GPs ordered to ration cancer scans: Lives ‘being put at risk’ by bureaucrats’ new cost-saving directive
Family doctors have been ordered to ration the number of patients they send for life-saving cancer scans to save money. They are being told to slash the number they refer to hospital for tests including ultrasounds, MRIs and CT scans commonly used to spot tumours.
Last night experts warned the cost-saving measures increased the risk of patients being diagnosed too late and dying unnecessarily. Britain has one of the lowest cancer survival rates in Europe, and experts say late diagnosis is to blame.
The cuts are being brought in despite Government pledges to give GPs better access to cancer tests in the hope of saving 5,000 lives a year.
Health Secretary Andrew Lansley promised to set aside £750million to help family doctors send patients directly for scans instead of having to refer them to a consultant to decide whether or not they should have a scan.
This process could add several weeks on to the diagnosis by the time patients have waited for an appointment and a slot for a scan.
But it has since emerged that a quarter of Primary Care Trusts are actively discouraging GPs from sending patients for these tests. The figures were obtained through a freedom of information request by GP Newspaper. Of the 116 PCTs which responded, a quarter said they had policies to reduce ‘inappropriate’ referrals by GPs for scans.
And five – Bury, Salford, South West Essex, Southampton, South West Essex, Southampton and Stockport – have banned family doctors from sending patients directly for scans, flying in the face of the Government’s pledge. Instead they are being encouraged to refer patients to hospital doctors who will decide whether or not they need a test.
Dr Clare Gerada, chairman of the Royal College of GPs, warned that stopping GPs from sending patients for scans will delay diagnosis of cancer. She said: ‘This is about money and finances, not about putting patients first. ‘How can a junior doctor in a hospital refer for an ultrasound while I – with 25 years’ experience – have to refer a patient to a specialist?’
Lindsay Wilkinson of Macmillan Cancer Support said: ‘Earlier diagnosis makes a huge difference to the chance of surviving cancer. It is vital that GPs are given direct access to diagnostic tests so that those with suspected cancer are diagnosed at the earliest opportunity. ‘Stopping GPs directly accessing scans could be a false economy if GPs have to refer to a hospital specialist who orders the scan anyway.’
Sarah Woolnough of Cancer Research UK said: ‘It is very worrying to hear of PCTs setting referral targets and decommissioning direct access to tests that could speed up a cancer diagnosis.’
Millions of patients a year are referred to hospital for scans including MRIs, ultrasounds, CTs and colonoscopies. They are often used to check for tumours but also to diagnose heart disease, strokes, Alzheimer’s and problems with joints. PCTs have to pay a hospital for every patient referred for a scan. A CT scan costs up to £600, an MRI around £500 and an ultrasound about £100, on top of the cost of a patient seeing a specialist.
Last year a major study showed that the UK had consistently lower survival rates for some of the most common cancers compared with Australia, Canada, Denmark, Sweden and Norway.
In January Andrew Lansley promised to ensure Britain’s cancer survival rates were ‘the best in Europe’ by giving GPs better access to tests.
Professor Sir Mike Richards, National Clinical Director for Cancer, said: ‘Early diagnosis of cancer is a very high priority for the Government. That is why the Cancer Outcomes Strategy, which we published earlier this year, put an emphasis on improved GP access to diagnostic tests. ‘We are working to improve access to relevant diagnostic tests for GPs and will shortly be publishing guidelines which have been developed by GPs working with radiologists and other specialists.’
Although the NHS has been protected from the Coalition’s programme of spending cuts, in reality it needs big above-inflation rises every year just to ‘stand still’. This is because of factors such as the ageing population and rapid medical advances. So many workers in the NHS argue that the 0.1 per cent real terms annual rise in the NHS budget is, in reality, a fall.
Health trust bosses have also been told to make £20billion in efficiency savings over the next few years.
Long overdue victory for right to defend your property in Britain
Florist, 72, will NOT face charges for stabbing to death gunman who raided shop
Anti-crime campaigners last night hailed ‘a victory for common sense’ after an elderly florist who stabbed an armed raider to death was told he will not face criminal charges.
Cecil Coley, 72, was playing dominoes with a friend in his family shop in Old Trafford, Manchester, when four masked men armed with knives and guns forced their way in and demanded the takings.
During the ensuing struggle a pistol was fired but the florist grabbed a knife from the shop counter and lashed out, causing one of the raiders, Gary Mullings, to reel back with a serious stab wound to his chest. The 30-year-old dropped his pistol, staggered out into the street and collapsed. He later died.
