Lung Cancer Screening

Eleanor Laing Excerpts

Monday 26th June 2023 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

Before we come to the statement, I am required to put on record Mr Speaker’s disappointment that an important policy has not been announced first to the House. Not only have Ministers been on the airwaves trailing the policy on lung cancer, but a detailed press notice appeared on the Department’s website well before the start of this statement. Mr Speaker has repeatedly made it clear that such announcements should be made first to the House, that to do otherwise is discourteous to the House, and that this practice must not continue.

[The Secretary of State for Health and Social Care (Steve Barclay)]

Thank you, Madam Deputy Speaker. May I first address the remarks you made on behalf of Mr Speaker? Of course, any disappointment expressed by Mr Speaker is a matter of concern. No discourtesy was wished on the part of the Government. It may be helpful to clarify that no change of policy is being announced in the statement; it is an expansion of an existing policy, which I hope the House will regard as good news. However, we very much take on board any concerns that Mr Speaker has expressed.

With permission, Madam Deputy Speaker, I would like to make a statement on our national lung cancer screening programme for England. About a quarter of patients who develop lung cancer are non-smokers. We all remember our much-missed friend and colleague, the former Member for Old Bexley and Sidcup, James Brokenshire. He campaigned tirelessly to promote lung cancer screening and was the first MP to raise a debate on that in Parliament. His wife Cathy is continuing the brilliant work that he started in partnership with the Roy Castle Lung Cancer Foundation.

In 2018, after returning to work following his initial diagnosis and treatment, James told this House that the Government should commit to a national screening programme and use the pilot to support its implementation. I am sure many colleagues in the Chamber will recall him saying:

“If we want to see a step change in survival rates—to see people living through rather than dying from lung cancer—now is the time to be bold.”—[Official Report, 26 April 2018; Vol. 639, c. 1136.]

Despite being a non-smoker, James knew that the biggest cause of lung cancer was smoking and that the most deprived communities had the highest number of smokers. That is why I am delighted that today the Prime Minister and I have announced a national lung cancer screening programme, building on our pilot programme, which will target those who smoke or have smoked in the past.

Lung cancer takes almost 35,000 lives across the UK every year—more than any other cancer. Often, patients do not have any discernible symptoms of lung cancer until it is well advanced; in fact, 40% of cases present at A&E. Since its launch in 2019, and even with the pandemic making screening more difficult, our pilot programme has already given 2,000 lung cancer patients in deprived English areas an earlier diagnosis. That matters because NHS England states that when cancer is caught at an early stage, patients are nearly 20 times more likely to get at least five years to spend with their families.

We all know that smoking is the leading cause of lung cancer. It is responsible for almost three quarters of cases, and in deprived areas people are four times more likely to have smoked. We have deployed mobile lung trucks equipped with scanners to busy car parks in 43 deprived areas across England. Before the pandemic, patients from those areas had poor early diagnosis rates, with only a third of cases caught at stage one or two. To put that in context, while a majority of patients diagnosed at stage one and two get to spend at least five more years with their children and grandchildren, less than one in 20 of those diagnosed at stage four are as fortunate. Thanks to our targeted programme, three quarters of lung cancer cases in those communities are now caught at stage one and two.

Targeted lung cancer checks work. They provide a lifeline for thousands of families.

We need to build on that progress, which is why we will expand the programme so that anyone in England between the ages of 55 and 74 who is at high risk of developing lung cancer will be eligible for free screening, following the UK National Screening Committee’s recommendation that it will save lives. It will be the UK’s first and Europe’s second national lung cancer screening programme. If results match our existing screening—there is no reason to think that they will not—when fully implemented the programme will catch 8,000 to 9,000 people’s lung cancer at an earlier stage each year. That means that each and every year around 16 people in every English constituency will be alive five years after their diagnosis who would not have been without the steps we are taking today. That means more Christmases or religious festivals with the whole family sitting around the table.

Alongside screening to detect conditions earlier, we are investing in technology to speed up diagnosis. We are investing £123 million in artificial intelligence tools such as Veye Chest, which allows radiologists to review lung X-rays 40% faster. That means that suspicious X-rays are followed up sooner and patients begin treatment more quickly.

