Ed Miliband commits Labour to a one-week cancer test guarantee funded by new levy on tobacco firms

Ed Miliband tomorrow (Sat) pledges that a Labour government would guarantee that NHS patients in England will wait no longer than one week for cancer tests and results by 2020.

Announcing the next priorities for Labour’s £2.5bn NHS Time to Care Fund, he will declare his ambition for the health service to have the best cancer survival rates in Europe, which could save up to 10,000 lives a year.

The cancer package being announced today is part of Labour’s ten-year NHS Plan. It includes a commitment to raise the level of early cancer diagnosis – when treatment is more likely to be successful – with further public information campaigns, as well as ensuring GPs have the training and support they need to spot symptoms and refer patients speedily.

This is intended as a first step towards achieving one-week access to key tests for all urgent diagnostics by 2025, saving lives – and saving hundreds of millions a year in NHS costs for treating conditions diagnosed late.

The plan underscores the purpose of Labour’s NHS Time to Care Fund, which will make the investments needed to begin the transformation of the health service into one more focused on helping people stay in their communities through better support and prevention as well as on early diagnosis and treatment.

The cancer test guarantee will be made possible by £750 million new investment over five years, matched by revenue raised through a new levy on tobacco firms which make huge profits on the back of ill-health. Smoking is the largest single cause of premature preventable deaths in the UK.

As well as helping to improve early diagnosis, rapid access to cancer tests will ensure people diagnosed with the disease can start treatment earlier and will also help reduce the anxiety involved in waiting for a cancer test.

Waits for cancer tests are currently increasing, with the number waiting more than six weeks for key tests used to diagnose cancer up from 1,900 in May 2010 to over 10,600 in August 2014.

In an interview with The Times being published tomorrow, Ed Miliband said: 

“Labour has different values on the NHS than this Government. We believe in collaboration rather than free-market competition, in prevention not picking up the pieces, and accountability rather than undermining patients’ rights and guarantees.

“Labour has different priorities from this Government. We would raise taxes on the most expensive homes worth over £2 million in our country, hedge funds which avoid paying their fair share, and the tobacco firms whose products cause so much ill-health and suffering. This money will help pay for the investments we will make with our NHS Time to Care Fund.

“And, unlike this Government, Labour has a plan for the NHS so that it can meet the challenges of the 21st Century. We have already said we will guarantee GP appointments within 48 hours. And we have already shown how our Time to Care Fund will ensure the NHS has 20,000 more nurses, 8,000 GPs, 5,000 home care workers and 3,000 midwives so they have the time to care for you.

“Now Labour is setting out the next stage of our NHS Plan: a guarantee that no-one will have to wait longer than one week for cancer tests and results by 2020. It is critical that we improve early diagnosis of cancer - a killer disease that one in three of us will get -  so that we can match the best countries in the world for surviving it.

“And this is a plan paid for by money raised from the profits of the tobacco firms whose products have done so much to cause cancer in the first place.

“Over the weeks and months to come, Labour will set out further details of our NHS Plan. We will show that Labour’s values, Labour’s priorities and Labour’s plan can nurture and sustain our health service so it is there for our children and meets the challenges of this century as successfully as it did in the last.”

Background:

Tory failure on cancer

Under this Tory-led Government, waits for cancer tests and treatment are increasing, and cancer services are under pressure:

There has been a £790 million real-terms cut in spending on cancer services so far over the course of this Parliament, with spending in 2012/13 being £230 million lower in real terms than spending in 2009/10.

Cancer experts have criticised the Government’s reorganisation as “hampering efforts to develop services and improve performance” and say as a result cancer services have been “standing still for the last two to three years.”

Waits for key cancer tests are increasing:

• In August 2014, 10,616 patients waited longer than six weeks for key cancer tests – more than five times the 1,856 patients in May 2010.  
• Waits for key imaging tests requested by GPs are rising: For example, for abdominal ultrasound requested by GPs, the median wait from test request to test result is currently 29 days – up from 23 days in 2012.
• The target for people to receive their cancer treatment within two months has now been missed for the first-time ever. 

