Disappointingly, there were no announcements in the Budget that specifically support men with prostate cancer. But Philip Hammond did announce additional funding for NHS England. Our policy manager, Tim Windle, reflects on a missed opportunity and outlines what NHS England and the devolved nations must do now to improve the future for men with prostate cancer.
It’s unusual for the Budget to be held on a Monday. But with the usual Wednesday being Halloween, the Chancellor apparently wanted to avoid any horror-themed headlines. That didn't stop Philip Hammond giving away a lot of little treats to different areas of the economy, though, from the freezing of beer duty to fixing potholes.
One area where there weren't any treats was health. Instead the Chancellor played one big trick, only confirming the extra £20.5bn of annual funding for NHS England by 2023 that had already been announced. Each of the devolved nations will receive a proportionate amount of this additional funding, but it won’t be ring-fenced to health spending.
We were disappointed. We thought this was the perfect opportunity to outline some of the investment necessary to meet the needs of a growing number of men living with or after prostate cancer. This includes £19 million for MRI scanners to diagnose advanced prostate cancer, and £45 million to ensure that all men with prostate cancer have access to a Cancer Nurse Specialist or a key worker. Instead, it will be up to NHS England to decide how this money is spent.
NHS England is currently pulling together a 'Long Term Plan', which will include a cancer strategy focused on earlier diagnosis, better treatment and support for people living with and beyond a cancer diagnosis. We absolutely agree with these priorities, particularly if they include a commitment to preparing for a UK population-wide screening programme for prostate cancer.
We are determined to find the test that can make such a screening programme possible and look forward to more details from the Government about the £75 million they announced for prostate cancer research in April. But we need to make sure that ahead of any screening programme, the NHS is doing all that it can to improve earlier and more accurate prostate cancer diagnosis to reduce late-stage diagnosis now.
This includes NHS England continuing the good work it's already doing rolling out multiparametric MRI (mpMRI) before biopsy in England, as well as supporting more hospitals to become prostate cancer rapid diagnostic centres, and making the best use possible of the current PSA test. We know that the PSA test isn’t perfect. But slight changes to this test could make it better, including looking at free PSA, PSA density, PSA kinetics and incorporating a patient's individual risk based on family history and ethnicity.
The PSA test's lack of accuracy means it can lead to over-diagnosis, over-treatment and men unnecessarily suffering with the long-term side-effects of those treatments. But with the help of mpMRI's more accurate scans, more men are choosing active surveillance. So over-treatment is gradually reducing and only fast-growing, aggressive prostate cancers are receiving radical treatment.
It's only by making such vital changes and improvements now that we can stop men being diagnosed too late with prostate cancer. NHS England has a big opportunity with its 'Long Term Plan', and we'll be working with them – and putting pressure on them – to ensure their plan delivers for men living with prostate cancer and those who could be diagnosed in future. We’ll also be putting pressure on the devolved nations to make sure they spend the extra money they will receive on their health services and on men with prostate cancer.
With our input, your support and the promise of more Government money for research, we hope the NHS achieves its ambition to improve earlier prostate cancer diagnosis and doesn't attract any horror-related headlines.