Journalists can help improve quality of cancer services says UK Cancer Czar
By Peter McIntyre
The media plays a critical role in creating political momentum for change to improve health services,
the UK’s National Cancer Director, Mike Richards, has told a group of journalists from across Europe.
A combination of evidence-based statistics and human interest stories in 1999 triggered the then
Prime Minister, Tony Blair, to appoint Mike Richards as what the media quickly dubbed ‘the Cancer
Czar’ with a brief to improve mortality figures.
Mike Richards said that he personally would prefer not to be in public eye, but that media attention
was essential if things were going to change. “My appointment was greeted as good news for about
24 hours, and after that all the bad news stories came out about people not getting treatment and
about late diagnosis. We were deluged with bad news and I got experience very quickly in dealing
with the media.
“Let me be honest I have ambivalent feeling towards the media. I measure my success by how rarely
I have to do the [BBC Radio] Today programme. I don’t need the publicity - I am not trying to get
elected. But I know that we need those bad news stories. If all the journalists stopped criticising and
said cancer is wonderful, my ability to move things forward would be diminished.”
“If all the journalists stopped criticising and said cancer is wonderful,
my ability to move things forward would be diminished”
Mike Richards was speaking to broadcasting and print journalists at an “Off the Record” training
course Can Europe cope with the rising burden of cancer? organised by the European Broadcasting
Union and the European School of Oncology on 18 and 19 June 2012.
It attracted journalists from 16 European countries, many of which are facing problems with
healthcare because of severe austerity measures. Journalists from Romania told Mike Richards that
they found it hard to get politicians to listen, especially as they had gone through 30 different
Ministers of Health over the past 20 years. But he urged them not to give up.
“You would be surprised at how many do read your stories. I think we have a major problem of
changing perspectives and beliefs. You can influence the political system. It takes time. It took time
in the UK. Unless the politicians are presented with a problem they will leave it alone. They have lots
of other demands on their time and on resources.”
“It takes time. It took time in the UK. Unless the politicians are
presented with a problem they will leave it alone”
He said that the UK had been in denial about the poor state of cancer services, despite the mortality
figures for the UK being worse than other Western European countries. Even when the first
EUROCARE statistics showed mortality rates lagging behind “we dismissed them as unreliable and
the doctors said they cannot be true”.
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Things began to change as cancer experts, cancer charities and patient groups became concerned.
“Who was listening? Very importantly the media was listening and I am sure you all know that the
power of the individual story backed up by statistics is very powerful.”
He was at a meeting hosted by the health minister with women lobbying to get the drug Herceptin
approved for breast cancer treatment and whose campaign had received high profile media
coverage. One of the women told the minister that she was desperate for the drug and she had two
brothers who were prepared to sell their houses so she could buy it. The Minister asked one of the
other women about situation. She replied. “I am in exactly the same position but I don’t have any
brothers.” Shortly afterwards health commissioners were told that they should provide the drug at
public expense.
“What influenced Tony Blair over a period of three, four or five years was you, the journalists,
writing stories. The bad news was there and you could not ignore it, and journalism had a big part to
play.”
The UK has improved its record on cancer although it is still behind the leading countries. “What
changed is that it became a political issue,” Mike Richards said. “Perhaps the single most important
thing is building the community that says we must have better survival or outcomes for cancer. We
need to get clinicians, academics managers, civil service, patients, politicians and charities pulling
together.”
Now UK cancer services are to use the power of information to reduce an estimated 10,000 lives a
year that could be saved if people with cancer had earlier diagnosis and best practice treatment and
care. Public campaigns are being run to give greater recognition of symptoms of lung cancer and of
colorectal cancer, for which screening has also been introduced. Far too many patients arrive at
hospital as emergencies, he said, when their symptoms could have led to earlier investigations.
“Far too many patients arrive at hospital as emergencies, when their
symptoms could have led to earlier investigations”
The National Cancer Service is about to publish details of a survey of cancer patients’ experience of
their hospital treatment, and they are also piloting a survey of treatment centres to see which have
the best outcomes for bowel cancer surgery. Ultimately the aim is to link the patient experience to
outcome data and to persuade hospitals to take ownership of the patient stories.
“Some of our most famous teaching hospitals, where clinical outcome and survival are quite good,
have very poor patient experience. We want the best cancer intelligence system in the world
because we think this will drive improvements in outcomes. “
Mike Richards said he had drastically underestimated how long it would take to bring about change.
“I told Tony Blair I thought it would take five years. I was completely wrong, after ten years we have
still not got there. The job will never be finished and someone else may need to do it.”
But he said that multidisciplinary teams were now well accepted in the UK as the best way of
treating cancer and the risk of patients getting the wrong or bad treatment was now much lower. A
recent training programme to increase the number of surgeons who use laparoscopic (keyhole)
surgery to treat cancer patients was found to have paid for itself in reducing the complication rate.
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The focus is now on earlier diagnosis and on the quality of care after treatment for long-term
survivors.
Tit Albreht, from the Slovenian Institute of Public Health, led a working group to survey national
cancer plans across Europe, to be published later this year. He said that the media had a role to play
in removing an aura of shame that exists in some countries around cancer.
In Slovenia the media had helped to raise the response rate for colorectal cancer screening from
28% to 71%, so it is now amongst the best in Europe. In all, about 800 stories had been written and
he recalled one about a man who had delayed sending in his stool sample, but had then spoken out
after screening discovered cancerous polyps which were then removed.
In Slovenia the media had helped to raise the response rate for colorectal cancer screening
from 28% to 71%, so it is now amongst the best in Europe.
Olaf Steenfadt, project manager for the EBU, who chaired the sessions, asked whether the review of
cancer plans would recommend media strategies to be included. Tit Albreht told him, “We will
definitely work on it. It is not part of the current template, but it is extremely important.”
During the training event journalists received briefings from cancer experts about the latest statistics
and discussed ways in which they can broadcast and write more clearly about cancer prevention,
screening, treatment and the social issues that surround cancer.
Anna Wagstaff, assistant editor of the ESO journal, Cancer World, said, “Journalists have spoken
about the fatigue of only writing about individual cases and even getting involved in fundraising.”
She said that if journalists could highlight the need for a good cancer plan and policies it would
encourage young cancer doctors who were demoralised by spending cuts in lower income countries
to stay and work to improve services.
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