Maggie Throup – 2022 Speech on Cancer Services
The speech made by Maggie Throup, the Conservative MP for Erewash, in the House of Commons on 8 December 2022.
It is a pleasure to follow the hon. Member for Easington (Grahame Morris), who speaks with much knowledge and personal experience, which makes a huge difference. I welcome the report of the Health and Social Care Committee on cancer services, and the subsequent response from the Government. I commend all Select Committee members involved in producing that excellent report and I have every confidence that more quality reports will be produced on this subject and many others under the leadership of my hon. Friend the Member for Winchester (Steve Brine).
I am grateful for the opportunity to discuss the report further. I will focus on community diagnostic centres and the role of diagnostics more generally in supporting cancer services. With 91 community diagnostic centres already open, a further 19 announced yesterday and 40 more to come before March 2025, this is definitely a good news story. I am delighted to have a community diagnostic centre in my constituency at Ilkeston Community Hospital. It opened a year ago. In its first eight months, it delivered more than 6,500 tests, checks and scans. To date, across all the community diagnostic centres that have opened, 2.4 million tests, checks and scans have been carried out. That is excellent news, but not the full story.
The success of the upcoming 10-year cancer plan—we hope that it is upcoming and has not been shelved—as well as tackling the backlog, elective recovery plans and levelling up, depends heavily on diagnostics. Diagnostics, whether in vivo or in vitro, are crucial to the overwhelming majority of patient pathways and are central to health outcomes. I know that the royal colleges, specifically the Royal College of Radiologists, and many other organisations support investment in improving cancer services across England and, at the same time, addressing historic postcode lotteries created over recent decades.
Community diagnostic centres have an important role to play in this, but they bring their own problems. There are already existing chronic workforce shortages and ageing equipment that prevent cancer diagnosis and improvements in cancer care. There is a shortfall of 30%—1,453—full-time equivalent clinical radiologists and a 17%—148—shortfall of clinical oncologists. Those shortfalls vary in severity for each region, but I take a particular interest in the east midlands, where my constituency is. The east midlands has the same shortfall of clinical radiologists as the national average, which is 30%, but the shortfall in clinical oncologists is above the national average, at 28%, while 19% of clinical radiologists and 18% of clinical oncologists are forecast to retire in the next five years, adding even further pressure on a workforce already struggling to meet demand.
A global study has found that a treatment delay of four weeks, which could be caused by a workforce shortage, is associated with a 6% to 13% increase in the risk of death, and that worries me as it could have a detrimental impact on the outcomes for cancer patients across Erewash, however hard those in post work. If we are to improve cancer services in England, we must invest in clinical radiology and clinical oncology training places to ensure that there are enough clinicians throughout a cancer patient’s pathway. I know there is competition for clinicians across all disciplines, but, if we are to improve outcomes for our cancer patients, we need to attract radiologists and oncologists.
I pay tribute to everyone involved in this aspect of medicine, whatever their role, and of course our NHS workforce across all disciplines. I include all the amazing people, whether healthcare professionals or volunteers, at my local hospice, Treetops Hospice Care, who each day make the end of life a better experience for so many of my constituents—a huge thank you to everybody.
I have mentioned that one of the other barriers to community diagnostic centres reaching their full potential is the lack of investment in equipment in the existing system. The UK has fewer scanners than most comparable countries in the OECD: it has 8.8 CT scanners per million of the population while France has 18.2 and Germany has 35.1; it has 7.4 MRI scanners per million of the population, while France has 15.4 and Germany has 34.7. Industry surveys have shown that one in 10 CT scanners and nearly a third of MRI scanners in UK hospitals are over 10 years old, and 10 years is usually the age at which this equipment can be considered obsolete and must be replaced.
In June, the Royal College of Radiologists surveyed a representative sample of its members in England about equipment needs, revealing that 49% of clinical radiologists and 21% of clinical oncologists said they do not have the equipment they need to deliver a safe and effective service for patients in their department or cancer centre. Only 32% of clinical radiologists and 54% of clinical oncologists said their equipment is fit for purpose, with the rest saying it is substandard or only acceptable to some extent. There must be a comprehensive audit of all diagnostic equipment across England so that investment is made in the right equipment where it is needed most.
I have some questions for the Minister, for whom I have great respect. I know just how much she cares about getting it right for patients. First, are clinical radiology and clinical oncology training places being invested in to ensure there are enough clinicians throughout a cancer patient’s pathway and, if so, will that investment include both the 50% of trainee costs covered by Health Education England and the other expenses incurred by trusts? When it comes to equipment, are community diagnostic centres taking the investment preference over and above the replacement of obsolete diagnostic equipment in hospitals, and will an audit of all diagnostic equipment be carried out? Of course, as has been mentioned, one of the elephants in the room—or, more correctly, in the Chamber—is: how do we help to prevent people from getting cancer in the first place?
Across the UK, there are huge health disparities. When heat map after heat map is laid over the UK —whether for high smoking rates, high levels of obesity, high rates of cardiovascular disease, high rates of cancer, excess alcohol consumption or poorer health outcomes—they all show that the same areas are affected detrimentally. Therefore, we need to consider how we are going to achieve the Government’s targets to become smoke-free by 2030 and to halve childhood obesity by 2030. Perhaps, after the festive season, there can be a fresh look at measures to tackle excess alcohol, because alcohol, smoking and obesity are all markers of and can all cause cancer. If we are serious about tackling cancer, we need to be serious about preventing it as well, and it is never too late. We are always excited to hear about new therapies that have been proved to be effective, but surely we need to get as excited about preventing cancer in the first place, so my final question for the Minister is: when can we expect the health disparities White Paper to be published?
There are many innovations to harness across all diagnostics, while community diagnostic centres, genomics and AI have a role to play, as do many more innovations, but until the unprecedented challenges—including the huge workforce pressures, out-of-date equipment and preventive measures continuing to be watered down—are addressed, cancer diagnosis and treatment will never reach their true potential. The Government state in their response to the Select Committee’s report that
“the Government’s forthcoming 10 Year Cancer Plan will set a new vision for how we will lead the world in cancer care, including ensuring we have the right workforce in place.”
That is an admirable ambition, and we all want the Government to succeed. Indeed, they must succeed, as this will be transformational for the life chances of my constituents in Erewash and those of the whole nation. As my hon. Friend the Member for Winchester has said, I look forward to reading the Government’s 10-year cancer plan very soon.
