Irish Cancer Society report on “Access to Diagnostics Used to Detect Cancer” shows stark public – private divide

Public patients face waits of up to 480 days for important tests used to diagnose cancer, according to the report of an in-depth survey of GPs called Access to Diagnostics Used to Detect Cancer, commissioned by the Irish Cancer Society, carried out by the Irish College of General Practitioners (ICGP) and published this morning.

The report shows a striking difference in access to tests for cancer between the public system and the private system. General practitioners cited unacceptable delays across a number of areas, but highlighted tests for gynaecological, neurological, urological and head and neck cancers, as particularly problematic.

Waiting times for MRI Brain scans were estimated to be on average 20 times higher in the public system than the private, while the difference in average waiting times between public and private systems for abdominal and pelvic ultrasounds is 70 days.

The Irish Cancer Society says that this report highlights a stark divide between those who can afford to pay for private health insurance and those who cannot.

Donal Buggy, Head of Services and Advocacy at the Irish Cancer Society said: “The grim reality of our health care system is that the difference between life and death can come down to your ability to pay for healthcare.”

According to the report, 88.5% of GPs surveyed said that ability to pay affected a patient’s access to referral services.

Mr. Buggy continued: “We know from the many cancer patients and survivors who have shared their stories with us, that our two-tier system of health care leads to huge differences in outcomes based on whether you can afford to pay for private health insurance or not. This report makes clear that GPs working right across the country and in all socioeconomic areas, face a struggle in securing timely tests to diagnose public patients”.

Currently, 46% of our population have private health insurance1, around 39%2 hold a medical card with the vital entitlements it brings, while the remainder of the population have access to public healthcare, but have little to no support for the costs that entails.

Mr. Buggy said: “Early diagnosis often means a cancer is more likely to be treated successfully, intervention will be less complicated, and chances of survival may be higher. However, for the majority of the population without access to the private system, they may have to face lengthy waits that deprive them of early access to either a diagnosis or peace of mind.”

The Irish Cancer Society/ICGP report on access to tests used to detect cancer suggests that those with private health insurance are more likely to delay visiting their GP than medical card holders. Mr. Buggy said that “this indicates that ability to pay may also determine the point at which a person presents to a GP with symptoms.”

Speaking on the report, Dr. Brian Osborne, practising GP in Galway city and Assistant Director of the ICGP Postgraduate Resource Centre said: “Lack of access to tests for cancers leads to delays in diagnoses. These delays can potentially lead to worse outcomes for patients.”

“Difficulties in accessing diagnostic tests within a reasonable period of time means that at times GPs are compelled to send patients to hospital emergency departments in the hope that they can access relevant tests there. GPs also try to contact specialist services in hospitals to expedite appointments for patients but a lack of streamlined referral processes for most cancers can lead to long delays.”

The Irish Cancer Society’s report shows that personal relationships between GPs and specialists play an important role in ensuring access to tests for cancer for patients.

Donal Buggy added: “The fact that access to tests may be influenced by established relationships is a concern given that newer GPs may not have the same lines of contact to consultants or specialists. We believe that improved information sharing practices would go some way to removing a reliance on such relationships”.

The Irish Cancer Society/ICGP report has made a number of recommendations, including:

  • The introduction of new guidelines for referral for cancer tests that would mean the right patients are seen at the right time
  • That GPs have access to tests for suspected cancers within 28 days in each Hospital Group
  • Making access to more tests available to people in their communities, resulting in the earlier diagnosis of cancer
  • The development of cancer symptom awareness campaigns which would encourage patients to present earlier
  • Making electronic referral the standard method of GP referral for suspected cancers and promoting the use of ‘e-referral’ among GPs

Mr. Buggy said: “The comprehensive range of recommendations included in the report, if put in place, will make a big difference, across a wide range of areas, to ensuring early diagnosis of cancer.”

“However, without a wider conversation about, and commitment to, ensuring equal access to a universal, publicly-funded healthcare system for all, the huge inequalities of our peculiar provision of healthcare will remain and those who cannot afford to pay will be left behind. The Irish Cancer Society will continue to campaign for universal health care”.

The Irish Cancer Society believes that all citizens are entitled to the opportunity to live a long and healthy life, and the ability to pay for private health insurance should not determine a person’s lifespan or quality of life.

Anyone concerned about cancer can call the Irish Cancer Society’s Cancer Nurseline on Freephone 1800 200 700. Visit www.cancer.ie/cancergap to view a full copy of the report.