Care trust defends cancer policy

Cancer drugs are not always accessible to patients

An East Midlands health trust has defended its system to decide who gets treatment for rare forms of cancers after criticism from a patient group.

The Rarer Cancers Forum said dozens of patients across the UK were missing out because of a postcode lottery.

Derby City Primary Care Trust said it used a fair system involving clinicians to decide who had treatment, and spent millions of pounds.

The Rarer Cancers Forum said the PCT rejected more than 80% of applications.

The trust refused 12 out of 15 applications for treatment of rare cancers, while at Derbyshire County PCT, 37 of 83 applications were turned down.

The people making decisions here are not faceless bureaucrats Dr Andrew Wakeman

Dr Andrew Wakeman, director of public health from Derby City Primary Care Trust, said the PCT had invested a higher level of funding for cancer treatment than similar PCTs and the England average - spending £20m in 2006/07.

"We do have to make hard decisions. The people making decisions here are not faceless bureaucrats," Dr Wakeman said.

"It is heavily clinically led involving both doctors and nurses."

Dr Chris Packham, director of public health for Nottingham City Primary Care Trust, where all seven applications for rare cancer treatment were turned down, said the refusals represented less than 1% of the total cancer treatment cases since October 2006.

Rarer Cancers Forum spokeswoman Penny Wilson-Webb said it was vital more clinicians were involved in making the life-changing decisions.

"In many PCTs, no clinicians are involved whatsoever in the decision-making."

PCTs are not forced to fund treatments which have not yet been appraised by the National Institute for Health and Clinical Excellence (Nice), or which are not being appraised.

A cancer may be classed as "rarer" either because it affects an unusual part of the body, or because the cancer itself is of an unusual type, is difficult to diagnose, or requires special treatment.