Saturday, 13 November 2010

Health and Funding

According to the National Cancer Intelligence Network, 23% of all cancer cases go undetected until the emergency admission stage.

Pensioners and the poor are more at risk of being diagnosed late.  The detection rate is even worse among sufferers of brain tumours or acute leukaemia, with more than half of these cancers diagnosed only in an emergency.

The figures are described as 'shocking' by leading cancer charities and spokesmen said a lack of awareness of symptoms and a failure by doctors to identify the early warning signs were largely to blame.

In the past 24 hours I was informed someone dear to me, let's call him George, was dying of a brain tumour.  He is only 64 years old and generally healthy, although he suffers from bouts of depression.  Around 6 months ago it was noticed his behaviour was rather odd and he was eventually persuaded to see his doctor.  The diagnosis was depression and anti-depressants were prescribed.  The behaviour slowly continued to worsen and his closest friend advised the family that it was certainly very unlike the usual bouts of depression he suffered.  The GP arranged a consultation with a psychiatrist.  No rush of course - that appointment was weeks away.  The family, who all live outside this area, were consoled by the fact that once an 'expert' had investigated the problem would be resolved.

However, the GP had to be called as an emergency when it was found George couldn't dress himself one morning.  Other physical signs had been there for some weeks but doctors always had a reason for them.  That morning the GP sent him to the local psychiatric hospital as an emergency.  Within an hour he was sent to A & E for emergency admission.  A scan was done and he was rushed to Ninewells, the local teaching hospital, where a biopsy was done. That was two weeks ago.

I visited George last night and I doubt if he recognised me.  The brain tumour is so large the medics at Ninewells said it was well beyond any treatment. Within the two weeks he has deteriorated rapidly but he is in no pain.  He never had any pain.  If he had complained of a headache perhaps his GP would have investigated the other physical symptoms.  Who knows.

The story becomes farcial now.  George only has weeks or a few months to live.  The hospital can't do anything for him and want the bed. They say he is 'not ready' for the hospice and a nursing home is the only answer as he requires 24-hour care.  One of his sons, who lives in Edinburgh and has taken charge of his Dad's welfare, has asked if he can be moved to Edinburgh as a three hour round trip each day is putting tremendous strain on him.  He was told this week that all Edinburgh nursing homes are full.  I don't believe that. Not for one minute.  This is a money issue pure and simple. George's welfare isn't the 'prime importance' our politicians would have us believe.  If it was, I have no doubt a nursing home could be found in Edinburgh immediately.

Health boards are financially responsible for all of us, if we can't afford to fund our care by private means.  We're all just a number with a £ sign in the front. From investigations made today I discovered that generally health boards are reluctant to transfer funds to another health board and that would appear to be the answer in this case.

Unfortunately I can do little to help in this situation, but I'm writing about it to highlight the myth that our NHS, (and that includes Scotland), is the best in the world.  In fact experts say England's poor detection rates could explain why the country has much lower survival rates than other countries in Europe.  Scotland will be in a similar position although I can't find current statistics.

This post is not to point fingers but to show we do need to look to other countries and admit our cancer services needs immediate improvement.  In England, of those with brain or central nervous system cancer 58% were not picked up until they were seen in hospital, along with 57% with acute leukaemia and 47% with pancreatic cancer.  Shocking figures indeed.



Joe Public said...

A sad story, SR.

"Around 6 months ago it was noticed his behaviour was rather odd and he was eventually persuaded to see his doctor."

There are a significant number of (older) people who 'get on with their lives' being reluctant to contact their doctor because they don't want to appear to 'waste' the doctor's time. They have a (sometimes misplaced) faith & confidence in their body's remarkable ability to 'heal itself'.

They have never visited the doctor with a mere 'cold' to get a Sick Note & 2 weeks on the 'Club' with pay. They perceive a 'medical' issue as necessary only if there's actual pain or a tangible, physical problem.

And they never appear in the statistics, because they've not been counted as "Service Users".

One sometimes wonders if we tackle health issues Arse-About-Face. At birth, individuals should perhaps be given a book-of-credits; those that 'save' them for a later-day get to 'spend' them all at once in old age.

Demetrius said...

One of the dark secrets of the NHS is how difficult it can be to be referred for testing and how few routine tests are done in comnparison with other developed countries. My local PCT refused testing even in anaphylaxis cases and I have known too many people who died and did not get tests despite continuing problems over years. One lady who died of lung cancer was on antibiotics for two years for chest infections by her GP.

subrosa said...

It is sad Joe. Seemingly there are 8000 people a year who die from brain tumours.

My point is that our system doesn't seem to be set up to deal quickly with those who are terminally ill like this. The family shouldn't have to wait until funding is organised before he can be moved to a nursing home.

subrosa said...

We have a terrible rate here in Scotland Demetrius, although with those cancers which have detection testing it's much better. Breast and bowel cancer is being caught early so as treatment is successful in many cases.

Unfortunately in this case no pain was involved, just small physical symptoms which were put down to depression, even though he'd never had them before.

We always associate brain tumours with headaches but I now know there are many other signs.

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