Prostate Cancer

Lord Bethell Excerpts

Wednesday 3rd September 2025 Lords Chamber

[Lord Bethell (Con)]

My Lords, I give huge thanks to my noble friend Lord Mott for this important debate, and thanks also to the noble Lord, Lord Patel, for pointing out that we need better diagnostics with better specificity and sensitivity. We all aspire to a new generation of diagnostics, but we have to live with what we have today. My noble friend Lord Dobbs pointed out that timely assessment is the most urgent thing if you are developing prostate cancer. That is why I would like to address the question of risk aversion: a culture that, I am afraid to say, holds back timely intervention.

The evidence suggests that, too often, doctors’ intolerance of uncertainty is directly associated with diagnostic delays and errors, sidelining informed choices for patients and instead favouring the psychological comfort of clinicians. The NHS culture too often infantilises patients. In modern life, we are used to making 35,000 decisions a day, so the suggestion that patients cannot handle the complexity of modern tests, the idea that diagnoses may be reversed, or the pressure of diagnosis is, frankly, absurd. Yet studies reveal wild variations in PSA testing between GP surgeries, driven often by individual bias, not by science. This lottery is completely unacceptable.

This is a system-wide problem involving not just prostate cancer. Early detection of disease is vital if we are to turn around our national health disaster. We need risk-based screening, mandatory GP engagement and accountability for delays. Therapeutic privilege should be dead and buried; patients deserve informed choices and agency.