4 February, 2023

World Cancer Day finds us in a slightly strange place in terms of cancer policy.  If I’d started to write this piece last week, I’d have been talking with some anticipation about the long-promised Cancer Strategy.

However, at the end of last week, we discovered that the Cancer Strategy, which we have been waiting for with increasing restlessness across the healthcare sector, will not happen.

The strategy should have been the detail that built upon the NHS Long Term Plan’s aims for cancer, published in 2019;

  1. by 2028, 55,000 more people each year will survive their cancer for five years or more
  2. by 2028, 75% of people with cancer will be diagnosed at an early stage (stage one or two).

In addition, the aims would be delivered in a way that:

  • improves the quality of life outcomes
  • improves patient experience outcomes
  • reduces variation
  • and reduces inequalities

There is nothing to suggest that these long-term aims have changed. Although 2028 feels like it is rapidly approaching, they remain noble aims that all of us would welcome. In the press communications when the Cancer Strategy was first announced, there was also a commitment to cancer prevention with a focus on:

  • Taking exercise
  • Watching what we eat and how much alcohol we consume
  • Stopping smoking

Instead, Health Secretary Steve Barclay MP (North East Cambridgeshire) announced the Major Conditions Strategy. This will combine six of the most prevalent conditions faced by people in the UK. The conditions are:

  • cancer
  • cardio-vascular disease, which includes stroke and diabetes
  • chronic respiratory diseases
  • dementia
  • mental ill health
  • musculoskeletal disorders.

Although details are still limited, it is understood that within these, only suicide prevention will have a standalone strategy.

Major Conditions Strategy

The Health Secretary introduced the Major Conditions Strategy in a speech in which he referred to a “shift to integrated, whole-person care”. He stated that the current healthcare system often sees conditions treated in “siloes”. This is in keeping with the Government’s introduction of Integrated Care Systems, replacing NHS trusts, which will bring primary, secondary and social care closer together, removing the existing friction between them.

Crucially for us at BCUK, the strategy does talk about “shifting the focus to ‘good health’ and early intervention”. That should give some comfort to those of us focused on cancer prevention. But this has to be tempered by the lack of detail and a feeling without a specific, tailored strategy with clearly identified actions. The Major Conditions Strategy is a diluted version of what the Cancer Strategy could and should, have been.

In the background to this remains the Women’s Health Strategy. A ten-year plan for improving health outcomes for women which aims to “improve the way in which the health and care system listens to women’s voices, and boost health outcomes for women and girls.” This also saw the appointment of the UK’s first Women’s Health Ambassador, Dame Lesley Regan.

Again, we should all welcome these aims, but it is not clear how the Women’s Health Strategy works alongside the new Major Conditions Strategy. If we take things at face value, there is no lack of good intentions, but that does not always result in good or effective policy.

The Chemicals Strategy 

We are also keeping a close eye on other areas of the Government, not least the Department for Environment, Food & Rural Affairs (Defra). In a meeting last week with Parliamentary Under-Secretary of State for Environmental Quality and Resilience, Rebecca Pow MP (Taunton Deane), myself and colleagues from a range of environmental and animal welfare organisations were promised that the Chemicals Strategy, originally announced 5 years ago, would be published this year. However, no firmer timeframe was given. You may be spotting a theme here.

The Chemicals Strategy is absolutely key to understanding what the regulatory landscape for chemicals will look like in the UK going forwards. As we diverge further from our European counterparts, the Retained EU Law (Revocation and Reform) Bill is back in Parliament this week. UK REACH remains a long way behind the quality. And, scope of the EU REACH regulations that it is meant to replace.

What’s next?

There is a clear need for clarity on the Government’s thinking and intentions. The inevitable consequence of this divergence is that the UK public faces greater exposure to chemical pollution and the related risks of breast cancer and other diseases.

It is telling that the Government has managed to unite healthcare organisations. Environmental campaigners. Politicians. Even the chemicals industry in the belief that the current situation, with a lack of clarity, suits nobody.

However, there is a feeling amongst us that, even after such a long delay, a rushed strategy doesn’t take account of initiatives like the Women’s Health Strategy. The Major Conditions Strategy may only confuse the picture further. These strategies must work in lockstep to be effective. The Government needs to take its own advice and avoid working in siloes.

Amongst this, BCUK will keep fighting for better, more effective regulation and the highest safety standards in chemical regulation. I hope I can write again on World Cancer Day 2024. Telling you that the Government of the day has joined us in that aim.

 

Gareth Lloyd-Johnson

Gareth Lloyd-Johnson, Policy and Campaigns Manager at Breast Cancer UK.



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