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Cancer Services
Motion made, and Question proposed, That this House do now adjourn.--[Mr. Betts.]
9.49 pm
Mr. Eric Illsley (Barnsley, Central): I am grateful for having secured the Adjournment debate this evening, especially as it has begun at such a reasonable hour. I am less happy about the subject that I intend to raise with the Minister of State, Department of Health, my hon. Friend the Member for Southampton, Itchen (Mr. Denham), whom I welcome back to the Dispatch Box after his visit to the Trent regional health authority this morning. I hope that his visit was productive and that he promised lots more money for that health authority.
Once again, I am raising issues of health care in my locality, specifically in the Trent region. I want to consider the failure of a succession of doctors and consultants to detect cancer in an individual until it was so far advanced that treatment will prove especially difficult.
The type of cancer is mouth cancer, which is a particularly unfortunate form. The tumour from which my constituent suffers was so large when it was diagnosed in March that he was advised that it was inoperable without the risk of losing his tongue, larynx and voice box, and thus the power of speech. If the diagnosis had not been delayed, my constituent could have had an operation much earlier. Such treatment could have been successful. I hope that he will still be able to have an operation if the current treatment is successful.
My constituent, Steven Harley, is a 41-year-old business man. He is also a personal friend; that makes the case all the more difficult. I shall explain the case in a nutshell. Mr. Harley developed throat pains, which became increasingly severe, last July. Nineteen medical examinations by 11 different doctors did not lead to a diagnosis of those throat pains as a form of mouth cancer.
Mr. Harley visited his general practitioner to complain of a sore throat. In the following 10 weeks, he saw his GP six or seven times. He had blood tests and courses of antibiotics. He was told that he was probably suffering from a virus and that he would simply have to sit it out. At that time, there was no suggestion of referral to an ear, nose and throat specialist or any offer of an MRI scan, which might have picked up the tumour. Mr. Harley suffered 10 weeks of persistent pain.
I accept that GPs cannot be expected to diagnose special types of cancer. Indeed, many GPs go through their medical careers without seeing, or dealing with, particular types of cancer. I do not therefore claim that a GP should have been able to tell Mr. Harley immediately, "Yes, it's cancer. Here's the treatment. Off you go." However, Mr. Harley asked his GP more than once, "Could this pain be a form of cancer?" He was repeatedly told that it was not. If a GP is sufficiently qualified to dismiss unequivocally an inquiry about whether a condition is cancer, he should be aware of the other side of the coin. How does he know that a condition is not cancer? If the signs exist, would he recognise them? If not, how can he simply deny that a condition is cancer? He cannot do that without knowledge about, or expertise in, cancer.
Mr. Harley has private medical insurance, which enabled him to arrange to see a specialist. He saw the specialist three times in four weeks. After those
consultations, he was told that nothing had been found and nothing could be done. Even that specialist did not even consider a scan or a referral to another specialist or anyone else. Incidentally, had Mr. Harley wanted to take advantage of an ear, nose and throat surgeon at Barnsley, he would have been unlucky. Of the two places for ENT surgeons that Barnsley had at that time, there was one vacancy. One of the surgeons had left and the other one was off sick. He would not have been able to see an ENT surgeon at Barnsley if he had wanted to do so. Even now, ENT surgery on people in Barnsley is carried out at Rotherham district general hospital. There is a locum in place at Barnsley throughout the week, but if anyone in the area has an ear, nose and throat problem between 5.30 pm on Friday and 9.30 am on Monday, he or she has to go to Rotherham. I am not happy with that.At this stage, Mr. Harley's pain was increasing severely. It was spreading in his mouth, jaw and neck. He felt that he had to visit Barnsley district general hospital one Saturday night to ask for pain killers. He presented himself at the casualty department to ask for them so that he might have help in sleeping. He did that on several occasions. He once more returned to his general practitioner, and again he was dismissed by the practice. Through his insurance, he arranged to see privately an orthopaedic surgeon in December, thinking that something orthopaedic could be wrong with him. He was told by that surgeon that there was nothing wrong and that nothing could be done for him.
By millennium eve, or new year's eve, Mr. Harley was in so much pain that he went once again to the casualty department of Barnsley district general hospital. He described his symptoms to a junior doctor. He asked for help and particularly for pain killers because the pain was so intense. The junior doctor prescribed pain killers and sent him home.
The pain was so bad that Mr. Harley presented himself again on millennium day, or new year's day. He asked for stronger pain killers. He told the doctor that the pain killers that he had been given the previous evening were not giving him any respite and that he needed something stronger. He was then seen by a senior doctor, who took his blood pressure. He refused to give him any stronger pain killers and laughed at the idea that the pain killers that he had already been given were not sufficient to do the job. He then took Mr. Harley on one side, put his arm round his shoulder and said, "Look, if I were your brother I would tell you to forget about this, to go home and live your life." That was the attitude of the doctors at Barnsley district general hospital--go home and get a life.
