- Email: [email protected]
UK government overhauls nationwide cancer health care
POLICY AND PEOPLE
UK government overhauls nationwide cancer health care Forman also noted that improved care by 2003/4 and said that “there is care needed to be seen alongside no greater priority for the National developments such as increases in Health Service than modernising canmanpower in several cer services”. specialties. Last The reforms were December, a study by broadly welcomed by the Royal College of cancer specialists and Physicians warned the medical charities government of this point although it has been and stressed the need suggested that peer for more medical oncolreview of cancer services ogists. could be seen by some Richard Sullivan, as interference. head of clinical proBut Prof David grammes for the Cancer Forman (Northern and Research Campaign said Yorkshire Cancer that “as we see it you are Registry, University of Reform is widespread going to have a dramatic Leeds) said: “without improvement in speed of referral and such review processes it is never really patients being brought in. But what’s possible to audit the care being progoing to happen is that a slow down is vided against external standards.” Prof going to occur because there are simMichael Coleman, Head of Cancer ply aren’t the people to deal with and Public Health Unit, London them”. School of Hygiene and Tropical The government also announced Medicine, agreed that monitoring was that the National Institute of Clinical crucial and that the new investment Excellence (NICE) would be assesswas long overdue. ing several new anti-cancer drugs this year. But Sullivan said that if NICE India amends regulations for sale of morphine did recommend particular drugs and India’s Health Ministry announced on Jan 18 that it has relaxed the law regarding “if these drugs are to be used in routhe sale of morphine tablets. Currently there are strict controls on the sale of the tine treatment then money must be drug. “Since morphine is a much needed drug for the care of terminally ill cancer made available from government”. patients, restrictions on its availability have proved a hindrance to providing them Altogether the government suggests relief”, said the Health Ministry. The revised provisions will make morphine tablets that it aims to save 10 000 per year by available from licensed hospitals, Regional Cancer Centres, and other such 2010. Although the statistic puzzled palliative-care centres that are approved by state governments. Morphine tablets Sullivan, he warned that “it is not simwill be purchased by these centres from a licensed manufacturer. To curb misuse, ply a numbers game you have to the new regulations stipulates that the drug should be kept under the custody of improve the basic standard of care the medical officer in charge of the centre “Morphine tablets are so cheap that before you can improve the mortality every cancer patient in India can afford it. But both doctors and patients need to rate and that takes time”. be educated”, comments M Krishnan Nair, director of the Regional Cancer Centre
he UK government launched national standards for cancer treatment on Jan 18. The standards are detailed in a 200-page manual for health professionals and provide guidance on how services and care should be delivered. With these guidelines in mind, hospital trusts will then develop action plans to make up for any shortfalls against the national standards. To ensure standards are being met, from April this year teams of cancer specialists will visit hospitals. The government also announced that the Cancer Collaboratives scheme—a pilot project in nine areas aiming to reduce waiting times for cancer diagnosis—will be expanded to the rest of the country and backed by an investment of £7·5 million. The UK has among the highest mortality rates for several major cancers compared with its European neighbours. In an attempt to reverse this situation the Health Secretary, Alan Milburn, promised an extra £570 million for nationwide cancer
T
in Thiruvananthapuram. Dinesh C Sharma Haroon Ashraf
Concern over psychiatric patients’ involvement in drug trials in Ireland sychiatric patients in Ireland have taken part in more than 50 clinical drug trials over the past 3 years according to the Department of Health. The data shows that more than 30 hospitals and psychiatric institutions have participated in clinical trials that involved people under care for psychiatric reasons. Most of the trials have taken place during the past 24 months with some hospitals participating in more than one trial. One hospital has taken part in seven trials since 1988 while another participated in six. The Minister for Health said stringent procedures are in place to govern clinical trials in institutions. The Irish Medicines Board has
P
THE LANCET • Vol 357 • January 27, 2001
written to all the pharmaceutical companies, asking for further details including information on how patients were recruited for the testing. The Irish Council for Civil Liberties said the use of psychiatric patients raised fundamental questions such as whether the people involved in the trials are capable of giving informed consent and whether the drugs being tested were for the good of the people participating in the clinical trial. It said other people can give consent on behalf of incapacitated patients only where the drug is life saving, or where it restores health, alleviates the condition, or relieves suffering. Opposition mental health
spokesman, Dan Neville, describes the information as alarming and says he wants the Minister to give full details on the clinical trials. “I am extremely concerned about the number of such trials. Patients suffering from psychiatric illness are very vulnerable and the institutions concerned must be extremely responsive to the trust placed on them by those who are ill, as well as their families”, he said. The authorities must make public the procedures used to obtain informed consent from the patients, the level of consultation with families, and the type of trials, he added. Karen Birchard
291
For personal use only. Reproduce with permission from The Lancet Publishing Group.
