Blair's war on cancer is a sham, say top doctors

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The Independent Online
SENIOR CANCER doctors have warned the Government that its high- profile plans to tackle Britain's cancer survival record - one of the worst in Europe - will make no difference to recovery rates and could even put lives at risk.

They say the "two-week promise" to get cancer patients into clinics within 14 days of diagnosis is driven by political expediency rather than clinical need.

Richard Sainsbury, acknowledged as a leading authority on breast cancer, told the Independent on Sunday that there is "no evidence" that the policy is working and suggested it was introduced for political reasons. "It wasn't introduced because it makes a difference," he said.

His attack comes as cancer specialists admit they routinely lie about the quality of drugs they can offer to patients.

Last week a conference attended by one third of Britain's oncologists provoked uproar when as many as one in 10 said they had difficulty prescribing the latest drugs, and that patients were not kept informed.

One consultant from the North-west said: "It's frustrating to know that drugs were there that the patient should be having and we can't prescribe them. I hate lying to patients. The underfunding of radiotherapy in the UK is a scandal that the public only becomes aware of when they experience cancer. It's costing lives and costing untold suffering."

Dr Sainsbury said the national approach to cancer had become skewed by ministers' "two-week promise".

"I think more important than the two-week rule is to see the establishment of teams available to discuss the management of these patients," he said. That way the most urgent cases would be treated quickly and the system would not get clogged up with people who did not need cancer care.

Experts estimate that around half the referrals made by GPs turn out not to be cancer while last year about 40 per cent of cancers were not referred urgently, despite the two-week rule.

Dr Sainsbury said: "There are ladies with breast cancer who are not referred urgently. They are being delayed by the two-week rule which is being abused because there are people who come to their GP and are anxious. They will end up being fast-tracked into our clinics."

Under the rule, which surgeons believe was introduced at the behest of the Downing Street Policy Unit, GPs who suspect someone has cancer have to refer that patient within 24 hours. Specialists then have 14 days in which to see them.

MPs on the Commons science and technology select committee are so concerned at the situation they are set to visit the US and Canada in the New Year to investigate why cancer survival rates are so much better.

Britain's spending on cancer is considerably lower than the spending of other countries. The NHS spent just 95p per head of population on chemotherapy in 1997. In Germany the figure was six time higher at pounds 6.24. In France, survival rates for ovarian cancer are 40 per cent, compared with 25 per cent in Britain.

Private health companies have further highlighted the gap that now exists between treatments for cancer available on the NHS and that through private medical insurance by confirming that they impose no cap on the amount that of money that can be spent on each patient for drugs. This means that powerful new anti-cancer drugs, such as Taxol, which is used to treat ovarian cancer and can cost pounds 9,000 per patient, will be available.

The private medical insurer PPP Healthcare often deals with claims of pounds 50,000 per patient for cancer treatment. "People are waiting unduly long periods in the NHS," said Dr Adrian Bull, a spokesman for PPP Healthcare.

Private insurers insist the only treatments they will not fund are experimental drugs that have not been subjected to extensive peer review and trials.

The Cancer Research Campaign called for the Government to own up to rationing so that it could be done in an "accessible, transparent and well-informed" manner. "I don't think one should lie to your patients as they need to know the facts," said David Secher, the CRC's director of drug development.

"If people find out about this sort of thing it will shake their confidence," he said. "Researchers like us feel demotivated when we find we have a drug that is better for the patient because so often the local health authority makes an arbitrary decision not to use it, and the patient is denied the treatment."

The Tory health spokesman, Dr Liam Fox, said of the two-week rule: "Because it treats everybody with one type of cancer exactly the same, it will mean a lot of people who are not urgent have to be seen in the same time- scale and offers the distinct possibility that people with serious cases may be missed."

`NHS didn't fund drug'


Lesley Martin, a 50-year-old school inspector, was diagnosed with breast cancer in 1998. She has just won a battle to receive an expensive drug after a charity agreed to meet the pounds 12,000 cost.

"I WORK in the education service so I guess I'm used to asking questions. I was lucky in having a specialist who was open and I am in debt to her. It appals me that some people are not being told the truth.

"I was diagnosed in February 1998 and underwent surgery to remove the tumour. A year later the cancer re-occurred in my lymph glands. There were two drug options; Docetaxel or another drug. The specialist was honest that the Docetaxel would likely be the most effective, but Avon Health Authority did not fund the drug. The irony was that I had just moved house from an area which did fund Docetaxel.

"I had colleagues with homes in Somerset and it would have been easy to acquire an address there. But this was my second diagnosis and I didn't want to waste any more time changing specialists. Luckily I was accepted by the charity and started treatment. My latest scan shows the tumour is shrinking."

`I cover up inadequacies as a matter of routine'


A top cancer specialist at a large teaching hospital, who asked to remain anonymous, says inadequacies in the NHS are routinely covered up.

"AT TIMES we have to, I would not say lie, but cover up the inadequacies of the system. For example, patients come to me with a diagnosis and I tell them `You need a scan, but we can't do that for four to six weeks'. I say it's important that we get everything prepared first, but the real reason is that we don't have the budget to staff the equipment outside nine-to-five hours.

"It's the same with drugs. For example, a patient who has chemotherapy will be started on a simple anti-sickness regime. On the standard drugs a percentage of patients will be sick, but we wait until they actually are before we move them on to the more expensive drugs. We should have given them in the first place.

"The Government has said that colorectal, lung and breast cancer are a priority, but where are they going to divert resources from? The fear is it will be from lesser-known cancers such as gynaecological or heart and neck cancers, which also have devastating effects on sufferers. But the Government doesn't seem to think this is so important.

"We spend only 95p a head on cancer drugs in this country and drug companies are moving out because they do not see a future here. That has big implications for us clinicians. For example, if you want to experiment using one of the drugs on a different type of cancer - in the past the company may have given you the drug for research or provide it at a cut-rate price. If we don't get this cash, we are never going to be at the cutting edge.

"Drug companies also provide educational grants to go overseas - if we want to be innovative and know what is going on out there we have to mix with our colleagues from Europe and the States.

"I went to a North American hospital last year who said they would be very keen if I ever wanted to go over there. I must admit, it is a very attractive prospect as they have infinitely more resources there.

"So why is Britain so low down in the survival list? Part of the problem is that when people are diagnosed they aren't sent to the right specialist in the first place. I see patients who haven't been sent up to me until there is a real problem and I think, why didn't I see them two years ago?"