Tory MP Patrick Mercer, a long-time campaigner on the issue, said last night that the case vindicated David Cameron’s promise to clarify what measures the law permits a person to take in defending themselves and their property against intruders.
Otherwise, he said, those who act in self-defence face the threat of prosecution, leading to a ‘waste of time and intense discomfort for the householder and their family’.
A spokesman for local campaign group Families Against Crime said: ‘Confronted with a masked gang armed with guns and knives, anyone would react in the way Mr Coley did to defend himself and his friend. ‘It has been a long time coming but finally the justice system has caught up with living in the modern world. This is undoubtedly a victory for common sense.’
Nafir Afzal, chief crown prosecutor for the North West, said of the July raid: ‘It is difficult to envisage a more frightening set of circumstances than these. Four men, armed with guns and a knife, forced their way into the shop.
‘Mr Coley received a number of injuries, including a serious facial injury, and his friend was knocked unconscious. At some point in the incident one of the guns, a blank firing pistol, was fired. ‘All the evidence indicates that when Cecil Coley took hold of a knife that was on the shop counter and struck out with it, he was acting in a way that he felt instinctively necessary to protect himself, whilst fearing for his life.’
He said: ‘Householders, shopkeepers and anyone going about their lawful day-to-day activities can be reassured that the law will protect them if they use reasonable force to protect themselves, their families and their property.’
Mullings’ brothers Joseph, 24, and Kyle, 18, both of no fixed abode, along with Nathan Walters, 26, of Liverpool, have been charged with robbery of the shop and are due to appear in court next month.
The decision comes after householder Peter Flanagan, 59, was cleared of murder after being arrested over the fatal stabbing of a burglar who broke into his house in nearby Salford.
In June Justice Secretary Ken Clarke said a householder who knives a burglar will not have committed a criminal offence under plans to clarify the law on self-defence in England. He said people were entitled to use ‘whatever force necessary’ to protect themselves and their homes.
Political correctness endangers a village cricket club
A red tape nightmare has hit our village cricket club for six
The demands made on our little village cricket club in Litton, Somerset, reflect wider problems with the way Britain is run.
Compared with some of the weightier matters addressed in this column, the threatened closure of a tiny Somerset cricket club might seem trivial. But the team for which I play on Sundays is battling for survival because it has been caught by a bizarre bureaucratic doube-whammy which reflects much of what is going askew with the way our country is run – not least the extent to which our mighty government machine has lost contact with the everyday lives of those it is meant to serve.
On the one hand, our club has been told that, for the field and two semi-derelict sheds where we change and keep our mowers, we must pay “non-domestic rates” equivalent to more than £100 for every home game we play.
On the other, we are told by Her Majesty’s Revenue & Customs that we cannot get any relief on this exorbitant demand because our constitution does not state explicitly that membership is open to anyone regardless of “sex, age, disability, ethnicity, nationality, sexual orientation, religion or other beliefs”.
Litton Cricket Club’s constitution has always stated that we are open to anyone who wants to join. Our players range in age from 11 to 73 and have included a Nigerian and my son’s 12-year-old Indian nephew. Wives help with teas, children play on the boundary; the club is warmly supported by many villagers, not least at our fund-raising annual dinners and quiz nights. But because our constitution does not include a “non-discrimination” clause worded in exactly the way laid down, we must pay rates 10 times larger than any other village club in our area, and more than our members could be expected to pay.
Our battle to win rate relief began 10 years ago, when we were first faced with a demand for over £700. We discovered that this was only £400 less than a demand that was being objected to by one of the top city clubs in southern England, with 150 playing members and a large, fully-equipped clubhouse. Eventually we won relief, thanks to the intervention of local councillors.
Some years back, however, our council outsourced responsibility for its business rates to Capita, a private firm based in Bromley, Kent, which last year told us the policy had changed. In March we were told we would now have to pay the full tax unless HMRC classified us as a CASC, a Community Amateur Sports Club.
We filed an application to HMRC and paid £70 as a first instalment, but were then threatened with court action unless we paid the full sum. Thanks to the intervention of our local councillor, we were given a stay of execution until our CASC application had been processed. Last month we finally had a letter from Liverpool to say that our application had been refused. This was because our constitution did not in effect make it absolutely explicit that the club would not discriminate against any one-legged Inuit lesbian Druid pensioner who might wish to join,
We appealed, explaining that the club’s survival depended on it. Having rewritten our constitution exactly according to the formula suggested on HMRC’s website, we asked whether, if we made a new application, this would now be acceptable. Liverpool’s refusal of our appeal last week explained that it was not HMRC’s concern whether our club closed. It said nothing about our new constitution, but merely repeated its insistence that the old one had not stated. the prescribed wording that our club was open to anyone (it merely said “membership is open to anyone”).
