Patient's 265-day wait caps litany of NHS cancer failure

Key quote "We cannot give a specific date on when it will be met and, whilst yearly progress has improved, we acknowledge that much more significant improvement is needed. The whole of the NHS must redouble its efforts to ensure these are met." - Andy Kerr, the health minister

Story in full HUNDREDS of Scottish cancer patients are still being forced to wait months for treatment, and ministers admitted yesterday that they had no idea when the problem would be solved.

Andy Kerr, the health minister, said he was "extremely disappointed" by new figures which revealed the Scottish Executive had failed to meet a target of 95 per cent of cancer patients starting treatment within two months of urgent referral by their doctor. Ministers had pledged the target would be met by last December.

However, the latest statistics showed that, in one case, a patient was left waiting 265 days - nearly nine months.

They also exposed worrying drops in performance for the treatment of breast, lung, skin and bowel cancers.

A report showed that only 79.2 per cent of cancer patients overall were treated within the target period from April to June this year, just a slight improvement from 78.5 per cent during the previous quarter.

This means more than 460 patients waited longer than two months during this period.

The performance compares poorly with England, where the latest figures show 93.8 per cent of cancer patients were treated within two months of referral, rising to 99.6 per cent for breast cancer cases.

Professor Gordon McVie, a former head of Cancer Research UK, said the fact that 20 per cent of patients were not starting treatment within two months was "absolutely unacceptable". In any event, he said, the two-month target was "not at all challenging" and it should be nearer one month from referral to treatment.

Mr Kerr was unable to say when the target would be delivered. "We are continuously working towards meeting cancer targets," he said. "We cannot give a specific date on when it will be met and, whilst yearly progress has improved, we acknowledge that much more significant improvement is needed.

"The whole of the NHS must redouble its efforts to ensure these are met."

The new statistics showed that, of nine different cancer types, five saw performance worsen over three months. All nine failed to meet the 95 per cent target. The percentage of patients meeting the two-month target for lung cancer dropped from 86 per cent to 82.6 per cent, while breast cancer fell from 89.4 per cent to 88.2 per cent. For skin cancer, the figure decreased from 97.1 per cent to 85.4 per cent.

One patient in Lanarkshire had the longest wait from referral to treatment for colorectal cancer - 265 days - while a lung cancer patient in Greater Glasgow waited 187 days.

Prof McVie said the question of how soon treatment should be given for the best results depended on the type of cancer. However, he added: "What doesn't depend on the cancer is the psychological impact of a diagnosis.

"Everyone who is told they have cancer starts to worry and the sooner they start treatment the better, as this eases their anxiety. But the vast majority of cancers do get worse without treatment."

Experts said the reasons for the cross-border differences were complex, but could be due to hold-ups for diagnostic tests in Scotland or differences in the collection of data.

Executive officials also admitted they needed to improve their tracking of patients so people did not get lost in the system. Cancer Performance Support Teams have been sent into Forth Valley, Glasgow and Highland health boards to tackle their long waits.

Professor Jim Cassidy, from the Beatson Oncology Centre in Glasgow, said slower access to diagnostic tests could be one reason why Scotland fared worse than England on the cancer targets.

"We have made improvements. There are one or two sticking points we need to address, but there is confidence that these will be solved," he said.

The charity Macmillan Cancer Support said the figures were a disappointment to the 26,000 people in Scotland diagnosed with cancer each year.

A spokeswoman said: "With elections coming up next year, we are expecting each of the political parties to demonstrate how they would ensure the targets on waiting times are met.

"We also expect an open and transparent debate around why targets are not being met and recognition of the impact the waiting process has on the physical and emotional wellbeing of people living with cancer."

Jenny Whelan, head of the charity Cancerbackup Scotland, said: "Patients need to know that the speed of their treatment does not depend on where they live, yet these figures show that waiting times vary drastically from one area to another."

The SNP said the Executive had a "moral obligation" to meet the two-month target as soon as possible. "The maximum wait in the First Minister's own backyard in Lanarkshire is 265 days, which is a disgrace," Shona Robison, its health spokeswoman, said. "Patients must be given the best chance and early diagnosis is vital."

The sufferer

'No treatment but cells multiplying'

TEACHER Linda Lucas refused to wait for NHS treatment for breast cancer after receiving her devastating diagnosis.

