We go through the end of the wheat. Other parts of the uk. So how would an expected move by nhs england to reconfigure the targets for Cancer Care Waiting Times affect that . Nhs england is taking a new tack on cancer Waiting Times. Well be asking Cancer Research uk and Labours Health minister in the welsh senedd whether this will bring radical improvement for patients on waiting lists, or is itjust a way of covering up failure . Also tonight more possible danger ahead for donald trump as his fourth indictment could be delivered this week, this time a state, not a federal charge, which a future President Trump could not pardon. Well be joined by a lawyer who tried to prosecute trump and one who worked to defend him. And on the eve of the 25th Anniversary of the 0magh bomb, which took 33 lives and injured 200 more four months after the good friday agreement, why has justice never been served . Well hear from voices across the communities in Northern Ireland. Good evening. Nhs Waiting Times have, in recent years, dominated the Health Agenda and provided regular political flashpoints. Now nhs england is expected to change the way it measures cancer response times by rejigging the targets, many of which have been missed in recent years, from nine to three. Among the three targets to be kept is a diagnosis within 28 days of referral. Among those being dropped is the requirement to have a first Consultant Appointment within two weeks. The proposed changes are yet to be formally announced. But follow a year long consultation. Reports of their arrival comes as englands Health SecretarySteve Barclay went on the offensive on Health Issues this morning some believe a sign of the governments desire to move the conversation on after its focus last week on the small boats. Labour has been critical today of both the new Cancer Targets and of the governments record on the nhs more broadly. Well discuss the implications of all of this for the Nations Health and for politics in a moment. First, heres kate. The proportion of uk patients surviving cancer has improved over the last few decades. Take lung cancer, the uks biggest cancer killer. Between 1995 and 2014, the five year Survival Rate for the newly diagnosed increased by almost 8 . What the uk needs to be more worried about is that Survival Rates in other countries like denmark and australia, countries with broadly comparable Healthcare Access and expenditure, are still ahead. Now, one thing we know is key to improving survival is early diagnosis and treatment. The five year Survival Rates for Breast Cancer diagnosed at stage 1 and stage 4 can differ by 75 . England currently has nine targets for nhs trusts with the aim of speeding things up. Most are not being met. Take the target for suspected Cancer Patients to only wait two weeks between being referred and seeing a consultant. Performance dropped below the dark line of the target around 2018, although during the pandemic years, there was another fall. And the target of 85 of patients only waiting two months from referral to treatment. That started to be missed a bit earlier around 2014. Now its about 60 . There have been proposals to change those targets for almost a decade now. Last year, a clinically led nhs review recommended they were cut down from nine targets to just three. A consultation on that proposal is due for a final government decision any day. Some of this is merely simplification. Take these three existing targets. Theyre almost identical. All essentially want patients to only wait two months between referral and treatment. The recommendation is to combine them into one target with the same ambition. The more controversial change is to remove a target for patients to see a specialist within two weeks, and replace it with the aim of patients only waiting a month to receive a diagnosis or be cleared. The reason for this shift is having a hospital appointment doesnt guarantee a quicker diagnosis. Today, some patients can be sent directly to be tested, skipping the need for that first appointment. But with the target encouraging a hospital visit, nhs reports suggest some trusts arrange meetings but no tests to basically stop the clock on the target, while patients would still be waiting to know whether they had cancer. The proposed targets have been already trialled in 11 english trusts since 2019. By 2021, almost 79 of patients at the new Target Hospitals were getting a diagnosis within a month, compared to nearly 72 of patients in other hospitals, a seemingly slight improvement. 0verall, nhs england would not meet this proposed new month long diagnosis target. It hit 75 only once in february this year. And we have to remember, when the independent cancer taskforce first recommended this change all the way back in 2015, it suggested a target of 95 right the way at the top there. Getting there would take more than a target. Well, changing the targets in themselves is unlikely to make a big difference to how Patients Experience the service, because one of the underlying problems in terms of the underlying problems in terms of how quickly patients are seen as just the gap between the number of people coming forward and being referred and the capacity of Cancer Services to see people, diagnose them, scan them, do tests and so on, and that gap has been growing over time. Improving Cancer Survival is a wholesale challenge. Targets, we should remember, merely set the goal. Kate there. Joining me now in the studio is director of evidence and implementation at Cancer Research uk naseer turabi, and from pembrokeshire, the welsh Minister For Health and social services eluned morgan. We did ask the government tojoin us, but no minister or conservative mp was made available. Good evening both of you. Eluned, first of all, labour has said the government is shifting the goalposts because they cannot meet the targets for cancer, but clinicians have been involved in this, and not only clinicians, the Cancer Task Force has been behind these changes for eight years . We have modernised the way that we measure our targets, our lists in relation to cancer four years ago. We have a single measurement. 