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Charles' diagnosis throws UK's long cancer treatment waiting times into sharp relief

Public health officials aim for 75% of patients with suspected cancer to receive a diagnosis within four weeks of a doctor's urgent referral

Published: Wed 6 Mar 2024, 10:42 PM

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This July 2023 self-portrait provided by Anna Gittins shows the elementary school principal from Hereford in western England in a hospital bed during her cancer treatment. — AP

This July 2023 self-portrait provided by Anna Gittins shows the elementary school principal from Hereford in western England in a hospital bed during her cancer treatment. — AP

For Anna Gittins, three months would have spelled the difference between life and death.

The elementary school principal from Hereford in western England was shocked when she found out she had advanced colorectal cancer in 2022. But when she contacted her local hospital, she was told no one would be able to see her for three months “due to high demand and low capacity of senior doctors".

“I've just been diagnosed with stage 4 bowel cancer, metastasized to my liver. I don't have three months to wait,” she said, using another term for colorectal cancer. She was just 46.

Gittins had access to private health care and has since undergone surgery and chemotherapy. “I consider myself so lucky, but there are so many people who will die needlessly when more prompt treatment would help them,” she said. “And that's not fair. Not in a country like ours.”

Gittins is among thousands of people with cancer let down by Britain's National Health Service, a once-revered institution now widely seen to be in acute crisis due to years of underfunding and staff shortages.

Waiting times to diagnose and treat cancer across the UK have worsened in recent years and are near record highs — and experts say too many cancers are diagnosed too late. Experts warn the burden of cancer will grow as the country’s population ages.

Palace officials' recent announcement that King Charles has been diagnosed with cancer has highlighted the issue. Officials didn't say what form of cancer Charles has, only that it was discovered during a recent corrective procedure for an enlarged prostate.

The 76-year-old monarch's decision to openly share his cancer diagnosis was widely praised, and experts said it was a powerful reminder that cancer affects 1 in 2 people in the UK. The news triggered a “King Charles effect" — immediately boosting visits to cancer information and support websites nationwide.

But many couldn't help compare the swift treatment Charles received, days after he was diagnosed, with how ordinary Britons fare at public hospitals.

Public health officials aim for 75 per cent of patients with suspected cancer to receive a diagnosis within four weeks of a doctor's urgent referral. They also say 85 per cent of cancer patients should wait less than two months for their first cancer treatment.

But the last time all such waiting time targets were met in England was in 2015, experts say, and the delays are even worse in poorer parts of the country like Northern Ireland.

One in three patients in the UK are waiting more than two months to start treatment after an urgent referral for cancer assessment, according to the independent think tank Nuffield Trust. In total, 225,000 people have waited too long since 2020, Radiotherapy UK says.

Survival for common cancers in the UK consistently lags behind countries with similar universal health care systems and per capita spending on public health, a recent report by the charity Cancer Research UK found.

Apart from longer waits, people with cancer in the UK also received less chemotherapy and radiotherapy treatment than countries such as Canada, Australia, Denmark and Norway, another study by the charity said.

“It's quite worrying that we treat less in the UK than in comparable countries. For lung cancer, for example, 28 per cent of patients get chemo in the UK. In Norway it's 45%,” said Naser Turabi, director of evidence and implementation at Cancer Research UK.

Turabi pointed to lack of investment in both equipment and specialist staff in the past 15 years, resulting in the U.K. ranking near the bottom among 36 developed countries for its number of CT and MRI scanners.

“We know we have an aging population, but there's no specific commitment from the government to meet the demand that we know is coming,” he said. "We can’t even provide online bookings for screening appointments. The digital infrastructure is 20 years out of date."

Demonstrators hold up placards in support of a strike by nurses outside St Thomas' Hospital in London on December 20, 2022. — AP

Demonstrators hold up placards in support of a strike by nurses outside St Thomas' Hospital in London on December 20, 2022. — AP

Kathy McAllister, a cancer survivor, is so frustrated with the NHS inefficiencies that she has retrained as a cancer awareness campaigner.

The former marketing director from Belfast, Northern Ireland, said she waited at least two months to start treatment after she was diagnosed with late-stage colorectal cancer in 2019. She added that she only managed to secure a follow-up scan after treatment because she persisted in chasing it down with hospital bosses.

“It's just a wait at every stage,” said McAllister, 53. “You expect cancer should be such a priority, that once you see a doctor they’re going to put arms around you, you’re going to be looked after, but you’re not. You're just another number because they're so overwhelmed.”

Cancer care isn't the only part of the NHS that's in crisis. Millions struggle to book appointments with their general practitioners or dentists, hospital emergency departments are regularly overwhelmed, and record numbers of people are stuck on waiting lists for routine treatments.

The Covid-19 pandemic worsened the situation, but the NHS — a huge institution employing more than one million people — has long struggled to cope as public funding shrinks and life expectancy grows. Many blame the crisis on the austerity policies of successive Conservative governments, which have cut budgets in health, social welfare and education during 14 years in power.

Asked about the delays in cancer care, NHS England said more people than ever are being diagnosed at an early stage of cancer and more treatment options are available. Over the past year, nearly 3 million people received potentially lifesaving cancer checks, compared to 1.6 million a decade ago, it said in a statement.

Prime Minister Rishi Sunak, who has made cutting waiting times a key priority, has blamed an unprecedented series of doctors' and nurses' strikes for the lack of progress.

Tens of thousands of doctors have walked off their jobs multiple times since late 2022 to protest deteriorating conditions and demand better pay, which unions say does not keep pace with surging inflation. Last month junior doctors staged a strike for six days, the longest such disruption in NHS history.

McAllister, the cancer survivor, wants cancer care to be a focal point ahead of Britain’s general election, expected to take place this year. She's calling on the government to draw up a cancer plan and devote as much focus and urgency to cancer as they did to the Covid-19 pandemic.

“It’s just shocking every time cancer waiting times come out they get almost ignored. We've become a bit numb to those statistics," she said. “We need people to stand up and say, 'It isn't good enough.'”



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