More work is needed to bring the quality of cancer care in all areas up to the level of the best

Joanna Rule, CancerBacup

Dr Peter Homa, chief executive of the CHI, told BBC Radio 4's Today programme there had been some "significant" improvements, but much that needed to change.

He said: "The treatment that patients receive very much depends on what hospital the patient was cared for, and indeed the type of cancer that they suffered from."

Professor Mike Richards, the government's national cancer director, told Today: "The pace of change is quickening, but we have a long way to go."

Cancer charities said the problems were symptomatic of a wider crisis in the health service, and that there was no "quick fix".

1995 suggestions

Improving cancer care became a government priority several years ago, after it was found survival rates for many cancers in the UK were lower than in other EU countries.

There is poor communication and a failure to plan care in a systematic way

Audit Commission report

The latest survey said many recommendations made in the landmark 1995 Calman-Hine study have yet to be implemented.

These included specialists for all cancer patients, more effort to spot cancer early, and cancer networks to make sure the best techniques and organisation were used across the NHS.

The new report said in some areas patients struggled because there were gaps in the way service was delivered, with doctors failing to talk to each other.

"From the patient point of view, there is poor communication and a failure to plan care in a systematic way between the different professionals involved," it said.

But Dr Homa pointed to some improvements - including that 92% of patients referred by GPs to specialists as urgent were now being seen within two weeks, and that many had appreciated the way their diagnosis was given.

'NHS on its knees'

Cancer charity CancerBacup agreed more work needed to be done, with chief executive Joanna Rule calling for the quality of care in all areas to reach the level of the best.

This was particularly important "in terms of waiting times for diagnosis and treatment, access to modern treatments, and provision of palliative care."

A spokesman for the Cancer Research Campaign said it was easy to find flaws in the way cancer services were provided in the UK - but less easy to come up with solutions.

He said: "The NHS is on its knees in many places - criticism is one thing, but constructive criticism is another."

Cancer 'czar'

In recent years the government has published national standards on several different types of cancer, and appointed Prof Richards as cancer "czar" to oversee reform.

In 2000, its NHS Cancer Plan set out targets for prevention, diagnosis, treatment and care of cancer patients.

Last month, the government's own progress report against these targets suggested some were already being met.

Prof Richards told Today clinicians and managers were working together very closely to fill in any gaps in a "detailed" and "ground level" way.