75 of our patients have to start their treatment within 62 days from suspicion, so it is one single cancer pathway, and again, that is something that was developed with clinicians, and also with those, in fact, who are interested in this particular area, that the key thing is, we have to remember what is in the interest of patients, and stopping the clock is not in their interest. They need things to be done, they need to know where they stand in relation to that one single pathway, and thats why we went for that particular approach in wales. But you make that approach in wales, but why is wes street in criticising the government for another streamlining approach . What is so good about is not so good about the in england . I good about is not so good about the in encland . ~. , in england . I think the thing to remember in england . I think the thing to remember is in england . I think the thing to remember is that in england . I think the thing to remember is that simply in england . I think the thing to i remember is that simply changing in england . I think the thing to remember is that simply changing the targets doesnt mean you start meeting a different target. What is important is that Additional Resources go in, and we are all challenged in relation to the huge demand there is for Cancer Testing across the United Kingdom, and the fact is, in order to find around 10 of people, you need to test 90 of people you know it wont have cancer in the end. Lets turn to you, naseer turabi. Does Cancer Research uk think the government is walking away from targets, or is it actually a good idea . ,. Targets, or is it actually a good idea . ,. ,. , targets, or is it actually a good idea . ,. , idea . Cancer research uk are broadly Su Ortive Idea . Cancer research uk are broadly sunportive of idea . Cancer research uk are broadly sunportive of this idea . Cancer research uk are broadly supportive of this change idea . Cancer research uk are broadly supportive of this change in supportive of this change in targets supportive of this change in targets. We think it will make them more targets. We think it will make them more meaningful, but it comes against more meaningful, but it comes against a more meaningful, but it comes against a backdrop of missed targets, against a backdrop of missed targets, as your item said, since 2015. Targets, as your item said, since 2015, the targets, as your item said, since 2015, the fundamentals of delivering against 2015, the fundamentals of delivering against those targets are about care, against those targets are about care, not against those targets are about care, not about the standards tell the targets themselves. So care, not about the standards tell the targets themselves. The targets themselves. So does chanauin the targets themselves. So does changing the the targets themselves. So does changing the targets the targets themselves. So does changing the targets and the targets themselves. So does changing the targets and methodology change diagnosis and Survival Rates . I think Survival Rates is probably a bit hopeful, but it should change some bit hopeful, but it should change some of bit hopeful, but it should change some of the incentives in hospitals to provide some of the incentives in hospitals to provide more meaningful care, so as your to provide more meaningful care, so as your item to provide more meaningful care, so as your item suggested, just prioritising an appointment on its own is prioritising an appointment on its own is not prioritising an appointment on its own is not so important, but prioritising whether someone gets told whether or not they have cancer is. ~. ,. ,. ,. , is. Eluned morgan, there are two thins is. Eluned morgan, there are two things here is. Eluned morgan, there are two things here. You is. Eluned morgan, there are two things here. You talked is. Eluned morgan, there are two things here. You talked about. Is. Eluned morgan, there are two things here. You talked about having one target after diagnosis, but to get to that diagnosis, you need to see your gp first and foremost. Isnt that the major problem . And its notjust isnt that the major problem . And its not just for wales. Isnt that the major problem . And its notjust for wales. The key thing is to get to see your gp, clear the backlog, but the trouble is, people cant get to see their gp. Primary care isnt being prioritised. Gp. Primary care isnt being rioritised. ~. ,. , prioritised. What we have done in wales has changed prioritised. What we have done in wales has changed the prioritised. What we have done in wales has changed the gp prioritised. What we have done in i wales has changed the gp contract. We have seen the akm bottleneck. So why are your waiting time is so long, then, if you are managing to get people to the Gps Quicklywhy are you Waiting Times and so long . If you Waiting Times and so long . If you look at our Waiting Times, the median in wales is 19 weeks, and the median in wales is 19 weeks, and the median in wales is 19 weeks, and the median in england is 1a weeks, so. So you are worse. Haste median in england is 14 weeks, so. So you are worse. So you are worse. We are not far behind england, so you are worse. We are not far behind england, but so you are worse. We are not far behind england, but certainly