Scared — too shocked to cry. That’s how mother-of-three Catherine Wilcockson felt as she put the phone down after learning that her next chemotherapy session due next week had been cancelled – yet another victim of the Covid-19 outbreak as it takes its toll on the NHS and its resources.
School kitchen assistant Catherine, 37, was told she had a cancerous brain tumour, the size of two apples, last May after a scan following a seizure.
Surgery could remove only 80 per cent of it and Catherine, a single mum of three daughters: Tia, 19, Christie, 16 and Shani, nine, from Sheffield, south Yorkshire needed 30 sessions of radiotherapy before starting a nine-month course of chemotherapy in October.
The treatment involved three different drugs: procarbazine, tablet lomustine and vincristine by an intravenous drip. ‘It was grueling — I had to have the dose reduced in my last session as it had caused liver problems — but scans showed it was shrinking my tumour,’ says Catherine.
It is estimated that the three private clinic networks — Rutherford Health, Genesis Care and HCA UK — could treat an estimated 5,000 patients per month. Thousands more will be treated in other private hospitals
Four weeks ago, Catherine got the news she longed to hear: the remaining tumour had shrunk dramatically. ‘I’d thought I was on my way to beating the tumour and getting on with my normal life again, returning to work and looking after my girls.’
Then last week her consultant called to say her next session on the 15th April was cancelled.
‘The doctor said she would phone in eight weeks ‘for a chat’ to see what will happen next,’ says Catherine. ‘She couldn’t give me any assurances or a date for when it would happen, which was devastating.’
Any delay in her final sessions could be vital. ‘The type of tumour I’ve got can grow back and I want to make sure as much of the tumour as possible is destroyed,’ says Catherine. ‘I’ve been through so much in the last ten months any delay now seems unfair.’
Numerous cancer patients have found themselves in a similar position to Catherine as some NHS trusts have cancelled chemotherapy and routine cancer operations to free up beds and manpower to cope with the coronavirus crisis.
But now comes some good news — with the announcement that NHS cancer patients will receive treatment in private hospitals with immediate effect to reduce delays to their care.
It is estimated that the three private clinic networks — Rutherford Health, Genesis Care and HCA UK — could treat an estimated 5,000 patients per month. Thousands more will be treated in other private hospitals.
Professor Karol Sikora, chief medical officer at Rutherford Health, said: ‘NHS England is instructing the local trusts to deal with the private clinics. This will cover every priority chemotherapy and radiotherapy NHS patient.
But now comes some good news — with the announcement that NHS cancer patients will receive treatment in private hospitals with immediate effect to reduce delays to their care
‘Most curable cancer patients will benefit from this arrangement, those who are dependent on immediate treatment and with a good chance of surviving. This comes at a crucial time, a year will have been lost in this horrid pandemic (in terms of the backlog of cases it will cause.’
An NHS England guide published last month has suggested that doctors ‘categorise patients into priority groups 1-6’, with top priority for chemotherapy, which is seen as ‘curative therapy with a high [greater than 50 per cent] chance of success’.
If a patient is receiving palliative cancer therapy with little chance of surviving more than a year, they will be given the lowest priority. It is understood those in high priority categories, ranked one to three on that scale, will receive treatment at the private clinics. The new move has been welcomed by cancer experts.
‘The Covid-19 pandemic has placed unprecedented pressure on our health service, and although the NHS is doing everything in its power to give cancer care as usual, the reality is difficult decisions are having to be made such as delaying treatment for some patients,’ says Emlyn Samuel, Cancer Research UK’s head of policy.
One cancer specialist, who didn’t want to be named, adds: ‘We know from numerous studies that delays to breast cancer surgery or chemotherapy, for example, reduce cure rates and lower survival.
‘These risks far outweigh any the potential risk from Covid-19.’
NHS hospitals already have the ability to use the independent sector to treat NHS patients. However, under guidance issued by NHS England last week, they are being encouraged to look to the private sector for help where cancer treatments are being delayed.
When the NHS uses a private hospital to carry out the procedure, the national tariff — how much hospitals are paid for carrying out certain treatments — is simply paid to the private hospital rather than the NHS.
