`Useless' medicine costs UK millions

Jeremy Laurance
Friday 05 February 1999 00:02 GMT
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THE NATIONAL Health Service is spending hundreds of millions on procedures that may cause more harm than good, while denying treatment to cancer patients whose lives could be prolonged, according to two studies published in the British Medical Journal.

The studies suggest that if removing varicose veins and screening for cervical cancer in older women were withdrawn and the money saved spent elsewhere more patients would benefit.

One option would be to increase spending on cancer treatment, which is half that in France and one-third that in Germany. Yesterday, cancer experts called for a new "human rights" movement to ensure all cancer patients get access to the treatment they need.

Death rates from cancer in the United Kingdom are higher than in many European countries and are directly linked to spending, according to the World Health Organisation. Five-year survival rates for ovarian cancer are 25 per cent in the UK and 40 per cent in France.

The two BMJ studies demonstrate the growing pressure on the NHS to ensure the maximum value from its pounds 40bn budget. Although 50,000 people a year seek surgery for unsightly varicose veins there is no evidence that it improves symptoms of heavy, swollen or aching legs, according to researchers at the University of Edinburgh.

From a study of 1,500 people, they found the symptoms were just as likely to occur in those who did not have varicose veins, and people with varicose veins were no more likely to suffer from the symptoms than those with unaffected veins. Removing varicose veins had no effect.

The second study, from University College London, suggests that the NHS may also be wasting money screening older women for cervical cancer in whom the disease is rare. They say that if regular NHS screening were to stop at 50 instead of the current 64, there could be an extra 600 cases of cancer each year but a saving of one-quarter of the pounds 132m annual cost of the programme in England.

However, although increasing numbers of health authorities are reluctant to pay for varicose-vein surgery, the ethical and political consequences of trying to restrict cervical screening make change there unlikely. A spokeswoman for the National Cervical Screening Service said research was underway to investigate the benefits of screening for older women.

Figures cited at the International Congress on Anti-Cancer Treatment in Paris yesterday show wide variations in cancer survival in different countries. Patients diagnosed with colon cancer have a 36 per cent chance of surviving five years in the UK, 51 per cent in Switzerland and 60 per cent in the United States. Professor Herbert Pinedo, head of medical oncology at Vrije University in Holland, said: "The price of anti-cancer treatments is too often a target for cost-saving measures."

NHS screening programmes for breast and cervical cancer and foetal abnormalities should be abandoned and patients who want regular checks should pay, a consultant obstetrician at Leeds General Infirmary suggested yesterday. Mr Jim Thornton said in a report for the right-wing Institute of Economic Affairs, that the costs of nationwide programmes were not justified by the numbers of people saved.

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