We all know scans and radiological tests are important for early diagnosis. We are less aware, (because dead people don’t vote) that lack of radiotherapy treatments keeping up to date and with adequate capacity are going to cost more lives. If the Health Service you are in was to be rationed overtly, and for smaller things you don’t fear rather than expensive things you do fear, the system would be much better and more equitable. Frontier issues and a Regional Cancer divide would remain however…
Two letters in The Sunday Times 6th April 2014 say:
Barriers to diagnosis
Not for the first time, GPs are left to shoulder the blame for more failures within the NHS. While I acknowledge that my GP colleagues do need to take some degree of responsibility, a difficult task is made more so by current referral channels.
The two-week-wait system has made no difference to rates of early cancer diagnosis. It only works well where the diagnosis is obvious anyway, such as with breast or skin.
Delays are increased by the barriers put up to GP access to diagnostics such as ultrasound, endoscopy and MRI. GPs can increase rates of early cancer diagnosis but must have the tools to be able to do so.
Dr Peter Holloway GP and Clinical Commissioning Group, Mendlesham, Suffol
Too few radiologists
We share the aspiration of Harpal Kumar (“GPs must end culture of delays”, Focus, last week) to achieve diagnosis of cancer at an earlier and therefore more treatable stage. However, we have reservations about his proposed strategy of carrying out diagnostic tests on more people.
The demand for imaging tests has already far outstripped the ability of NHS radiology departments to cope. With around half the number of radiologists per head of population that other western European nations enjoy, we simply do not have the capacity to interpret significantly larger numbers of scans.
We support the national screening programmes for breast and bowel cancers, which can best be detected by imaging. Earlier diagnosis of other cancers will most reliably be achieved by targeting imaging to people with specific symptom complexes and risk factors. We have been producing guidelines for doctors on the appropriate use of imaging for more than 20 years and we are keen to work with Cancer Research UK, healthcare leaders, Macmillan Cancer Support and other stakeholders to ensure that imaging strategies are designed to promote earlier diagnosis.
If this involves an increase in the number of people undergoing tests, significant further investment in radiologists and radiology services will be required.
Giles Maskell President Royal College of Radiologists