GPs are sending non-urgent patients to hospital emergency departments in the hope they will get diagnostic tests for which they would otherwise have to wait up to two years.
Other tactics employed by GPs to beat lengthy delays for their public patients include using personal friendships with consultants to get them squeezed in for tests ahead of the waiting lists.
The Irish Cancer Society has described both practices as unsustainable and called for greatly improved access to diagnostic tests for patients who cannot afford to pay for them privately.
Research by the Irish College of General Practitioners (ICGP) on behalf of the Irish Cancer Society shows massive differences in waiting times for tests such as X-rays, ultrasounds, CT and MRI scans, and scopes depending on whether a patient is public or private.
While breast, lung, prostate, and skin cancers are now fast-tracked for all patients under the rapid access clinics scheme, waiting times for tests for other suspected cancers vary greatly depending on ability to pay.
Some of the worst disparities are in cases where abdominal or pelvic ultrasounds and brain MRIs are needed. In the worst scenarios, public patients wait anything up to 480 working days — a year and 10 months — for an abdominal ultrasound while private patients wait a maximum of 60 working days or three months.
Public patients wait up to 280 working days for a brain scan, 14 times longer than the maximum wait of 20 working days experienced by private patients. The difference is even greater when waiting times are averaged — 125 working days for a public patient or 25 times longer than the five working days for a private patient.
The HSE’s National Cancer Control Programme (NCCP) has taken issue with some findings, and in particular the study’s failure to distinguish between urgent and routine cases.
Dr Marie Laffoy of the NCCP said what appeared to be a lengthy wait for an ultrasound would be perfectly acceptable in the case, for example, of the routine surveillance of a gynaecological cyst which only required annual checks.
Dr Brian Osborne, assistant medical director of the ICGP, however, cited the case of a 51-year-old man awaiting a colonoscopy for prolonged diarrhoea and occasional bleeding.
People presenting with stage one colorectal cancer have excellent prospects of long-term health but those who present at stage four only have a 10% chance of being alive in five years.
This patient’s blood tests were normal, he had not lost weight so he could not be classed as urgent but, Dr Osborne said: “He may have haemorrhoids, he may have colitis, he may have cancer. He needs tests to know which.”
The NCCP said: “We appreciate fully that further improvements in cancer services are required, including greater awareness of cancer symptoms and early diagnosis. We look forward to ongoing collaboration with our colleagues in general practice and the ICS to ensure this is achieved.”
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