The 51-year-old, from Cupar, Fife, decided to go for private care when she was told she would have to wait seven weeks for surgery to remove the tumour.

She would then have been left waiting four months for radiotherapy on the NHS.

And when Mrs Lucas decided to have breast reconstruction surgery last year, she had to wait over 12 months - despite the Executive's six-month target.

But because she was offered the first stage of cancer treatment within two months, Mrs Lucas would be counted as meeting the target - despite then having to wait four months for radiotherapy.

She said it was "unacceptable" that patients were left waiting for so long.

"It is a very anxious time when you are told you have cancer.

"If you are not getting treatment, you do not know what could be happening in your body.

"The cells could be multiplying and you just want to start treatment as soon as you can so you can pick up your life and carry on with it."

Mrs Lucas, who was diagnosed in 2000, is now clear of the disease but she is worried that other women might not be so lucky if they face delays in treatment. "The NHS staff who looked after me were fantastic; I could not praise them highly enough," she said.

"But there are just not enough of them and there needs to be more money put into the service if it is going to get better."

The A&E departments

Wide variations in emergency figures

THE length of time that patients wait in accident and emergency departments varies widely across Scotland, figures show.

An Executive target, due to be met by the end of 2007, says that patients visiting their local emergency department should be seen within four hours of arrival.

Figures for September show that 90 per cent of patients in Scotland are already being seen within this limit.

But this drops to 71 per cent at Edinburgh Royal Infirmary (ERI) and 79 per cent at Glasgow Royal Infirmary.

Andy Kerr said the figures published yesterday were "extremely encouraging". He said: "A year ahead of the target date, 90 per cent of core A&E departments are meeting the four-hour target, with one-third already above 98 per cent."

Falkirk Royal Infirmary saw 100 per cent of patients in A&E within four hours, with Ninewells Hospital in Dundee and Perth Royal Infirmary close behind on 99 per cent.

NHS Lothian said their latest figures for the ERI in October showed 89 per cent of patients were being seen within four hours. David Bolton from the health board said: "We are being asked to deal with a greater number of the more difficult cases than any other department in Scotland."

The operations

Success a year early

SCOTLAND is set to meet its target of a maximum 18-week wait for patients needing surgery a year early, the Executive said yesterday.

Andy Kerr said the target should be achieved by next month, ahead of the original timetable of December 2007.

The number of patients waiting more than 18 weeks for inpatient or day-case treatment was 3,365 at the end of September, compared to 9,672 in 2005.

"The numbers of patients waiting more than 18 weeks for inpatient and day-case treatment is at an all-time low - down 65 per cent over the year," Mr Kerr said.

The number of patients waiting more than 18 weeks to be seen at an outpatient clinic increased slightly from 11,319 at the end of June to 14,665 by the end of September.

The Conservatives pointed out that while targets were being met, median waits for treatment had increased.

"The median wait for an outpatient has increased from 47 weeks in 1999 to 51 weeks in the latest figures," the Conservative health spokeswoman Nanette Milne said.

"With inpatients, the median wait has increased from 35 weeks to 46 weeks in the same period. This is not good enough."

The Scans

Ordeal for 8,000 needing diagnosis

THOUSANDS of patients are still waiting weeks for key diagnostic tests such as MRI and CT scans, according to statistics.

By the end of next year, no patient should wait longer than nine weeks for a diagnostic test in the NHS.

But figures yesterday showed that almost 8,000 waited longer than this target in September.

The biggest hold-ups in radiology tests were for MRI scans, with 1,952 patients waiting for longer than nine weeks.

However, this was down from 2,358 in July.

The numbers facing long waits for CT scans also fell from 693 in July to 498 by September.

There were 3,818 waiting over the target time for endoscopy examinations, frequently used to diagnose cancer - down from 4,624 in July.

Delays in cancer treatment have been partly blamed on hold-ups in getting crucial diagnostic tests carried out.

Andy Kerr, the health minister, said: "The numbers waiting longer than nine weeks for key diagnostic tests is coming down all the time and has been dramatically reduced by 27 per cent over the July to September period.

"Faster diagnosis leads to faster treatment for patients and I look forward to seeing this momentum maintained."

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