Leading article: The price of a healthier country

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The Independent Online

A diagnosis of cancer is traumatic. Speedy test results, a sympathetic doctor and rapid access to treatment all help to alleviate the anxiety. But one of the most persistent complaints among patients, with cancer and with other long-term conditions, is the ever changing panoply of health care staff. Labour's proposal to introduce dedicated cancer nurse specialists to provide one-to-one care for cancer sufferers at home, announced by Gordon Brown in a speech to the King's Fund yesterday, was instantly dismissed by Liberal Democrat health spokesman, Norman Lamb, as a "desperate, pre-election bribe".

But it will be welcomed by patients. The more difficult question, posed by Andrew Lansley, Tory health spokesman, is how it will be paid for. The NHS budget will come under unprecedented pressure after 2011. The Department of Health has nevertheless found £20m in 2011-12 to be put towards extra nurses. According to Mr Lansley, this is enough for 476 nurses (at an annual cost of £42,000 each) which is equivalent to an extra 31 minutes per patient per year. The health department says it also plans to assess "different models of one-to-one support" to identify the "most cost effective approach." On these figures, it will have to.

The King's Fund raised a further caveat. Even if the funds are available, are there nurses of the right calibre available to fill the extra posts? The real challenge, it rightly says, will be finding, training and employing sufficient community nurses.

The proposals are part of a larger, decades old, project to shift care out of hospital into the community. Labour says such a move could save the NHS £2.7bn. Governments have looked longingly at similar proposals in the past, and their associated savings, without coming close to realising them. Communities establish bonds of affection with their local hospital and are not content to see the bricks and mortar replaced with virtual networks of staff running mobile clinics in GP surgeries and sending front line workers into patients' homes.

Labour's plans are ambitious, popular and would improve cancer patients' quality of life. But as the election approaches we must beware empty promises that have little hope of realisation.

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