Making Cancer Patient Pathways Work

In the context of what Stephen Harrison and Bruce Wood (2000) called “scientific bureaucratic medicine,” integrated care systems (e.g., clinical pathways coordinating and standardizing services) have been considered the superior organizational model for solving health care issues such as delays, variation, and conflicting interests in the Global North since the 1980s (Allen 2014; Pinder et al 2005; Power 1999). In 2007, Denmark implemented national cancer patient pathways to accelerate cancer diagnosis and treatment and provide seamless access to standardized, high-quality cancer care (Probst, Hussain, and Andersen 2012).
Accelerating diagnosis and treatment is a politically and technologically enabled process (Rosa 2010) that assumes that lives might be saved by pushing the pace of decisions and reducing cancer-related wait times (Tørring, this volume). Overall, acceleration of diagnostic interventions is a common approach to cancer control in the Global North (Hamilton et al. 2016; Mæhle et al 2021; Neal et al. 2014). In Denmark, acceleration was first promoted through the “Agreement on Acute Action” policy in 2007 (Danish Government and Danish Regions 2007). This agreement specifies acute action—that is, timeliness—as the most efficient way to control cancer. In this chapter, I show how the logic of
the pathways has manifested in the context of cancer control.