so you are worse. We are not far. Behind england, but certainly what we do in wales is prioritise the most urgent cases, and also it is probably worth emphasising that we count differently. We include diagnostics and therapies in our waiting list, unlike in england. Coming back to you, naseer, the amount of targets are changing down to three, but it is a reconfiguration rather than just chopping things are. But three weeks to see a consultant to form a weeks to see a consultant to form a weeks to get a result, whether that is a diagnosis are clear, surely that is better . This diagnosis are clear, surely that is better . � ,. , better . As i said, we are very sunportive better . As i said, we are very sunportive of better . As i said, we are very supportive of these better . As i said, we are very supportive of these changes, | better . As i said, we are very i supportive of these changes, but they dont supportive of these changes, but they dont change the underlying resources they dont change the underlying resources that are available to hospitals. 50 resources that are available to hositals. ,. , resources that are available to hosnitais resources that are available to hositals. I. ,. , hospitals. So if you were to change the underlying hospitals. So if you were to change the underlying resources hospitals. So if you were to change j the underlying resources available, how would you final that in . Realize how would you final that in . Really this takes long how would you final that in . Really this takes long term how would you final that in . Really this takes long term planning how would you final that in . Really this takes long term planning to i this takes long term planning to stop you this takes long term planning to stop you cant magic up highly skilled stop you cant magic up highly skilled clinicians overnight, and what skilled clinicians overnight, and what we skilled clinicians overnight, and what we really need is that long term Political Leadership that will bring long term Political Leadership that will bring us the resources we need in the will bring us the resources we need in the nhs will bring us the resources we need in the nhs. We mentioned those International Comparisons earlier, and actually, the difference in those and actually, the difference in those countries is that they do more diagnostics, those countries is that they do more diagnostics, they cast the net wider. Diagnostics, they cast the net wider, and that is how you find canter wider, and that is how you find cancer more easily. But it should be said, cancer more easily. But it should be said. With cancer more easily. But it should be said, with these targets, the same patients said, with these targets, the same patients that are tracked today will be tracked once these new standards are in be tracked once these new standards are in place. Be tracked once these new standards are in place, so its really important for people at home to realise important for people at home to realise that. But important for people at home to realise that. Important for people at home to realise that. �. ,. ,. ,. ,. , realise that. But do you also agree that art realise that. But do you also agree that part of realise that. But do you also agree that part of the realise that. But do you also agree that part of the problem realise that. But do you also agree that part of the problem is realise that. But do you also agree that part of the problem is primary care . ,. That part of the problem is primary care . , that part of the problem is primary care . , care . Primary care access has been under a lot care . Primary care access has been under a lot of care . Primary care access has been under a lot of strain, care . Primary care access has been under a lot of strain, and care . Primary care access has been under a lot of strain, and so under a lot of strain, and so definiteiy under a lot of strain, and so definitely there are pressures in primary definitely there are pressures in primary care, absolutely. Primary care, absolutely. Steve barcla , primary care, absolutely. Steve barclay, eluned primary care, absolutely. Steve barclay, eluned morgan, i primary care, absolutely. Steve i barclay, eluned morgan, launched primary care, absolutely. res barclay, eluned morgan, launched an attack on the Nhs In Scotland and wales today, saying that he could offer capacity because englands Waiting Times are shorter. Isnt that a good offer . If it Waiting Times are shorter. Isnt that a good offer . That a good offer . If it was an offer that that a good offer . If it was an offer that was that a good offer . If it was an offer that was free, that a good offer . If it was an offer that was free, i that a good offer . If it was an offer that was free, i would i offer that was free, i would certainly be taking up on it. Maybe it will be free. Certainly be taking up on it. Maybe it will be free. Sorry . Certainly be taking up on it. Maybe it will be free. Sorry . Maybe i certainly be taking up on it. Maybe it will be free. Sorry . Maybe it i it will be free. Sorry . Maybe it will be free. It will be free. Sorry . Maybe it will be free. I it will be free. Sorry . Maybe it will be free. I would it will be free. Sorry . Maybe it will be free. I would be it will be free. Sorry . Maybe it will be free. I would be very i will be free. I would be very surprised will be free. I would be very surprised. If will be free. I would be very surprised. If it will be free. I would be very surprised. If it is will be free. I would be very surprised. If it is free, i will be free. I would be very surprised. If it is free, iwill| surprised. If it is free, i will take him up on the offer. But ijust wonder where he will find the cap