Cancer patients are getting patchy access to a fund to provide expensive treatments on the NHS, casting doubt on a Conservative election pledge.
A total of £200 million has been promised from today to pay for drugs that are not routinely available, but a six-month trial of the scheme has spent only half its budget and treated fewer patients than experts predicted, The Times has learnt. Doctors have complained that it is confusing and bureaucratic and has perpetuated a “postcode lottery” of care.
The full Cancer Drugs Fund, much trumpeted by David Cameron during the election campaign, launches today. The pilot scheme has been available since October, with £50 million of funding. Of this, £23 million has so far been spent.
A late surge in applications took patient numbers to just over 2,000, still short of the 2,600 projected by the Rarer Cancers Foundation, which campaigns for greater access to drugs not approved by the National Institute for Health and Clinical Excellence (NICE). Despite government claims that the fund would provide patients with access to any treatment “which their doctors have recommended”, at least 150 applications for funding have been turned down.
Andrew Lansley, the Health Secretary, said: “The interim fund has already helped more than 2,000 cancer patients across England. We are confident that the Cancer Drugs Fund will, over the next three years, continue to meet this previously unmet need and improve the lives of many thousands more cancer sufferers.”
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The fund is designed to provide new treatments that can extend life by months or years but are considered too expensive by NICE, which assesses value for money for the NHS in England and Wales. Previously patients had to apply to local health authorities to receive these treatments as “an exceptional case”, meaning that those living in one area could be prescribed treatments not available elsewhere.
Far from addressing this problem, latest figures for the fund show there are huge regional variations in how the money is being spent. While the West Midlands region had spent 95 per cent of its £5.4 million by the start of March, South Central had spent £718,000, 17 per cent of its allocation. South East Coast had used 29 per cent of its £3.9 million.
Economists have questioned whether the fund is a good use of NHS money, warning that it will divert money from other services. The Government admitted this month that the bulk of the money was to come from existing local health authority budgets.
“I do feel bad that others will suffer because of this. We thought it was new money,” said Karol Sikora, a leading oncologist and former adviser to the World Health Organisation. He added that the fund was not working as it should, with the benefits going to the most determined claimants, with other deserving cases turned away.
“It’s very surprising [that the money has not been claimed] but it’s a very bureaucratic process for oncologists. The difficulty going forward is to make it a national fund, not a postcode lottery,” Professor Sikora said.
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Mike Hobday, head of policy at Macmillan Cancer Support, said he welcomed the scheme but that it was “very worrying” to see regional variations. “Clearly one of the main reasons for the Cancer Drugs Fund was to end the postcode lottery in access to drugs.”
The Department of Health said that demand varied across the country. “The vast majority of applications have been approved but every decision made through the interim cancer drugs fund is being made on a clinical basis.”