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The prime minister and health secretary have criticised the NHS on cancer, but new figures suggest the service is a world leader

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Denis Campbell, health correspondent
guardian.co.uk, Monday 7 November 2011 18.48 GMT
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Andrew Lansley and David Cameron, who have used criticisms of the NHS record on cancer to justify a planned shakeup. Photograph: Dan Kitwood/PA
David Cameron and Andrew Lansley’s repeated criticisms of the NHS’s record on cancer have been contradicted by new research that shows the health service to be an international leader in tackling the disease.

The findings challenge the government’s claims that NHS failings on cancer contribute to 5,000-10,000 unnecessary cancer deaths a year, which ministers have used as a key reason for pushing through their radical shakeup of the service.

In fact, the NHS in England and Wales has helped achieve the biggest drop in cancer deaths and displayed the most efficient use of resources among 10 leading countries worldwide, according to the study published in the British Journal of Cancer.

“These results challenge the feeble justification of the government’s changes, which appear to be based upon overhyped media representation, rather than hard comparable evidence. This paper should be a real boost to cancer patients and their families because the NHS’s performance on cancer is much better than the media presents. It challenges the government’s assertion that the NHS is inefficient and ineffective at treating cancer – an argument for reforming the NHS,” said Prof Colin Pritchard, a health academic at Bournemouth University.

He co-wrote the research with Dr Tamas Hickish, a consultant medical oncologist at Poole and Royal Bournemouth and Christchurch hospitals in Dorset.

The research shows that ministers have misrepresented the NHS’s record on cancer in order to gain support for their unpopular shakeup, said Pritchard.

The prime minister and the health secretary have said that both survival and death rates from the disease in Britain are low by international standards. Cameron, for example, claimed during last year’s general election campaign that Britain had a higher rate of cancer deaths than Bulgaria.

The authors studied cancer mortality and the amount of GDP spent on healthcare between 1979 and 2006 in England and Wales and nine other countries, including Germany, the US, Spain, Japan and France.

While cancer deaths fell everywhere, England and Wales saw the biggest drop in mortality among males aged 15-74 – down 31%. While six countries saw falls of at least 20%, England and Wales – which in 1979-81 had the third highest rate with 4,156 deaths per million men – improved the most, achieving the fifth lowest rate among the 10 countries by 2004-06 with 2,869 deaths per million. Among men aged 55-64 and 65-74, who are more likely to get cancer, mortality dropped by 35% and 28%.

While mortality among women the same age declined by less, at 19%, that was the third biggest improvement after Japan (23%) and Germany (20%).

And the NHS was the most efficient of the 10 countries at reducing cancer mortality ratios once the proportions of GDP spent on healthcare were compared, the study found. While England and Wales spent less on health than most others, they achieved the biggest overall annual fall in cancer mortality over the 27-year period, of 900 deaths per million. Once average GDP spending on healthcare was compared, the NHS saw the biggest fall in male and female cancer deaths of an extra 119 lives a year per 1% of GDP spent, ahead of the Netherlands (74) and almost double that in Germany (68), France (67) and Japan (60).

“That shows how good England and Wales are on cancer care, relative to spend. We do significantly more with proportionately less. It means that 34,484 people are alive today that wouldn’t have been if things had not improved since 1980,” said Pritchard.

Two authoritative studies have concluded that cancer survival rates in the UK have lagged behind those in comparable major developed countries, though experts dispute which indicators give the most accurate picture of Britain’s cancer performance. For example, Prof John Appleby, chief economist at the King’s Fund health thinktank, published research in the British Medical Journal earlier this year which disputed the portrayal of Britain as “the sick man of Europe” and argued that cancer survival rates had been improving, significantly in the case of breast cancer.

Duleep Allirajah, policy manager at Macmillan Cancer Support, said: “In the past 10 years cancer services in the UK have improved dramatically. Waiting times have decreased and services have been modernised.” But, with cancer survival improving, the NHS now has to address new challenges, notably improving care for patients who have undergone treatment.

“Far too many people in the UK still experience sometimes serious problems related to their cancer treatment. For many these can persist up to 10 years after treatment. The focus now must be for the government and the NHS to address the issues of aftercare and making sure cancer is treated as a long term condition,” said Allirajah.

Pritchard said: “David Cameron and Andrew Lansley are happier with NHS ‘bad news’ stories rather than, as our research shows, that we should celebrate the NHS which, in monetary terms, is vastly superior to the private healthcare system of the USA.

“Of course we should always be looking to improve. But the only way to judge the NHS is to compare it with other countries, which shows that we are still getting the NHS on the comparative cheap.”