UK government overhauls nationwide cancer health care Forman also noted that improved care by 2003/4 and said that “there is care needed to be seen alongside no greater priority for the National developments such as increases in Health Service than modernising canmanpower in several cer services”. specialties. Last The reforms were December, a study by broadly welcomed by the Royal College of cancer specialists and Physicians warned the medical charities government of this point although it has been and stressed the need suggested that peer for more medical oncolreview of cancer services ogists. could be seen by some Richard Sullivan, as interference. head of clinical proBut Prof David grammes for the Cancer Forman (Northern and Research Campaign said Yorkshire Cancer that “as we see it you are Registry, University of Reform is widespread going to have a dramatic Leeds) said: “without improvement in speed of referral and such review processes it is never really patients being brought in. But what’s possible to audit the care being progoing to happen is that a slow down is vided against external standards.” Prof going to occur because there are simMichael Coleman, Head of Cancer ply aren’t the people to deal with and Public Health Unit, London them”. School of Hygiene and Tropical The government also announced Medicine, agreed that monitoring was that the National Institute of Clinical crucial and that the new investment Excellence (NICE) would be assesswas long overdue. ing several new anti-cancer drugs this year. But Sullivan said that if NICE India amends regulations for sale of morphine did recommend particular drugs and India’s Health Ministry announced on Jan 18 that it has relaxed the law regarding “if these drugs are to be used in routhe sale of morphine tablets. Currently there are strict controls on the sale of the tine treatment then money must be drug. “Since morphine is a much needed drug for the care of terminally ill cancer made available from government”. patients, restrictions on its availability have proved a hindrance to providing them Altogether the government suggests relief”, said the Health Ministry. The revised provisions will make morphine tablets that it aims to save 10 000 per year by available from licensed hospitals, Regional Cancer Centres, and other such 2010. Although the statistic puzzled palliative-care centres that are approved by state governments. Morphine tablets Sullivan, he warned that “it is not simwill be purchased by these centres from a licensed manufacturer. To curb misuse, ply a numbers game you have to the new regulations stipulates that the drug should be kept under the custody of improve the basic standard of care the medical officer in charge of the centre “Morphine tablets are so cheap that before you can improve the mortality every cancer patient in India can afford it. But both doctors and patients need to rate and that takes time”. be educated”, comments M Krishnan Nair, director of the Regional Cancer Centre
he UK government launched national standards for cancer treatment on Jan 18. The standards are detailed in a 200-page manual for health professionals and provide guidance on how services and care should be delivered. With these guidelines in mind, hospital trusts will then develop action plans to make up for any shortfalls against the national standards. To ensure standards are being met, from April this year teams of cancer specialists will visit hospitals. The government also announced that the Cancer Collaboratives scheme—a pilot project in nine areas aiming to reduce waiting times for cancer diagnosis—will be expanded to the rest of the country and backed by an investment of £7·5 million. The UK has among the highest mortality rates for several major cancers compared with its European neighbours. In an attempt to reverse this situation the Health Secretary, Alan Milburn, promised an extra £570 million for nationwide cancer
T
in Thiruvananthapuram. Dinesh C Sharma Haroon Ashraf
Concern over psychiatric patients’ involvement in drug trials in Ireland sychiatric patients in Ireland have taken part in more than 50 clinical drug trials over the past 3 years according to the Department of Health. The data shows that more than 30 hospitals and psychiatric institutions have participated in clinical trials that involved people under care for psychiatric reasons. Most of the trials have taken place during the past 24 months with some hospitals participating in more than one trial. One hospital has taken part in seven trials since 1988 while another participated in six. The Minister for Health said stringent procedures are in place to govern clinical trials in institutions. The Irish Medicines Board has
P
THE LANCET • Vol 357 • January 27, 2001
written to all the pharmaceutical companies, asking for further details including information on how patients were recruited for the testing. The Irish Council for Civil Liberties said the use of psychiatric patients raised fundamental questions such as whether the people involved in the trials are capable of giving informed consent and whether the drugs being tested were for the good of the people participating in the clinical trial. It said other people can give consent on behalf of incapacitated patients only where the drug is life saving, or where it restores health, alleviates the condition, or relieves suffering. Opposition mental health
spokesman, Dan Neville, describes the information as alarming and says he wants the Minister to give full details on the clinical trials. “I am extremely concerned about the number of such trials. Patients suffering from psychiatric illness are very vulnerable and the institutions concerned must be extremely responsive to the trust placed on them by those who are ill, as well as their families”, he said. The authorities must make public the procedures used to obtain informed consent from the patients, the level of consultation with families, and the type of trials, he added. Karen Birchard
291
For personal use only. Reproduce with permission from The Lancet Publishing Group.