How will our lung cancer screening programme work? It will use GP records to identify current or ex-smokers between the ages of 55 and 74 at a high risk of developing lung cancer, assessed through telephone interviews. Anyone deemed high risk will be referred for a scan, and will be invited for further scans every two years until they are 75.

Even if they are not deemed at high risk of lung cancer, every smoker who is assessed will be directed towards support for quitting because, despite smoking in England being at its lowest rate on record, tobacco remains the single largest cause of preventable death. By 2030, we want fewer than 5% of the population to smoke. That is why in April we announced a robust set of measures to help people ditch smoking for good, with 1 million smokers being encouraged to swap cigarettes for vapes in a world-first national scheme. All pregnant women will be offered financial incentives to stop smoking, and HMRC is cracking down on criminals who profit from selling counterfeit cigarettes on the black market.

The lung cancer screening programme has been a game changer for many patients: delivering earlier diagnoses, tackling health inequalities and saving lives. We are taking a similar approach to tackle obesity, the second biggest cause of cancer across the UK. The pilot we announced earlier this month will ensure that patients in England are at the front of the queue for innovative treatments by delivering them away from hospital in community settings. Together, this shows our direction of travel on prevention, which is focused on early detection of conditions through screening and better use of technology to speed up diagnosis and then treatment, because identifying and treating conditions early is best for patient outcomes and for ensuring a more sustainable NHS for the future, for the next 75 years. I commend this statement to the House.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the shadow Secretary of State.

[Wes Streeting (Ilford North) (Lab)]

Before I begin, I would like to take this opportunity to pay tribute to the life of Margaret McDonagh, Baroness McDonagh of Mitcham and Morden. Margaret was the first women general secretary of the Labour party and the best: a political organiser second to none; kind, compassionate and made of steel. I am one of so many people throughout the Labour party and the Labour movement who benefited from Margaret’s kindness, generosity and wisdom. She was a friend, a mentor and a political hero. It breaks my heart that so many glioblastoma victims like Margaret have no hope of treatment and that a diagnosis means a death sentence. So, in sending, I am sure, condolences from across the House to Margaret’s sister, my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh), the best tribute we could make to Margaret and the best condolences we could offer her sister and family, is to unite across the House and resolve to do everything we can to make the breakthrough discoveries we need so that other people like Margaret do not receive this devastating death sentence.

I also join the Secretary of State in paying tribute to the late James Brokenshire, who was unbelievably kind to me when I went through my own cancer diagnosis—even more generous given what he was going through, which was so much worse.

I thank the Secretary of State for advance sight of the statement.

Lung cancer patients in this country are less likely to survive than patients in most European countries. Why? Because patients today find it impossible to get a GP appointment. On receiving an urgent referral, they wait too long for a scan. On receiving a cancer diagnosis, they wait months for treatment. And before the Government blame covid, the target for patients to start treatment within 62 days of referral has not been hit

since 2015.

The Secretary of State was not joking when he said that he is not announcing anything new today. The programme announced today will not be fully rolled out until 2030. So, after 13 years in Government, they are not announcing action today and not even for the next Parliament, but for the one after that. I thank the Health Secretary for making commitments for a second-term Starmer Government to deliver.

On the workforce, the problem with the plan is that the NHS simply does not have the staff to deliver it. The Prime Minister and the Health Secretary have been all over the media setting out the upcoming workforce plan, although they have not yet said a word to the House. Is this why it will take seven years to roll out the screening programme, because they have no plan to bring down NHS waiting lists today? We have been waiting almost as long as we have been waiting for the right hon. Member for Mid Bedfordshire (Ms Dorries) to hand in her resignation and call a by-election.

While the Health Secretary writes the Labour party’s 2028 manifesto, junior doctors who treat lung cancer patients are due to walk out on strike for five days. More than 650,000 operations and appointments have already been cancelled due to NHS strike action. Is it not time for the Health Secretary to accept he has failed, step aside and call in the Prime Minister to finally meet junior doctors? If the Prime Minister has time to negotiate gongs for Conservative cronies with Boris Johnson, he has time to meet junior doctors.

Today we learnt that the National Cancer Research Institute announced it will be closing after 22 years, due to

“uncertainty in the wider economic and research environment.”

There is still so much we do not know about cancers and so many treatments still to be discovered and developed, yet clinical trials have fallen off a cliff in recent years.

What impact does the Health Secretary expect the closure to have on cancer clinical trials?

