Open letter to Health Secretary Sajid Javid

Dear Secretary of State for Health and Social Care,

Re. Cancer Charity calls for ‘war on cancer’ commitment in Yorkshire

You recently announced that it was time to launch a “war on cancer”, and that you were working on a new vision to “radically improve the outcomes for cancer patients” in the UK.

Yorkshire Cancer Research is Yorkshire’s dedicated and independent cancer charity. We’ve been on the front line of a war on cancer in our region for nearly 100 years, finding new ways to prevent, diagnose, and treat cancer.

Yorkshire has significantly higher rates of people getting and dying from cancer than the England average. And while the pandemic has had a noticeable impact on cancer care in our region (as it has across the country and the world), many of the problems were present long before COVID-19.

This World Cancer Day, I'd like to highlight three of the challenges we’re facing in Yorkshire which the Government can and must address to impact cancer not just in our region but elsewhere too.

We ask the Government to:

1. Prioritise ‘levelling up’ cancer survival across the country and publish a clear plan with details for how this will be achieved in Yorkshire.
2. Deliver on its promise to provide additional funding for the cancer workforce and provide clarity on how much will be committed, where it will be spent and how it will have an impact for people with cancer.
3. Reverse cuts in public health budgets, particularly in areas of Yorkshire which have been hardest hit by diminished funding for stop smoking services.

Deprivation and poor health go hand in hand. Compared to the most affluent areas, the most deprived areas of the country have more cancers diagnosed, fewer diagnosed early, more deaths from cancer, and lower chances of surviving a year after diagnosis. You recently called the health gap between the richest and poorest a “moral outrage”, and we sincerely agree.

Yorkshire is the third most deprived region in England, and many of our cities and towns have high levels of local deprivation. For example, Hull is the fourth most deprived local authority in England, and nearly half of its local communities are ranked among the most deprived in the country.

Inequality is causing the deaths of thousands of people in Yorkshire and across the country. Our analysis has estimated that if all areas of Yorkshire were equal to the most affluent areas of our region, 2,000 lives could be saved every year from cancer.

The Government has made promises to ‘level up’ the poorest parts of the country. We welcome your recent announcement that a new long-term plan for cancer will be developed. We request that ‘levelling up’ cancer survival across the country is made a priority, and that a clear plan is published with details for how this will be achieved in Yorkshire.

Early diagnosis of cancer is an important determinant of survival. The clearest impact can be seen for lung cancer: almost nine in 10 people diagnosed at stage one are alive one year later, but only two in 10 people diagnosed at stage four survive for a year or more.

The NHS Long Term Plan set a target that by 2028, three in four staged cancers would be diagnosed early (at stage one or two). However, the most recent statistics show that even before the pandemic only two in four people with a known stage were diagnosed early in Yorkshire – a figure that is likely to be negatively impacted by the pandemic but one which the charity is actively funding vital research and services to improve. Based on recent rates of change we estimate Yorkshire will miss this target by more than 40 years, meaning people in Yorkshire will continue to be diagnosed later, and more will die from their cancer as a result.

Diagnosing cancer early depends on having enough diagnostic staff. However, staff shortages have been a long-running issue, and even before the pandemic, one in 10 diagnostic posts were unfilled.

As part of One Cancer Voice (a coalition of more than 50 cancer charities), we’ve called on the Government to increase funding by £216 million to boost the cancer workforce by 45% by 2029. The recent comprehensive spending review committed “hundreds of millions of pounds in additional funding” to make a bigger and better trained NHS workforce. But we want to see clarification on how this money will be spent and how it will improve cancer diagnosis in Yorkshire.

Yorkshire has the highest rate of smoking in England, and, every hour, one person dies because of this addiction. As well as causing 4,500 cancers every year in our region, smoking costs us £1.61 billion a year in healthcare, lost productivity, and social care.

The most deprived areas of our region are also the places with the highest rates of smoking. Smoking accounts for as much as half of the difference in life expectancy between the richest and poorest of society.

The Government has set a target for the UK to go smoke-free by 2030. But Yorkshire is set to miss that target by 15 years if the pre-pandemic rate of progress continues.

We believe people who wish to stop smoking deserve to receive help. But public health budgets have been cut in real terms by 24% since 2016. And it is extremely worrying that the most deprived areas are also those which have seen the biggest cuts in public health grants. For example, Hull’s public health grant has been cut by £32 per person per year, the largest per capita cut in Yorkshire. This is concerning because Hull has the second highest smoking rate in the country.

Cuts to public health budgets mean hard choices have to be made by local authorities in Yorkshire. Unfortunately, it is stop smoking services and tobacco control which have borne the brunt of these cuts, with a fall in spending of 37.3% since 2016.

To help more smokers quit, we support what you have called a ‘vaping revolution’, to increase investment and focus on vaping products as part of stop smoking services. As a charity we have done a lot to highlight the potential of vaping devices and dispel some of the myths around these products. However, only one in 10 local authorities provide vaping products as part of their stop smoking services.

Our message is clear: if we want to stop tobacco causing the deaths of thousands of people in Yorkshire, stop smoking services need to be properly funded. To have any real impact on smoking, charities and other organisations have estimated an investment of £1 billion per year would be needed to restore public health budgets to 2016 levels. We believe that this should be funded in part by a ‘Smokefree fund’, a levy on tobacco companies to pay for the damage their products have caused to our nation’s health. We want to see this commitment made in the forthcoming Tobacco Control Plan for England.

Helping more people to quit smoking would have a huge impact on lung cancer – the biggest cancer killer across Yorkshire. It cuts short the lives of more than 3,000 people in our region every year.

To reduce deaths from lung cancer, Yorkshire Cancer Research has been funding a pioneering community-based programme called the Leeds Lung Health Check. It integrates lung screening with dedicated stop smoking services as a ‘one-stop-shop’, in a mobile CT scanning unit. Our experts believe it could be the model for a national lung cancer screening programme. Some of the findings have already been incorporated into the NHS England Targeted Lung Health Check Programme, which you spoke highly of to the Health and Social Care Select Committee last week.

This is just one example of a huge range of work supported by our charity over nearly 100 years – made possible by the generosity of the people of Yorkshire.

However, it’s a sad irony that these services are being funded by the same people in deprived communities who need them most but who are least able to pay for them. We believe that vital health programmes in Yorkshire and elsewhere need the backing of government, both local and national.

Action needs to be taken now to save thousands of families from the devastation and heartbreak that cancer continues to bring to people living in our region.

I look forward to seeing the details of your vision for improving cancer services and survival. I would love to invite you to visit our services in Yorkshire, and see for yourself how the “war on cancer” is being fought in our region.

Yours sincerely,

Dr Kathryn Scott

Chief Executive

Yorkshire Cancer Research