Doctors in a hospital corridor

As the Conservative leadership campaign continues towards its finale it will be interesting to see whether Rishi Sunak and Liz Truss are brave enough to give a realistic account of the challenges facing the NHS, the pressures under which its staff are working and the impact on patient outcomes if problems are not properly addressed.

The challenges faced by the NHS remain gargantuan in scale. For years, CRUK has been sounding the alarm about the chronic shortages in NHS workforce (over 105,000 vacancies at last count) and equipment, its ageing infrastructure and estate – all of which have held back efforts to improve early diagnosis.

The Government has missed key targets on cancer waiting times in England since 2015. It has never met its target to ensure 75% of patients are diagnosed or have cancer ruled out within 28 days of referral. We worry that things may get worse – as the data begins to reveal the full impact of the COVID-19 pandemic on early diagnosis and cancer treatment.

The lack of genuine and robust debate on this topic is alarming – including the trade-offs currently facing the Secretary of State for Health & Social Care. Last week, for example, brought news that the Government pledged to give NHS-staff a pay rise of up to 5%, which we, along with many other health charities, welcomed.

But the revelation that 2% of this may have to come from the NHS’ existing budget, potentially amounting to a staggering shortfall of £1.8 billion in unplanned costs, is very concerning. More worrying still is that this shortfall will likely mean funds will be diverted from the planned rollout of tech and diagnostic capacity across the health service.

It’s right that the Government honours the pay rise, but now is not the time to be backsliding on ambitions for diagnosing more cancers early and saving more lives. The choice between either adequately investing in staff or equipment, both of which are vital in delivering these services, is a false economy, ultimately affecting those who can least afford it.

A lack of proper investment also risks undermining the good work that has been done. Just last month, the new Community Diagnostic Centres reached a milestone of delivering one million tests. The Government mustn’t risk reducing the potential of these innovative services by failing to adequately fund both the staff and equipment needed to deliver them.

Now is the time to level with the public about the growing gap between patients’ healthcare needs and the capacity of the system to meet them. We are, after all, waking up to the scale of the problem facing our health services. Despite the heroic efforts of NHS staff, a recent survey for CRUK found that 75% of people in the UK said the NHS was too understaffed and underequipped to tackle cancer.

The specialist staff who valiantly keep our cancer services don’t just need a pay-rise. They need a PM who understands the burdens the health service is under, who has a long-term vision and reform plan for the NHS and road map for ensuring cancer patients get care that they deserve and need.

They need our future PM to be honest with the public about the investment required to keep the NHS going, reform it and to be clear about the impact that different rates of tax (or borrowing) will have on cancer waiting lists and the urgent care that so many people require.

One in two of us will develop cancer at some point in our lives – so this debate matters and should take centre stage in the days, weeks and months ahead. A failure to do so will surely be harshly felt at the next General Election.

Michelle Mitchell is Cancer Research UK’s chief executive

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