Scotland’s Cancer Strategy: an ambitious plan that’s good news for patients

Cancer is a big issue in Scotland, and the statistics are striking. Last year the disease became Scotland’s biggest killer. More than 80 people are diagnosed every day. And survival still lags behind the rest of the UK, and some of our European neighbours.

Tackling this won’t be easy. And it needs serious investment.

So, for over two years, we’ve been watching closely and campaigning for the Scottish Government to produce a plan that will help prioritise the nation’s efforts in tackling cancer. And today in Edinburgh, alongside our Scotland vs Cancer campaign event, that plan has been unveiled. Scotland now has a new Cancer Strategy.

We think strategies like this are vital. They help set priorities, and lay out where money should go to help the NHS work as best it can for its patients.

But it’s no great secret that, when it comes to financing healthcare, all UK nations are facing tough times. On top of this, they are under unprecedented pressure to manage demands that will only get more challenging if trends in health (such as an aging population and more expensive treatments) continue.

In short, asking for more money is tough, but has never been more urgent.

So today’s headline announcement – of £100m over the next term of the Scottish Parliament – is very welcome news.

And, as we’ll explore below, this investment is being placed in some key areas we’ve been pushing for the last few years.

Preventing cancer

As the old adage goes, prevention is better than cure, and across Scotland there’s a glaring need to reduce the number of patients who need NHS treatment for conditions that could have been prevented.

Our figures show that four in 10 cases of cancer fall into this bracket. And the Scottish Government may, rightly, point to two landmark public health measures that we think will make a difference.

The first was an early and strong commitment to plain, standardised tobacco packaging – something that’s vital to help Scotland achieve its target for becoming ‘tobacco-free’ – and something very few countries have yet committed to. (But was there, perhaps, a missed opportunity to commit to update this excellent 2034 target in the new cancer strategy, rather than merely reiterate intentions to follow it?)

The second involves the ongoing and significant legal battle to introduce minimum unit pricing for alcohol.

And while there are no similar big prevention issues tackled in the plan, we do welcome the commitment to review the 2009 ‘route map’ Preventing Obesity and Overweight in Scotland, and we’ll be looking for strong action within that. There are also plans to look at some radical new proposals on obesity outlined in the recent board meeting of Food Standards Scotland (such as action on price, promotions, labelling and taxation).

Overall, we hope that more can be done to help prevent people in Scotland developing cancer in future.

Early diagnosis

We were eager to see a continuation of Scotland’s Detect Cancer Early programme, and we’re really pleased to see the strategy includes a commitment to do so.

In line with calls from our Scotland vs Cancer election campaign, the strategy features a £2 million per year diagnostics fund, and plans to buy some 2,000 new endoscopes to help ease the pressure that the country’s diagnostic services are under.

A commitment to a 40 per cent increase in the number of nurses capable of managing this service also suggests there are good intentions to make sure the investment has the impact that’s desperately needed.

The plan also featured two partnerships with Cancer Research UK. The first continues work with our growing health professional engagement programme, expanding it across Scotland to help support and advise GP practices on increasing early detection, and helping those who want to take part in screening to do so.

And “the wee c” partnership, aimed at tackling fatalistic attitudes to cancer, will also see continued support in highlighting the positive stories of treatable cancers when detected early.

Improving treatment

…Over the next parliament we will invest an extra £50 million in radiotherapy services – it will buy new, state of the art equipment and employ an additional 100 radiotherapy specialists to work in our cancer centres

– Nicola Sturgeon MSP, 12 March 2016

In her speech at the SNP conference last weekend, First Minister Nicola Sturgeon announced an intention to ensure advanced radiotherapy techniques are available for all patients who would benefit – a big commitment, which we have been pushing for recently. This is also included in the strategy, and is great news.

Scotland already has world-class radiotherapy machinery, and the £50 million commitment to keep this up-to-date and, crucially, ensure there is money to invest in the highly skilled professionals needed to operate the technology is also very good news.

We highly commend the Scottish Government for such a strong commitment to radiotherapy. And we look forward to seeing more patients treated with these machines, and a reduction in side effects as treatment becomes far more targeted.

There was also £7.5 million of new money committed to surgery. But the full details on where this will be spent – and what the targets are – remain to be seen.

While surgery and radiotherapy are crucial ways of treating and, for many, curing cancer, drugs also play an important role in cancer treatment.

But finding ways of paying for the latest cancer drugs – and ensuring those who need them can get them – is a big challenge, and not just for Scotland.

Finding a sustainable funding solution for cancer drugs must be a priority. But there was no clear outline in the strategy for how Scotland will approach this, and we would have welcomed that being part of the plan.

There was, however, £1 million of funding announced for assessing how these medicines work in the patients that are given them on the NHS in Scotland, rather than in trials that companies present to the Scottish Medicines Consortium. This could form one part of addressing the challenges around drug costs, and it may prove helpful in making sure the harms and benefits of cancer medicines are properly balanced, and the NHS is getting the best value for money.

So we’ll be keeping a close eye on how these plans develop.

Broader issues

Inequality is a big problem in Scotland. There are strong links between socioeconomic deprivation and the number of people diagnosed with and dying of cancer. So £5 million of new money targeted at this issue is welcome, and we’ll be looking for more detail on exactly how this will be spent, and with what aims.

Research remains at the heart of all progress in cancer, so must remain priority. Commitment to continue our ECMC partnership in Edinburgh and Glasgow is therefore welcome.

The plan also acknowledged the importance of good data, which effectively tells us what works and what doesn’t. Scotland can produce good data, but too often it appears years after what’s being measured happened. Early work is underway to dramatically speed up this processing while linking it with other information about cancer in Scotland. This is good news, and £2 million of investment committed in the plan should help.

A really positive step

With 50 actions listed, some noble ambitions and lots of new money, we see this as a strong plan that will impact on cancer survival in Scotland.

The next challenge will be to make sure the clearest commitments are met, and carried out carefully and on budget.

But as we’ve mentioned above, some points are vaguer than others. And it’s important that the sentiments behind these are not lost. We look forward to working with the Scottish Government on the prevention agenda particularly, where more action should be defined for the next term.

Now the plan is in place, we will work hard to both support and challenge the next Scottish Government in sticking to these plans.

This is a really positive step, and we relish the challenge to help make it happen.

Gregor McNie is a senior public affairs manager at Cancer Research UK