Cancer postcode lottery- London patients get three times more funding than those in Leicester

The full extent of Britain’s postcode lottery in cancer care has been laid bare by research showing some health trusts are spending three times as much per patient as others.

Huge variations in funding mean that cancer sufferers’ chances of being given life-extending drugs, surgery, and specialist care vary wildly from one part of the country to another.

While the average amount spent on a cancer sufferer in some parts of London is almost £15,000 a year, in Leicestershire it is less than £5,000.

Cancer experts said the research, carried out by The Sunday Telegraph, exposed a “grotesque lottery” in which life-and-death decisions were routinely being made by bureaucrats who were “unelected, unaccountable and unqualified” to make the rulings.

The figures obtained by the paper give the most detailed picture so far of the postcode lottery in cancer care.

Data from 150 Primary Care Trusts for 2007/2008 detailing cancer funding was divided by separate NHS records showing the number of cancer sufferers in each area.

Average spending was highest in Tower Hamlets, in East London, where cancer patients were allotted £14,697 for the year.

Those living in the cities of Birmingham, Leeds and Manchester all received average funding of at least £12,500.

Spending was lowest in Leicestershire and Rutland, with just £4,989 allotted to the average patient; about £500 more was spent in Harrow, North London, Hampshire, Northumberland and North Yorkshire.

Last year a study of patients with advanced cancer showed a tripling in the life-expectancy of those given drugs which many PCTs refuse to pay for.

Research on patients treated by University Hospitals Birmingham Foundation Trust compared the fate of 40 given the drugs Sutent and Nexavar for kidney cancer with 40 whose requests for funding were denied.

Those given the drugs survived 22 months, while those denied them lived just seven months, the study found.

Prof Nick James, director of research and development at University Hospital Birmingham, said: “A lot of PCTs are severely restricting access to drugs which can make a substantial difference to survival”.

While PCTs across Birmingham had agreed to fund many drugs for cancer patients living within their borders, those living further afield could only secure the same treatment if they won lengthy battles with bureaucracy, Dr James said.

The oncologist and professor of oncology at the University of Birmingham added: “Clinicians and patients in some areas are forced to battle continuously with bodies which are unelected, unaccountable and unqualified”.

He said that patients and doctors wasted “hundreds of hours” drafting appeals, writing to MPs and campaigning in the local media in an attempt to be heard by PCTs who often failed to even reply to correspondence.

The research found that PCTs across the country spent an average of £7,807 on cancer patients per year.

Jonathan Waxman, professor of oncology at Imperial College London, accused the labour Government of devising a “grotesque lottery” of local decision-making by PCTs in order to duck the blame for difficult decisions.

He said: “It is an absolutely absurd system, which is exposed by this excellent investigation. These discrepancies in funding are the reason people die.

“Why should how you are treated depend on where you live, and on decisions made by 150 different organisations who don’t have specialist knowledge of the patient?”

The study found the gulf between funding allocated in different parts of the country was growing.

Figures analysing spending per head of population showed the highest spending in Leeds, at £157 per head, compared with just £48 per head in the London boroughs of Camden and Newham.

The gap between the PCTs spending the most and those spending the least per head of population (weighted to take account of the health of the local population) increased from £70 to £109 between 2006/2007 and 2007/2008.

Cancer charities expressed alarm at the extent of the differences revealed by the research.

Sarah Woolnough, head of policy at Cancer Research UK, which raises funds to find treatments for cancer, said: “These huge variations in how much PCTs spend are worrying. We urge the Government to ensure that all PCTs deliver an efficient and high quality service for cancer patients in the face of predicted NHS cutbacks”.

Mike Hobday, from Macmillan Cancer Support, said: ” We know there are some PCTs which say yes to everything, and others which almost always say no, and that is something that we are concerned about.

“Some variation is to be expected, and in fact is necessary to meet the needs of particular populations, but it is really important that those commissioning services examine these findings closely”.

Dr Peter Marks, director of public health at NHS Leicestershire County and Rutland, said its local death rates for cancer were significantly lower than in the rest of England, while survival rates for specific cancers were similar, and in some cases better, to those elsewhere.

Shadow Health Secretary Andrew Lansley described the findings as “extremely concerning”.

He said: “Britain languishes near the bottom of the table in Europe when it comes to five year cancer survival rates. It’s clear that ministers’ promises to improve access to cancer drugs and treatments are ringing hollow for many vulnerable patients.”


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