Spring Budget 2023: What does it mean for the mission to beat cancer?

As we saw today, the Spring Budget is a key moment in the political calendar for health and research because it is one of the major moments where the entire landscape can change in an hour-long speech. Though the Chancellor has a plethora of economic plates to spin, we at Cancer Research UK always believe every Budget is a moment for a Government to seize upon and make real impact on cancer research, prevention, diagnosis, treatment and care.

For those still picking through the numbers or who haven’t got the time to pore over the documents with a fine toothcomb, here’s our quick primer on the highlights of what this budget meant for our mission to beat cancer:

Health and workforce

The NHS cancer workforce has been stretched to their limit, with record numbers of vacancies and shortages across key cancer professions, compounded by unprecedented demand on services.

So all eyes were on whether the Spring Budget would be the moment that the Chancellor – who committed to publishing an NHS Long Term Workforce Plan last autumn – would take this opportunity to address the NHS workforce crisis that’s contributing to record long waits for cancer care.

We’re still left waiting for that long term plan for the NHS workforce, with Jeremy Hunt promising it would come ‘shortly’ – hopefully days rather than weeks. It’s vital that this plan finally gets to grips with the chronic shortages in the NHS cancer workforce – setting out the staff we need in key cancer specialties and crucially funding the recruitment and training of the staff needed to help the cancer patients of today and tomorrow.

More positively, changes to pension rules could go some way in helping the NHS’s most experienced staff keep working to tackle the growing waits facing cancer patients. Simplifying the system, by increasing the Annual Allowance and removing the lifetime tax free allowance, is a big step for removing pensions tax measures which disincentivised older NHS consultants from continuing work.

There was also positive news with the announcement that the UK medicines regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), will receive £10m in extra funding over the next two years to implement new ways to accelerate approval of new treatments. If this means high standards can be maintained, but important decisions can be made quicker, it could mean new treatments are available faster to patients in the UK while making the UK a more attractive destination for launching new medicines and clinical trials.

Prevention

As I type, tobacco duty hikes will be coming into place across the country with notable above the Retail Price Index (i.e. above inflation) increases being announced. Smoking remains the biggest cause of cancer and death in the UK, and we know that increases in cigarette prices are a key way to encourage people to stop smoking. But as our #SmokefreeUK campaign – which has more than 90 MPs on board already – has been highlighting, this alone won’t be enough.

The best thing the UK Government could do now is to actively help those who are motivated to quit to do so, especially those in more deprived groups who bear the brunt of smoking-related disease. We would back any move by the Government to put more of the income derived from tobacco duties towards funding stop smoking services and quit campaigns.

Alternatively, they should make the tobacco industry foot the bill for the damage their products cause through a Smokefree Fund. Only last week, in the No Smoking Day debate in Parliament, the Government said that it would be announcing “bold, innovative and ambitious” action on tobacco control, when it finally responds to the Khan Review. We look forward to seeing this response in the coming weeks, and for the funding to match this ambition.

Yesterday, the public health grant allocation of £3.5bn was announced for 2023/24, which protects the value of the grant in real terms. This is welcomed, but it will still be £1bn a year less than it was in 2015/16 due to a series of funding cuts. This compromises local authorities’ ability to fund vital services that prevent ill health, including stop smoking services.

Science and research

The “science and technology superpower” ambitions were given prominence in the Government today and we firmly welcome any focus on boosting the country’s scientific output – after all, we’re proud of the positive impact our research and work has on not only the health of the nation, but the wealth. In 2020/21, the £1.8 billion of investment in cancer research generated more than £5 billion of economic impact, from high-skilled jobs to the impact of improved health for working adults – every £1 invested generated £2.80 of economic benefits.

We had concerns that at a time when oncology start-ups are facing tough economic challenges, a cut in tax credits for small and medium enterprises (SMEs) would hurt a vital pipeline for accelerating discoveries from labs to clinics. We are glad our calls in our budget submission to mitigate this potential impact, and the public efforts led by the BioIndustry Association, were recognised. The government’s decision to revisit the R&D tax credits for research intensive SMEs in the Budget means eligible companies will now receive £27 from HMRC for every £100 of R&D investment. According to the budget speech, this means an eligible cancer drug company spending £2m on research and development will receive over £500,000.

We will also be keeping an eye on the relaunch of the Investment Zones programme, which aims to create 12 high-potential, knowledge-intensive growth clusters across the UK. Each cluster is promised to drive the growth of key sectors in the UK including the life sciences—bringing investment into areas which have underperformed economically. Cancer Research UK welcomes these initial proposals, especially as they put life sciences front and centre, will now be centred around universities and research organisations, and will be present across all four nations.

Finally, last month there were reports that the Treasury had clawed back £1.6bn of funding that was originally allocated for Horizon association. We had hoped that the budget may have provided some clarity over where this funding had gone, but this was not included. Swiftly securing Horizon Europe association is overwhelmingly in the best interests of cancer researchers and patients globally, and we will continue to support sectoral efforts in favour of association.

In conclusion then, some encouraging announcements in relation to Life Sciences and R&D but we are still left with unanswered questions in relation to the publication of the NHS workforce plan and the bold action promised on smoking. At a time when cancer waiting times have worsened, we, and the 1 in 2 of us who will get cancer, need answers to these questions soon if we are to deliver on the Government’s manifesto commitment to improve cancer survival in this country.

Ian Caleb is Public Affairs Manager (Westminster) at Cancer Research UK