Cancer registration in England is under serious threat. For more than 20 years cancer registries were the responsibility of the regional health authorities, which have now been abolished. Although a new organisational structure and new funding mechanisms were supposed to have been in place in April 1996, much is still undecided. The likely path to be followed is devolution of funding and contractual responsibility to lead purchasers. Such devolution accords with the ideological framework of the changes taking place throughout the NHS, but it sits uneasily with the need for a national system of uniformly acceptable quality.
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