Press Notice No. 20 of Session 2005-06, dated 26 January 2006
TWENTIETH REPORT: THE NHS CANCER PLAN: A PROGRESS REPORT (HC 791)
Mr Edward Leigh MP, Chairman of the Committee of Public Accounts, said today:
"The picture is mixed at this halfway point in the 10 year course of the Cancer Plan. The NHS has met a number of important targets and there has been significant progress in improving cancer services and in making NICE approved cancer drugs more available. More money is getting through to the front line of cancer services.
"But there are areas where progress has not been impressive. We are still waiting for a full national programme to educate people about the signs of cancer. We have yet to know if the targets for cutting waiting times for diagnosis and treatment by the end of 2005 have been met. There are still stark inequalities in cancer death rates around the country and inequalities in the availability of the most effective cancer drugs.
"Many cancer networks, particularly in more deprived areas, are failing to address these problems. It is hard to believe that nearly a third of the networks visited by the NAO had no comprehensive plans for providing cancer services in their locality. But that was what they were set up to do. Their effectiveness needs to be monitored closely and, where necessary, improved. And the Cancer Plan must be comprehensively updated with fresh targets and complete clarity about whether they are being met."
Mr Leigh was speaking as the Committee published its 20th Report of this Session, which examined three main issues: improving the provision of cancer services in England; making cancer networks work; and addressing inequalities.
Cancer services are a major priority for the NHS. Although death rates from the disease have been falling, more than one in three people develop cancer at some point in their life. The 10 year NHS Cancer Plan published in 2000 built on existing cancer initiatives, to provide a comprehensive strategy to tackle cancer across the whole patient pathway. It established 34 cancer networks in England, to lead the improvement of cancer services in each locality.
Progress against the targets and commitments in the Plan has been encouraging, though with slippage in meeting some target dates, such as for raising public awareness of the signs and symptoms of cancer. Targets relating to waiting times, to be met by the end of 2005 will prove challenging, as will the target for 800,000 smokers to quit for at least 4 weeks between 2003-04 and 2005-06. Increased funding for cancer services is getting through to the front line and being spent directly to fund new drugs, staffing and new services, though some key staff positions remain vacant.
Cancer networks have introduced a new way of approaching the delivery of cancer services, involving several organisations, including the Strategic Health Authorities, acute and primary care trusts, the voluntary sector and local authorities, with significant successes in terms of better local cancer services, use of new drugs and funding for palliative care. But in some network localities, commissioning of cancer services is not sufficiently joined-up, and relationships between constituent organisations can be difficult. Some lack comprehensive plans to implement the Cancer Plan and monitoring of progress is inconsistent.
There are clear disparities between the affluent and poorer members of society in terms of cancer outcomes, with higher mortality rates in deprived areas and survival rates which consistently favour London and the south. There is also wide geographical variation in the use of NICE approved cancer drugs across the country, including those for breast cancer. With some networks being less effective than others there is a risk that less affluent parts of the country may lose out.
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