Scots GP's cancer care 'shame' should concern us all

The unit had already been open for some seven years, also treating skin disorders, when its directors decided to limit the work it carried out to the treatment of cancer patients, appointing a full staff of medical officers, including a pathologist. 

It boasted an outdoor dispensary at 22 West Graham Street and a nursing service was established to assist patients in their own homes, 60 years before the arrival of Marie Curie nurses.

The head of the new Glasgow Cancer Hospital was Dr George Beatson  (later Sir George) a name that is now synonymous with the city's world-leading cancer centre.

He published a paper in the Lancet in 1896 of three cases of women with breast cancer, in which their ovaries were removed, with significant improvement in outcome. 

It remains one of the biggest breakthroughs in cancer treatment.

Fast forward to the present day and there is good reason for optimism. 

Most people reading this column will have relatives or friends who would be alive today if they had had access to the diagnostic procedures and treatments that are available today.

The latest breakthrough, making the headlines yesterday, potentially heralds the arrival of a new type of cancer therapy that uses a weakened form of the cold sore virus to infect and destroy harmful cells and led to one patient's tumours vanishing.

READ MORE: Glasgow cancer doctor says 'inevitable' NHS will see more advanced cancer cases due to Covid delays 

Kryzsztof Wojkowski was receiving end-of-life care for cancer of the salivary glands and the disease is no longer detectable.

A blood test that detects "actionable" faulty genes is also undergoing trials in America and survival rates for many cancers, most notably breast cancer, have been transformed while immunotherapy drugs are prolonging lives.

However, cancer remains a killer that strikes both the young and old and early diagnosis remains critical. This is, in part, down to vigilance of our own health but some cancers have more obvious symptoms than others.

Much of it is out of our hands and relies on timely diagnosis to give those pioneering treatments the best chance of working.

Most people will have been alarmed to hear a leading doctor say this week that he is "ashamed" of the care his cancer patients receive.

Ian Kennedy, the new chairman of the British Medical Association in Scotland, said patients were facing long waits at every stage of their diagnosis from their first GP appointment to surgery or chemotherapy.

Newsquest (Image: Newsquest)

Dr Kennedy, a family doctor in the Highlands, said that patients were becoming "too tolerant" of the poor service they were receiving.

In an interview with yesterday's Times  he said: "When it reaches the stage that patients who have cancer diagnoses are having to complain to their GPs because they are not able to get seen and they are not able to get treatment, that tells us just how bad things are becoming.

He warned that most GP practices in the Highlands were one retirement or resignation from total collapse and said steps must be taken including increasing the 4.5% pay offer on the table.

Patients should not wait more than two months (62 days) between the date the hospital receives an urgent referral for suspected cancer and the start of treatment.

READ MORE: Sturgeon: Super-rich 'laughing all the the way to the actual bank' after Kwasi Kwarteng's tax cut 

Figures show five per cent of patients waited more than 110 days while the median wait was more than six weeks during the first three months of the year.

The NHS is facing unprecedented pressure and of course much of this is a legacy of the extraordinary demands Covid placed on the health service and continues to. Accident and emergency waits, largely due to availability of beds, are rarely out of the headlines.

Newsquest (Image: Newsquest)

I recall interviewing a cancer specialist at Glasgow's Beatson in 2020 who said he was already seeing more patients with advanced cancer, months after GP appointments were rationed and some procedures were paused.

One patient who has undergone treatment for cancer in May was told he would be seen by his consultant to discuss the results within eight weeks.

He waited 12. Of course, he is fortunate that he is (hopefully) on the other side of the cancer journey but we shouldn't underestimate the stress of waiting to be told if you are cured. However, he does not blame Holyrood for the situation.

READ MORE: Kenny Logan's prostate cancer was 'huge shock' 

He said: "The Scottish Government does not have the overall control of the budget and has limited scope to increase funding for the NHS.

"Brexit has been a disaster for the NHS and has caused staffing shortages."

The Scottish Government maintains that it is diagnosing and treating more cancer patients now than before the pandemic but has acknowledged that "we must do more to improve our diagnostic pathways for cancer."

Making cancer a priority inevitably means the treatment of other illnesses might be compromised. 

Those with conditions that are not life threatening but incurable and excrutiatingly painful also have the right to expect a good standard of NHS treatment.

I cover many reports by the Scottish Public Services Ombudsman, which point towards mistakes or delays in cancer diagnosis or treatment. 

Doctors are not infallible, it is an uncomfortable reality but mistakes happen as in all walks of life and for every bad story there are many many more positive ones that don't make the papers.

There are no easy answers for ensuring the smooth running of our cancer services. Some will point towards the amount we pay for our health service, others will blame mismanagement or the constitutional make-up of the UK.

However it is critical that the Scottish Government listens to those at the sharp end of cancer care to ensure the country's remarkable legacy continues.