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16 February 2023

King's expert warns scrapping England's cancer plan will cost lives

Professor Richard Sullivan at the Institute of Cancer Policy writes in the BMJ today that the UK government’s proposal to roll England’s long-term plan for cancer into one strategy covering all major conditions is ‘a catastrophic decision that will cost lives’.

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Professor Sullivan, along with co-writer Ajay Aggarwal at the London School of Hygiene & Tropical Medicine says the decision “jettisons decades of global consensus that to deliver affordable, equitable and high-quality cancer care dedicated cancer plans are required.”

Cancer is the single largest cause of death in the UK and one of the most serious healthcare burdens for societies. The authors explain that the strategic direction and coordination of all cancer services requires both a cancer-specific plan and an array of operational tools to address issues of centralisation and variation in practise to avoid inequalities in access and outcomes. Cancer is also extremely costly for health systems, patients, and wider society.

They argue that the current plan to subsume England’s long-term plan for cancer into a generic chronic disease strategy “is totally inconsistent with internationally accepted benchmarks set by the World Health Organisation and followed by all other member states.”

They add that subsuming cancer into an overall non-communicable disease agenda “simply signals that cancer is no longer a political priority, or reflects a government not willing to deal with its complexity and escalating costs.”

A long-term plan for cancer is more critical than ever following over a decade of declining funding for cancer services compounded by the impact of the Covid-19 pandemic, they add. Such a plan needs to address the post-pandemic realities of backlogs for care: sicker patients with more advanced cancers, and huge deficits in cancer-specific workforce.

They note that national cancer audits in England and Wales report wide variation in access to the most effective cancer treatments and in quality of care.

“These quality gaps reflect systemic and structural issues across multiple and complex cancer pathways that can only be addressed by an evidence driven dedicated cancer control plan which considers the key determinants of cancer outcomes, in particular workforce, infrastructure, quality assurance and health service delivery,” they conclude.