Just under 20,000 people are diagnosed with cancer in Wales every year, and it's now widely known that cancer kills more people in Wales than any other disease. The good news is that the survival rate for this disease is increasing, with 60 per cent of patients diagnosed between 2014 and 2018 surviving their cancer for five years or longer, which shows that treatments are improving.

However, despite these steps forward, the impact of COVID-19 and the shortage of staff in the health service are likely to lead to a first decline in survival rates. The challenges facing cancer services in Wales have been compounded by COVID, as in all sectors within the health service. Welsh Government figures show that 20,000 fewer people were given urgent referrals for cancer diagnosis between March and November 2020, compared with the period before the pandemic. We now know that 1,700 fewer people started their cancer treatment in Wales in the year between April 2020 and March 2021. Cancer services were significantly disrupted in the wake of COVID, jeopardising diagnosis and making it more difficult to treat, which then led to a decline in their chances of survival.

We also know that health service staff are exhausted after responding to the pandemic, as well as trying to maintain cancer services, while also trying to carry out more infection control measures. However, while many cancer services have now largely returned to the levels where they were before COVID, the reality is that cancer outcomes in Wales were not good enough even before the pandemic. We can't therefore go back to how things were. There remains a need to transform services urgently to improve cancer outcomes in the long term.

That brings me to the workforce. I want to place on record our thanks to the workforce, who have gone the extra mile time and time again over the recent challenging period. As the son of a cancer patient, I wish to thank them personally, and I am sure that that gratitude is echoed by everyone here in the Senedd today. However, the inconvenient truth is that the health service has relied on the goodwill of the workforce to keep the service going, with more than one in four doctors working unpaid overtime. Even before the pandemic, Wales was experiencing significant gaps in the workforce for diagnostic and cancer services, such as imaging, endoscopy, pathology, and non-surgical oncology.

These gaps have significantly affected our ability to identify cancer early, provide the most effective form of treatment, and improve the chances of survival. For example, while there has been an increase in the consultant workforce for clinical oncology throughout the UK and Europe, there has been no increase in five years in the Betsi Cadwaladr University Health Board area. In 2020, there were only 7.8 radiologists per 100,000 people in Wales, while the European average is 12.8. Indeed, Wales has half as many radiologists per head of population as France and Spain. And north and west Wales have the lowest number of clinical radiologists per capita compared to the rest of the UK.

There are steps that can be taken in the short term to address this situation, such as mixing skills. Innovations with new technologies can also help to maximise the potential of the cancer workforce as well. And, of course, we must look at supporting the well-being of the workforce in order to retain them. But, while these steps can help, it is only by addressing the crisis in the real workforce that we can find a solution to the broader question of staffing. We must therefore see the Government increase staffing levels in key cancer professions by investing in training and employing more cancer staff to fill current vacancies, and ensuring that the workforce has the capacity to meet growing demand, as well as time to innovate and transform services.

This brings me to the next point, namely waiting times. It's fair to say, as we've mentioned, that COVID has had a detrimental impact on these cancer services. Data for September 2021 show that 59 per cent of patients had received their first treatment within 62 days of the suspicion of cancer. This is well below the target of 75 per cent. This worrying statistic tells us that far too many patients are waiting too long before being diagnosed or treated. But we can’t improve the results unless we see an increase in the workforce and the equipment required to catch it early enough.

Now, the suspected cancer pathway, which was announced back in the spring, is to be welcomed. But more needs to be done to reduce waiting times and to give patients the best possible chance of early diagnosis, early treatment and survival.

I also welcome the quality statement for cancer, which was published this year. But it is an inadequate statement. It's not a cancer strategy, and the previous cancer strategy has now come to an end. Wales will therefore be the only nation in the UK without a cancer strategy, something that the WHO says that every Government should adopt. We therefore must strengthen the quality statement for cancer, and we must develop a cancer strategy for Wales urgently.

Finally, I want to turn quickly to the Richards review, undertaken by the health service in England. One of the key recommendations of the review was having diagnostic hubs for elective diagnostics, and taking elements such as scanning and testing out of acute hospitals in order to build capacity. But, of course, we require additional investment to create these, together with workforce, equipment and so on. The Government therefore needs to consider this fully, and I would urge the Government to explore the possibility of establishing a pilot scheme, with a view to developing hubs of this kind here in Wales.

So, to close, we recognise that the COVID crisis has made things very difficult for the cancer services and health services in general, and we officially thank the workforce for their bravery and their work during this period. But things weren't right before then. We recognise that steps have been taken in the right direction, but we need much more. We have to see investment in the workforce, which means increasing the training opportunities and increasing the numbers, particularly the specialist workforce. We need a cancer strategy that's clear, building on the statement that was made in the spring, setting out a vision and clear targets and accountability. And finally, we need to see a commitment to trial and adopt some of the recommendations in the Richards report. After all, we don't need to reinvent the wheel. So, by implementing these, we can be confident that more patients will have a quick diagnosis and that survival rates will increase. Thank you very much, Dirprwy Lywydd.