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If England’s cancer care was as good as the best in Europe 10 000 deaths would be avoided

BMJ 2010; 341 doi: (Published 09 December 2010) Cite this as: BMJ 2010;341:c7098
  1. Adrian O’Dowd
  1. 1London

Around 10 000 people with cancer who die in England each year could survive if they lived in the “best” European country, officials from the Department of Health have admitted.

Officials giving evidence to MPs on the parliamentary public accounts committee on 7 December said that despite progress in improving cancer services in recent years, England still lagged behind some European countries.

The committee was holding an evidence session as part of its inquiry into the National Audit Office report Delivering the Cancer Reform Strategy, published in November.

That report studied how cancer services have changed in England since the Department of Health’s The NHS Cancer Plan was published in 2000 and then refreshed with the five year Cancer Reform Strategy of 2007.

Committee member Steve Barclay, Conservative MP for north east Cambridgeshire, asked: “If we were to look across cancers as a whole, how many avoidable deaths are there this year from cancer in this country if we compare ourselves to the European best?”

Mike Richards, national clinical director for cancer and end of life care, giving evidence, said: “Overall if you put all cancers together, there are around 10 000 avoidable deaths per annum.”

The “best” country was defined by countries whose data was reliable and by taking the average of the top three countries’ performance.

“If we brought ourselves up to that standard, we would save 10 000 lives a year,” said Professor Richards.

MPs asked why this was the case given that the UK’s spending on cancer was at the average European level.

“It is extremely difficult to compare expenditure for cancer between countries,” said Professor Richards. “We have narrowed the gap in terms of expenditure on health as a whole and we know, broadly speaking, that our expenditure on cancer has gone up in line with our expenditure on health.”

He said the department had not done enough on raising the public’s awareness of cancer and added: “We are about to do a whole lot more. We will be doing more in the new year at a local level with over 100 of the 152 primary care trusts and we will also be doing a pilot of a regional awareness campaign in two regions. If that is successful, we would want to go ahead and do national campaigns.”

MPs asked why there was such variation in the use of chemotherapy for cancer in different areas of the country—from 5% to 36% of cases—as identified in the National Audit Office report.

Professor Richards said this was an example of poor recording of data.

“I think this is a coding problem and this highlights the need for better information. We will work with those PCTs [primary care trusts] that are identified from this to see what the problem is in recording,” he said.

David Flory, deputy NHS chief executive, also giving evidence, said the new GP led commissioning consortium that will control most of the NHS budget from 2013 would deal with the issue of better data collection for cancer services and treatment.

“GP consortiums are now beginning to set themselves up and operate in shadow form,” said Mr Flory. “They are not going to wait around until the PCTs have gone in 2013 before taking on their commissioning roles and responsibilities.”


Cite this as: BMJ 2010;341:c7098

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