We need to get good people from wherever they are willing to come to us. Let us stop pussyfooting around and get on with it.