Spending Review 2021: Promising commitments, unanswered questions

Today, the Government set out its spending plans for the next 3 years.

We saw the Comprehensive Spending Review (CSR) as an opportunity to put the UK on a path towards better cancer survival, through growing the cancer workforce and investing in diagnostic equipment, research and public health.

It was billed as the moment the Government would set out how it was going to ‘build back better’ – critical, given this is likely to be the last spending review before the next General Election.

So, did the Government deliver?

The picture is still emerging and we don’t have a full sense yet of what each announcement will mean, but broadly it looks promising. Here’s what we know right now.

Progress on diagnostic equipment

On diagnostic kit, we estimated that Government needed to invest at least £1.3 billion just to reach the average number of scanners compared to other countries. And a figure likely in the billions to fully roll out innovative ‘one stop shop’ Community Diagnostic Centres.

In positive news, earlier this week the Chancellor announced £2.3 billion across the next 3 years for transforming diagnostic services, investment meant to set up at least 100 new Community Diagnostic Centres across England.

‘One stop shop’ diagnostic centres have the potential not only to expand capacity, with welcome new scanners, blood testing labs, endoscopy suites and other important testing kit. They will also bring diagnostic tests together in new sites set in communities across the country – helping patients more easily access these key cancer tests.

This money was accompanied by another £1.5 billion to expand the number of beds in NHS hospitals and set up new surgical hubs with extra theatres to tackle backlogs in urgent procedures, which could make important progress in tackling growing waits for cancer patients.

Early positive signs on workforce, but clarity needed

Of course, the new equipment will need an expanded cancer workforce to operate it – and here there’s also some positive signs, but with a lot of uncertainty remaining.

We estimated that the Government needed to invest around £216 million across the next 3 years into training a cancer workforce able to deliver world class cancer care.

Today, the Government announced there will be ‘hundreds of millions of pounds of additional funding’ to build a bigger, better trained NHS workforce.

A promising commitment, but it’s still far from clear how this money will be targeted – meaning we don’t yet know whether this increased investment will see growing numbers of staff in the cancer workforce. We will be pushing for that to be the case.

Now the Government and the NHS need to urgently clarify that today’s announcement will deliver the vital investment needed to grow the cancer workforce. This will be key to turning their commitments to improve cancer outcomes into reality.

Boosting research and innovation – but not as much as promised

In his speech, the Chancellor committed to spend £20 billion in R&D by 2025, and £22bn by 2027. While this is a disappointing scale back of what was originally promised (£22 billion by 2025), it is still a strong boost to R&D funding with a clear trajectory for spending increases.

Within this, £5 billion for health research over the next 3 years has been allocated, which represents a £1.2 billion increase between now and 2025. This funding includes £95 million to deliver the Government’s ‘Life Sciences Vision’, including its commitments to cancer, as well as £30 million for the National Institute for Health Research to invest in research skills and training for healthcare staff underrepresented in research.

While a lot depends on how and when this spending is distributed, this increase in health research could provide much-needed support for cancer researchers and help strengthen the UK’s ability to improve cancer outcomes through research.

Investment in public health

Preventable disease continues to have a massive impact on our nation’s health, the NHS and the wider economy – something that only became clearer during the pandemic.

Despite this, the Spending Review announced no real terms increase in the public health grant. This follows the significant cuts Local Government has experienced in recent years, with the most deprived local authorities facing the most severe reductions.

Vital services – like those that can help people stop smoking, maintain a healthy weight and manage their alcohol intake – are experiencing severe strain and this will do nothing to relieve it. The Chancellor has also missed a key opportunity to undo the damage to public health and to Government revenues of years of alcohol duty freezes.

And while we were pleased to see an increase in tobacco taxes, it’s nowhere near what will be required to make smoking obsolete. That’s because increasing taxes is just one piece of puzzle – what we need are tobacco control comprehensive strategies with services to help people quit smoking, something this money won’t be specifically earmarked for.

We’ve been calling for a dedicated fund – making the highly profitable tobacco companies pay for the damage they cause – for years. This would use industry funds, but without industry interference. However, disappointingly there’s been no dedicated investment in tobacco control.

Unless remedied for the upcoming Tobacco Control Plan for England – this will seriously threaten the UK’s ability to achieve smokefree ambitions and reduce smoking-related health disparities.

What next?

While there are still some unanswered questions following today’s Spending Review, on the whole, Government has made a number of positive commitments on cancer services and research.

Now, we’ll be working with Government and the NHS to fully understand exactly what the commitments made today will mean for cancer patients and research now and in the years to come.

And we urge you to do the same.

Email your MP today and urge them to request that the Secretary of State for Health and Social Care, Sajid Javid, outlines exactly how much of this funding will go to training key cancer professions.

We’ll also be working hard to ensure that any investment delivers for cancer patients, in both building better cancer services and supporting life-saving cancer research.

A critical test will be whether these announcements will help meet the Government ambition to diagnose 3 in 4 cancers early by 2028 and whether they help meet their manifesto commitment to improve cancer survival in this country.

The announcements today are also specifically for England, meaning there’s more work for us to ensure that the vital investment seen today in growing the cancer workforce and securing more vital diagnostic kit is replicated in budgets in Wales, Scotland and Northern Ireland.

Thank you

Where there have been wins today, they belong to the whole cancer community. Cancer charities large and small have united behind the One Cancer Voice and All-Party Parliamentary Group coalitions.

All-Party Parliamentary Group on Cancer coalition campaigners handing in our petition to Parliament

Our Campaign Ambassadors have led our #CancerWontWait campaign, sharing their personal stories and meeting their MPs to help ensure cancer remains at the top of the political and policy agenda. And tens of thousands of people added their voices to our petition.

Together, we’ve been relentless in our campaigning to secure investment in cancer services. Uncertainty over funding for NHS staff is frustrating, but it won’t stop us.

And if today has shown us anything, it’s that when we speak with one voice, we can start to make real progress.

Matt Sample is a policy manager at Cancer Research UK