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The Parliament Brief: Is the government taking a risk with its cancer strategy?

MPs have questioned whether bringing cancer within the scope of the Major Conditions Strategy is wise.

By Harry Clarke-Ezzidio

Welcome to the Parliament Brief, where Spotlight, the New Statesman’s policy section, digests the latest and most important committee sessions taking place across the House of Commons and House of Lords. Previous editions can be found here.

Who? In the final session of its inquiry into the future of cancer treatment, the Health and Social Care Select Committee invited Andrew Stephenson, the minister for health and secondary care, to give evidence. He was also joined by two NHS England senior staff: Cally Palmer, national cancer director, and Professor Peter Johnson, national clinical director for cancer.

When? Monday 29 January, 4.30pm.

What was discussed? The session focused on why the government’s plan to roll cancer into its wider Major Conditions Strategy diverges from examples set by other countries, which are instead producing dedicated strategies to tackle the disease.

Why did this come up? Cancer research and treatment has long been a focus of the committee, and in recent years the government has changed strategy on how it intends to deal with the disease. In 2022, the then health secretary Sajid Javid opened a consultation on creating a ten-year plan to reform cancer treatment (garnering more than 5,000 responses). A year later, in early 2023, Steve Barclay, another former health secretary, announced that his predecessor’s work would be scrapped, and folded into the Major Conditions Strategy instead, which will lay out plans to tackle six areas of serious disease within one holistic strategy. That strategy is due to be released this year, but an interim policy paper was published last year. You can read Spotlight‘s analysis of it here.

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Many industry experts believe this all-encompassing approach is not the right direction of travel. A recently launched manifesto by the charity Cancer Research UK warned that progress made on tackling the disease is “at risk of stalling”. It asked whichever party wins the upcoming election to set up a new National Cancer Council, which would “drive cross-government action on cancer” and deliver a ten-year cancer strategy for England. 

So what did they say? Addressing Stephenson in his opening remarks, Steve Brine, the Conservative chair of the Health and Social Care Committee, quoted earlier evidence given in the inquiry that suggested England “is increasingly becoming a bit of an outlier in the lack of a rallying call for cancer”, due to not having a designated plan.

Brine, quoting evidence previously given by Keep up with Cancer, a network of pharmaceutical companies, said: “The EU has its ‘Beating Cancer’ plan; America has its ‘Moonshot’ [initiative] and Singapore… has its own cancer strategy.” Brine also quoted Julie Gralow, chief medical officer of the American Society of Clinical Oncology, who had previously told the committee that if the US were to adopt the UK’s approach and replace its Moonshot plan with a major diseases strategy, this would result in a loss of “momentum” and “focus” on tackling cancer, and would ultimately increase rates of disease as well as death.

Stephenson admitted that he himself was originally “slightly sceptical” about the move to an all-encompassing diseases strategy when he was appointed to his role last October, “[but] the more I’ve looked at it, the more I think it is the right approach”. He added that the government are looking at “more long-term ambitious plans” that could be implemented within cancer treatment, with the Major Conditions Strategy acting as a baseline.

The five other drivers of ill health that form part of the strategy are chronic respiratory disease, cardiovascular disease (including stroke and diabetes), dementia, mental ill health, and musculoskeletal disorders. “We know the majority of people who are suffering with cancer also are living with another major condition,” said Stephenson. “So I think having a strategy that looks at how we knit everything together, is the right approach.”  

“I believe once [the full strategy is] published, we need to be a lot more clear on how we are driving forward the various cancer ambitions and other ambitions we still have as a government,” he added.

So, when is the full strategy going to be published? It’s due in 2024, but Stephenson, though tight-lipped, hinted to MPs it would be sooner rather than later: “I very much intend for it to be early this year, but I can’t be any more specific,” he said.

Brine pressed him on whether the government’s chosen model to tackle cancer in England was adequate. “We’ve definitely received evidence… that the benefits associated with countries that have a long-term strategy for cancer – in terms of planning of services and outcomes for patients – do better,” he told Stephenson. “Is your assessment that we can still get to that same place with this course of action?”

Stephenson argued that other nations’ priorities, such as making services better coordinated and more focused on patient outcomes – “how we knit services together, how we diagnose conditions earlier, how we do wraparound care” – are also integral parts of the Major Conditions Strategy. Though he admitted that the government still needs to “flesh out” plans, he added that “we already have various targets and metrics for cancer, and lots of investment going into research and innovation in this space”. 

While the Major Conditions Strategy is an “overarching strategy”, Stephenson said that “disease-specific plans” could also be developed to complement it once the strategy is published.

What next? Stephenson’s appearance marked the final session in the committee’s inquiry, and a report will be published in due course. In the meantime, many working across cancer treatment and other major conditions will be waiting for the publication of the full strategy.

[Listen now: Is the NHS ready for developments in cancer care?]

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