Jon Ashworth: Cancer care is not immune from the financial crisis facing the NHS

This is the speech delivered today by Jonathan Ashworth, shadow health secretary, at Britain Against Cancer 2016: Working together to ensure delivery at Central Hall, Westminster.

Thank you. I’m delighted to be here and what is my first Britain Against Cancer Conference.

I want to start by thanking everyone in this room for everything that you do.

You provide and manage care to patients and their families when they are sick, worried and going through some of the most difficult times imaginable.

We should all be proud that the UK is home to so many innovative, creative and passionate leaders working on cancer care.

And I thank not just those of you who are here as professionals. Whether clinicians, NHS workers or from charity and other bodies. But also all the volunteers who give their time, energies, goodwill and so much more to care.

I have seen for myself when I visited the Macmillan Support Centre at Leicester’s Royal Infirmary the compassion and dedication of volunteers who work alongside the professionals offering help, counselling, support with benefits and most simply but perhaps most crucially just being there to listen. So every day you make a difference to people when they need it most. For that I have immense respect for you all and pay tribute to you today.

And can I also thank the APPG for the work you do in Parliament particularly John Baron your Chair and Nic Dakin your Vice Chair both hugely respected across the House – there are no finer advocates for this cause than John and Nic and I thank you both for your dedication and commitment.

Later this week in the Commons John, Nic and MPs from across the House will speak in the Cancer Strategy debate in the Commons. Leading for the Labour will be our Shadow Public Health Minister Sharon Hodgson. If you haven’t had chance to meet Sharon yet please get in touch, I know she is keen to meet you all and work with you.

Cancer is a priority for everyone in this room – including me.

I understand just how many, from the doctors and nurses on the wards to those managing post-treatment care and relatives as well, are involved in securing the best for people with cancer.

Which is why as Labour develops its policy platform for the future I want to work with you, listen to you and develop ideas with you. I want to hear about the drivers and levers we can use, about the things which you need changed to help you and to help your patients.

So a clear message from me today is – my door is always open to you – nurses, doctors, carers, patients, voluntary groups and volunteers because not only does an ongoing dialogue allow me to my job properly it’s also the right thing to do. We know cancer remains one of the biggest health challenges facing the country today.

The number of people estimated to be living with cancer in the UK now stands at 2.5 million. That’s more than the population of Birmingham. 350,000 new cases of cancer were reported in 2014. And 163,000 people died from cancer in the same year. It is why cancer must stay at the top of the agenda.  The prevalence of cancer is increasing. Half of the people born since 1960 will be diagnosed with cancer in their lifetime. Every two minutes someone in England will be told they have cancer.

Labour welcomed the publication of the Cancer Taskforce’s strategy last year and was pleased to see the Government support it too. My party knows from its time in Government the real difference disease-specific strategies can make to people’s lives. The NHS Cancer Plan and the Cancer Reform Strategy helped to transform cancer care in this country.

By the time Labour left office the number of people getting a diagnosis for cancer was up. Mortality rates were falling. Survival rates were rising. More patients were living with and beyond cancer. And people’s experience of cancer services was improving. It is a tribute to this record that the Coalition Government choose to carry on many of the initiatives we introduced. Where the Government have got things right we have supported them, like the national Cancer Drugs Fund. Or for example, the announcement of the London Cancer Hub – a world-leading life-science campus specialising in cancer research, treatment, education and enterprise. Labour would want to put this expertise at the forefront when decisions are made about how services are provided in the future.  But when the Government have got things wrong we have said so.

We know the Government has missed its 62 day cancer treatment every single quarter for almost three years. Indeed since 2009/10 the number of people waiting longer than two months for cancer treatment has increased by 272 per cent. We fear this means cancer care going backwards, not forwards.

The best way to fight cancer is to prevent it from developing in the first place. Two in five cancer cases might not have happened had their lifestyles been slightly different. It is all too often the choices we make – and the lives we live – that determine the cancer we might get. We all have a responsibility to manage our own health – but the government has a role too. The introduction of the smoking ban in 2007 was treated with scepticism by some. The nanny state gone too far, they said.  But nearly a decade on and it is now seen as the most important public health intervention in 100 years. It’s proof government action can make a difference.

