Clinics forced to cut therapy to dying

NHS cash crisis: 'Second-rate' treatment for cancer sufferers
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Health Editor

Dying patients in urgent need of pain relieving radiotherapy treatment can expect only "second-rate" care from the National Health Service unless the Government commits extra funds to cancer services, a leading specialist warned yesterday.

Dr Victor Varley, clinical director at the Bristol Oncology Centre where 20 patients a month are likely to be refused radiotherapy because the hospital has run out of money, said that other centres across the country were also being forced to "prioritise" cancer patients.

Those with curative conditions were receiving radiotherapy, while scores of terminally ill patients were being prescribed painkilling drugs instead of palliative radiation treatment, he said.

"This is less than the optimum treatment," Dr Varley said last night. "A single radiotherapy treatment to a painful bone can bring relief for several months. To achieve the same effect with drugs requires large doses which make the patient drowsy and affect quality of life." Cancer which has spread from a primary tumour to the bone can be very painful.

The crisis in Bristol follows a decision by the United Bristol Healthcare Trust to close one of the five radiotherapy machines at the oncology centre to save money. This will reduce the number of treatments the centre provides by 40 a week. Doctors are liaising with GPs to determine which patients will be turned away; they cover a wide range of ages and are likely to be in the final stages of breast, lung, ovarian, prostate, and bowel cancer.

A spokeswoman for the trust said that the centre faced a pounds 500,000 overspend to the end of this financial year. Extra-funding from Avon District Health Authority of pounds 400,000 had failed to resolve the problem. "We've treated 10 per cent more outpatients than we were contracted for, provided 40 per cent more chemotherapy and spent pounds 160,000 more on drugs," she said.

Professor Charles Coombes, director of the Cancer Research Campaign's laboratories at the Hammersmith Trust, west London, said that the Bristol crisis was "very desperate" but that data to support Dr Varley's claims was hard to come by.

However, he said that nationally, a growing proportion of terminally ill patients were being pushed to the back of the radiotherapy queue. "It varies from centre to centre; it is a few days here but much longer in other centres," he said.

Overall, there are now more cancer patients largely because of an ageing population. More of the cancer budget is being consumed by chemotherapy treatments which have improved survival rates in recent years, the professor said.

This leaves less money for radiotherapy but more patients who actually need curative radiotherapy following successful adjuvant drug treatment. Dying patients in need of palliative care are suffering as a result.

Professor Coombes backed Dr Varley's demand for immediate extra funding. "Unless this government is prepared to recognise the problem and allocate a larger proportion of NHS resources to cancer care, Britain will continue to have the poorest survival rates in the world," he said.

A spokeswoman for the Department of Health said that the crisis in Bristol was a local matter for the trust and health authority to resolve. Cancer was one of the success stories of the NHS with improvements in research, treatment, equipment and screening, she added.