There was a time when matters like this could have been quickly sorted out by a couple of councillors familiar with our village. Instead, this battle, involving enough paperwork to fill an inch-thick file, has taken so many months that, if only I were a lawyer and able to charge £500 an hour, I could retire on the proceeds.
We have now made our new CASC application, which we hope will tick every one of the many required boxes. Meanwhile the fate of our club hangs on the ruling of one official in Liverpool and another in Bromley, Kent, each more than 100 miles from the little Someset village where their decisions are awaited with considerable interest.
Free schools good, profit motive better
I went on the BBC News Channel yesterday afternoon defending free schools against the charge that they would lower standards and lead to social segregation.
First, it is worth re-capping what the ‘free schools agenda’ is all about. Essentially, it has two purposes. The main one is to increase the supply of good school places by letting independent providers set up new schools, and receive state funding on a per pupil basis. The idea is that this allows parents to exercise a meaningful choice over where their child is educated. That drives schools to compete for pupils, which increases accountability and drives up standards. The second purpose of the free schools agenda is to give schools greater freedom from bureaucratic interference: let them innovate, let them focus on teaching the child in front of them, and stop thinking the man in Whitehall always knows best.
School choice may be a radical idea, but it isn’t a new one, and it has worked where it’s been tried – most famously in Sweden, that well-known socialist nirvana. Moreover, it is hard to deny that the British education system is in need of serious reform: despite the fact that spending has practically doubled in real terms over the last decade, Britain has tumbled down the international league tables. Academic research has even suggested that 17 percent of British 16-19 year olds are illiterate, while 22 percent of them are functionally innumerate – a shocking indictment of a failing system.
Moreover, the claims made by the critics of free schools do not hold water. They suggest that free schools will promote inequality, but this has not been the experience in Sweden or the US. In fact, American evidence suggests the opposite: that privately operated schools can be better integrated, since attendance is not as closely linked to where one lives as it is in the state sector. Indeed, it is worth remembering that our current schools system is deeply unequal precisely on these grounds – in many cases it amounts to little more than segregation by house price. Live in a nice area, and chances are you’ll get to attend a fairly decent school; live on a sink estate, and you probably won’t be so lucky. Free schools offer an escape route.
At this stage, however, it is worth making a point about the profit motive – which Nick Clegg today ruled out of bounds vis-à-vis free schools. The trouble with not allowing for-profit companies to run free schools is that it dramatically narrows the pool of potential school operators. Fewer new schools will be set up, and those that are established are more likely to be concentrated in relatively affluent areas, where parents have the time and the ability to push for them. By contrast, if we were to allow profit-making free schools, we would get far more of them, and see more of them being set up in deprived areas – where both the demand and the need for them is greatest. Whatever Nick Clegg says, the profit motive in education could easily be a force for social mobility, not against it.
Finally, a point on standards: there simply isn’t any convincing evidence to suggest that free schools will provide a lower standard of education than state comprehensives, or that standards at those state comprehensives will suffer because of the existence of free schools. True, part of the rationale behind school choice is that irredeemably bad schools should go out of business. But that is surely as it should be: a system where good schools can grow and be replicated, and where bad schools are not kept interminably on life support, will lead to standards being driven up across the board.
Jesus thumbs-up ad gets thumbs down
“Britain’s advertising watchdog has banned a mobile phone company commercial which featured a cartoon Jesus who winked and gave a thumbs-up gesture.
The Advertising Standards Authority (ASA) ruled that the Phones 4 U campaign, which carried the slogan: “Miraculous deals on Samsung Galaxy Android phones”, appeared to be mocking the Christian faith.
“We considered that, although the ads were intended to be light-hearted and humorous, their depiction of Jesus winking and holding a thumbs-up sign, with the text “miraculous” deals during Easter, the Christian Holy Week which celebrated Christ’s resurrection, gave the impression that they were mocking and belittling core Christian beliefs,” the ASA said today.
“We therefore concluded that the ads were disrespectful to the Christian faith and were likely to cause serious offence, particularly to Christians.”
Are Christians that thin-skinned? I guess some may be. But compared to the abuse that gets hurled at American Christians, it’s pretty trivial.
Anyway, Christians are heavily discriminated against in Britain so I suppose it’s good to see them getting a bit of recognition.