Most primary care trusts are failing to assess whether the cancer treatments they commission offer value for money, according to MPs.

A report by the public accounts committee found only 22 per cent of PCTs had examined their providers’ cancer services on value for money grounds, while 12 per cent had no plans to do so.

The inquiry into the Department of Health’s five year cancer reform strategy found most PCTs did not link cost and activity data to rates of incidence, prevalence and survival.

Spending on cancer services varied from £55-£154 per head, the committee found, and 54 per cent of this variation could not be explained.

Despite value for money being one focus of the strategy, only around half of PCTs had identified where spending of no benefit to the patient could be cut, and four fifths could not demonstrate efficiency gains.

The committee said it was “surprised” that value was not a higher priority for commissioners.

The report, Delivering the Cancer Reform Strategy, concluded the DH and the NHS Commissioning Board should establish clear standards requiring consortia to demonstrate how they will ensure value for money.

The DH should set out how it will measure improvements and what incentives and penalties will be put in place, it said.

Chair Margaret Hodge acknowledged mortality rates were falling but said survival rates were still poor compared with the best in Europe.

She said: “That is generally a sign of low awareness of symptoms, among the public and GPs, and late diagnosis.”

She identified “unexplained wide variations” in performance and available treatment.

The National Audit Office found the DH spent £6.3bn on cancer services in 2008-09.

The DH published its updated strategy Improving Outcomes in January.