A life lost? Or finding solutions for cancer diagnosis and prognosis

Writing this, one week after my brother died peacefully on his favourite sofa from where, in recent weeks, he had watched endless programmes about cooking, eating food and salvage hunting. Things he would never do again. Why had he become stuck on the sofa watching things he would not do?

Late last year, he was told there were problems related to his lungs from lifetime asthma. He continued to enjoy his life and planning for his retirement. Earlier this year, the doctors believed he had a hiatus hernia. Again, no proper examination and he continued his retirement plans, getting on with life thinking he would have a medical procedure, retire; savour good health after clearing issues.

Still, things did not improve for him. Another doctor told him his liver problems were related to his drinking without examining him and clearly making assumptions on lifestyle.

Everything by telephone. Nothing by physical, clinical, examination to look beyond poorly constructed assumptions and a superficiality not becoming of medical teaching and learning across the United Kingdom.

The last week of April he finally got to see a doctor after our sister stood and demanded a physical appointment in our health centre. Our brother went to hospital and was diagnosed with oesophagus cancer. Again, he thought treatable. Get on with planning. On further examination, the oesophagus cancer was found to be in his stomach. Another return to hospital for a full examination and the consultant quietly told him he had incurable cancer. A prognosis of life expectancy? Maybe months.

Maybe, as it turned out, weeks.

No retirement.

From his proper diagnosis to his death? Less than two months.

What is this pointing to? Death is a finality none of us will avoid under present medical science.

But we can all plan and we can all take those plans from our heads and deliver on them for our own enjoyment; to ensure those around us, those who care for us, are able to savour the days with us building memories they will carry forward.

My brother had spent his life working in the family business. Starting at the age of 16 and dying at 69 years of age. Sum total — 53 years and for what?

Life cannot be summed up in monetary terms as the good wishes and appreciation of everything he has done for others is very apparent. People noted his grumpy, often obdurate style, then swiftly brought through the positives of when he was asked to support something, he supported it.

What is apparent is he didn’t get to appreciate the appreciation of others.

Our brother was diagnosed with cancer only after months of ill-health and struggling with a system designed to serve key people in it rather than those who needed, required, to use it for their health and wellbeing. Despite all the billions of sterling pounds spent, the digital system does not build coherence and a smooth referral approach.

Fine words will not bring his life back. Will not address the inept, if not downright incompetent, processing in diagnosing, building a quality prognosis onto a life lived but possibly not fully enjoyed.

The statistics state clearly a situation where the system is not working. Not supporting frontline professional healthcare people — Office of National Statistics — death rates 15% above 5 year rolling average.

What are we going to do so others can be supported far better than our brother?

How do we move together and challenge the self-serving becoming apparent in a system not working for the frontline health professionals?

Support the people who require their insights, knowledge and that professionalism?

‘We’ not being just those who knew my brother but all those who have endured similar angst and journeys of pain where accountability has been absent. Cancerresearchuk.org Over 2million people in backlog for cancer care. Where one person’s suffering can bring action for continued improvement.

‘We’ includes all of us who value the NHS, the National Health Service, and all the people who devote their energy to delivering for others across the British society.

This is not a eulogy; this is a call to action so others do not suffer the fate befalling our brother and many, many, others in the two million plus waiting list for people looking to know if they have cancer, can cure it or need to plan for quality of life in their remaining time.

With SARS-CoV-2 we witnessed frontline personnel in the NHS totally overloaded. Running on adrenaline and the motivations originally making them go into the healthcare industry in the first place.

Backed by saucepans being banged and not rewarded for being the essential workers as senior managers worked from home strategizing to plan and planning to re-strategize. The frontline people have not been fully supported. Are still not fully supported by policy and managerial skills required to deliver back-office functions facilitating strategic investment and longer-term planning taking some of the pressure from people constantly having to undertake remedial adjustments to daily, weekly, monthly scheduling of resources.

Time is ripe to hold senior managers accountable. Time is ripe to have full disclosure of how so many procurement processes have gone awry. The latest revelations regarding PPE, personal protection equipment, British Medical Journal government failure in procurement processes and the political shenanigans around the disproved panacea of privatisation Parliament points on Lancet study showing links between privatisation and treatable deaths now need concerted challenges given the weight of indisputable evidence showing inept, incompetent and downright corrupt practices.

Look again at how suggestions, comments and, yes, complaints, are handled in a system presently self-referencing with cosy relationships too often apparent in how governance is undertaken.

Our National Health Service.

Unions have been ostracised rather than embraced. Professional bodies have become defensive for members rather than contributing to the development in a Health Service taking pride in being part of a social protection system creating levelling up without all the political guff we endure.

Our Health Service.

Not more political rhetoric but proper engagement looking at what has happened and full, inclusive commitment to address the structural issues we have allowed to become problems. Problems killing people. Systems not supporting professionals who feel the frustrations of people not served by our health service. Our health service. Not this or that company’s health service — Private firms awarded over £15billion in contracts 2014–19. A health service part of basic services delivered so we can all build a far more innovative and inventive economy delivering real added value for all who have the skills to contribute. Not the extractive economics of privatisation but the inclusive education to advance the next generation to develop and feel pride in what has been built as a foundation for a socially protected, inclusive society where originality and intelligence are appreciated and supported.

Mutual support benefit and real inclusive growth.

Our Health — to serve and be served.