...receiving the best possible treatment
After the death of revered food critic and journalist AA Gill a debate has arisen over the level of cancer treatment available on the NHS and the funding for potential life-extending treatments.
Mr Gill was told that a form of immunotherapy, nivolumab, could have extended his life but the NHS was unable to fund the treatment, thought to cost approximately £68,000 a year.
Responding to the tragic story, Daxa Patel – Partner in Medical Negligence – explains how the age and health history of patients could be influencing NHS decisions on expensive forms of treatment.
“Full English of cancers”
Mr Gill was famed for his combative writing style and controversial comments on everything from areas of the British Isles to TV presenters and restaurants.
He revealed in an edition of his regular Sunday Times column ‘Table Talk’ that he had what he described as “an embarrassment of cancer, the full English.”
In a follow-up column, a colleague explained how Gill was determined to be treated on the NHS, as he wanted the human connection he felt would be provided on the NHS that would not be matched by the private healthcare he could have opted for.
With his late diagnosis, Gill’s survival chances were slim but he began a course of chemotherapy, which was unsuccessful in shrinking his tumours.
Writing a farewell piece in the Sunday Times magazine, Mr Gill explained how his oncologist recommended immunotherapy but the revolutionary treatment had not yet been passed for NHS funding by the National Institute for Health and Care Excellence (NICE), which reviews new drugs and treatments before they are funded by the NHS.
Cancer care: NHS vs. private provisions
In his final column, Gill claims that his oncologist recommended nivolumab, a form of immunotherapy, as it would be the course of treatment used by every oncologist in the First World.
Despite this recommendation, the treatment – which costs four times as much as chemotherapy – is not funded by the NHS in England and Wales, while in Scotland – whose government makes its own decisions about what treatments are available to NHS patients – has chosen to fund the treatment.
Immunotherapy works by stripping the camouflage used by cancerous cells, which usually makes the body’s immune system incorrectly identify cancer as normal cells, and allows the immune system to try and fight cancer.
While the treatment is not a cure, it is expected to offer an improved prognosis and can significantly extend the life of a cancer patient.
Mr Gill claimed that the reason the treatment is not being funded is due to its limited reach and scope, as it offers the best results to lung cancer sufferers who had a history of smoking.
This, Gill alleged, causes campaigners for the therapy to be: “old men who think they’re going to die anyway”, who he said weren’t “very effective activists” and do not demand the “public pressure that young mothers’ cancers and kids’ diseases get”.
Eventually Gill paid privately to begin a course of nivolumab; however, it is believed that it may have been too late for the treatment to take effect.
Explaining the implications of Gill’s experience with the NHS, Daxa said:
“This is a very sad story where someone’s life has been cut short because the treatment recommended by their oncologist was not available on the NHS.”
“It seems that Mr Gill himself was claiming that it is because of the type of patients that would benefit from nivolumab that it is not being funded in England and Wales, which, if true, would raise the question, was the decision not to offer this treatment in England influenced by costs and the age of patients?”
“When the NHS was founded by Nye Bevan, his vision was to provide a universal health care to all. However, it now seems that the system has to weigh up the costs of treatment with the value of a patient’s life, which is a shocking thing to say about a healthcare system that’s regarded in reasonable esteem by many healthcare ranking metrics.”
“Mr Gill’s experience raises a number of questions, namely why are we falling short and what can be done about it?”
“While NHS is still offering excellent free healthcare to many, for which we should be grateful, isn’t there always room for improvement? Would Mr Gill had a better survival chance had he been a resident of Scotland where this treatment is available? “
“These are serious questions that need to be addressed by those in charge. Whether this relates to funding for the NHS or the amount of red tape holding back new treatments, we need to ensure that we are always looking to raise standards, especially in terms of cancer treatment, for which the NHS has amongst the worst survival rates in Western Europe.”
Written by Daxa Patel.
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