Cancer treatment in Britain is lagging behind the rest of Europe, with a huge postcode lottery on getting the right drugs or therapies to patients who need them, the Government admits.

A five-year plan for the future of cancer services is to be unveiled by the Health Secretary on Monday, which will aim to overhaul care for patients on the NHS and set out expansion of screening programmes and a focus on “survivorship” as more patients go into remission.

But a draft of the new cancer reform strategy, seen by The Times, admits for the first time that Britain has poor survival rates compared with Western Europe, the US and Canada and that patients are waiting too long for both radiotherapy and chemotherapy for the most common cancers.

Doctors will be given “essential” orders to increase the number of radiotherapy doses amid evidence that only half the required number of treatments are being delivered.

However, there will be no extra funding to deliver more services or to address widespread health inequalities. Instead, money to improve diagnosis and treatment will have to be found through efficiency savings.

One in four deaths in England is now attributable to cancer, but survival rates are improving to the extent that there are one million people living with cancer in England alone.

While Britain spends more than any other European nation on cancer care, access to new drugs is relatively slow, and those that are approved for use on the NHS are still being refused to patients in some areas.

Important reports have cautioned that staff shortages and lack of equipment are leading to long waiting lists in radiotherapy — where radiation is used to shrink solid tumours — and could be cutting the chances of patient survival. Breast cancer patients are waiting three months for therapy, despite evidence of a 60 per cent risk of the disease returning if they are not treated within eight weeks.

In the document, Mike Richards, the National Director for Cancer Services, notes: “Good progress [on survival rates] over past ten years, but much more to be done.”

The strategy will highlight how there has been little progress on some cancers, such as lung and pancreas, and that major inequalities remain in death rates between rich and poor.

The NHS has tripled spending on cancer since the introduction of the Government’s last cancer plan in 2000. But spending also varies greatly around the country, with some primary care trusts spending £40 per patient and others £140.

Some of the strategies have already been announced, pilot programmes to screen 47-year-old women for breast cancer, lowering the starting age from 50. Screening for bowel cancer will be extended to age 75, rather than 70.

Ministers are expected to highlight the need to raise awareness of lifestyle factors associated with cancer, such as smoking and overexposure to the sun.

Professor Richards also calls for faster access to new cancer drugs by letting the National Institute for Health and Clinical Excellence consider treatments for use on the NHS at the same time as they are applying for licenses in general. Doctors will also be urged to provide more “emotional” support for long-term sufferers.

Karol Sikora, former head of the cancer programme at the World Health Organisation, said that Britain was a world leader in treatment for rarer forms of cancer but was “let down” by long-term and short-term survival rates for the most common kinds: lung, breast and colon cancer.

He suggested a lot of the extra money had gone towards salaries for people who never dealt with patients. “We have funded managers to deal with targets while in France, Germany and Italy that bureaucracy just does not exist,” he said. “It is clear that the NHS cannot afford to spend any more on treating cancer, the drive now is towards equity and efficiency.

“We need to provide a far more customer-focused service as close to people’s homes as possible. Better organisation and new models of working which involve the independent sector would bring about a revolution for future patients and save lives.”

The NHS delivers 1.5 million courses of radiotherapy treatment every year, when the ideal would be at least 2.5 million, according to the Royal College of Radiologists.

Times Recommends

• In Margot Fonteyn's footsteps
• Forget beautiful people, let's have wonky Brits
• Fundamentalist brew: faith and power