IS the Scottish Government making the progress it wants to on cancer care?

Last week saw the publication of its new 10-year strategy for cancer, but before we move on it is worth asking how much progress was actually made on the key objectives of its previous action plan, and how much the latest incarnation really shifts the dial.

More of the same?

The 'Beating Cancer: ambition and action' blueprint, published in 2016, was focused on improving prevention, survival, and diagnosis, and narrowing inequalities. Much of this is echoed by the new plan, which has set targets for 2033.

While five year survival has improved, but the pace of change has slowed. Between 1995/99 and 2005/09 there was a 9 per cent gain in survival rates, but this slowed to 6.1% over the most recent decade.

Five-year survival from colon cancer in Scotland actually dipped slightly, from 61.3% for those diagnosed between 2010-2014 to 59.8% for those diagnosed between 2015-19. Scotland is only now approaching where France was a decade ago for breast and cervical cancer survival (86% and 65% respectively).

It remains to be seen what the long-term impact of the pandemic will be.

When it comes to prevention, last week's strategy had little new to offer. The goal remains "healthier lifestyles": less smoking, alcohol and obesity.

Both the 2016 and 2023 plans envision that no more than 5% of adults in Scotland will be cigarette smokers by 2034. This looks to be on track (it fell from 17% in 2019 to 11% by 2021) and average alcohol consumption per head has also declined since 2016. Obesity, on the other hand, continues to rise with no immediate public health measures on the horizon to curb it.

Inequalities in incidence have widened: in 2016, people living in the most deprived communities in Scotland were 26% more likely to be diagnosed with cancer than the most affluent; by 2021 the difference was 30%.

As for diagnosis, fewer patients than ever are starting treatment with 62 days of an urgent referral with suspicion of cancer. The major bottleneck is timely access to scans and scopes. We simply do not have enough staff to cope with the number of referrals for tests.

How, not what


Cancer charities welcomed the new strategy's aims – particularly when it comes to reducing late-stage diagnoses, and placing a bigger emphasis on historically less-survivable cancers such as pancreatic and lung – but they cautioned that it must be backed up by adequate investment.

To sceptics, the strategy came with a long list of 'whats' and much less detail on the 'hows' of delivery.

One cancer sector professional, speaking anonymously, said the civil servants "did their best in the absence of clear political direction and vision from ministers".

They added: "I always got on well with Humza but struggled to understand exactly what he wanted to achieve and how we would get there. So the strategy covers lots of ground and says the right sort of things, but... the 'how' element is lacking.

"And in the current financial climate and with no real plan to address workforce shortages it's going to be hard."

The Herald:

Patients let down


The fragility of the workforce was highlighted by the plight of bowel cancer patients in Highland whose treatment has been plunged into chaos following the unexpectedly early departure of a specialist colorectal oncology consultant.

With the board unable to find a replacement – either permanent or locum – 78 patients from the Highland and Western Isles region have now had their chemotherapy suspended or delayed. It is unclear when it will resume, with the likeliest scenario being that patients will be sent to hospitals in other health board regions.

Grampian and Tayside have so far offered to take a "small proportion" of those affected, but other patients face travelling even further.

The looming crisis was flagged with ministers at the end of April, but it was June 5 before the Scottish Government...

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