Britain: Thousands dying ‘because simple screening system has been delayed’

Delays in introducing a screening programme for a deadly blood condition are costing the lives of thousands of men each year, doctors say. Aortic aneurysms — swellings in the main artery of the stomach — can kill without warning and are the third most common cause of death for older men. But the Government has failed to bring in a national screening programme nearly two years after it was urged to do so.

All four UK health departments are considering whether all men in their mid-sixties should be screened for an abdominal aortic aneurysm (AAA), which is found in up to one in ten men aged 65 to 79. About 7,000 men bleed to death every year because of the condition, even though it can be prevented by a simple operation.

Campaigners say that checking whether men are at risk of a ruptured aneurysm would cost 25 million pounds, half the price of the breast cancer screening programme, and would save as many lives — at least 3,000 a year. The UK National Screening Committee recommended the programme in January last year and sketched out how it would work in May this year.

The abdominal aorta carries blood to the intestines and other organs nearby. Aneurysms, in which the arteries weaken, stretch and bulge, are common in this part of the body. Ruptured aneurysms are catastrophic: more than 85 per cent of men die when an unsuspected aneurysm bursts, compared with only 5 per cent of those who have a planned operation. However, those at risk can be assessed by a simple ultrasound scan.

George Hamilton, president of the Vascular Society of Great Britain and Ireland, accused ministers of unnecessary delays in implementing a full screening programme. “Ruptured aneurysm is a common and painful way to die. The evidence in support of screening is incontrovertible,” he said. The test, which involves measuring the diameter of the aorta, is funded in only a few areas, such as Gloucestershire, where a screening programme has been running since 1990. Yet doctors who offer screening to patients privately have been frustrated by criticisms that they are illegally charging for the service. Brian Heather, a vascular surgeon who pioneered screening for AAA cases at the Gloucestershire Royal Hospital, said that the test could be performed with a briefcase-sized portable ultrasound machine.

Factors that can contribute to the likelihood of developing an aneurysm include family history and risk factors for heart disease such as smoking, obesity and high blood pressure.

Derek Kendall-Smith, 77, a former England rugby international and managing director of a jewellery firm, had surgery for an aneurysm two years ago. He said that a 95 pound voluntary test had saved his life. “If I hadn’t been screened I would have had no idea there was ever a problem,” Mr Kendall-Smith, of Marlow Bottom, Buckinghamshire, said.

A Department of Health spokesman said: “This assessment has to take account of the likely impact on existing healthcare services and the infrastructure and staffing requirements.” [Translation: It would cost too much]

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Australia: Public hospital staff warned of prison for media leaks

Health authorities in Western Australia say public hospital staff have been warned they could face two years in prison if they leak confidential reports on adverse incidents. The Health Department is investigating the case of a confidential form, leaked to a Perth newspaper last month, that detailed the case of a man who died from a heart attack in Royal Perth Hospital's emergency department. The man had been admitted for a different health complaint, seen by doctors, stabilised and left on a trolley in the emergency ward awaiting a bed. After 11 hours in emergency, he suffered a massive heart attack and was unable to be resuscitated.

Royal Perth's executive director, Philip Montgomery, said it was the first state breach of a 1973 commonwealth law designed to protect the confidentiality of staff making incident reports under the Advanced Incident Management System, or AIMS. He said the hospital was concerned about the leaking of the AIMS form: "The point of the system is to encourage and facilitate staff to report incidents in such a way that their identity is protected, so clinical care can be improved."

Dr Montgomery said the penalty for releasing incident reports was two years in prison. "The consequence is that we've gone back to all our staff and made them aware you can't breach confidentiality." The matter could be referred to the Corruption and Crime Commission. Dr Montgomery said he accepted the man's 11-hour stay in emergency was too long "but we don't believe there has been any inappropriate clinical care".

An emergency staff doctor told The Weekend Australian the number of AIMS reports had dropped off immediately after the media story, because of staff fears of public disclosure.

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