That is why I know how disappointed many of you were when the obesity strategy was finally published. It was weak, it was water-downed, and it was a missed opportunity. Even the Chief Executive of Sainsbury’s said it did not go far enough. It left me wondering whether it was worth waiting for?

When it comes to improvements in public health, what happens locally is equally as important as what happens nationally. Investment in local screening programmes, awareness campaigns, stop smoking clinics can make a difference to the nation’s health as much as investment in the latest medical treatments. And yet, the Government has pushed ahead with short-signed cuts to public health budgets. Public health spending will be cut by 4 per cent a year in real terms over the next four years, with no guarantee further cuts won’t come. I strongly believe it’s economically illiterate and we will be paying for it in years to come.

More needs to be done to prevent cancer, but more must also be done to diagnose it swiftly. Early diagnosis has to be a priority for any good cancer service. Early diagnosis is better for the NHS and it is better for the patient. And yet we know that diagnostic services are under a huge amount of strain.

Cancer Research UK has warned that pathology services are at a tipping point, with a 17 per cent rise in patients waiting at least six weeks for tests. Investment has not kept up with demand and the quality of care is suffering as a result. This was an issue that was tackled head on in the cancer taskforce’s strategy. It gave a clear recommendation that NHS England should invest to unlock the extra capacity required to implement higher levels of cancer testing.

In its response to the cancer strategy, the Government committed to meeting the £300 million of additional funding required by 2020, and to invest £15 million in creating a National Diagnostic Fund. However, the £15 million falls short of the £25 million investment called for by the Cancer Taskforce. And without adequate monitoring and reporting I am concerned that the extra £300 million will get sucked into the giant black hole in hospital finances never to be seen again.

I say this because cancer is not immune from the financial crisis facing the NHS. The scale of the deficits within hospitals at the moment means that without the extra money that was asked for at last month’s Autumn Statement patient care is going to suffer because of cut backs and cost savings. One of the first causalities of these cuts to date has been hospital capital budgets.

Year after year we have seen capital budgets raided by Ministers who are trying to plug the black hole in day-to-day spending. This has led to a worrying rise in the hospital repairs budget. The amount needed to upgrade hospital buildings and equipment – in order to prevent “serious injury” and “catastrophic failure” – increased by 69 percent in just 12 months.

For cancer services, this means hospitals unable to replace or repair out-of-date radiotherapy machines. A recent Care Quality Commission report found a Trust that “had one machine that was 12 years old, one that was 13 years old and two that were 14 years old”. Labour’s own analysis published last year revealed that one in five machines were more than 10 years old and in urgent need of replacing. It’s unacceptable.

I welcome NHS England’s announcement in October to finally take action to deal with this issue. But, the money they have announced will only cover half of what needs to be done and we have had no indication when the rest will be forthcoming.

Finally, I want to talk about access to treatment and medicines. The introduction of the national Cancer Drugs Fund under the Coalition Government has helped to bring life extending treatments to thousands of patients ever year. There is no doubt that it has improved access to medicines and we welcome some of the historic issues relating to treatment access that it has helped to address. However, what was meant to be a temporary fix has become a permanent fixture that is no longer sustainable. The inability of the Coalition to implement value-based pricing and then value-based assessment has meant there is no long-term solution to ensuring patients can get fair and swift access to new cancer medicines.

And without a solution soon I fear that the disturbing trend we have seen recently with attempts to deny funding for new HIV prevention drugs or rationing access to hepatitis c treatments could soon start hitting cancer patients too.

I started my speech by welcoming the Government’s commitment to the ambitions of the cancer strategy, and I stand by those remarks.

We need to see a step-change in the fight against cancer. So let us work together to realise our shared goal: a world-class NHS delivering world-class cancer care.

Thank you very much and I really look forward to working closely with you all in the future.