Cancer patients are being systematically let down by the radiotherapy services in England, a damning government report concludes.

Lengthy waits and huge variations in service from place to place mean that tens of thousands of patients every year are receiving substandard service, reducing their chances of survival. The report to ministers from a top-level committee, whose broad conclusions were first revealed in The Times last month, calls for urgent action.

“Unless action is taken without delay, the Government will lose the opportunity to save lives, and services in this country will fall further behind those of other comparable countries” the National Radiotherapy Advisory Group says.

The NHS delivers 1.5 million courses of treatment every year, when the optimum would be 2.5 million, the report says. Variations between areas are said to be “unacceptable”, with the best-served areas delivering two and a half times as many courses as the worst. But it does not specify which areas are bad and which less bad.

Karol Sikora, a cancer specialist, said: “The report shows how bad things really are, but disguises just how bad the local gaps in services are. These areas which have fallen behind must be named too in order to target improvements.” Since 1997 the Government has invested more money in radiotherapy, but even this increase has fallen far short. The problems arise from miscalculations made 15 to 20 years ago, when the need for radiotherapy was significantly underestimated.

It was wrongly believed that radiotherapy would not have a key role to play in future cancer treatments and that demand for it would fall. This was a gross misjudgment, as demand has increased and will continue to increase as the population ages.

Radiation treatments involve large doses given by linear accelerators, given in a series of smaller doses to reduce injury to healthy tissue. Typically, an entire course might comprise 15 to 40 treatments.

The most productive centres deliver more than 10,000 courses per linear accelerator (linac) per year, the least productive only about 5,000.

The report calls for a target of at least 8,000 courses a year immediately, and 8,300 a year by 2010-11. Linacs should be kept running nine hours a day on average, with some running for as long as 11.5 hours a day.

They should be operated year-round, including Bank Holidays (with the exception of Christmas Day, Boxing Day, and one day at Easter), and include some treatments on Saturdays.

But the report rules out seven-day working because there are insufficient staff and patients may be reluctant.

Michael Williams, Vice-President of the Royal College of Radiologists, and co-chair-man of the advisory group, said: “Radiotherapy is one of the most effective cancer treatments available, but the UK has fallen short in its provision.

“This is the main finding of a second report published in the current issue of the journal Clinical Oncology. The research confirms that substantially less radiotherapy is given in the UK than is standard practice elsewhere in Europe and the USA.”

Professor Janet Husband, president of the college, said, “The report will be extremely valuable in determining future development and in building on the substantial investment in modern equipment achieved as part of the Cancer Plan.”

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