By Bill Heaney

The dreaded C word raised its ugly head in the Scottish Parliament on Thursday when Labour leader Anas Sarwar revealed that the disease was Scotland’s biggest killer and that the SNP government was falling further and further behind on waiting times for patient treatment.
Mr Sarwar told MSPs: “Everybody in our country has been touched by cancer, either directly or through a family member or friend. Cancer remains Scotland’s biggest killer.
“We have treatment waiting standards for a reason—we know that the faster someone is diagnosed and the faster they start treatment, the more likely they are to survive.

“The [SNP] Government has not met the 62-day standard for 10 years, and it is now not even meeting the 31-day standard. The situation is the worst that it has ever been. When will our cancer treatment standards be met?”

First Minister Nicola Sturgeon and Labour leader Anas Sarwar.

First Minister Nicola Sturgeon explained: “On the 31-day standard, performance this quarter has dipped very marginally below 95 per cent. Of course, we will work with health boards to get that back up. The 62-day standard for urgent referral for suspicion of cancer to first treatment is not being met, but we are taking a range of actions to secure improvement there.

“It is important to note that the targets are percentage targets. We set those targets, and I am not suggesting for a minute that they are not important, but when we look at the number of people treated on both those pathways, we can see a significant increase—more patients were treated on the 62-day and 31-day pathways in the latest quarter compared with the previous quarter, and in the latest quarter compared with the same time last year, and with the last full quarter before the Covid pandemic.

“In fact, we are now treating 35 per cent more people on the 62-day pathway than we were 10 years ago, and just under 16 per cent more on the 31-day pathway than we were 10 years ago.

“That is evidence of the fact that more patients are going through and being treated on those pathways. That is important, because the premise of Anas Sarwar’s question is absolutely correct: people need to receive urgent treatment for cancer.

“If we look at the 31-day performance target, we can see that the median wait for treatment there is four days. On the 62-day standard, the median wait for treatment is 48 days, and we will continue to take action to improve that even further.”

Anas Sarwar was not content with that answer. He said: “The First Minister is right—the numbers are important, because the situation is stark. Figures that have come out this week show that, in the past three months alone, more than 1,000 people did not start their treatment on time.

“That has devastating consequences. Cancer was already Scotland’s biggest killer but, in the past year, there have been 198 more cancer deaths above the five-year average. That is 198 more families who have lost a loved one.

“The national health service crisis is costing lives. We were told to expect a catch-up plan but, instead, things continue to get worse. We have patients who are worried about their diagnosis, families who are anxious for treatment to start and people who have lost a loved one. They are watching, so I ask again: when will our cancer treatment standards be met?”

The feisty First Minister replied: “I will come on to the range of actions that we are taking to meet the percentage targets, which are important, but the numbers that I am talking about here are important for the very reasons that Anas Sarwar has mentioned. The numbers signify individual patients with cancer.

“The figure that I gave a moment ago was a percentage figure. On the 62-day pathway, 10 years ago, in the quarter that we are talking about just now, 3,110 people were seen; in the most recent quarter, 4,161 people were seen. On the other pathway, 10 years ago, the figure was 5,500 people; today, it is almost 6,500. What does that say? It says that our cancer services are seeing more patients, and they are seeing more patients on those urgent pathways. That is important, and it is important for individuals.

“However, there is more work to do here. For example, over the next few years, we will invest £40 million to support cancer services and, specifically, to improve waiting times. That investment is focused particularly on urology and colorectal and breast cancer, because those are the pathways that are under the greatest challenge. We are investing in the endoscopy and urology diagnostic plan. We have six one-stop urology diagnostic hubs. We are committed to earlier diagnosis through the rapid cancer diagnostic services that are coming on stream.

“All of that work is important to further improve performance, but it is really important to recognise the volume of work that our cancer services are doing each and every day.”

Anas Sarwar added: “The First Minister cannot escape from the fact that treatment standards not being met means people not being diagnosed in time, treatment not starting in time and people losing their lives. The standard response from the First Minister will not comfort people who cannot get treatment or are losing a loved one.

“There has not been a single day during Nicola Sturgeon’s time as First Minister on which she has met the 62-day cancer treatment standard—not a single day.

The First Minister might not want to listen to me, but this is what Macmillan Cancer Support said this week: ‘Cancer waiting times have been getting worse for years and today’s figures show the worrying trend continues right across the country, even before the added pressure of winter is factored in’.

“Macmillan is again raising the alarm about cancer care in Scotland. If a doctor suspects that someone has cancer, the patient rightly expects to be diagnosed and treated in time. This is costing lives. After 15 years in Government and 10 years as First Minister, during which the 62-day standard has never been met, it is important that we get a straight answer. So, I ask again: when will both cancer treatment standards be met? Will it be in one year, five years, 10 years or never?”

The First Minister promised him: “We will continue to work each and every day to meet not only those targets but all targets across our health service. That is happening right now and in the most challenging of circumstances, as I think everyone knows. The fact of the matter is that, because of the investments that are being made and the actions that are being taken, the capacity of cancer services is increasing. That is demonstrated by the increase in the number of patients being treated on those pathways, which is important.

“Of course we need to see even more patients being treated, but I repeat the point that I made earlier: for the 31-day standard, the median waiting time is not 31 days but four days from the decision being made to treat a cancer patient to the treatment actually starting.

“For the 62-day standard, which is from urgent referral to treatment, the median waiting time is 48 days. We will continue taking action to improve that further.

“I do listen—I listen very carefull. I also listen very carefully to and work closely with organisations such as Macmillan Cancer Support, which does such a good job across cancer services.

“It is because we take all of that so seriously that we have put, and will continue to put, so much effort into ensuring that we reward those working in our national health service as well as we possibly can. Today, this is the only part of the United Kingdom in which there are no strikes in our national health service.

“The commitment that we give to our national health service, which will be demonstrated in our budget, is to continue to build capacity so that we continue to improve treatment for patients with cancer and for patients who present to the NHS for any reason.

Anas Sarwar and Jackie Baillie, the Labour MSP for Dumbarton, campaigning on all fronts to fight cancer.

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