Byline: ANGELA EPSTEIN
WOMEN are more likely to die early in Britain than in virtually every other western European country. It's an astonishing fact for a place which has always prided itself in the skill of its clinicians and world-leading research.
Yet over the past 40 years there has been an astounding downward spiral in female survival rates in the UK compared with other countries. According to the respected medical journal The Lancet, British women have fallen from 15th to 20th place in a league of death rates in 22 western European nations (the report investigated deaths from disease as well as fatalities in accidents and childbirth). Overall, fewer women are dying earlier, however, in the UK survival rates are not improving as fast as they are elsewhere.
How could this have come to pass -- especially when there has been a steady rise in the amount of money spent on health by Government? The fact is, while the amount spent here has risen from 6.8 per cent of our national income in 1997 to about 8.7 per cent in 2008, other countries such as France and Germany still spend more as a percentage.
Leading cancer specialist Professor Karol Sikora says: 'It's tragic and outrageous that the NHS has tripled its spending over the past decade and yet -- due to bloated and unnecessary administration and poor policy such as artificial targets -- we still perform so badly.'
A lack of resources is partly to blame for our poor results. An extensive study last year found that in Britain there are 8.2 MRI and CT scanners per million people; the European average is 11. There are also far fewer doctors in Britain: 2.5 per 1,000 population, compared to 3.4 in France, for instance. This causes delays in diagnosis.
Just as significant is NHS rationing of lifesaving drugs -- for example, the bowel cancer drug Avastin and Nexavar, the only treatment offering any chance of survival for patients with advanced liver cancer -- are routinely used in other European countries. These drugs typically offer three to six months of extra life, but some patients can survive for years. Although the drug-approving body NICE agrees they work, it says the health system cannot afford them.
Despite the much-heralded reduction in waiting times, these patients often wait longer between scanning, diagnosis and treatment than in other European countries. In France, for instance, the investigation for breast cancer -- the appointment, scan and diagnosis -- is all done within 48 hours, says Professor Sikora.
'Here we have a long, drawn-out appointment system where patients wait to see a doctor, then a specialist, then for the CT scan and then the results. It can all go on for months -- allowing time for cancer to spread and become more difficult to treat.
'The Government prides itself with the fact that suspected cancer patients can see a specialist within two weeks of their GP deciding they need a referral. It is the curse of the British public sector that everything involves waiting -- even though we have a good breast screening programme.'
THE good news is death rates for most cancers are falling; however, we still lag behind most of Europe. A damning league table, compiled by the highly respected Eurocare-4 study, ranked Britain 14th of 19 European countries in a survey of five-year survival rates for any cancer (that is survival for five years or more from diagnosis).
Expenditure is an issue -- 5 to 6 per cent of NHS expenditure goes on cancer, compared with 7 per cent in France and 9 per cent in Germany. Another issue is the need for better early diagnosis at GP level, say experts. This is partly a training issue, but it also reflects GPs' reluctance to refer because of costs.
The reason that small countries such as Iceland fare better than us, say experts, is that patients are in a progressive healthcare system, looked after by a greater number of doctors. …