Editorial: The fundamentals​ of how the NHS is run and provided are at the core of the cancer treatment problem

Cancer outcomes in the United Kingdom lag behind countries that have dedicated plans to tackle the disease, a new report claims.

In a commentary piece, in the journal Lancet Oncology, experts argue that cancer waiting lists are “still the worst they have ever been”. A new cancer plan should be a “key priority” for the government, the academics said.

The latest figures for the NHS in England show that 76.3% of patients in England urgently referred for suspected cancer in June were diagnosed or had cancer ruled out within 28 days – above target. The data relates to England but is alarming for Northern Ireland, because in health indicators such as waiting lists things are worse here than Great Britain.

There is though a common thread with regard to the NHS problems across the UK. There has been a lack of reality about what is feasible in a health service where everything is free, and where the hospital system has for a long time been hobbled by an infrastructure that was designed for the 19th century, and in which there is a public and political refusal to countenance reform, such as closing some units to consolidate and improve others.

There is no acceptance of the idea that over consultation of GPs, via free appointments, might be adding to the crisis. That perfect, limitless health care will be a struggle in a time of rising life expectancy, and so that some aspects of non urgent care might have to come out of the free NHS There is also a lower preventative health strategy than is seen in some other countries (matching which will take cultural change).

Like our broken, disgraceful, lottery system of residential care for the elderly, the problems in the NHS are not even being debated honestly, let alone addressed. As this report says, we need consistent cancer plans, as you get in France. But even before that we need to address core problems in the health service, and our expectations of it.