Patients forced to go to England for ‘drop in the ocean’ diagnosis
WELSH patients suffering from a condition that affects the oesophagus are having to travel to England for treatment because appropriate medical equipment is not available this side of the border.
Barrett’s Oesophagus is a pre-cancerous condition that can develop into cancer if it is not treated properly.
The condition can be treated by Radio Frequency Ablation (RFA) machines – but there are none in Wales.
According to Macmillan Cancer Support, Barrett’s Oesophagus is a condition where the cells of the oesophagus (gullet) grow abnormally: “The oesophagus is the muscular tube that connects the mouth to the stomach. Barrett’s oesophagus is not a cancer, but can develop into cancer in a very small number of people.
“Acid reflux and GORD (gastrooesophageal reflux disease) are the two main causes of Barrett’s oesophagus. Acid reflux is when stomach acid splashes back into the oesophagus. GORD is when the acid irritates and inflames the oesophagus. Around one in 10 people with acid reflux (10%) will go on to develop Barrett’s Oesophagus.
“The most common symptom of Barrett’s Oesophagus is ongoing heartburn and indigestion.”
Last month patients with the condition attended a presentation at the University Hospital of Wales by Dr Sunil Dolwani, a consultant gastroenterologist who specialises in treating it.
Mike Davison, a former senior aircraft engineer from Llandaff, Cardiff, was in the audience.
He said: “I was diagnosed with Barrett’s Oesophagus many years ago. I have regular check-ups and it is under control.
“I was aware that patients who need to have tissue removed have to go to Gloucester, where there is an RFA machine. But I was surprised to learn that while there are around 30 such machines in England, there are none in Wales. I was even more surprised to learn that the cost of such machines is around £34,000.
“Together with other patients, I was under the impression that they would cost around £1.2m or £1.3m. But £34,000 is a drop in the ocean and I can’t understand why the NHS in Wales doesn’t buy at least one so patients don’t have the inconvenience of having to go to England.”
An analysis carried out for Nice – the National Institute for Health and Care Excellence – concluded that using RFA was cost-effective.
A spokeswoman for Cardiff and Vale University Health Board said: “It is not possible that all types of diagnostic tests can be carried out within the health board and we work closely with our colleagues throughout the NHS network to assist us with testing and diagnosis for some conditions. On the rare occasions where we are unable to provide tests, we will refer patients to expert units outside of the health board who have the appropriate equipment, training and expertise to carry out the testing and diagnostics on our behalf.”