· Government unveils plans for 'world-class' service · Opposition says Labour's first strategy failed

Sarah Boseley, health editor The Guardian Tuesday December 4 2007

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[The prime minister, Gordon Brown, and the health secretary, Alan Johnson, visit the Royal Marsden hospital in central London as the government launches a five-year cancer strategy. Photograph: Shaun Curry/PA]

A new cancer strategy was unveiled by the government yesterday that focuses on prevention, radiotherapy and surgery rather than expensive new drugs.

Seven years after the first cancer plan, which was designed to bring the NHS into line with better-funded cancer services in Europe, cancer tsar Prof Mike Richards said there had been good progress but "we know there is much more to be done". The five-year strategy, he said, "will enable us to develop world-class services in this country, saving more lives and ensuring patients get the care they deserve".

While opposition politicians complained that the first cancer plan, launched in 2000, had failed to deliver, Gordon Brown, visiting the pioneering Royal Marsden specialist cancer hospital in London, said he believed the country was "making huge advances" in tackling the disease.

Richards said new cancer drugs were only part of the answer. The National Institute for Health and Clinical Excellence (Nice) will be expected to appraise any cancer drug that is coming to market, so the NHS can adopt it when it is licensed, but only if it is cost-effective. Drug costs are growing at more than £100m a year.

Richards emphasised the importance of surgery. "It cures more cancers than any other intervention," he said. The strategy provides for more training for surgeons, particularly in minimally-invasive "keyhole"

procedures which can lead to much swifter recovery.

Cancer prevention takes a higher profile in the new strategy. More than half of all new cancers could be prevented by the adoption of healthier lifestyles.

Smoking accounts for a third of all cancer deaths. New controls on tobacco are signalled, including the possible scrapping of cigarette vending machines. In an attempt to check the rising rate of skin cancers, the government will consult on the regulation of sunbeds and look at restricting their use by the under-18s.

Another big push on screening is planned, with a £100m investment in digital mammography equipment which is better at detecting abnormalities in the breast tissue of pre-menopausal women. Breast screening will be offered to all women aged 47 to 73 by 2012, and bowel screening extended from 2010 to all men and women aged 70 to 75.

Waiting times for treatment are to come down again. By 2010, no patient should wait more than 31 days for treatment to start.

Radiotherapy, which has been identified as a problem area since the launch of the 2000 plan, will also get more attention. An expert advisory report published in May said the need for radiotherapy had been underestimated and pointed to big variations in the availability and waiting times around the country. In spite of a £500m investment in new machines following the 2000 plan, radiotherapy still lags behind the rest of the Europe, the strategy document says. "To achieve a world-class radiotherapy service local investment will be needed both in equipment and workforce," it says.

Extra therapeutic radiographers have been recruited, but more have left the service than was expected.

Cancer charities warmly welcomed the launch, although the British Liver Trust and Ovarian Cancer Action warned that more was needed to check the rise in those specific cancers. The British Lung Foundation said lack of progress on lung cancer was spoiling the UK's overall record.

The shadow health minister, Mark Simmonds, said: "Gordon Brown and Alan Johnson have been forced to admit their failure to achieve the best cancer survival rates in Europe, despite the huge amount of money they've spent on trying. What is saddening is that if the UK achieved European-best levels of cancer survival rates, then 95 lives each day could be saved."

Main points

Prevention

Possible ban on cigarette vending machines and regulation of sunbeds with restrictions on use under-18

Earlier diagnosis

£100m investment in digital mammography to allow breast screening for younger women. Breast screening expanded to ages 47-73 by 2012

Bowel screening

Extended to all aged 70-75 from 2010

Treatment

£200m investment in radiotherapy equipment and staff. New cancer drugs to be fast-tracked by Nice to establish cost-effectiveness. Waiting times for any treatment including radiotherapy to come down to 31 days

Guardian Unlimited (c) Guardian News and Media Limited 2007