Women with a family history of breast cancer are being forced to wait so long for test results that some choose to have their breasts removed before they know whether they have the faulty gene, say health campaigners. A report by the charity Breakthrough Breast Cancer says that women are suffering "agonising delays" of two years or more for genetic test results. Many women had undergone private tests in the meantime, but others had resorted to mastectomies rather than risk developing the disease.
The charity said that in some parts of the country tests could take just a few weeks, but it emphasised that there were wide variations between laboratories and that the process was causing unnecessary anguish. It said that some women tested in 2002 were still waiting. In 2003 the Government promised that by 2006 anyone taking a genetic test should get their results within ten weeks.
The Government said yesterday that laboratories were "making excellent progress" towards meeting the goal. About 5 per cent of the 41,000 cases of breast cancer diagnosed in Britain each year are due to inherited faults in genes associated with strong family histories of the disease. A further 10 to 15 per centoccur in women with moderate family histories.
Most genetic tests look for changes or faults in the genes BRCA1 and BRCA2. A woman with a fault in one of these is up to 85 per cent likely to develop breast cancer, and up to 40 per cent likely to develop ovarian cancer.
Genetic testing involves a two-step process. First, in the diagnostic part, a living relative with breast cancer is tested. Next, the healthy person is tested to see if she has inherited the fault. This is called predictive testing.
The charity surveyed 27 genetic counsellors and more than 50 women who had been genetically tested. More than half of the counsellors had patients who had opted to have their breasts removed while waiting for their results or the results for an affected relative. Jeremy Hughes, the chief executive of Breakthrough Breast Cancer, said that it was unacceptable that women were forced to put their lives on hold while waiting for vital test results. He said: "The decision to take such a test is extremely personal, complex and difficult enough. That some then feel compelled to make crucial healthcare decisions out of fear of developing breast cancer while waiting for their test results is appalling."
A spokeswoman for the Department of Health said that waiting times for results had been a problem. She said that an extra 18 million pounds in funding had been allocated to NHS genetic laboratories to speed up the process. "They are making excellent progress towards this important goal."
Source
Ambulance problems still not fixed
Despite Queensland government assurances
A boy who fell through an aquarium almost bled to death because an ambulance was diverted to treat a man whose throat became sore after eating a hamburger, paramedics claim. The boy, 12, from Mooloolaba, had to wait 30 minutes before another ambulance arrived to take him to Nambour Hospital.
The mix-up has been blamed on a faulty computer system and lack of experienced staff at a Queensland Ambulance Service communications centre on the Sunshine Coast. "The QAS management have assured the public that all the problems have been rectified, yet situations like this continue on a daily basis," a senior ambulance source said. "The computer system does not work and the operators don't have any clinical knowledge, so there is a huge risk that people could die unnecessarily."
But a QAS spokesman yesterday said the boy did not have life-threatening injuries and his case was given a Code Two (non-urgent) priority. The ambulance arrived after 27 minutes. "This matter was correctly coded and dispatched accordingly, the spokesman said. "From all the facts available, it was a straightforward case."
The source said an ambulance was dispatched to the boy after he crashed through the aquarium at his home a fortnight ago. But the paramedic was diverted to another "higher priority" case. "The second patient had been sick with a sore throat for a week and had aggravated it by eating a Big Mac," the source said. "Once the paramedic told the guy to gargle his medication, as prescribed by his doctor, she was again dispatched to the boy. "In her words they were `the most horrific injuries that I had seen that hadn't come out of a car accident - there was over half a litre of blood on the floor, the thigh bone was visible, as were tendons and a lot of tissue'."
The source said call centre workers were inadequately trained and crews frequently responded to "Code One" emergency calls that were little more than patient transfers to hospital. "Ring up with a runny nose or be involved in a minor nose-to-tail and you will get an ambulance Code One. But ring up after falling through an aquarium, or collapse with a stroke on the footpath, and your ambulance will probably take half an hour or more to get there," the source said.
The Sunday Mail reported in January how a Kilkivan man almost died when the ambulance service ignored his wife's initial call for help after a machine accident. Paramedics were dispatched only after she called a second time, an hour later. Ambulance Commissioner Jim Higgins blamed that delay on a fault with the dispatch system. A communications officer was counselled over the incident, but frontline staff complained that many Triple-0 calls went unanswered.
The article above appeared in the Brisbane "Sunday Mail" on June 18, 2006
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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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