NHS Workforce Levels: Impact on Cancer Patients

Scott Arthur Excerpts

Thursday 23rd October 2025 Westminster Hall

[Dr Scott Arthur (Edinburgh South West) (Lab)]

You will not be surprised to hear, Mrs Hobhouse, that it is a pleasure to serve under you. I thank the hon. Member for Wokingham (Clive Jones) for securing this important debate. I declare an interest: my lovely wife has worked as part of the NHS workforce in Scotland for around 30 years, and on Monday she is due to start a one-year secondment to the Marie Curie hospice in Edinburgh, so I take this opportunity to wish her well. As I have more time to speak debate than expected, let me also take this opportunity to thank all the people in Edinburgh South West who raise money for that hospice, including BobCat Alpacas, which recently raised around £10,000 at its open day.

This morning I met with MacMillan Cancer support, as I am sure other Members did too. I want to recognise its efforts across the UK in supporting people facing a diagnosis, as well as recognising groups in my constituency such as The House of Hope, which supports people with a breast cancer diagnosis. We have to recognise the pressure that NHS staff are under—not just my lovely wife, but staff right across the NHS in the UK, although I will start by talking about England.

The pressure on the staff who are supporting cancer patients in the NHS is why I absolutely welcome the forthcoming workforce plan and the national cancer strategy. I hope they can make a real difference to staff and cancer patients in England. I am proud that it is a Labour Government that are showing real ambition—the word ambition is important here—but I support Cancer Research UK’s ask for a dedicated cancer workforce planning strategy. I also agree with Leukaemia UK that the 10-year workforce plan must enable and support the delivery of the national cancer plan. I am sure that is not a controversial view—it makes absolute sense.

I have been lucky to table a private Member’s Bill on rare cancers, and through that I have met many cancer charities. I have to say that all of them respect the work of the hon. Member for Wokingham—I am trying to find one that does not, but they all do. I recently met with Blood Cancer UK to talk about its work, and it informed me about this debate. I was asked to raise the situation in haematology in England, which is particularly concerning.

Blood cancer accounts for a third of cancer deaths in the UK, but Blood Cancer UK says that treatment is continuously impacted by staffing shortages. It told me about how one patient shared that they had had seven different consultants in the past five years, and they were terrified about not knowing who to contact if their symptoms got worse—not a great situation. Figures from Blood Cancer UK show that in south-east England the vacancies for advanced haematologist nurse practitioner roles are 111% greater than the numbers in post, so there are more vacancies than people in post. That impacts both patients and the staff in post, for whom it must be incredibly stressful.

I hope that in the upcoming workforce plan the Government recognise the central role that haematologists play in cancer care. We have to recognise that having a haematology workforce that is staffed to the correct level has benefits well beyond cancer care. I hope the Government will put measures in place to address the shortfalls. As the hon. Member for Wokingham said, steps to drive up the recruitment and retention of clinical nurses will be crucial.

Let me turn to Scotland, where of course health is devolved. Back in August, I welcomed the news that the risk of dying from cancer in Scotland had reached a record low, which is a fantastic landmark. However, the data only covered the period up to 2022. In 2025, cancer waiting times in Scotland have never been worse. The Royal College of Radiologists has indicated that, without addressing staffing, the situation will only get even worse. Right now, that seems unthinkable. Data shows that there is a 25% shortage of radiologists—again, a discipline that has benefits well beyond cancer care—and a 19% shortage of oncologists. One in five consultant haematologists are near retirement, and there is low recruitment into the sector, so patient groups are very concerned about what that means for the future.

The Scottish Government say that they are investing in cancer treatment, yet patients have been failed and left without effective care—that is the reality when we look beyond the press releases. Hon. Members do not have to take my word for it: Dr Iain Kennedy, who chairs the Scottish council of the British Medical Association, said that Scotland is now divided between people who can afford to go private and those forced to “languish” on NHS waiting lists. We often think about people going private for cosmetic work, or perhaps even hip surgery, but if people in Scotland, or anywhere, are going private for cancer care, that is a real inequality.

