Cancer services lottery scandal needs addressing

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Macmillan Cancer Support is right to focus attention on socio-economic deprivation and its impact on cancer patients, their families and carers (“Warning over inequalities among cancer patients”, your report, 2 November).

As Macmillan points out, such patients may well have a poorer prognosis and for many reasons, not least that they are more likely to develop cancers with inherently worse prognoses such as lung, oesophageal, pancreatic and gastric cancers. Prognosis also depends on prompt presentation to the GP with symptoms and then fast access to modern diagnostic and treatment services. Such ideal management should not but may be less for those from more deprived groups. Across Scotland we could do much better in all of this. 

At least we have five major regional cancer centres to deliver radiotherapy and chemotherapy. Soon, thanks to pressure from the services based on evidence gathered during successive Scottish administrations and analysed by clinicians, statisticians and the excellent teams in the cancer section at St Andrew’s House, there will be a satellite radiotherapy centre at Monklands Hospital in Lanarkshire, serving an area of significant deprivation. It, like the other five centres, will, again thanks to all administrations since 2000, have the most modern radiotherapy equipment available and it is to be hoped that it will be fully used unlike, I gather, currently in some centres in Scotland where staffing and other issues mean that not all Scottish patients receive the best and most up-to-date of treatments. 

In my view this is a scandal and needs addressed in the new cancer plan for Scotland. Macmillan makes a sound case for the plan to address issues of inequality and deprivation but even if all such critical matters were addressed, there are many other current concerns that must be taken into account, including understaffing, staff recruitment and retention, leadership, national arrangements for certain cancer types that overrule personal fiefdoms and political interests and much more. Perhaps it will also take a long-term view and consider, as our population grows, satellite centres in Fife, Forth Valley and Ayrshire – but only if the staffing, strategy and the great need for vision are addressed. It is sad but hardly a surprise that after eight years with total power over health and, hence, cancer services, the current government is only now thinking which way to go to improve a service and its still poor results.

(Dr) Alan Rodger

Clairmont Gardens, Glasgow

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