Colonoscopy test delays

THERE are now over 1,000 people around the country who are waiting more than three months for a colonoscopy, which can diagnose bowel cancer.

Figures released this week by the National Treatment Purchase Fund (NTPF), which manages public hospital waiting lists, show that the 1,073 people now on the waiting list represent a 25% increase on the December 2009 figure of 852.
The Irish Cancer Society has expressed concern that the latest figures also represent an increase of 13% or 122 more people on the May statistics. According to the society, another 219 people have been left waiting for six months for what is regarded as the most effective procedure in diagnosing bowel cancer, with 36 not seen for more than a year.
What makes matters even worse, however, is that the waiting time could be eliminated if people took advantage of an important back-up scheme – at no cost to them.  It has emerged that there has been a very poor uptake on the option to have treatment under the NTPF.
The National Treatment Purchase Fund has confirmed it is in a position to treat all of those patients who have been waiting more than three months for a colonoscopy. The fund has written letters to all these patients to advise them of their entitlement to a free test but, to date, the uptake has just been in the region of 20%. Patients have been urged to avail of the test, which could be arranged in a matter of weeks. This is an invitation that should not be ignored.
In broad terms, the NTPF secures places in private hospitals in Ireland and abroad to treat public patients who have been waiting for a long period for surgical procedures such as hernia operations and hip and knee replacements. Treatment is provided free.
The Irish Cancer Society has noted how important it is that public hospitals and patients are aware that the NTPF service is available. Referring to the latest figures, Kathleen O’Meara said, “We are now even more concerned at the growth in the number of patients on waiting lists for colonoscopies because we know that there is space for every patient waiting to be treated immediately by referring them to the NTPF.”
The Health Service Executive (HSE) has outlined how inroads are being made into the list of urgent referrals. It conducts a weekly audit of urgent patients awaiting colonoscopy examination in order to reduce the wait times. Last October, 363 people were waiting longer than the four-week target for urgent referrals, but the HSE said this figure had reduced month-on-month and in May of this year, there were 44 patients waiting more than four weeks. 
Nevertheless, the HSE supports the call made by the cancer society for patients awaiting tests to avail of the NTPF system to expedite matters. Patients can go down this road by contacting their GP or the NTPF directly.
The key role which the colonoscopy test can play in early intervention treatment of bowel cancer is highlighted by the fact that over 50% of patients in Ireland are not diagnosed until tests reveal they have stage three or four of the disease, which is the most advanced stage. During the early stages of the disease, many people do not have any obvious symptoms. Fewer than 5% of those with stage four survive longer than five years. Bowel cancer is second only to lung cancer as the most common cause of cancer death in this country. In 2008, there were 2,216 new cases and 966 deaths from the disease.
Meanwhile, the Irish Cancer Society has called for a national bowel cancer screening programme for everyone living in Ireland aged 50-74 years. A year ago, the society offered €1 million towards the introduction of a national bowel cancer screening programme.
In February, Minister for Health Mary Harney announced a bowel cancer screening programme for the 60 to 69 age group would be rolled out by 2012. While accepting this as a “good start”, the society wants assurances from Minister Harney regarding the completion of the rollout as soon as possible to include the 55 to 74 age group.
Investment in a programme that would facilitate early intervention cancer treatment, would prove far more cost effective for the State and ultimately the taxpayer than having to pay for expensive surgery and follow-up treatment down the line.  Also, more lives could be saved.

New professor of surgery
THERE was a welcome development, for a change, on the health front in Clare this week as the Mid-Western Regional Hospital, Ennis welcomed its first professor of surgery.
Professor Calvin Coffey’s appointment came about as a result of a link-up between the University of Limerick and the Health Service Executive.
In addition to his appointment as the new professor of surgery at UL’s Graduate Entry Medical School, Professor Coffey will divide his time equally conducting clinical and academic research for the medical school and working in Ennis and Nenagh hospitals and the Mid-Western Regional Hospital, Limerick.
“A huge boost for the hospital and Clare patients,” is how Ennis hospital manager, Frank Keane described the professor’s appointment.
He noted the hospital is fortunate to secure the services of such a highly qualified and experienced surgeon.
Professor Coffey has pledged to continue the development of technical surgical excellence in the region. Having received training from some of the best colorectal surgeons in the world, he has developed an interest in generating research programmes examining the causes of conditions such as colon cancer, inflammatory pelvic abnormality and inflammatory bowl disease.
The Mid-Western Regional Hospital, Limerick and the University of Limerick are engaged in ongoing clinical studies in association with the Cleveland Clinic where he has previously worked looking at immunology and colorectal cancer.
With regard to the centralisation of surgical services in the region, he believes the streamlining of surgical services in patient interest could only be beneficial.
Hopefully, the HSE is in a position to give Professor Coffey the resources his needs to deliver on his objectives.