Free prostate cancer scans ‘an unjust postcode lottery’
HEALTH Secretary Vaughan Gething is facing criticism over an anomaly under which men in some parts of Wales can get a scan for prostate cancer free of charge, while in other health board areas they have to pay £1,000.
Plaid Cymru AM Simon Thomas described the discrepancy as “shameful” and against the defining principles of the NHS.
But the Welsh Government said some health boards were offering the scan as part of a pilot scheme and that the advisory body on clinical procedures Nice – the National Institute for Health and Care Excellence – had yet to approve it.
Plaid Cymru AM for Mid and West Wales Mr Thomas said: “It is a terrible injustice that we have this postcode lottery on prostate diagnosis in Wales. Patients living in Cardiff and Vale, Cwm Taf and Aneurin Bevan Health Board regions are offered mpMRI scans as a diagnostic tool for prostate cancer, yet patients who live in Hywel Dda Health Board region are having to pay £1,000 and travel to England to access this service.
“It is shameful and goes against the very defining principles of our National Health Service. Since we have three health boards in Wales offering more then surely all of those health boards in Wales should offer more because, as the Welsh Government has confirmed in a letter to me, an mpMRI is not only cheaper than a TRUS biopsy, but it also does not carry the same health risks, such as bleeding, infection and even sepsis, which can further increase the costs to the NHS.
“The Cabinet Secretary for Health has failed to provide any justifiable reason why all health boards in Wales should offer this service to patients in Wales. All patients in Wales deserve to have access to equitable levels of cancer diagnostics, irrespective of which health board region they reside in.”
Patients in Betsi Cadwaladr Health Board region also have to pay £1,000 for a scan and Tory AM Mark Isherwood has also raised the issue with Mr Gething.
After the Health Secretary told Mr Isherwood Nice had not approved the procedure Geoff Ryall-Harvey, the chief officer of North Wales Community Health Council, wrote to Mr Gething pointing out that there had been two announcements last month relating to new diagnostic techniques in relation to prostate cancer.
He stated: “These developments offer men with prostate disease real hope of successful treatment but here in north Wales, and elsewhere outside Cardiff, we are behind the curve on 2014 Nice guidelines and we will be at the back of the queue when Nice recommend prebiopsy mpMRI in 12 months’ time.
“To remind you, prostate cancer is now the biggest killer of men, with those most at risk of developing the disease being men aged over 49 years old, and men of African-Caribbean or African descent. One in eight men will develop prostate cancer, rising to one in four men of Afro-Caribbean origin. Every year 11,819 men die from prostate cancer in the UK, with one man dying of it every 45 minutes. Simply waiting for the Nice guidance on prebiopsy mpMRI looks complacent in the face of the above facts. Again, I would urge you to start preparing now for this step change in prostate cancer care.”
A Welsh Government spokeswoman said: “Current Nice guidelines do not recommend pre-biopsy mpMRI. However, there is emerging evidence supporting the introduction of pre-biopsy mpMRI and the current guidance is being reviewed and is expected to be available in 2019. If the guideline is amended to incorporate pre-biopsy mpMRI then we would expect health boards to provide this.
“Prostate Cancer UK will also be issuing a consensus statement regarding this issue shortly. The Planned Care Urology Board will review this statement and will consider the Welsh position in line with this statement.
“We do not support variations in service provision across Wales. However, we recognise that sometimes clinicians take different views about emerging evidence before Nice guidance is published. It is for health boards to make provision for services and the Welsh Government is not able to directly fund the availability of this diagnostic technique.”