Policy detail:  

Labour’s early cancer diagnosis package

Labour’s goal is to match the best in Europe for cancer survival, which would save 10,000 lives a year – and late diagnosis is one of the key reasons why we lag other countries on cancer survival.

According to analysis by Cancer Research UK, at the moment just over half of cancers are diagnosed at an early stage. Over the next ten years, we want to see that increase to at least two in every three cancers being diagnosed at an early stage. To make progress towards this in the next Parliament, we want to get the country as a whole up to the standard of today’s best-performing areas (60% diagnosed at an early stage), which would mean tens of thousands more cancers diagnosed early each year by 2020.

Labour’s plans for early cancer diagnosis include:

a)  A one week cancer test guarantee.

By 2020, we will guarantee a maximum one-week wait for cancer tests, with results – on route to a goal of one-week tests for all urgent diagnostics by 2025.

We will start with a focus on those tests for which experts say there are particularly important benefits, such as chest x-ray for lung cancer, abdominal ultrasound for ovarian cancer and endoscopy for bowel cancer, before broadening the guarantee out to a wider set of tests. We will ask clinicians and experts to advise on the specific set of tests and the priorities for implementation.

Speeding up diagnosis will have several benefits, including helping people get treatment quicker and reducing the anxiety around waiting for a cancer test result.

b)  Better public awareness and encouragement to go to the GP.

A new round of public awareness campaigns to help the public recognise cancer symptoms and encourage them to go to their GP if they think they have relevant symptoms.

c)   Better access to ensure the public can get to see their GP.

We will give people the right to a GP appointment within 48 hours, or on the same day if they need it, as well as the right to book ahead with the GP of their choice, which is particularly important to improve continuity of care.

Research has found that patients who are able to see their GPs within 48 hours are less likely to have their initial cancer diagnosis via an emergency hospital admission.

In addition, we have committed to 8,000 more GPs by 2020, which will help improve access and ensure doctors get more time with their patients.

d)  Better support and training for GPs to spot cancer and commission tests.

Spotting the signs of cancer is challenging: there are more than 200 different types of cancer, some with vague symptoms and GPs will see on average less than eight new cancer cases a year. We will encourage the use of proven risk-assessment tools for cancer diagnosis in GP surgeries, and ensure GPs have access to the training and support they need to diagnose cancer.

e)   Improved screening programmes.

We will ask the National Screening Committee to make recommendations within a year on whether we should introduce new lung and ovarian cancer screening programmes, and we will ensure that the new Bowel Scope Screening programme is rolled out by the end of 2016.

Notes:

Despite huge progress in improving cancer services over the last decade, we still lag behind the best-performing countries on cancer survival.

It has been estimated that up to 10,000 deaths each year in England can be attributed to our lower survival rates compared to the best-performing countries.

Diagnosis of cancer at a later stage is generally agreed to be the single most important reason for lower survival rates in England – because treatment is less likely to be successful at a later stage. Several cancers, including bowel and lung cancer, are diagnosed later here compared to other countries.

Early diagnosis is critical to improving cancer survival, because treatment is more likely to be successful at an earlier stage. For example, when bowel cancer is diagnosed at the earliest stage, more than 9 in 10 people survive at least five years; but currently fewer than 1 in 10 people with bowel cancer are diagnosed at the earliest stage.

Almost a quarter of cancer cases in England are currently diagnosed through an emergency route – A&E and emergency hospital admissions – often at an advanced stage. This is a concern as survival rates for emergency presentations are significantly lower than for cancer diagnosed through other routes.

Late diagnosis is not just worse for health outcomes, but can cost more too.

The average cost of treating Stage 1 colon cancer is £3,373, compared to £12,519 at Stage 4, while for ovarian cancer, Stage 1 treatment costs £5,328, whereas Stage 4 treatment costs £15,081.

Recent analysis by Incisive Health found that if all CCGs were able to achieve the level of early diagnosis of the best CCGs, then, across all cancers, annual savings in treatment costs of just under £210m could be achieved.

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