Committee of Public Accounts


Press Notice No. 19 of Session 2005-06, dated 12 January 2006


NINETEENTH REPORT: DEPARTMENT OF HEALTH: TACKLING CANCER: IMPROVING THE PATIENT JOURNEY (HC 790)

Mr Edward Leigh MP, Chairman of the Committee of Public Accounts, said today:

"Cancer patients are being looked after better than they were five years ago and generally well.  I congratulate the NHS for that. But the experience of cancer sufferers is not as good as it could be. Too many are waiting too long to see a specialist following referral by a GP. Clinicians are often failing to provide patients with vital information they need about their condition. And prostate cancer, which kills some 10,000 men a year, is regarded as a lower priority than other common cancers when it comes to the provision of specialist care. The inequitable treatment of this group of NHS patients is entirely unacceptable."

"The system also lets down those in their last days. Four out of five cancer patients would prefer to die at home or hospice but half of those will die in hospital. The NHS must do more to respect cancer patients' wishes. In addition, the benefit system needs to be more effective in providing financial support for cancer patients."

"Terminally ill patients are eligible for financial help but over three quarters of cancer patients are not told this. This is scandalous. Cancer patients are missing out on an estimated £200 million a year. Not all people will wish to claim, but some - simply through lack of knowledge - will not be getting the financial support that is so important to them and their family to make their last days more bearable."

Mr Leigh was speaking as the Committee published its 19th Report of this Session, which examined the experience of patients who are diagnosed with cancer: their access to NHS specialist care and diagnosis, the support offered to them during and after treatment and the variations in their experiences.

In 1999-2000 the Department of Heath surveyed 65,000 cancer patients across all NHS Trusts in England. The Department identified areas for improvement, but found generally high levels of patient satisfaction in most areas, including dignity, privacy and respect. When published in 2002, the survey provided a baseline against which to measure changes in cancer patient experiences. Since this survey was carried out, additional funding of more than £1 billion has been provided for cancer services and the Department of Health and the NHS have introduced a range of measures to improve access.

To gauge progress made in the four years since the introduction of the Cancer Plan, the National Audit Office carried out a national follow up survey of cancer patients in early 2004 involving 4,300 patients in 49 NHS Trusts with the four commonest cancers: breast, lung, bowel and prostate cancer. Overall, patients were broadly positive about their experiences; some progress had been made in most aspects of the patient experience since 2000, though less so for prostate cancer patients. In addition, both prostate cancer patients and cancer patients in London as a whole reported a worse experience than other cancer patients.

Other elements of the patient experience where improvement is still needed, regardless of cancer type, include communicating information well, good symptom relief and providing options for some patients in their last days. In addition, terminally ill cancer patients were often not made aware of non means tested disability benefits that they could have claimed to alleviate financial hardship, estimated by Macmillan Cancer Relief at over £100 million in a six month period.

The main focus for the Department and local cancer networks over the past four years has been to publish good practice treatment guidance and to improve cancer supportive and palliative care in line with the National Institute for Clinical Excellence guidance. Hospice services and palliative care have received additional funding since 2003-04, though patients who wished to die at home or in a hospice were still more likely to die in hospital.


Click here to view Report