NHS changes 'drive cancer victims to private care'

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MANY newly diagnosed cancer patients have lost confidence in the National Health Service and are turning to the private sector for treatment, unaware that the quality of care is much poorer. Some start a course of treatment in the private sector but run out of insurance cover before it is complete. They then fall back on the NHS for the rest of their care.

Two of the country's leading cancer agencies, Cancerlink and Bacup, say that they have the first evidence that the internal market in the NHS is changing patients' perception of how they will be treated. Reports that hospitals are slowing down as they reach the end of the financial year, and of lengthening waiting lists for surgery and hospital appointments, are having an affect.

Patients think about the cost of their care and doubt whether NHS hospitals can afford the best treatment or care in terminal cases.

Maxine Rosenfield, information services manager for Cancerlink, said the agency had registered a significant increase in calls from anxious patients. Many were women, recently diagnosed with breast-cancer, but there were also calls from people with brain tumours, leukaemia and stomach, bowel and gynaecological cancers. There was also widespread concern about the quality of drugs prescribed - painkillers and anti-sickness drugs - with some patients fearing that they would get cheaper, less effective, brands in increasingly cost-conscious hospitals.

Nicky Hill, from Bacup, said patients were anxious about the delays in treatment and the kind of treatment on offer. 'There isn't the same confidence in the NHS's ability to treat them that there was six months ago,' she said. Eva Garland, of Marie Curie Cancer Care, added that staff there were aware of a 'general concern'.

The agencies say they 'talk through' the options with patients but do not recommend the NHS over private care. Cancer specialists, however, are outspoken in their condemnation of the private sector's ability to cope with the disease. Karol Sikora, professor of clinical oncology at the Royal Postgraduate Medical School at Hammersmith Hospital, London, said many patients embarked upon the 'Harley Street circuit' of referrals and cross-referrals. 'Patients are sent from one specialist to another when what they need is a biopsy and treatment. In private care you get a nice receptionist, nice surroundings with lots of flowers but it is not like first-class air travel. You don't get better treatment.'

Cancer required specialist doctors and nurses, radiotherapists, and counsellors, and first-rate equipment which private hospitals did not have.

Professor Gordon McVie, scientific director of the Cancer Research Campaign, said that the breadth of experience in the NHS was unrivalled.

'I often pick up calls from people who want to know if they should go privately. My advice is always 'no'. There are a range of nuances in cancer care which only the NHS has the expertise to deal with: staff to treat the side-effects of drugs and radiotherapy, psychotherapy and holistic treatments for example.'

Two health insurers, Private Patients Plan and Western Provident Association, said that they had noted an increase in the number of individuals - as opposed to companies - taking out private health insurance. It was too soon to say whether this was linked with the NHS changes.