Health in Focus: Rare Cancers Bill, Commission into Social Care and Interim report into Maternity care

In previous years, the Spring Statement would dominate the political discourse, acting as the sister to the Autumn Budget and providing a focal point to direct public policy and opposition criticism. However, with Chancellor Reeves’ shift to a single annual fiscal event, the Spring Forecast could instead be seen as another session of repetitive political pantomime.

The almost weekly rendition of an economic metric followed by ‘up’ or ‘down’ to rally the benches works to portray the image of a supported and backed Government. This allowed the Spring Forecast to become a moment for Reeves to celebrate the work of the Government so far. Reeves boasted about the record cash settlement for the NHS and reductions in waiting lists, which recent analysis by the Telegraph found will only meet their 18-week pledge 15 years late, and declined to include the topic of health in any of her forward planning, with focus centred on trade, investment, education, and energy.

Many in the sector will be disappointed by this speech, as it seems despite the NHS being placed at the core of the Government’s mission, the Government is not going far or fast enough to realise its potential. Most fundamentally, the value of improving and investing in the NHS is that it can release benefits and savings all across the economy. One of these areas, social care, experienced its first proper update from the Independent Commission into Adult Social Care when Baroness Casey of Blackstock, chair of the Commission, gave a speech to the Nuffield Trust Summit. Lady Casey called for a ‘sixth social giant’ to match the five set out by the 1948 Beveridge report which concerned the challenge of supporting the old and sick population. Lady Casey called for the Government to deliver the ‘creation moment’ for social care in what was ‘a moment of reckoning’, achieving progress against the backdrop of continual Government failure.

Days prior to the speech, Lady Casey wrote to the Health Secretary Wes Streeting setting out six initial recommendations, ahead of her interim report set to be published this year. The recommendations called for a designated board for adult safeguarding, an urgent review into adult safeguarding statutory duties, scaling up investment in dementia trials, faster progress on the Modern Service Framework for Frailty and Dementia, a Dementia Tsar, and a fast-track ‘passport’ scheme for those with Motor Neurone Disease. These recommendations were swiftly accepted in full by Streeting, who also confirmed that an interim Modern Service Framework for Frailty and Dementia will be published by September, with the full framework by the end of this year. With the Commission holding an end date of 2028, and the repetition of the long-term ‘National Care Service’ in every social care press release, social care may be the slowest moving sector in politics. Many label this the social care political ‘taboo’ with the most prominent example being the failed reforms set out by the May Government, labelled the ‘dementia tax’ in a media and political tsunami. Rather, it would seem it can be more promptly termed the older people ‘taboo’. Recent movements from the Government, but also political parties across the spectrum, further reconcile this. A dramatic moment of political self-harm with the stripping of winter fuel payments, the refusal to touch the Triple Lock, and the inert nature of social care, all highlight that the backlash embedded in policy that impacts older people’s lives leads to impasse on improvements and policy metathesiophobia.

The National Maternity and Neonatal Investigation, chaired by Baroness Amos, also saw an interim report in recent weeks in which Lady Amos identified six factors which were contributing to pressure on the maternity system and impact the poor performances of many wards in regard to avoidable baby loss. Notably, the interim report took a key focus on the issue of racism and discrimination in maternity wards. This included the prevalence of stereotypes regarding ‘angry or aggressive’ Black women who could tolerate more pain, the discrimination of Muslim women based on their religion, the judgement of young couples, and insufficient accessibility for non-English speaking patients. The report also took note of significant workforce pressures, with many staff working beyond capacity, stretched to fill obstetric rotas and with poor morale, incivility and stress across clinical teams. This has been compounded by poor relationships across workforce hierarchies and inaction against poor behaviour and improper practice. The report says these pressures have accumulated into poor wraparound care, a lack of compassion, and diminished capacity and support in neonatal deaths and throughout the bereavement process.

The Rare Cancers Act gained Royal Assent on 5 March, a Private Member’s Bill by Dr Scott Arthur that has been backed by the Government since it was tabled in October 2024. The Bill was introduced to improve the Government’s focus and research on rare and less common cancers, which can be defined as cancers that affect no more than 1 in 2000 people. The current landscape means that pharmaceutical companies are disincentivised to fund rare cancer research because it appeals to smaller populations, creates weaker profits and can be logistically difficult to conduct clinical trials. The Act requires the Secretary of State to review the law on market authorisations for specialised medicines, called orphan medicinal products, considering international approaches and whether the current approach properly encourages research and investment into rare cancers. The Health Secretary is to report on this within three years of March 2026. The Act also creates a bespoke contact registry for rare cancer patients, appoints a National Specialty Lead and opens the National Disease Registration Service to help facilitate, centralise and promote rare cancer clinical trials.

The Act has been backed by many rare cancer charities including the Less Survivable Cancers Taskforce, as well as Blood Cancer UK and Brain Tumour Research, who have said the Bill will work to build a framework to improve survival rates for cancers where patients can benefit from a more coordinated research landscape alongside a clearer core point of accountability for the Government. A key feature of the Government’s life sciences strategy has been to try and bring pharmaceuticals companies onboard, working with NICE and the MHRA to bring down clinical trials waiting times and bureaucracy, uplifting investment through the Life Sciences Innovative Manufacturing Fund, and most recently, through the passing of the National Institute for Health and Care Excellence (Amendment) Regulations 2026 empowering the Secretary of State to direct NICE’s cost-effectiveness threshold as a matter of public policy. This influx of investment and ‘cosying up’ has been welcomed by the sector but also been scrutinised for a perceived choice to promote corporate profits over patient centred care. Specifically, the Liberal Democrats have been vocal in their criticism, calling for a clear impact assessment of the decision and advocating for this funding to be directed towards more hospital beds and efforts to tackle the crisis of corridor care.

As the political narrative crescendos into the May local elections and the 2024 King’s Speech, policy is expediting, with the notable passing of the Medical Training (Prioritisation) Act and the Rare Cancers Act, and the imminent Tobacco and Vapes Bill, rounding up the policies outlined in 2024’s King Speech. Labour will look to turn around their polling and the aftermath of the triumph of the Greens in Gorton and Denton. Since the Mandelson saga, Streeting has obscured himself back into the perimeters of the cabinet and has faced calls for his sacking in the wake of a secret plot against Starmer. Many commentators fear that a Labour wholesale reshuffle and reset is inevitable when political destruction impends in the local, Welsh, and Scottish elections in May, and Streeting may be the favourite to throw his hat in the ring for the premiership.