I have a plan to save 10,000 lives a year, but no one will listen. That is the number of the shocking excess of cancer deaths in the UK over the European average. The excess is mostly attributable to late diagnosis, or so the health regulator, the National Institute for Health and Care Excellence (Nice), has announced. The reason for late diagnosis is not money. It is our old friend, professional restrictive practice.
Years ago my GP said I should have a colonoscopy and checked me in to a prominent London teaching hospital. An appointment with a “top specialist” led to an inspection, to my embarrassment, in front of a class of his students. After inspection he proudly announced (to them) that I should have a colonoscopy. I protested that that was what my GP had ordered and I expected that day. He shrugged. Only he could order a colonoscopy, he said. I should make another appointment.
A month later, seriously worried, I went to a private clinic where a colonoscopy discovered a malignant growth, which I immediately had removed. Another month passed and an NHS official called to ask if I would still like my appointment. I thanked the NHS for trying to kill me.
Now Nice has said that cancer diagnosis should be made earlier. The BBC duly muttered about where the resources would come from. I recalled a devastating documentary from 2007, in which Sir Gerry Robinson tried to run a failing hospital. He would get into his car at the end of the day and slump in the seat with despair. It was not the patients or the nurses who were driving him mad. It was the consultants, who ran the hospital like a sideline to making money.
Nice daringly suggests that GPs should order “referrals for some routine tests without going through specialists”. This is revolutionary. We are not told what the specialists or the NHS hospitals say to that. But it has nothing to do with money, indeed the opposite. The early detection of cancer would save millions. And tests and scans at private testing centres cost roughly a tenth of what NHS hospitals charge commissioning groups for a specialist consultation plus test. Private waiting times are hours, not weeks or months.
The NHS testing regime is a racket, yet no one dares say so. It is a cliche that the NHS is over-managed. It is not. It is badly managed, because a politicised service is wallowing in a mix of institutional ideology and restrictive practice. People are dying because of it.
