Select Committee on Science and Technology Appendices to the Minutes of Evidence


Memorandum submitted by the Royal College of Physicians

  Progress has been slow in implementing the National Cancer Plan, largely for two reasons. The first is that National Cancer Plan money has not been ring-fenced and in some areas has been used to fund other cost pressures (eg junior hospital doctors pay etc). This has led to planned investment into workforce (oncologists, radiographers, physicists, chemotherapy nurses etc) and new anticancer drugs being deferred yet again (and further postcode lottery with respect to cancer services). The second reason is that previous healthcare reforms encouraged hospital trusts to act independently. Now the National Cancer Plan (correctly) wants hospital trusts within cancer networks to start working together and embarking on collaborative initiatives that will lead to more investment in one trust than another so that patients in the network benefit. It takes time to change philosophy in the NHS!

  A very great concern that is emerging is the impact on clinical cancer research introduced by NICE constraints on recommending funding of optimal anticancer drug treatments. As well as the risk that the UK is being relegated into the second division in terms of providing best care for its cancer patients, the future of first class clinical cancer research is threatened. If NICE do not approve a particular option (eg rituximab in non-Hodgkin's lymphoma, trastuzumab in breast cancer), then UK oncologists cannot undertake trials that will be meaningful in the international context. Cancer trials in the UK are highly respected and have frequently led the world in delineating cancer treatment options. There is now a real threat to clinical cancer research in the UK in relation to the rest of the world and this is occurring at the same time as the government is investing in cancer research networks.

  The issue of cancer registration is an important one in relation to patient confidentiality, as recognised by many. It is in the process of being resolved but I do not know sufficient detail.

  The National Cancer Research Network is now in the process of being established. It has a Co-ordinating Centre in Leeds and the first wave of nine (of a total of 34) cancer research networks have received funding to be set up. An initial disappointment was that only £100K per million population has been given to these networks in the current financial year. This will not matter as long as the full £200K per million is allocated in the year 2002-03. There are some teething problems as trusts learn that this new and welcome funding is for the network rather than individual trusts and hence allocation of funding is by need and performance in recruiting patients to clinical trials rather than by trust size. The National Cancer Research Network is a greatly appreciated boost to clinical cancer research, largely as a consequence of the ring-fenced nature of the funding and the much needed increase in the workforce infrastructure for such research. It can keep the UK at the forefront of increasingly competitive international cancer research but it needs sensible and helpful cooperation from NICE to do so (see comments above).

  The National Translational Cancer Research Network is in the process of being set up and would-be participants are currently involved in a competitive bidding process, the outcome of which will be known in the relatively near future.

Professor Ian Gilmore


6 December 2001

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