CANCER patients are asking the Scottish NHS to pay for treatment in Europe because they were unable to get the latest surgical techniques at home.
Retired NHS consultants are among those who have gone to Germany to have an operation for prostate cancer, believing the way the surgery is carried out - with the assistance of a robot - will give them the best chance of complete recovery.
However, while some patients have been able to get NHS funding to cover the cost of the treatment - others have been refused.
The new technology, in which surgeons make precise incisions by controlling a robot, is increasingly being used to remove the prostate gland in cancer patients around the world. There is a risk of incontinence after prostate surgery and some studies have found men who have the operation using the robot regain bladder control relatively quickly afterwards.
Retired neurologist: I never thought I would become a health tourist
In England almost 60 per cent of radical prostatectomies were robot assisted last year and in the United States the figure is around 80 per cent. However, in Scotland the first robot only went into action in August. It is not yet fully operational and so far the centre in Aberdeen has treated around 20 patients.
Anxious to avoid incontinence, a number of men have tried to obtain robot assisted surgery and - finding it unavailable in Scotland - sought funding to have the procedure in Europe.
Former footballer Ronnie McCuaig asked NHS Greater Glasgow and Clyde for the procedure when he was diagnosed with prostate cancer in 2013. He was told it was unavailable and Mr McCuaig's own father used his savings to pay for him to go to Germany for the treatment. Mr McCuaig, 62, from Dumbarton, has been fighting for the fee of around £10,000 to be be refunded ever since.
He he has now turned to the Scottish Public Health Services Ombudsman to investigate.
"It has been an absolute nightmare," said Mr McCuaig. "I fear I could have had radical surgery when there were alternative options out there which had not even been explained to me."
Another prostate cancer patient, a former NHS consultant who did not wish to be named, also applied to NHS GGC for robotic surgery in Germany under a European directive covering cross border care. The health board rejected his application and subsequent appeal.
The retired consultant said: “I subsequently learned that another patient who lives a few miles away but in the catchment area for Forth Valley had the same procedure as myself in Leipzig by the same surgeon and had his expenses fully refunded under the directive.
“Another friend in the Clyde area recently had the same procedure and surgeon in Leipzig and has been offered a partial refund which he is appealing.
“Different health boards, are using different interpretations of the EU directive. Result ..post code lottery for surgical treatment of prostate cancer in Europe.”
NHS Forth Valley has confirmed it refunded the costs of a resident being treated in Germany "in line with Article 56 of the 2011 EU cross border directive which allows reimbursement up to the Scottish National Tariff set for certain healthcare procedures".
However, in a statement NHS GGC, said: "We have agreed to facilitate the referral of any patient wishing to access this surgery but on the understanding that the board will not fund this surgery as alternative local treatment options are available."
The issues came to light after three constituents independently approached Jackie Baillie, public services spokeswoman for Scottish Labour, about the same problem. Ms Baillie said: “There must be many more men across Scotland who have been denied access to robotic surgery, based on which health board they live in. We need to stop this postcode lottery in the NHS."
Health Secretary Shona Robison said once it was fully operational "any man who is deemed clinically appropriate for robot assisted surgery for prostate cancer should be able to access the robot in Aberdeen, should they choose to do so."
She added that West of Scotland health boards are planning to introduce a robot before the end of next summer.
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