6 hours agoShareSaveHugh PymHealth editorShareSaveBBC”It was really bad – we had patients dying on the waiting lists – politicians were getting desperate.”Jesper Fisker, chief executive of the Danish Cancer Society, is looking back 25 years – to the moment Denmark decided to transform its approach to treating cancer.At that point, he says, the country did not have a strong record.”It was a disaster,” he recalls. “We saw Danish patients out of their own pocket paying for tickets to China to get all sorts of treatments – endangering their health.”Some went to private hospitals in Germany that offered new treatments unavailable in Denmark.Back then, Denmark’s record on cancer was low compared to that of other rich countries. But so was the UK’s.From 1995 to 1999, Denmark’s five-year survival rate for rectal cancer was essentially tied with the UK’s, on around 48%, according to the International Cancer Benchmarking Partnership, a research body. It put both nations well below countries like Australia, which had a 59% rate.Now, thanks to a bold plan, Denmark’s performance on cancer has jumped ahead. By 2014, its five-year survival rate for rectal cancer had risen to 69%, close to Australia’s. (The UK’s rose too, but only to 62%.)Analysts think the trend has probably continued (though these are the most up-to-date figures available). And it’s a similar story for other cancers, including colon, stomach, and lung.This Danish success story has caught the attention of UK policymakers. Health Secretary Wes Streeting says that aspects of the Danish model are feeding into government plans. Some could well be included in a new long-term cancer plan for England, due to be published in the autumn.So, what’s their secret, and can the NHS learn from Denmark?Big investments and thoughtful touchesWalking today into Herlev Hospital on the outskirts of Copenhagen makes for a rather different experience to arriving at an average NHS hospital. The foyer is hung with bright, vivid paintings by the Danish artist Poul Gernes. There are 65 in all.The philosophy is that endless white walls can unnerve patients, while colour can be a pleasant distraction from their problems.Getty ImagesIt is a sign of the attention Denmark has paid to even the atmosphere of hospitals – small, thoughtful touches, alongside investment in more traditional equipment.Dr Michael Andersen, a consultant radiologist and associate professor at the hospital, shows off a high-tech scanner, only the fourth of its kind used by any hospital around the world.Buying hospital equipment like this – particularly scanners – has been central to Denmark’s cancer strategy.”In 2008 the government made the decision to make a heavy investment into scanner systems,” Dr Andersen explains. “They purchased between 30 and 60 – they’re an integral part of the way we work.”Particularly important for cancer are CT scanners, which look deep inside a person’s body. Denmark now has about 30 of them per million people – the average of other rich countries stands at 25.9. The UK, meanwhile, lags way behind with just 8.8 scanners per million people, according to the 2021 figures.Getty ImagesThe investment in cancer equipment, according to experts, led to a huge expansion in diagnostic capacity in Denmark. Unless funding to meet increasing patient demand is made, they argue, England could continue to lag behind on the quality of care.This all comes despite the fact that Denmark’s health spending hasn’t seen a huge boost. Calculated by spending per head of the population, Denmark is ahead; but as a share of national income, its health spending is similar to, and in fact slightly below that of the UK’s.A bold set of plansThis is just one part of a bold plan drawn up by Danish health leaders. Along with introducing new equipment, and rethinking the atmosphere of hospitals, they also made it possible for patients to be treated with chemotherapy at home.New national standards govern how quickly Danes must be treated: following a referral, a cancer diagnosis has to be given within two weeks. Then, if treatment is required, it has to start within the two weeks of diagnosis.If these targets are not met patients have the right to transfer to another hospital – or, failing that, another country – whilst still being funded by the Danish health system.This is quite a contrast to the UK nations. Here, the target is for patients to start treatment within around nine weeks (officially, 62 days) of an urgent cancer referral.Getty CreativeMichelle Mitchell, chief executive of Cancer Research UK, believes that there is a lack of accountability in the English health system specifically, with too many NHS organisations. Addressing this, she says, should improve the quality of cancer care.”That means clarity over who in the government and NHS is responsible for delivering each part of the plan.”Ultimately, responsibility for the success or failure of the plan should rest with the health and social care secretary.”She points out that there are similarities between England and Denmark’s state-run health systems – for example, the roughly similar amount they spend on health as a share of national income, meaning Denmark’s example could be followed in England.But this would require a long-term plan, political leadership, higher investment, more cancer screening, and stronger targets. Which is no easy feat.Going beyond just ‘treating’ cancerElisabeth Ketelsen, who is 82, is an active person, still swimming in international events – she has broken world records for her age group. But in 2022, she discovered a lump in her breast.”I saw the doctor on Monday – on the following Thursday I had mammography and a biopsy and from then on it went so quickly my head was spinning, almost.”Elisabeth KetelsenJust three weeks after the diagnosis Elisabeth, who is from Denmark, had surgery. Radiotherapy started two weeks later.Last year, the cancer reappeared in her spine and she was immediately prescribed chemotherapy pills and hormone treatment. The cancer stabilised and …
