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Last Updated: Thursday, 22 May, 2003, 14:22 GMT 15:22 UK
Huge variations in cancer care
Woman being screened for breast cancer
Ministers have pledged to improve NHS cancer services
Millions of pounds earmarked for cancer services has not been reaching patients, a government report suggests.

Professor Mike Richards, the government's cancer tsar, has identified huge variations in the amount of money being spent on cancer care across England.

It shows that in some areas, cancer centres have received less than 60% of the money earmarked to pay for better services.

The report also shows that government efforts to improve cancer care got off to a very slow start.

Cancer reforms

Ministers announced plans in September 2000 to boost cancer care and to spend millions more on improving services.

However, Professor Richards has found that 80m earmarked to pay for improvements in the first year of the plan may have been spent elsewhere.

Worst affected areas
West London
South East London
Surrey, West Sussex & Hampshire

His report does not say where the money was spent. But Professor Richards has suggested NHS trusts may have used it to fund other services.

The Department of Health said cancer spending is now back on track and that the initial shortfall has been rectified.

However, the figures show that in some areas the money is still not getting through.

In parts of London and the South-East, less than 60% of the new money had been spent on cancer services by April 2003.

Professor Richards acknowledged that funding cancer services has not been a priority in some parts of England.

In a letter to ministers, which accompanies the report, he said: "It is clear that a few health communities with financial difficulties have not given investment in cancer services the priority that the Cancer Plan anticipated."

Services 'improving'

Professor Richards said that improvements have been seen in areas where the money has got through.

"There is encouraging evidence that where the funding is getting through, it is starting to make a real difference.

Where the funding is getting through, it is starting to make a real difference
Professor Mike Richards

"However, we have much more to do to extend the benefits of increase investment across the full spectrum of cancer services."

He highlighted low levels of spending on services for patients terminally ill with cancer.

"The survey bears out our earlier concerns that investment in palliative care has been moving very slowly," he said.

Professor Richards suggested more needs to be done to cut waiting times for treatment.

"Although we have made a good start, we still have a long way to go. We still have work to do to reduce waiting times from referral to treatment, particularly the waits for imaging, endoscopy and radiotherapy."

He added: "We urgently need more doctors, nurses, radiographers, biomedical scientists and administrative support staff."

Ministers asked Professor Richards, in January, to carry out an audit of cancer spending over the past two years.

It followed claims from doctors that they were not seeing promised extra funds.

The report was published as ministers announced an extra 165m to pay for new cancer diagnostic and treatment equipment.

It will pay for the replacement of all MRI scanners, CT scanners and linear accelerators in use in the NHS before 1997.


Cancer Research UK welcomed Professor Richards' report. Its medical director Dr John Toy said he was worried about variations in cancer funding.

"The significant shortfall in year one funding meant networks were having to play catch-up in year two," he said.

Not all patients are benefiting equally from the Cancer Plan cash
Dr John Toy, Cancer Research UK

"Cancer Research UK is particularly worried that the figures show wide variations across the country.

"Not all patients are benefiting equally from the Cancer Plan cash where you live really does influence the standard of treatment and care you receive."

Joanne Rule, chief executive of CancerBACUP, said: "It's extraordinary that the funding isn't tracked as a matter of course so that the public can have confidence that the money is spent on the services for which it's intended."

Peter Cardy, chief executive of Macmillan Cancer Relief, urged the government to keep track of money earmarked for cancer.

"This tracking exercise happened for one reason: charities and MPs asked why cancer money wasn't getting spent where it's meant."

Delyth Morgan, chief executive of Breakthrough Breast Cancer, said: "It confirms what we expected - that new investment was slow to get through.

"We are concerned that in some areas less than 60 % of new funds have got through to the cancer networks."

Shadow Health Secretary Dr Liam Fox said: "At least the government has finally come clean. But why should anyone believe that this latest promise will actually lead to money reaching the patients?

"What is it going to take to convince ministers that their insistence on micromanaging the NHS damages patient care? "Politicians need to stop interfering in the running of the NHS. Professionals must be given the freedom to practice what they were trained to do."

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