Cancer mortality rates for the poorest in Scotland are 78% higher than those for the richest. That shames me as a Scot, and I want change. The Scottish Government are failing to address the very low staffing levels that feed these issues. There is no workforce plan. The UK Government are currently looking at one, but there is none in Scotland. They actually had one, which expired in March this year. I checked it this morning, and it did not even mention cancer care. Perhaps that is why we have the worst cancer waiting times on record.

While the UK Government are taking action through the workforce plan, which I look forward to hearing more about from the Minister, the situation in Scotland looks like it can only get worse. We will have an election for the Holyrood Parliament next year. I hope that cancer care is a key part of the discussion, because it is in real crisis in Scotland. The country needs change. Our NHS needs change.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

It is a real pleasure, as always, to serve under your chairship, Mrs Hobhouse. I thank the hon. Member for Wokingham (Clive Jones) for raising this matter, which affects constituents in every part of this United Kingdom of Great Britain and Northern Ireland. I always admire the hon. Gentleman because of the personal experiences with cancer that he tells us about. I have heard about them from him personally, but also in this Chamber. His heart is for those with cancer, and those who suffer and need to find a cure. I congratulate him on all he does.

As the hon. Member for Harrogate and Knaresborough (Tom Gordon) mentioned, the Macmillan coffee morning was this morning. Macmillan put forward some recommendations this morning, and I wonder whether the Minister has had an opportunity to have contact with the group. Macmillan is always helpful—it is not here to catch anybody out—and it was putting forward positive ideas on how to do things better. Perhaps the Minister can indicate whether that opportunity has come forward.

In this life, there are not many things that I say I hate—when I use that word, I mean it—but I do hate cancer. I hate the devastating effect it has on people and families. I hate that children suffer and that their parents can only stand by and watch, as happens on many occasions. I hate that children are left motherless or fatherless and that nothing can be done. I hate having to deal with that dreadful disease. But most of all I hate that we cannot cure it—at least, not yet.

One of my requests to the Minister, who is always incredibly helpful, is on research and development. Statistically, one in two people we meet—half the people in this room—will have cancer; 50% will survive, and 50% will not. The research and development is so important for getting to the day when we find a cure. I know the Minister is committed to that, and I hope she can give us some idea what is being done on that.

Each of us in this place will have been touched by cancer. I think of my own dad. My dad has been dead now for 10 years, but he was a cancer survivor on three occasions. He put that down—as I would as well—to the skill of the surgeon, the care of the nurses and the prayers of God’s people, which helped him get out the other side.

We can argue about microwaves, about preservatives in food and about genetic or carcinogenic factors, but this debate is about ensuring that NHS workforce levels enable every sufferer to have the best chance possible to fight cancer. As the hon. Member for Wokingham and others who have spoken have said, we are not there just yet. There are insufficient NHS workforce levels in Northern Ireland—I know that that is not the Minister’s responsibility, but I want to give a flavour. Things are not that different there; what happens in Northern Ireland happens in England, Wales and Scotland. If cancer patients have delayed diagnoses and treatments, that can lead to potentially life-threatening consequences and increased anxiety. First, people are anxious about their health, and then they are anxious about how to pay the bills: “Do I get benefits? Can I get some help to get me through? Can I get my mortgage extended?” People have to face up to really life-altering circumstances, and unmet support needs as well.

Then we have the shortages in key roles, such as specialist nurses, radiologists and surgeons. Unfortunately, that means that treatment targets are frequently missed and patients do not receive the full support they require during and after treatment. The situation is worsened by growing waiting lists, increased workloads for existing staff and a lack of resources for both acute and community-based care.

