NHS refuses to fund new prostate therapy for men

Hundreds of men are being denied an alternative to radical surgery for prostate cancer because the National Health Service is refusing to pay for it. Hard-up primary care trusts across England have stopped funding brachytherapy, a new form of radiotherapy, although it has been approved by the National Institute for Health and Clinical Excellence (Nice).

Doctors and patient groups have accused the NHS of discriminating against men. John Neate, chief executive of the Prostate Cancer Charity, said: "Nobody should have to battle bureaucracy when they need all their energy to come to terms with a diagnosis."

Brachytherapy has fewer side effects than removing the prostate or giving radiotherapy for five days a week over seven weeks. Only 10%- 15% of men are left impotent after brachytherapy, compared with about 50% of men who undergo surgery.

The 9,000 pound treatment takes just one day. The patient has radioactive pellets implanted into the prostate gland. These target and kill the cancer.

Brachytherapy is not suitable for all prostate cancer sufferers but doctors believe that it is the best treatment for patients who have small tumours which have been caught at an early stage. Stephen Langley, a consultant at the Royal Surrey County hospital in Guildford, one of about 10 in England offering brachytherapy, said: "A similar number of men die from prostate cancer every year as women who die from breast cancer, but there is a fraction of the money going into prostate cancer."

The issue will be raised this week at the British Medical Association's staff and associate specialists conference. The Department of Health said: "With devolved decision-making, trusts can make different choices. The principle of local autonomy is important."

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VAST NHS COMPUTER BUNGLE

Evidence that the government's troubled 20 billion pound National Health Service computer system has lengthened waiting times for patients has emerged for the first time. It was hoped that a pilot scheme for the technology at the Nuffield Orthopaedic Centre NHS Trust in Oxford would show the benefits of the delayed system. Instead, when it went "live", the computers crashed, data could not be found and some patients found that they were facing among the longest waits for operations in the country.

In December 2005, just 12 people were waiting more than six months for an operation in England. But in the same month the Connecting for Health computer systems were launched at the Nuffield and the number of people waiting longer than six months started to rise. Within a few weeks more than 100 people in England were waiting longer than six months, most of them at the Nuffield, which insists that the problem is now resolved.

Staff who were instructed to sort out the problem could not even establish from the malfunctioning computers which patients had been waiting the longest and the numbers kept climbing. Details of the waiting list problems at the Nuffield, released under the Freedom of Information Act, will increase pressure on the government for an independent review of the scheme.

Lord Warner, the health minister, confirmed last week that the system was already delayed and would cost up to 20 billion pounds. The figure originally given by the government for the project was 6.2 billion.

The problems at the Nuffield were so severe that hospital managers could not even compile accurate data for the Department of Health on patients waiting to be treated. Figures now released by the hospital show that it repeatedly breached the government's key target of keeping no patient waiting longer than six months for an operation. On March 31 the number of patients waiting longer than six months for an operation was 123, out of a national total of 199 patients. This meant that the hospital, in most areas one of the best performers, had temporarily fallen to the bottom of the national league table for patients waiting longer than six months.

Leon Price, 31, who had to wait longer than six months for a back operation, said: "You have to wait long enough to be seen without problems like this. It's ridiculous that people were waiting even longer because of a faulty computer system."

The hospital is now confident that it has addressed the problems and that no patients are breaching the government's key six-month waiting target. Computer experts say the problems at the Nuffield highlight the need for a national review of the programme.

Ross Anderson, a professor in security engineering at the University of Cambridge, warned that the new system was likely to cause "chaos and disaster" in the NHS. "They're ripping out the old systems but they're not replacing them with anything better," he said.

The Connecting for Health scheme is intended to create centralised medical record systems for 50m patients and link more than 30,000 GPs in England to 300 hospitals by 2012. Many doctors and IT experts are concerned that a centralised system will make the NHS even more vulnerable to damage from computer failures. Connecting for Health said that the old computer systems at the Nuffield were in a state of near collapse and the new ones would improve patient care, although there had been initial problems. "It did cause disruptions to some patients, for which we are sorry," said a spokesman.

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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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