Annex I
MACMILLAN CANCER RELIEF
1. BACKGROUND
1.1 Macmillan's over-riding purpose is to achieve
for everyone equal and ready access to the best information, treatment
and care for cancer, and to ensure that unnecessary levels of
fear are set aside. In pursuit of these objectives, we have recently
launched an initiative that we call "a voice for life",
which has three main aims:
1. To enable people with cancer to have more
of a voice in their own treatment and care, so that they are more
in control of what is happening to them.
2. To challenge public attitudes to cancer
and to counter the dark and fearful reputation it has acquired,
which causes unnecessary suffering to people who live with the
illness.
3. To increase the number of cancer experts
in the UK, so that everyone can have equal access to the best
information, treatment and care.
1.2 In working towards the achievement of
these aims, Macmillan promotes developments and improvements in
cancer care within the NHS. One of our major distinguishing features
is the close partnership we have forged with the NHS since the
appointment of the first Macmillan nurse in 1975. We currently
use a considerable proportion of our annual income—virtually
all of which is self-generated—in collaboration with the
NHS.
1.3 One of the ways we do this is by fully
funding nursing posts for an agreed period by arrangement with
NHS health providers—Trusts and authorities—on the
understanding that the relevant employing body will maintain the
post subsequently. We also fund a range of medical and academic
posts and certain posts in the social work field in the same way.
Most of the 70-plus capital projects which we have funded—both
new build and refurbishment—are part of the NHS building
stock and are planned in collaboration with the NHS Trust or authority
concerned. In addition, we make grants to patients with cancer
who are in financial need, to supplement whatever welfare benefits
they may be entitled to. We fund a range of other provision, among
them Macmillan Carer schemes and Macmillan information centres,
and we are concerned to raise standards generally by ensuring
that the public are made aware of the standards of cancer treatment
and care they can reasonably expect.
1.4 Since 1975 we estimate we have invested
well in excess of £200 million in the NHS, and have assisted
some four million people with cancer.
1.5 Macmillan has strongly and consistently
supported what have come to be known as the "Calman-Hine
proposals" for the re-structuring of the nation's cancer
services since they were first sent out for consultation in 1994.
We have dedicated ourselves to assisting their implementation
in whatever ways we can.
2. MACMILLAN
NURSES
There are over 1800 Macmillan nurses in post
within the NHS, of whom some 500 are currently being fully funded
by Macmillan. About half these nurses work in the community, and
about half in hospitals. We are increasingly funding Macmillan
specialist nursing posts in cancer and palliative care in such
fields as breast care, paediatrics, lymphoedema and genetics,
and in particular treatment specialisms such as chemotherapy and
radiotherapy. In 2000 we plan more than 100 more such posts.
3. MACMILLAN
MEDICAL POSTS
In the medical field we have established over
200 medical posts within hospitals and the community. These include
posts for senior doctors working full- and part-time at consultant
level, and for senior lecturers who combine clinical practice
with teaching within medical schools. In 2000 we are planning
more than 50 more such posts. In addition we fund training programmes
for other medical staff from senior registrar to junior hospital
doctor level. A programme of funding GP facilitator posts has
been launched; 25 such posts are already in place and more are
planned.
4. MACMILLAN
PATIENT GRANTS
In 2000 we expect to disburse more than £5
million in small grants to people with cancer who are in financial
need. Applications are made on behalf of patients by Macmillan
and other nurses, social workers and other professional field-workers.
Applications need to include a statement of household resources
based on savings/disposable income criteria, and a medical certificate.
5. MACMILLAN
SOCIAL WORK
SUPPORT
Macmillan are supporting the development of
palliative care into the social work profession by pump-priming
Macmillan social work lectureships in palliative care. Six such
lectureships are already in place (in the Universities of Southampton,
Hull, Reading, Plymouth, Middlesex, Cheltenham/Gloucester). A
number of social worker posts are also supported.
6. MACMILLAN
BUILDING PROJECTS
Macmillan has developed or helped to develop
more than 70 cancer care units. Past work included collaboration
with other voluntary bodies to construct hospices, but nowadays
our strategy is wherever possible to collaborate with the NHS
to build or refurbish units integral to NHS provision on hospital
sites and day centres. We currently have some 30 projects in progress
across the country in a programme running to about £6 million.
7. ASSOCIATED
CHARITIES
Macmillan grant-aids four associated charities,
taking a direct interest in their operations: the Breast Care
and Mastectomy Association, the National Association of Laryngectomee
Clubs, the British Colostomy Association and CancerLink (information
and support for people with cancer).
8. MACMILLAN
INITIATIVES
Macmillan sees innovation in the field of cancer
treatment, care and support as an integral aspect of its activities.
In 2000 we plan to spend some £2 million on expanding our
support for cancer information services within the NHS, for the
Macmillan Information Line (launched in December 1997) and the
Macmillan website (launched in December 1998); we are funding
two national Practice Development Units dedicated to improving
cancer and palliative care nursing through a practice-research
programme; we disseminate best cancer practice through the Macmillan
National Institute of Education sited in five universities (a
sixth site in Wales is planned for early 2000). Following a pilot
programme, we are planning to develop eight new Macmillan Carer
schemes designed to support cancer patients living at home with
the aim of allowing their discharge from hospital sooner, or delaying
their admission to hospital. In November 1999, as a practical
expression of our "a voice for life" initiative (see
para 1) we instituted the first-ever direct soliciting of cancer
patients' opinions through the national "Open Space"
initiative, the results of which are being analysed by the British
Market Research Bureau and will be available shortly. On 18 January
Yvette Cooper helped us launch the first-ever educational cancer
project for schools, for which Macmillan, in conjunction with
teachers and educational experts, produced educational packs for
primary and secondary schools intended to allow teachers to explore
the language of cancer with children as part of the national curriculum.
Macmillan Cancer
March 2000
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