The Calman-Hine report: a personal retrospective on the UK's first comprehensive policy on cancer services

Lancet Oncol. 2006 Apr;7(4):336-46. doi: 10.1016/S1470-2045(06)70659-3.


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.

MeSH terms

  • Health Policy*
  • Health Services Accessibility
  • Humans
  • Medicine*
  • National Health Programs*
  • Neoplasms / complications
  • Neoplasms / therapy*
  • Policy Making
  • Retrospective Studies
  • Specialization*
  • United Kingdom