Professor Sikora adds: ‘Across the country trusts are enabled to use their local private cancer providers. So, for example, at Rutherford’s Newport centre we are dealing with the big cancer centre for South Wales in Cardiff.’
An NHS source said it will be down to individual hospitals to decide whether to use the private sector for their cancer patients. Local NHS cancer services have been told they are able to use their local private providers if that makes most sense in their area to make sure people who need it can get cancer care,’ the source told Good Health.
‘However, services are going to be structured differently in different parts of the country. This doesn’t mean that all cancer patients will receive a letter to say their treatment is now going to be in a private hospital — it will be down to trusts to decide how they want to organise their services.’
GenesisCare has said it is ready to treat NHS cancer patients at its 14 centres and that discussions are ‘ongoing’ (file image)
The idea is the NHS creates ‘hot’ and ‘cold’ Covid-19 hospitals — those hospitals which are treating Covid-19 patients, and those where other patients can be treated. ‘Independent healthcare providers are committed to working hand in hand with the NHS to help tackle the coronavirus pandemic including through the unprecedented arrangement to put nearly all private hospital capacity at the disposal of the NHS for as long as needed,’ says David Hare, chief executive of the IHPN.
An NHS spokesman said: ‘Under a major deal struck with the independent hospital sector, the NHS will now have access to an extra 8,000 hospital beds across England, nearly 1,200 more ventilators, more than 10,000 nurses, over 700 doctors and over 8,000 other clinical staff.’
Macmillan Cancer Support has welcomed the co-operation. GenesisCare has said it is ready to treat NHS cancer patients at its 14 centres and that discussions are ‘ongoing’. Catherine hopes she will be among those to benefit. I totally get that Covid patients need their treatment — but cancer patients need treatment too — in many cases just to stay alive.’
Additional reporting: JO WATERS
WE CAN’T ABANDON NON-COVID PATIENTS AND PUT THEM AT RISK
Dr Renee Hoenderkamp is a GP in London. She says:
One of my patients, who has lung cancer, had an operation scheduled for last week. She is an otherwise very fit and healthy 70-year-old, and reasonably could have been expected to go into full remission.
And then, without warning, her operation was cancelled. Someone, somewhere following a diktat, had taken a red pen to the list and crossed through her name. They had probably not looked at her case, nor considered the benefit of the surgery to a woman who was a mother, a sister, and a wife, with potentially 30 years of life ahead of her, before taking away her hope — possibly her life.
Every month, thousands of cancer patients are having operations cancelled as beds are taken up by Covid-19 victims. The NHS is throwing ‘non-urgent’ and elective surgical procedures, as well as all screening programmes, out of the window in its fight against the new enemy.
Yes, it has just agreed a deal with three private cancer clinic networks to treat 5,000 high-priority cases per month. But we will still see countless preventable deaths, and not only from cancer.
Covid-19 is taking precedence over everything else. It is an appalling knee-jerk injustice. Surely it is not right for a healthcare strategy to discard all ethical considerations and bulldoze through decisions which will cost lives in the name of saving them? Human beings are being treated as collateral damage.
Something as treatable as a urinary tract infection can be fatal without antibiotics and a short stay in hospital. The same applies to chronic obstructive pulmonary disease; to stroke patients who won’t get the medication they need in the vital four-hour window; to heart attack patients who risk being sent home too soon.
The list of those in danger in this crisis is endless, and it will get worse. Most early-warning tests, such as cancer smears, have been suspended, even though such illnesses can be treated successfully if caught early.
I am worried that in six months’ time we will see a tsunami of serious illnesses that should have been diagnosed much earlier. The grandmother of a close friend arrived at hospital last Tuesday all set to have an operation for her newly diagnosed breast cancer. As she sat there, filled with nerves but excited that she was getting the surgery she needs, staff phoned my friend to tell her the operation was cancelled.
No-one came to tell her grandmother in person. She was sent home, lonely and angry, to face alone what may be her last few months. Doctors are playing God in a way never before seen.
A colleague told me: ‘I worry about a backlash from the public when they realise the implications of what our Covid-19 response has done to the health of the nation.’