The Calman-Hine report: a personal retrospective on the UK's first comprehensive policy on cancer services.
Calman-Hine was the first comprehensive cancer report to be produced in the UK, and set out principles for cancer care and the clinical organisation for service delivery. It advocated a change from a generalist model (eg, care given by general surgeons and physicians) that was supported by specialists to a fully specialist service. The process of policy development was innovative and the report was accepted widely throughout the UK. However, implementation, which began at a time of organisational change across the UK National Health Service (NHS), was not addressed sufficiently in the years immediately after publication. Consequently, change was more variable both geographically and within a single location and took longer than necessary. Evidence from research, routine data, and external assessments suggest that the policy was eventually successful and a worthwhile change. Well thought out and sustained mechanisms for policy implementation are as crucial as well-designed policies, and government health reforms can conflict with specific policies for quality improvement.
Haward
Robert A
RA
Arthington House, Cookridge Hospital, Leeds, LS16 6QB, UK. bob.haward@doctors.org.uk
D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D008511:Medicine; D009313:National Health Programs; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D011050:Policy Making; D012189:Retrospective Studies; D013038:Specialization; D006113:United Kingdom