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Last Updated: Wednesday, 16 May 2007, 12:02 GMT 13:02 UK
Why France is so good at cancer care
By Fergus Walsh
BBC News, Medical correspondent

Edward Eden
Edward Eden is impressed by his care in France
How does NHS treatment for cancer patients measure up to that in France, where overall survival rates are higher?

France spends significantly more on healthcare than the UK and it does not have the same rationing of new expensive treatments.

The NHS has some of the finest cancer specialists in the world, and new techniques and treatments mean that survival rates are steadily improving.

And yet France does even better, with the best survival rates in Europe. So what are the differences between cancer care in the UK and France?

In part its down to speed of treatment.

The UK spends 8.3% of GDP on health, France 10.5% (OECD)
In 2000 the World Health Organization rated France the best country for health care in the world. The UK came 18th

The Centre René Gauducheau is a functional modern building on the outskirts of Nantes.

It is one of 20 specialist cancer centres in France and patients who come here know they are likely to get the best treatment.

Patients at the cancer centre don't need to worry that their radiotherapy may be delayed as can happen in Britain.

France simply has more radiotherapy machines - each costing up to £1 million.

Whereas the UK has 279 linear accelerators, France has 336 - 20% more for the same population

France also has more doctors - meaning faster access for patients.

The UK has 2.3 doctors for every 1,000 people. France has 3.4 - that's 50% more doctors.

Expensive drug

In the day care centre I met Edward Eden who retired to France from Scotland eight years ago.

The chemotherapy he is now receiving for prostate cancer was only approved for the NHS last year - long after it became widely used in France.

Dr Francois Pein
You are world-leaders in developing new cancer medicines, yet patients in France get the new drugs denied to your patients
Dr Francois Pein

Mr Eden is receiving Taxotere, which costs £8,000 for a course of treatment.

"The time it takes to see a doctor seems much quicker than the NHS," he said.

" From the moment I was diagnosed the treatment has been rapid and efficient - and no one has ever raised the subject of cost."

And that brings us to perhaps the starkest difference in treatment between France and the UK: access to new cancer medicines.

Research from the Karolinska Institute in Sweden published last week suggests the UK spends over £400 million a year on cancer drugs. France spends in excess of £900 million.

Dedicated funds

In France costly new cancer drugs are paid for out of a central budget.

The French government voted a few years ago that the raft of expensive new treatments should be ring-fenced so that hospitals did not have to choose between a cancer drug which extends life by a few months, and drugs for diabetes or heart disease.

Dr Francois Pein, the director of research at the Centre René Gauducheau believes there is a paradox about healthcare in Britain.

He said; "You are world-leaders in developing new cancer medicines, yet patients in France get the new drugs denied to your patients."

For example, we met Jean le Rouzo who has advanced bowel cancer and was receiving his latest infusion of Avastin. It costs £2,000 a month.

It is not available to NHS patients because the National Institute for Health and Clinical Excellence (NICE) which advises on new drugs says it is too expensive.

The drug prolongs life by around five months. In guidance published in January NICE said it was "not compatible with the best use of NHS resources".

By protecting the budget for new cancer drugs France has made a clear statement that cancer care is a priority above other health issues.

A raft of expensive new cancer drugs are on the horizon and these are likely to trigger a major debate in Britain what priority we should give to cancer.

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