Thank you very much, Deputy Presiding Officer. I’m pleased to open this debate, which calls for a focus on achieving a target of 28 days for diagnosis for those with cancer. This is a recommendation that was made by the independent cancer taskforce, which includes some of Europe’s finest clinicians, who said:

Rydym yn argymell y dylid gosod uchelgais y bydd, erbyn 2020, 95% o gleifion a atgyfeiriwyd gan feddyg teulu i gael profion yn cael diagnosis naill ai bod ganddynt ganser, neu nad oes ganddynt ganser, a bod y canlyniad wedi ei gyfleu i’r claf o fewn pedair wythnos.

The report also suggests that 50 per cent should receive their results within a fortnight.

Some of the more pedantic amongst us have drawn attention to the fact that the independent taskforce looks specifically at England. The suggestion, I suppose, is that we should never look at what happens elsewhere, or even that cancer changes its form when it crosses a border, but, of course, the recommendation has also been approved by Cancer Research as something that would be of specific value to Wales too. The health needs of people are the same and the need for early diagnosis is just as important.

Waiting times for diagnosis are longer here than they are over the border. Any reasonable analysis of data, I think, would demonstrate that. And because of new NICE guidelines, which do apply here in Wales, it will be easier for GPs to refer people for testing. So, an increase in capacity, I think, is going to be necessary.

We have seen improvements in diagnostic waiting times for radiology in Wales over the past few years, and clearly we want to see that continuing. But the figures are no better than they were back in October 2009, for example, so we are still trying to recover from that period between 2011 and 2014 when waiting times went through the roof.

It’s even worse when it comes to endoscopy diagnosis, which is crucial, of course, with colon cancer. Here, the median waiting time has gone from a little over three weeks in 2009 to a little under six weeks for most of this year. We haven’t seen any real improvement since 2014, and remember that is the median figure, which will mean that half the people are waiting even longer than that. So, you can see the challenges facing us in achieving a target of 28 days for diagnosis for 95 per cent of patients.

The Minister, I think, has claimed in the past that the target, to a certain extent, is being achieved, but that somehow it’s not being recorded. All I will say about that is that I’m sure it’s very frustrating for him that all of the targets that his Government does achieve aren’t recorded and published, when so many of the targets that are recorded show failures. Some people might assume from that that things aren’t perhaps going as well as the Minister would hope.

But let’s concentrate on something else that the Minister has said entirely accurately on a number of occasions: we need to look at outcomes. I agree 100 per cent with that. So, let’s emphasise the importance of having earlier diagnoses and what that can mean in terms of outcomes. Recent figures demonstrate that 93.2 per cent of patients who received a diagnosis at the earliest stage of colon cancer survived for five years, as compared with only 6.6 per cent where the disease had developed further. For liver cancer, between 50 per cent and 70 per cent of stage A patients will survive for five years with treatment, as compared with a median survival rate of between six and 11 months for those in stage C. More than 90 per cent of women diagnosed with breast cancer at the earliest stages do survive for at least five years, as compared with 15 per cent of women who are diagnosed at the most advanced stage of the disease. More than 90 per cent of women who are diagnosed with ovarian cancer at the earliest stage do survive for at least five years, as compared with 5 per cent of women diagnosed at the most advanced stage. The figures are very striking indeed. We know, of course, what they are, but it’s worth while looking at those bare figures just to remind ourselves of the importance of diagnosis and early diagnosis.

There’s often mention of comparing Wales with England. It’s fair in some contexts, not fair in other contexts, but, of course, we in Wales and England, together, should be looking at what is happening where performance is at its best. A few examples for you: the survival rates for breast cancer for five years, 79.1 per cent in England; 78 per cent in Wales—similar figures; in Sweden, the figure is 86 per cent, and that’s what our target should be. In England, 80 per cent of men with prostate cancer survive five years or more; the figure is 90 per cent in Austria; 78 per cent in Wales. Colon cancer, the survival rates for five years in England are 51.3 per cent; a little below 50 per cent in Wales; but in Germany, they achieve over 60 per cent—62.2 per cent—with the European average at 57 per cent. So, once again, we should be aiming to match the best, because all of these people in these other nations who do receive early diagnosis are people who benefit in the long term from that diagnosis, and the survival rates demonstrate that to us.

There are a number of reasons for late diagnosis: the unwillingness of patients, very often, to visit their GP with that persistent cough or a lump that doesn’t go away. Perhaps the patient has listened to Government advice not to visit a GP unless that’s entirely necessary. There are a number of reasons, of course, why people don’t go to their GPs. But longer waiting times are also a factor and sometimes complex symptoms need complex testing of the kind that we have seen being innovated in multidisciplinary centres in Denmark, and that is something that I’ve referred to on a number of occasions in the past. Once again, Cancer Research supports multidisciplinary centres of this kind. Here’s one quote:

Mae’n amlwg fod diagnosis cynnar yn hanfodol i wella cyfraddau goroesi mewn llawer o fathau o ganser. Mae hyn yn haws gyda rhai mathau o ganser, er enghraifft canser y fron a chanser y croen sydd â symptomau penodol. Mae heriau penodol yn bresennol mewn canserau pan fo’r symptomau’n annelwig.

We must provide all opportunities through diagnostic centres and by using the funding allocated through the budget, following discussions with Plaid Cymru, to ensure that that crucial target is one of the main priorities as we target scarce resource, but the resources that are available in order to secure the future health of the people of Wales.