The hon. Member for Wokingham spoke about pancreatic cancer. Many cancers are devastating, but pancreatic cancer is one of the worst. In the last 10 days, a young lady from Greyabbey, a village close to where I live, died of pancreatic cancer. She was 31 years of age, with a five-year-old son and a partner. I remember others. When pancreatic cancer is diagnosed, it is too late, because it has already taken effect and the body is already succumbing to that terrible cancer. That is why I go back to research and development. Will we find the cure for pancreatic cancer someday? Will we be able to diagnose it at an earlier stage so that we can give the treatment and help that are needed?

[Dr Arthur]

I know that this subject is important to the hon. Gentleman. Pancreatic Cancer UK is a fantastic charity. Unfortunately, he could not make this year’s Labour party conference in Liverpool, although he is always welcome to attend—Labour MPs go free, so he is welcome to join up. However, Pancreatic Cancer UK was there with scientists who are looking at a new diagnostic tool that, believe it or not, is based on a breath test. They can analyse a small particle in our breath to give an indication of whether there could be something that needs further investigation. That is a great example of how investment can help to save lives while bringing jobs to the UK. I am sure the hon. Gentleman will congratulate Pancreatic Cancer UK on all its work in this field, and on that little piece of progress.

[Jim Shannon]

I welcome the hon. Gentleman’s encouraging intervention. That is what it is all about. Of course, I attend my own party’s conference—I am not sure I would attend anyone else’s. Party conferences are a great opportunity to meet groups that are working hard, and they come to our conference too. That breath test is encouraging, and perhaps it will be part of the next stage of curing cancer, and particularly pancreatic cancer.

The target of starting treatment within 62 days of an urgent GP referral is not being met, with only 37% of patients receiving treatment within the critical window—those figures are from 2023. As of September 2023, some 545,000 people in Northern Ireland, which has a population of 1.95 million, were waiting for elective care. My goodness, is that not a scary figure? That issue is not the Minister’s responsibility, but it worries me when I consider it. It is the highest number on record. Waiting times for in-patient admissions and out-patient appointments, including for cancer patients, have increased dramatically since 2020.

There are shortages across multiple disciplines, including paediatricians, administrative support, pathologists, radiologists, chemotherapy nurses and palliative care staff. For example, while the number of clinical radiologists has increased, which is good news, the Royal College of Radiologists estimates that the workforce is still 50% smaller than is needed to meet demand. Yes, there have been advances, but we are not there quite yet. Current staff face extreme workload pressures, leading to a fear of missing early diagnoses, and also burnout for those whose commitment to help their patients is above and beyond what their wage packet might indicate.

We are not coping well. A constituent came to my office to ask why her first smear test results took 16 weeks to come back, and why she had to ring her GP on three occasions to get them. On her behalf, I had to email the doctor’s surgery and the health trust so that the biopsies were taken. It is easy to understand why her anxiety levels were through the roof. She now has to wait a further six to eight weeks to see whether she needs treatment. My goodness, it is little wonder that people are so worried, anxious and stressed.

The fact is that waiting times affect the mental health of even the young and the fit. If we are to give people the tools they need to win their health battle, as we need to, it begins with efficient diagnosis and treatment. We are not getting it right, and that is a fact. We can do better. Our constituents believe they are losing the battle before it truly begins, so what do we need to do? We need to bring our workforce up to par by ensuring that money in the NHS is spent appropriately and is not, to use an Ulster Scots word, frittered away.

I make a plea to the Minister for more research. I really believe that what we spend on research will be for the future and finding all the cures. If we go back a few years, only one in three people survived cancer; now it is one in two. That is an advance, and perhaps the day is coming when everyone can be in that place. I think of Queen’s University Belfast as one example. Its partnerships with medical companies to find cures are incredible, and those that it has found through its research are some of the best in the United Kingdom, if not the world.

To conclude, our NHS staff are second to none, but at times they seem to be working with one hand tied behind their backs, and that must cease. We must ensure we have sufficient funding to free them up to do the job and to fight cancer throughout this great United Kingdom of Great Britain and Northern Ireland—always better together.