Cancer care is in crisis say Doctors

THE government’s £2 billion scheme to revolutionise the treatment of British cancer sufferers has failed, with much of the money wasted on creating 400 bureaucrats.
A damning report by Britain’s biggest independent group of NHS doctors says many patients are waiting longer for treatment than they were when the programme was launched five years ago.
The proportion facing “appalling” delays for radiotherapy that could cure their cancer has doubled. Many new machines are waiting in boxes because of staff shortages.
The indictment by Doctors for Reform, a group of 900 NHS consultants and GPs, is a big blow for Alan Milburn, Labour’s election supremo, who launched the NHS cancer plan when he was health secretary. At a press conference last week Milburn said delivery of public services was at the heart of the party’s general election strategy.
The report — commissioned by the doctors’ group from three of Britain’s leading cancer experts — pins the blame on the failure to target money on frontline NHS staff. Instead, it says it has been spent on 400 “new, highly paid administrative” staff with no consequent “increase in clinical capacity”.
As a result, the study found:
# More than 70% of cancer patients are having to wait beyond the recommended maximum of four weeks for radiotherapy, compared with 32% five years previously.
# No improvement in waiting times from diagnosis to treatment for all the main cancers throughout 2002 and 2003 — and increased delays for urological and some gynaecological cancers.
# Huge delays in obtaining the scans and pathology tests needed to decide on the best treatment for a cancer victim.
# Patients continue to face a postcode lottery over the prescription of drugs despite an extra £124m to reduce those inequalities. For example, 5% of women with breast cancer in Derbyshire received the new drug Herceptin compared with 90% in Dorset.
# No national cancer information technology system: doctors continue to calculate doses of chemotherapy on paper where they are more likely to make potentially fatal errors than if done by computer. “If such a dangerous system existed for other procedures such as surgery. it would be regarded as completely unacceptable.”
# A projected shortfall of one third — 400 — in the number of key specialists required to analyse tissue to ensure patients get the right treatment.
Dr Maurice Slevin, one of the authors of the report, said: “Cancer care is in crisis but this is a solvable crisis if urgent and fundamental reform is introduced.”
In the past two years the Department of Health has made at least 20 announcements claiming big improvements in cancer care, citing an increase of nearly 1,200 cancer specialists and improvements in cancer survival rates.
However, the latest analysis estimates Britain still has one of the lowest survival rates in western Europe with only 36% of men likely to survive beyond five years compared with 55% in Austria, 50% in Sweden, 45% in France and Germany, and 44% in Spain. Currently more than 1m people are living with cancer in Britain. It has overtaken heart disease as the country’s biggest killer causing about 160,000 deaths a year.
John Reid, the health secretary, often quotes the statistic that more than 99% of patients are now seen by a specialist within two weeks of being referred by their GP but experts say it is the length of time until patients receive treatment that matters.
The report, published today by Reform, an independent think tank that helped set up Doctors for Reform last February, concludes: “The cancer plan is delivering poor value for money. It is simply not delivering as hoped and there are no reasons for expecting any dramatic improvements in the future. In the interests of patients we must look at ways of bringing about a rapid improvement in the situation.”
The study was by Professor Karol Sikora, a former chief of the World Health Organisation’s cancer programme, Nick Bosanquet, professor of health policy at Imperial College London, and Slevin, consultant oncologist at Barts and the London NHS Trust.
Doctors for Reform says progress has been held back by an NHS monopoly and wants 30% of cancer treatment to be handed to private companies over the next two years.
Mike Richards, the cancer czar, said waiting times for radiotherapy had risen as demand had increased sharply but added: “We have installed 40% more linear accelerators in the last five years and doubled the number of therapy radiographers in training.”