Cancer Plan

• Abstract
• Purpose of health policy or idea
• Characteristics of this policy
• Political and economic background
• Purpose and process analysis
• Expected outcome
• References

Abstract

Denmark has a poor record on cancer survival rates compared to other countries at a similar income level. In an attempt to address the problem the Government has announced an ad hoc plan seeking to bring the performance level at par with the best performers internationally. A previous ad hoc initiative was initiated in February 2000 (the National Cancer Action Plan).

Purpose of health policy or idea

The main objective is to bring the results of cancer treatment in Denmark on level with the best international performers.

Instruments include a mix of extra funding and fine tuning. The actions suggested by the central government will influence (or seeks to influence): 

1. The counties/regions  (the local governments which manage the Danish health care system) and how they manage the system. This includes investment in technology. 
2. Doctors (additional supplementary training)
3. Consumers (earlier screening, earlier diagnosis, expanded possibility of experimental treatment, "stop smoking" assistance)
4. Municipalities (extra funding to health care centres)

It is the governments understanding that the introduction of new local governments ("Regions" to replace the existing counties) will somehow be better equipped to achieve the goals of the plan. 

Main points

Main objectives

The main objective is to bring the results of cancer treatment in Denmark on level with the best international performers.

Type of incentives

Basically the Cancer Plan operates within the existing incentives and is thought to work by way of extra funding.

Innovationsgrad	traditionell		innovativ
Kontroversität	unumstritten		kontrovers
Strukturelle Wirkung	marginal		fundamental
Medienpräsenz	sehr gering		sehr hoch
Übertragbarkeit	sehr systemabhängig		systemneutral

Extra funding and statements on goals is a rather traditional form of policy.

Political and economic background

The Danish record on cancer tretament appears to be poorer than what is experienced in countries at a similar level of income. This is perceived to be a problem. A previous ad hoc intiative - the National Cancer Action Plan 2000 - has not produced the result hoped for and the present plan seeks to correct this.

Purpose and process analysis

Current Process Stages

	Idee	Pilotprojekt	Strategiepapier	Gesetzgebung	Umsetzung	Evaluation	Veränderung/Richtungswechsel
Implemented in this survey?

Origins of health policy idea

The policy intiative (a political agreement between the government a majority within parliament) is based on a  report from the Danish National Board of Health (link provided below).

The iniative follows a previous ad hoc initative from year 2000.

Initiators of idea/main actors

• Regierung: It is a government proposal so naturally they are supportive.

• Patienten, Verbraucher

• Politische Parteien: The DPP generally supports the government and, together with the two government parties, constitutes a majority in Parliament

Approach of idea

The approach of the idea is described as:
renewed:

Stakeholder positions

The vocal players (the government, Danish National Board of Health ,the Danish Cancer Society) supports the initiative. There is broad agreement that the dismal performance calls for some kind of action. Groups of doctors, however, have voiced concern that some of the initiatives will fail due to staff shortages. 

Actors and positions

Regierung
Minister of Health	sehr unterstützend		stark dagegen
Danish National Board of Health	sehr unterstützend		stark dagegen
Patienten, Verbraucher
The Danish Cancer Society	sehr unterstützend		stark dagegen
Politische Parteien
The Danish People's Party (DPP)	sehr unterstützend		stark dagegen

Influences in policy making and legislation

The agreement between the government and a majority within parliament is expected to become part of the following years budget.

Legislative outcome

pending

Actors and influence

Regierung
Minister of Health	sehr groß		kein
Danish National Board of Health	sehr groß		kein
Patienten, Verbraucher
The Danish Cancer Society	sehr groß		kein
Politische Parteien
The Danish People's Party (DPP)	sehr groß		kein

Positions and Influences at a glance

Adoption and implementation

Previous plans have involved tensions between the central government and the counties. An evaluation of the previous initiative suggested that the counties had not followed the intentions. For instance, one problem had been that scanners had been to dispersed (perhaps reflecting local ambititons rather than what was deemed to be optimal planning). It is conceiveable that similar problems will surface this time.

Monitoring and evaluation

The political agreement (as announced) does not specify the evaluation procedure but does indicate that evaluations will take place.   

Expected outcome

The previous plan did not succeed in bringing the Danish performance on level with countries with a similar level of income. According to the evaluation of the previous initiative there were problems of coordination between the central authorities and the counties. The government dismisses these kinds of problems and appears very optimistic that the new structure of the public sector (in which "regions" will replace counties and funding responsibility will rest with the central government and with minicipalities, i.e. agents seperated from the regions) will provide better incentives. It is, however, difficult to see why this should be the case as the new system will be very similar to the old.

One novel aspect is that municipalities will co-finance the regions, and the government expects this to strengthen the effort in preventive care by the municipalities (since municipalities in this way may save, in the long run, on resources to more expensive curative care). But municipalities are political bodies, and it it not obvious which incentive politicians operating in one election period have to take a long term perspective.

References

Sources of Information

The report Kræftplan II [Cancer Plan II] from the Danish National Board of Health is available (in Danish only) at Kræftplan II from the Board's homepage.

The policy paper Aftale mellem regeringen og Dansk Folkeparti (in Danish only) from the Ministry of Health specifying the political agreement between the government and one political party is available at Aftale mellem regeringen og Dansk Folkeparti from the Ministry's homepage.

Author/s and/or contributors to this survey

Michael O. Appel

Empfohlene Zitierweise für diesen Online-Artikel:

Michael O. Appel. "Cancer Plan". Health Policy Monitor, 01/10/2005. Available at http://www.hpm.org/survey/dk/a6/2