Health Secretary Andrew Lansley's planned NHS reforms represent a missed opportunity for cancer care, mainly because they do not build upon the success of the cancer networks, a new report warns. 

The government's proposals do not go far enough in improving treatment for cancer patients, and may even jeopardise the progress made over the past decade, according to the study, which is produced by health policy think tank 2020Health. 

Cancer networks, through which a patient's treatment and care are managed through a joined-up approach, are acknowledged as having improved cancer treatment in the UK, but there is growing concern that the government's new commissioning structure could undo the progress made so far, the report claims.

The UK still has one of the worst cancer survival rates among member countries of the Organisation for Economic Cooperation and Development (OECD). Despite spending £5.8 billion on cancer care, Britain offers poor survival rates compared to Europe, Canada, Australia and many Scandinavian countries, it says.

The study also claims that the government's proposals ignore feedback from health experts, who are calling for greater patient involvement in the design and management of their care.

"It's only fair for patients to play a more active role in shaping the direction of their health care," says Gail Beer, consultant director at 2020Health, and she goes on to criticise the mindset of providers of cancer care.

"Worryingly, the proposals do not change that the commissioning of cancer services is still based on targets and not outcomes. Targets on computer spreadsheets are meaningless to patients - what matters to cancer sufferers and their families is the outcome. What is right for one patient may be wholly inappropriate for another. The NHS needs to finally shake off its 'one size fits all' approach to healthcare," she says.

Ms Beer praises the progress that has been made in the treatment of the "big four" cancers - breast, colon, lung and prostate - over the last five years, and the report argues that these improvements are "directly attributable" to the introduction of cancer networks. However, it adds, this progress risks being undermined.

Cancer networks were introduced in 2000 to encourage the providers and commissioners of cancer care to work together to deliver quality, personalised services to patients, and Mr Lansley's reforms are a missed opportunity, principally because they do not build on the networks' success, according to Ms Beer.

"If the cancer networks are to be dismantled as a result of the latest reforms, the British public must be assured that their replacement is capable of delivering patient-focused improvements in cancer care. Mr Lansley's report offers little assurance that this will be the case," she says.

2020Health says that its research has revealed an "urgent demand" from health professionals for greater accountability in cancer care. It is essential for this to be "robust" in order to implement change at all levels of care, from planning and commissioning and into delivery, they say.

"Strengthen the mechanisms of accountability and we will improve how we plan and manage cancer care - failure to do so will impact directly on cancer sufferers," Ms Beer warns. 

She also emphasises that leadership will be "crucial" in navigating the way forward. "Cancer care cannot be reformed without engagement from clinicians at all levels and clarity about what needs to happen," she says, adding: "this is something the government must address as a matter of urgency - with cancer care, the stakes are very high indeed."