What else is the NHS keeping from us?
Alarm bells should have been ringing. So says a professor of cancer medicine. A devastating error has been made. So says the research charity Breast Cancer Now. Wholehearted apologies have been extended. So says Health Secretary Jeremy Hunt.
But alarms did not sound when vast numbers of older women failed to attend breast cancer screening clinics.
And what use are apologies, however wholehearted, to the families of the 270 women already dead? Or, as the euphemism goes, “may have had their lives cut short” by a shockingly basic IT blunder.
Almost half a million – 450,000 – women aged between 68 and 71 were affected. The 300,000 still alive today are sleepless with worry, terrified that they may be riddled with breast cancer because they fell through the cracks of a broken NHS.
An algorithm that failed, a glitch that went unnoticed. Not for a day, a week, a month or a year. Nine years. It was only discovered during a software upgrade.
By IT standards, that timespan represents a lifetime. For those women whose cancers were diagnosed too late, it was a life.
Treatment of breast cancer has a 99per cent success rate if started early; success meaning the patient is alive five years on. If found at an advanced stage, that rate plummets to 15per cent.
Due to a fault in an algorithm, women who had hitherto been offered a mammogram every three years were not invited for a routine check-up. Except, when you think about it, there’s nothing routine about a scan that can make all the difference between life and death.
There is puzzlement that none of the staff noticed the absence of older women from their daily patient lists. Are they partly to blame? Should they have raised questions? Eminent clinician Karol Sikora, dean and professor of cancer medicine at the University of Buckingham Medical School, believes they should.
“The fact that they didn’t is, I think, indicative of a problem – a blind spot – that exists across the health service,” he says. “We have become too reliant on technology. And because NHS staff assume the technology is infallible, they are no longer as tuned into what they are seeing or what their instinct and experience might be telling them.”
As far as we the public are concerned, we have been conditioned to assume someone in authority knows better. Even when we have been forgotten. We wait quietly and expect to reach the front of the queue, when really we should be complaining and asserting ourselves.
My heart goes out to women struggling with breast cancers, and secondary cancers that should have been caught years ago.
In these pages, 75-year-old nurse Patricia Minchin spoke with great eloquence and dignity about her breast cancer, which was diagnosed after she failed to receive an offer for a screening appointment. It has now spread. After a career in the NHS, she is devastated at such cavalier treatment. Or lack of it.
There is anger, too, that news of this catastrophic computer failure is only now being made public, although it was known to Public Health England as far back as January.
It surely begs the question: what other facts are they keeping in abeyance? Is this further delay down to cock-up, conspiracy or complacency?
The NHS IT system is sclerotic and has been described as the worst in both Western and Eastern Europe. This shocking shortcoming has cost lives, but there is another price to be paid: a fundamental loss of trust.
My generation, my mother’s generation, were brought up to believe that doctors knew best, that the NHS was a benevolent institution that only had our best interests at its centre. Today, we must acknowledge that the paternalistic cradle-to-grave NHS is a myth. We cannot rely on our health system for preventive care or early intervention; it can do both things superlatively, of course, but that any one of us will receive the treatments we need, when we need them, is no longer a given.
Cancer doesn’t just kill the patient. It causes harrowing grief to children and partners, siblings and parents. None of us knows if we will develop it. It is difficult to accept a cruel disease that attacks at random. How much more crushing to learn that it might have been discovered years earlier, but for a rogue computer programme?
But, in truth, the system no longer works. Overburdened and understaffed, our hospitals lurch from one crisis to another. Getting a same-day GP appointment feels like a minor miracle.
The model envisioned by Aneurin Bevan in 1948 was based on three principles: that it meets the needs of everyone, is free at the point of delivery and is based on clinical need, not the ability to pay.
Here, in 2018, it is increasingly clear that we want – need – something more fit for 21st century purpose, and that somebody needs to pay for that upgrade. The NHS is a beacon of world-class care in some respects; abysmal patients-dying-on-trolleys failings in others. That is not good enough. Yet our politicians still refuse to countenance a targeted health tax or private insurance schemes to dovetail with existing NHS expertise. Given a choice between the well-meaning haphazardness of a postcode lottery and an extra penny or two in income tax to get a premium service, who wouldn’t rather stump up the cash?
This has nothing to do with ideology or privatisation by stealth, but creating a health service fit for purpose, where staff use their initiative, the IT system works and hundreds of thousands of women aren’t badly let down.
By all means we should have faith in our NHS – but let it not be blind faith.