The Irish Cancer Society(ICS) report on waiting times for essential diagnostic tests makes sobering reading. A finding of “striking differences” in access between public and private patients in the Irish health system suggests reduced treatment options and diminished chances of survival for patients attending public hospitals.
The survey of almost 600 GPs across the country found that public patients have to wait up to 480 days for an ultrasound, 360 days for gastrointestinal tests such as colonoscopies, and 280 days for an MRI scan.
While public patients wait an average of 120 days for an MRI of the spine or central nervous system, private patients can access the test in less than a week. Meanwhile the difference in average waiting times between public and private patients for an abdominal ultrasound is 75 days.
These tests are a vital part of assessing patients who a doctor is concerned may have symptoms of cancer. Although a fast track referral system now exists for patients strongly suspected of having breast, lung, prostate and other cancers, and has made a significant difference in their early diagnosis and treatment, it would be inappropriate to swamp these clinics with people experiencing less specific symptoms.
Speedy access to scans and ultrasounds maximises the early diagnosis of cancer. And while the majority of tests performed will either be normal or indicate a non-life threatening illness, from a peace of mind perspective alone public patients deserve better.
The inequity unearthed by the ICS research affects over half the population who do not carry private health insurance. Frustrated and worried by delays some will borrow the hundreds of euros required to pay for certain scans. Others present to already overcrowded hospital emergency departments in the hope of being fast tracked for tests ordered by their family doctor.
An equally disturbing finding is the persistence of geographic differences in accessing these tests in the public system. One of the principal drivers for setting up the national cancer control programme a decade ago was to address the problem of cancer patients being denied access to radiotherapy purely on the basis of where they lived.
Yet this latest research found that the farther a patient lives from a hospital the longer they must wait for many diagnostic tests. The finding of a wide geographic variation between the shortest and longest waiting times for tests for patients in the public system is unacceptable.
The experience of Cork colon cancer patient Gerald Ingoldsby, who credits private health insurance with saving his life, stands in stark contrast to that of Susie Long, the Kilkenny woman who died from the same disease in 2007 having waited seven months for a colonoscopy in a public hospital.
Almost a decade later the question remains: why are more than 4,000 public patients who are waiting longer than the recommended 13 weeks for a colonoscopy having their lives put at risk?