Postcode Lottery? You bet!

Thought some of you might be interested in taking a look at the recent report on NHS spending by the King’s Fund.
(Google: “King’s Fund + NHS spending local variations in priorities”)

As we are all aware cancer services vary wildly around the country. In black and white it is unsettling. As of 2006 Knowsley PCT spent £152 per head on cancer whereas Bedfordshire spent £44.

In the grand scheme of things cancer plays third fiddle - mental health dominates all PCT spending, circulatory disease comes next with cancer getting just 6% of the total kitty.

But what is very intersting (I think) about this report is that it highlights how flexible spending can be and therefore how unreliable provision can be.
In 2004/5 Camden PCT spent more on cancer than any other PCT.
The following year they were 140th out of 152 for cancer spending.

Where does that leave us as “NHS customers.”?

Cancer spend (per head)

Knowsley £118
Bournemouth/Poole £116
Nottingham £116
Wakefield £116
Trafford £115

Ealing £47
Westminster £48
Newham £49
Kensington/Chelsea £50
Southwark £51

If you want to find out your PCT spend go to and then Click Here For Full Tables which downloads as a MS word file.

Doesn’t surprise me - I live in Newham, it has one of the worst death rates from cancer in the country. I wonder why


Shropshire is £92 which seems about average.It is interesting to note that despite the higher spend the death rate is higher in the north.

Anyone know if there are equivelant tables available for Scotland?

Interesting the bottom five are all London boroughs, including Kensington & Chelsea PCT which has loads of (very) wealthy bits in its area. Maybe the gentry don’t show up on the stats as NHS consumers. Knowsley, on the other hand, was listed a few years ago as England’s poorest borough, and for all I know still is. Newham is definitely not a wealthy area, as Mole will confirm. So perhaps there’s a correlation between per capita income and NHS spend.

Or perhaps Boris needs a bit of a kicking…

Does anyone know just what is included in this per capita spending figure?

I think you have to consider ethnicity here to be fair…please don’t think I am being discriminating. Not all nationalities are as cancer aware as others. Some women would not dream of presenting with a suspected cancer to a GP for various diferent reasons, and therefore cancer would be the cause of death (for example) but not always presented.

I agree it is a great deal to do with PCT’s but these facts have to be taken into consideration too.

I live fairly close to Newham, and work with people who were previously employed by their PCT and it definitely needs a dam good shake up, that’s for sure.

What the figures reveal is how the individual PCTs decide to divvy up their budget.
I think the Camden statistic is extraordinary. In just one year their cancer funding went from the highest in the land to the 140th!
Unless miraculously the London Borough of Camden suddenly found itself cancer free then that drop off in per capita spending must have impacted negatively on cancer service provision.

I have thought about one reason Newham may have low relative spend. The population in newham is highest in younger age bands, cancer is most common over 50. A lot of white people moved eastwards out of the borough a long time ago so by and large most are not going to be in the right age group to be at most risk of cancer.

Mind you, survival rates in poor areas are worse than in rich ones so really they should be spending more relatively speaking. And as someone said they need to make sure people from ethnic minorities are clued up about cancer, where I live white people are in the minority so maybe I should say black ethnic majorities need to have much more focus on their needs re cancer


I distrust bald statistics.

However, looking at the full table, it does say that these figures have been adjusted for age, demographic, etc.

Furthermore, I imagine that a relatively low spend does not necessarily translate into worse service. If that per head figure includes something like admin staff costs, it may perhaps reflect that some authorities are simply better organised, less wasteful, expect their staff to work harder than others and drive closer bargains with their suppliers…I guess what I am trying to say is - it might not only be how much they are spending, but how well they are spending it.

Just a thought


It must also depend on what the PCT sees as the borough’s most pressing needs - I see that the top 10 for spending in mental health are London boroughs (if you count West Essex as London).
I find that relatively heartening - I don’t want to start a “who’s worst off” war here, but raising money for cancer charities is a doddle compared to trying to get money into mental health. So some of this may well reflect the fact that there are fewer resources available outside the NHS to help patients with other diseases. (I suspect I will need to retire to a bunker after this statement - but where’s the Pink October for autism or dementia?)



I agree Lyn about financial provision for other problems.

The life limiting element of cancer is problematic because cost-effective investment is often measured by mortality stats which I think distorts the issue.
Especially as people are living longer with cancer.

Hi Lyn

I’m in the bunker with you. Absolutely agree. Breast cancer is protrayed as ‘sexy’…mental health and autism…oh no…

best wishes


I have just got back from N.I.C.E. question time they are much better than politicians they did not answer any questions.We could not do them for misrepresentation as it was called question time!
One remark they did make was if you cannot get access to a cancer drug to write to your M.P.

Love Debsxxx