On Friday 4th February, the Health and Social Care Secretary, Sajid Javid declared ‘a war on cancer’ during the launch of a consultation on a new 10 year Cancer Plan. 

Delivering a speech at the Francis Crick Institute , he proclaimed that this plan would catapult the UK to the top of the rankings for cancer outcomes in Europe. While admirable, this aim will be incredibly hard to achieve. Despite the rhetoric, the UK is quite literally the sick man of Europe when it comes to cancer outcomes. This was the case before the pandemic and is only expected to get worse in the years to come.

His assessment of the issues isn’t necessarily the problem, however each of the priorities in the plan can be seen as a tacit admission of failure for Conservative health policy since 2010. 

On prevention, years of austerity have left the poorest communities with the least health resilience (the ability to adapt to health challenges) and 15-20% more likely to develop cancer. The UK also performs poorly in early detection and diagnosis. Pre-pandemic, only 44% of cancers were caught at Stage 1 or 2 (when the cancer hasn’t spread to other parts of the body) against a target of 75% by 2028. This is no slight on NHS staff who have worked tirelessly both before and during the pandemic to meet these targets and should be praised for what they have managed to achieve within the funding settlement set by the Government. However, if we weren’t on track to hit the target pre-pandemic, we’re certainly not on track now.  

Research commissioned by the Labour Party recently found that key targets are being missed throughout the patient pathway. Patients are meant to wait 14 days, at most, from being referred by a GP to seeing a specialist – the current wait is 13 times higher. In November 2021, nearly 1,500 patients waited more than 31 days before starting treatment, 1.5 times higher than in November 2019 and almost five times higher than November 2010. In all, there were 290,428 people waiting for cancer referrals for over two weeks, between April and November 2021.  

Following a referral,  patients often miss out on the latest and most innovative treatment available for their cancer type. The UK ranks poorly for late-stage clinical research which brings the greatest patient benefit. Even if treatments were widely available it is unlikely that there would be adequate staffing levels to ensure access to a multidisciplinary team and best standard of care. The staffing shortfall is estimated to reach 29% by 2025, yet the workforce was a ‘major omission’ from the cancer plan.

All of this culminates in the UK having the lowest survival figures for all but two cancer types in Europe. According to the Health Secretary himself, we have “persistently poor outcomes” compared to other countries - after 12 years of Conservative Government. 

We know that cancer is the public’s top health concern but instead of braggadocio, empty rhetoric and rehashed targets they want better screening, timely diagnosis and access to the best treatments and care.

Wes Streeting and the rest of the shadow health team have done well to hammer home these messages over the last few months but with the threat of COVID-19 receding the public will want a compelling vision for the future. This doesn’t need to be filled with blue sky thinking and washy slogans but should prioritise building resilient cancer services for the future. This means focusing on workforce planning and tackling the postcode lottery to ensure equitable treatment and care across the country. 

For many cancer patients and their loved ones, the Cancer Plan is too late. Under the Conservative Government, the NHS has not replaced the staff who have left or the infrastructure which has depleted. Neither the issues nor the Government’s proposed solutions are new. Instead of empty rhetoric and recycled commitments, what patients need is action – and if this doesn’t materialise, there is a Government in-waiting ready to deliver.  

Subodh Tailor is a Senior Account Executive at Hanover Communications working in their health policy, advocacy and public affairs team. Prior to this he studied politics at the University of Edinburgh, where he helped co-organise the Free for All. Period. campaign for universal access to free period products in Scotland. He is also a trustee of Cancer Awareness for Teens and Twenties and an alumni advisor to Sanitree.  He tweets at @subodhtailor.

---

1 Arnold et.al (2019). ‘Progress in cancer survival, mortality, and incidence in seven high-income countries 1995–2014 (ICBP SURVMARK-2): a population-based study’. Available at: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(19)30456-5/fulltext 

2 Cancer Research UK (2022). ‘Cancer incidence’. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/incidence#heading-Zero 

3 Cancer Research UK (2022). ‘Cancer incidence’. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/incidence#heading-Zero 

4 Crosbie et.al. (2022). ‘Disadvantage and disease’ Available at: https://documents.manchester.ac.uk/display.aspx?DocID=58439 

5 Nuffield Trust (2021). ‘Cancer survival rates’. Available at: https://www.nuffieldtrust.org.uk/resource/cancer-survival-rates

6 Illman (2021). ‘Past and present NHS cancer leads at odds over progress on early diagnosis’. Available at: https://www.hsj.co.uk/policy-and-regulation/past-and-present-nhs-cancer-leads-at-odds-over-progress-on-early-diagnosis/7030486.article 

7 Dunford (2022). ‘NHS cancer treatment waiting times at record high - how bad are they and why?’ Available at: https://news.sky.com/story/nhs-cancer-treatment-waiting-times-at-record-high-how-bad-are-they-and-why-12535526 

8 ABPI (2021). ‘Global rankings – number of clinical trials initiated in 2020 by country by phase’. Available at: https://www.abpi.org.uk/facts-figures-and-industry-data/clinical-trials/global-rankings-number-of-clinical-trials-initiated-in-2020-by-country-by-phase/ 

9 Royal College of Radiologists (2021). ‘Clinical oncology workforce census report’. Available at: https://www.rcr.ac.uk/system/files/publication/field_publication_files/clinical-oncology-uk-workforce-census-2020-report.pdf

10 Michelle Mitchell (2022). Available at: https://twitter.com/Michelle_CRUK/status/1483846149547208705 

11 Javid (2022). ‘UIN905068’. Available at: https://hansard.parliament.uk/Commons/2022-01-18/debates/06309D21-000A-4624-A774-DD94CE1D75B1/details#contribution-6582A516-501C-4291-A4CD-8AAE44060C84 

12 Taylor et.al. (2021). ‘British Public Attitudes towards cancer Research and Treatment in 2021’. Available at: https://www.ucl.ac.uk/pharmacy/sites/pharmacy/files/vfr_web_edition_british_public_attitudes_towards_cancer_research_and_treatment_in_2021_latest_version.pdf