I find that incredible. No one would go to a hospital on new year's eve or new year's day over the millennium period unless he or she had a real problem. However, a doctor was dismissing Mr. Harley out of hand. There were three things wrong with that doctor's approach. First, he failed absolutely to diagnose anything wrong with Mr. Harley. He refused to acknowledge that there was any possibility that he could be suffering from any sort of disease, let alone cancer.
Secondly, he would not believe the extent of the patient's pain and accordingly did not prescribe a pain killer. Thirdly, he did not refer him elsewhere so that he might get some relief. He then took Mr. Harley on one side and told him that he was imagining things, that there was nothing wrong with him and that if he went away and forgot about it, everything would be all right.
I am concerned that my constituents are being treated by a doctor with such an attitude. It is bad enough that South Yorkshire, Barnsley and the Trent region have so many problems as a consequence of the health authority's poor funding and that there has been poor performance over previous years, without having to deal with the attitude of the medical profession in certain circumstances.
Is the training and education of our doctors so bad as to produce such a response when one of my constituents presents himself in pain during a bank holiday period? Have we reached the stage when a doctor takes a person on one side and says, in effect, that he does not believe him?
It being Ten o'clock, the motion for the Adjournment of the House lapsed, without Question put.
Question again proposed, That this House do now adjourn.--[Mr. Betts.]
Mr. Illsley: Is knowledge of cancer really so poor in our health service? Should we believe that none of the 11 different doctors--from GPs to specialists and consultants--who were consulted on 19 occasions could not put a finger on the problem and say, "I think that this could be cancerous. I must refer you for a scan or to a specialist oncologist who knows about this condition."?
The catalogue of errors involving Mr. Harley continued. In January, he arranged another private consultation with another consultant. He had an MRI scan, but was told that nothing could be done. That MRI scan took place seven months after he had first complained about his symptoms. The specialist he saw prescribed pain-killers and gave him a return appointment. That appointment took place on 1 March this year, by which time Mr. Harley had lost two stone and had difficulty eating or speaking because of the size of the tumour, which was swelling in the back of his tongue.
That specialist referred him to an ENT surgeon in the same hospital because, at last, they had diagnosed that his problem could be mouth or throat cancer. Those were private consultations, but at least his condition was diagnosed. Unfortunately, he was told that the tumour had become too large, so he could not undergo surgery immediately. He was told that he might require operative treatment if chemotherapy and radiotherapy could not shrink the tumour. He was also told of the threat of losing his tongue, voice box or larynx.
Mr. Harley is undergoing chemotherapy and, I think, radiotherapy to try to shrink the tumour. My family and I--and, I am sure, the House--wish him well and hope that his treatment will enable operative treatment to be carried out successfully. However, during nine months, a man who had private medical insurance under which he could arrange private consultations quickly and at short notice underwent 19 examinations by 11 doctors. What would have happened to someone who was simply an NHS patient in those circumstances? I fear that that cancer would have gone undiagnosed for far longer.
Mr. Harley tells me that, when he was diagnosed with mouth cancer, he contacted Cancer Bacup, one of the cancer charities in this country, which sent him a leaflet about mouth and throat cancers. When he read about the symptoms, he realised that he had been suffering from every one. He had presented himself to doctors while suffering from the symptoms listed in the leaflet,
but 11 doctors could not equate them with cancer, while the charity could do so. If Mr. Harley's condition had been detected earlier, it could have been treated far more easily. Why was he not believed when he presented himself in such pain? Why was he not listened to? Why did none of the doctors think that he could have cancer? Why were they so sure that he was wrong and they were right? I sincerely hope that the various health authorities involved will take a good long look at themselves and ask whether what happened was good enough. The Government should consider the issue nationally and especially in the Trent region, where underfunding is always a problem. I am becoming a little tired of complaining in the Chamber about the poor health service that my constituents receive, and we now have another problem to add to all the rest that I have raised.I should like to touch on a connected issue concerning the availability of cancer drugs, especially taxanes. There are various derivatives of that type of drug, but they are generally known as taxanes. I should like to place on record my thanks to Hugh McKinney of the campaign for effective and rational treatment, whom I met today to discuss this issue. As my hon. Friend the Minister knows, there are real concerns that such drugs are not available on the NHS. I have been told this evening that they are likely to be available only to private patients, and that NHS patients will not have access to them. That is of real concern to me because the vast majority of patients in my constituency are NHS patients and will be denied access to those drugs.
I am also told that the availability of those drugs will depend on the type of cancer, and that we are likely to move from postcode prescribing to tumour-type prescribing. Whether the drug will be available will depend on the type of cancer. Even with the 6.8 per cent. much welcomed uplift in cash funding for the NHS, there will still be a problem of funding for these drugs.
This case has been a nightmare for my constituent, and he is still living it. He has been ignored, insulted and left to organise his own health care. I hope that he now gets the proper treatment that he deserves, and that my area gets a better health service than it has at present.
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