Clinicians are to be given the power to say how a multi-million pound investment should be spent to change Scottish cancer services, under plans launched by health minister Susan Deacon.
Although health boards will still remain the budget-holders, they will be expected to pay more attention to the views of clinicians, other health workers and patient groups when deciding how the money should be used and services redesigned.
Ms Deacon announced the changes last week when she launched Scotland's cancer strategy, Cancer in Scotland: action for change.
She also announced an investment of£40m to form a dedicated fund to support the strategy, on top of some£100m already committed to cancerspecific projects.
The strategy will be spearheaded by a beefed-up Scottish Cancer Group, which will be reconfigured to involve more patient and voluntary-sector representatives.
The group will be headed by Dr Anna Gregor, an Edinburgh oncologist who will become lead cancer clinician for Scotland.
Three strengthened regional cancer advisory groups will also be created. These will work with the new unified health boards to decide how services should be run.
Dr Mac Armstrong, the new chief medical officer for Scotland, is believed to have convinced the minister to take a 'leap of faith' and hand more power to the clinicians.
Dr Gregor said it was an opportunity which would also bring challenges. 'I am pleased that the minister has trusted us, but I am sure it will also come with strings attached, ' she said.
'There are barriers to change in cancer services, although they are more flexible than some other parts of the health service. We have to change organisational and professional culture.
'The fundamental key to this is to focus on the role of the patient, not organisational traditions and professional interests. We must take the lottery and the hassle out of cancer care for patients.'
The Scottish cancer strategy is less target-heavy than the English plan, which was announced last year. Many aspects of the English plan, including workforce and equipment issues, have already been addressed in Scotland over the past two years.
Dr Armstrong said it was not about taking control away from managers, who would still be accountable under the new performance assessment framework.
But they would be expected to demonstrate that they had listened to the regional cancer advisory groups.
Cancer in Scotland: action for change.
www. scotland. gov. uk