After 13 years of Conservative rule, the verdict is in. A report published today by the King’s Fund reveals that the NHS has fewer CT and MRI scanners than other advanced countries, and

“strikingly low numbers of…clinical staff”.

That explains why the King’s Fund also found that the NHS was hit harder during the pandemic than other healthcare systems. It is not just that the Government did not fix the roof when the sun was shining; they dismantled the roof and ripped up the floorboards. It also helps to explain why patients in this country are less likely to survive treatable conditions, such as breast cancer and stroke, than those in comparable nations, and why we have one of the lowest levels of life expectancy. The King’s Fund summed it up with something of an understatement, saying that the NHS had “seen better days.” Is it not the case that the longer the Conservatives are in office, the longer patients will wait?

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Before I call the Secretary of State, let me say to the hon. Member for Ilford North (Wes Streeting) that I think the whole House will join him, and me, in sending condolences to the hon. Member for Mitcham and Morden (Siobhain McDonagh).

[Steve Barclay]

On behalf of His Majesty’s Government, Madam Deputy Speaker, I echo your sentiments and those of the shadow Health Secretary in sending the House’s condolences to the hon. Member for Mitcham and Morden (Siobhain McDonagh), and also our fond remembrances of Margaret McDonagh. She played a pivotal role in the 1997 landmark election for the Labour party, and her loss will be keenly felt on the Labour Benches, but also much more widely across the political spectrum.

The hon. Gentleman raised a number of issues relating to screening, on which there is much consensus in the House, but one issue that he did not particularly note is the importance of this programme in closing the health inequality gap. The detection of stage 1 and stage 2 cancers, which has had such a remarkable impact on survival rates, has been targeted at the areas with the highest smoking rates and, therefore, the most deprived communities. I hope there will be a fairly wide consensus across the House that that is a real benefit of the programme. We aim to take the proportion of lung cancer survivors from 15% to 40% over the next 18 months, and to 100% in the years ahead, and we are talking today about a series of measures that have proved to be effective: there is remarkable evidence of the survival rates that they generate.

The hon. Gentleman raised a number of wider issues related to the Government’s record on cancer. The NHS has seen and treated record numbers of cancer patients over the last two years, with cancer being diagnosed at an earlier stage more often and survival rates improving across almost all types of cancer. Indeed, the expansion of the screening programme is a good illustration of the clear progress that the Government are making.

The hon. Gentleman raised the issue of junior doctors—an issue that we have debated a number of times across the House. He says that he does not support the junior doctors in their demand for a 35% pay rise. They have, of course, offered to spread it over an extra year to take 2024-25 into account, but for that they want a 49% pay rise. This is slightly esoteric: the hon. Gentleman says he does not support their demands, but he also criticises the Government for not meeting those demands.

The hon. Gentleman raised the subject of research funding, and I was grateful to him for doing so, because the Government are spending more than £1 billion on research through the National Institute for Health and Care Research. I have met the president of Moderna, with which the Government have signed up to one of our landmark partnerships with the life sciences sector. There is huge potential for us to work with life science partners as part of our health commitment. It is clear that those within the industry see the Government’s commitment and are responding to it, even if Labour Members fail to do so.

We are expanding our programme because it demonstrably works. It is tackling health inequalities and significantly increasing survival rates. It is part of our wider commitment, through our work with Genomics England and our work on the national screening programmes to screen 100,000 babies. The programmes cover not just lung cancer but, for instance, breast cancer. My hon. Friend the Member for Winchester (Steve Brine), the Chair of the Health and Social Care Committee, raised the issue of HIV screening with me last week. That is one of the areas in which early detection is having clear results. We are diagnosing more cases, which is why survival rates are improving in almost all types of cancer.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the Chairman of the Health and Social Care Committee.

[Steve Brine (Winchester) (Con)]

I remember dear James Brokenshire saying the words that the Secretary of State repeated today in the House. James made this happen—this is a fantastic prevention announcement. Although this nationally expanded programme cannot prevent lung cancer, will the Secretary of State confirm that we will stick by the principle of making every contact count? When people come forward for a lung risk assessment, we can offer emotional support where a problem has been detected, provide smoking cessation services to those who are still smoking, or just put our arms around people where there are comorbidities. When people come into contact with the health service, will we make every contact count for them?