Adopt a national cancer strategy and save 423,000 lives over the next 30 years. It seems almost too good to be true. And if something seems too good to be true, it often is.
The strategy announced by Prime Minister Stephen Harper last week certainly sounds impressive. Mr. Harper cited an estimate from unnamed "experts" that 423,000 lives will be saved by 2036 with an initial expenditure of just $260-million over five years. "Make no mistake about it, the Canadian Partnership Against Cancer is going to save lives," he said.
But what is the strategy? This is how Mr. Harper described it: "The Canadian Partnership Against Cancer will serve as a clearing house for state-of-the-art information about preventing, diagnosing and treating cancer." A clearing house. A library. For $260-million, a library. "Its job is to make sure that the best cancer-care practices in any single part of Canada are known and available to health-care providers in every part of Canada."
The vaunted strategy, in other words, is an attempt to get Canadians from different parts of the country to talk to one another. Don't deputy ministers of health from every province and territory already meet? Don't the ministers do the same? Does it really require another expensive bureaucracy, in this case a non-profit agency at arm's length from government, to bang a few heads together? How will Canadians hold the agency accountable?
Readers who have been following this newspaper's series on cancer care will be aware that the quality of care, the funding and treatment practices and the results vary from province to province. Britain has a national strategy that seems to be helping to lower the death rate from cancer. So why are we skeptical?
Because $260-million spent on a policy group is $260-million that is not going to treatment and equipment. Because in a country that has not met its modest waiting-time targets for radiation therapy, all new promises are suspect. Because Canadians shouldn't have to wait a decade or two to hold this new agency accountable for the government money it receives. (Simon Sutcliffe, the agency's vice-chair, said the public can judge its effective- ness in the short term by looking at the percentage of cancer patients who live five years or more; at waiting times for treatment; and at the proportion of people who are screened for various cancers. But it will be years before a fair assessment can be done.) And because Britain's strategy and Canada's are entirely different.
Britain's is overseen by the National Health Service, and includes new money for prevention and care, as well as waiting-time guarantees. Canada has no national health service. It also has no waiting-time guarantees. Health care is a provincial responsibility, and no one -- not the federal government, and not a non-profit agency, no matter broadly based -- can tell the provinces what to do. It is difficult to see how this $260-million clearing-house will make a difference commensurate with the cost.