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This article reports on the fourth in a series of annual Pavilion conferences, charting the gritty texture of real‐time organisational development set against the formal policy agenda. Those engaged in PCT development will find the messages instructive and reassuring.

Primary care groups need to address some uncomfortable issues if they are to become effective as organisations in their local networks. The paper examines PCGs' relationships with their health authorities, given the inherent contradictions in national policy, and recommends a devolved approach to ensure that a range of stakeholders can participate in their work.

Cancer discussion is perceived as a taboo subject among different cultures and societies including Africans. This perception has caused limited knowledge about the disease and prevented some from seeking early diagnosis and treatment. With West Africans now living in western societies where cancer is openly discussed, this study aims to explore how black Africans perceive the disease and the implications for healthcare.

Five focus groups of 53 persons from Ghanaian and Nigerian migrant communities in Luton participated in this study.

Perceptions of fear, shame and denial were identified as key elements of how people perceive and react to cancer among the study population.

Secrecy and apprehension were identified as major barriers and have prevented some from adequately accessing and utilizing cancer facilities in the country. The feelings of fear, secrecy and stigma associated with the disease across different ethnic groups, cultures and nations also exist among the study population. These outcomes are similar and chime with published findings of limited cancer perception research among other ethnic groups and races here in the UK and across the globe.