The Department of Health declined to respond directly to Pritchard and Hickish’s findings. “There is a difference between achieving efficiency and the results patients receive. While it is good that NHS cancer treatment is relatively efficient, we know that the results patients actually get lag behind many other countries,” said a spokesman.

“Our cancer strategy is clear – we aim to save 5,000 lives extra every year by 2015 which will bring us up to the level achieved in many other comparable countries. We owe it to patients to deliver standards which are up there with the best in the world,” he added.

http://www.guardian.co.uk/society/2011/nov/07/nhs-cancer-figures-cameron-lansley

TUC PensionsWatch shows top pensions rise along with big jump in FTSE chiefs’ pay as real wages for workers decline

The directors of the largest 100 British companies are in line for average annual pension payments of £224,000 each, according to a survey today.

The report shows 362 top directors have built up final salary pensions worth £568m and the average pension pot transfer value is at a record high – £3.91m compared with £3.8m last year. Directors also retire earlier than their staff. The most common age is 60, while for ordinary scheme members it is 65 and expected to rise.

The highest earning pensioner among current FTSE 100 directors will be the former chief executive of oil group Royal Dutch Shell, who is entitled to £1.2m a year from his company scheme. Jeroen van der Veer, who stepped down from the top job in 2009 but remains on the board, has amassed a pension pot worth £21.6m, the TUC has revealed in its 9th annual PensionsWatch report.

Just before his retirement, Van der Veer declared that pay had little impact on performance, saying: “If I had been paid 50% more, I would not have done it better. If I had been paid 50% less then I would not have done it worse.”

The details of FTSE directors’ pensions comes days after another survey showed that chief executives at the top 100 companies saw pay and bonus packages jump by an average of £1.3m to almost £4.5m last year, the biggest leap in nine years.

According to a study commissioned by the High Pay Commission, the average pay deal for a FTSE 100 boss soared from £3.09m to £4.45m as business leaders were able to enjoy record windfalls from share-based incentive schemes, thanks to a sharp bounce in the stock market.

The benefits reaped from the stock market bubble by FTSE 100 executives have not been mirrored on the shop floor. Annual wage rises stood at 2.2% for the final three months of 2010. Factoring in the rising cost of living – the retail price index stood at 4.8% last December – that means most workers in Britain saw a significant decline in their real incomes.

The TUC survey shows a growing number of bosses receive cash instead of, or in addition to, company pension scheme contributions. Pearson’s long-standing chief executive, Marjorie Scardino, banked the largest cash payment, of £620,700 – nearly 76% of her salary – while Peter Clarke, chief executive of hedge fund Man Group, pocketed £532,000 – 94% of his salary.

Stephen Hester, chief executive of state-controlled Royal Bank of Scotland, received the third largest cash payment, collecting £420,000, or 35% of his salary.

Companies with defined contribution schemes – less advantageous than the final salary schemes gradually being phased out – make much larger contributions to directors’ pensions as a proportion of salary than they do for the average employee.

Directors surveyed enjoyed average company contributions of 22% of their salaries. The average for all employees is 6.7%, while many companies set default contributions even lower, at 3%, according to the Association of Consulting Actuaries.

TUC general secretary Brendan Barber said: “This survey highlights the real pension scandal in Britain today. Public sector workers are rightly furious about being told that their pensions of just a few thousand pounds are ‘gold-plated’ and unaffordable by the same business leaders who stay silent on the multimillion-pound pensions that many enjoy themselves.”

Barber added: “It’s hardly a surprise that these lavish rewards are signed off when directors sit on each other’s company remuneration committees. This culture of mutual backslapping must be tackled by giving ordinary staff members a voice on remuneration committees.”

Barber called on the government to force companies to disclose directors’ pension arrangements so that they could be scrutinised by staff and shareholders.

With more directors opting for cash payments, the TUC says pensions secrecy is increasing. In some cases, retirement cash is listed under other “emoluments”, making such payments harder to detect. “This may result in the number of directors being covered in any review of executive retirement provision shrinking,” according to the report.

Directors still receive 23 times more than the average worker, a figure which has stayed fairly constant since the survey began in 2003. Members of company and public sector schemes receive an average annual pot of £9,568, while the average public sector pension is £6,497.

Darren Philp, policy director for the National Association of Pension Funds, said: “More transparency is needed around boardroom pensions. It is also worrying that directors’ pensions are not usually linked to performance. This could mean bosses are rewarded in their retirement despite failure in the job. Pensions must not become a back-door to boosting pay.”

http://www.guardian.co.uk/business/2011/sep/07/ftse-directors-pensions-worth-millions