Published: 08/01/2004, Volume II4, No. 5886 Page 9

National cancer director Professor Mike Richards has expressed concern over the health service's ability to meet waitingtime targets set for next year.

Speaking to an audience of cancer experts, he said: 'Achieving waiting-time targets between referral and treatment by 2005 remains a very considerable challenge - with diagnostic and radiotherapy services being particularly problematic.

'The very low baseline levels of staffing and facilities in these areas inevitably take time to put right, ' he added, emphasising the need for 'process redesign'.

Professor Richards added: 'There has been resistance to this concept on the grounds that it will not work for patients. But we now have ample evidence - for example, in radiology - that it does.'

His comments formed part of an acceptance lecture for the first Hambro Macmillan Fellowship last month, sponsored by Macmillan Cancer Relief deputy president Richard Hambro, awarded to 'individuals who have made an outstanding contribution to improving the lives of people affected by cancer'.

Professor Richards said that improving cancer care required interested bodies to listen to each other and provide better leadership. Barriers to progress on cancer outcomes in the past had included 'blindness, tunnel vision, arrogance, passivity, nihilism and tribalism'.

The Department of Health and the NHS, he said, 'can, I believe, help overcome blindness and tunnel vision by building on recent moves towards openness and transparency'. High-quality IT systems and comparative data were critical for this, he suggested.

Policy makers should improve their planning processes by better calculation of investment and workforce needs as well as improvement levers such as targets.

He also called on them to encourage patient-centred research.

Professor Richards said health professionals and managers needed professional body leadership to help them deliver when feeling so overburdened. But he said managers could also gain more from service and workforce redesign, while clinicians in particular needed training in leadership and teamwork.

'Service developers and service evaluators do not necessarily work as well as they might together...I think we could put these two together and when we do have something that is successful we could then roll it out much more quickly across the health service.'

The cancer community was also challenged by Prince Charles, who presented the fellowship award, to provide more 'holistic care' now demanded by patients.

Prince Charles said: 'An important part of this is encouraging access to complementary therapies, not just for those who can afford to pay. I was also pleased to see the beginnings of investment by the DoH in this field and it would of course be nice to see a bit more.'