Dying cancer patients are denied approved drugs

Hundreds of cancer patients may have been left to die without access to life prolonging medication, despite the drugs being approved by the labour government.

A postcode lottery means hundreds of people are missing out on life-prolonging care

Now figures obtained under the Freedom of Information Act show that a cancer patient’s chances of overruling health authorities who deny them access to drugs depends on where they live.

Some NHS trusts, such as Torbay in Devon and Salford in Manchester, granted all appeals while in others, such as Kingston in southwest London, only 7% were granted. In about one-third of trusts, fewer than half of the requests for drugs that can cost thousands of pounds a month were approved.

Access to cancer drugs has become an election issue, with the Conservatives saying they will ensure the National Health Service directs £200m more into supplying new drugs. The money will come from what the health service would otherwise have had to pay to meet Labour’s hike in National Insurance, which the Tories have said they would partially reverse.

The drugs concerned have all been approved by the labour government’s National Institute for Curbing Expenditure (Nice). However, each of 152 primary care trusts (PCTs) in England is allowed to use its own interpretation of Nice’s regulations.

In some cases patients who have already had two courses of chemotherapy are not allowed the drugs; in other cases they must have tried cheaper alternatives before being eligible. Those who do not meet the conditions must appeal to an “exceptional case” panel.

Widespread variation in attitudes between health trusts emerged in research to be published in Health Insurance magazine. It asked how many “exceptional-case funding requests” for cancer were received by trusts in 2009.

It named five drugs, including Rituxan for leukaemia; Tarceva for lung cancer treatment and Revamid for blood cancer.

All such appeals were granted by 17 healthcare trusts, with the areas benefiting ranging from Walsall and Manchester, to Torbay and Suffolk. However, Kingston and Northamptonshire refused most of the appeals made to them.

Forty one of 122 primary care trusts that responded granted fewer than half requests. The figures present an incomplete picture because some trusts may prescribe medicines without the need for patients to appeal. Critics, however, say they still show unacceptably wide variations in practice.

Specialists also complain that the NHS trust officials who decide whether or not to grant the appeals are rarely experts in the disease, so they help to create the wide discrepancies.

Karol Sikora, a cancer specialist at Hammersmith hospital, west London, said his department has a wallchart that marks both sympathetic and unhelpful PCTs. “You find yourself talking to office temps and all sorts of unlikely people who are apparently making these life-or-death decisions,” said Sikora.

Memo to Gordon Brown- laughter really is the best medicine

On the morning after Gordon Brown’s “disastrous” day- Health Direct sends a message to him: laughter can do as much good for your body as a jog around the park, scientists have claimed.

laughter save lives

Gordon Brown smiling

Doctors describe “mirthful laughter” as the equivalent of “internal jogging” because it can lower blood pressure, stress and boost the immune system much like moderate exercise.

A number of volunteers asked to watch just 20 minutes of comedies and stand up routines saw a dramatic drop in stress hormones, blood pressure and cholesterol.

That means that the “laughercise” could be a way to reduce heart disease and diabetes. It is especially important to the elderly who may find it hard to perform more physical activities.

Dr Lee Berk, from Loma Linda University, California, who led the study, said that emotions and behaviour had a physical impact on the body.

He concluded “that the body’s response to repetitive laughter is similar to the effect of repetitive exercise”.

“As the old biblical wisdom states, it may indeed be true that laughter is a good medicine,” he said.

Dr Berk, who has been studying the effects of laughter for more than two decades, said that the high you get from a giggling fit was similar to the endorphin rush from exercise.

He has shown how it can reduce your risk of a heart attack and diabetes and generally regulate the body’s vital functions.

It is also an important way to de-stress after a day’s work, he believes.

In the mid-1990s, Dr Berk found that laughter increases the number of natural killer cells in cancer patients. Natural killer cells are the body’s way of fighting tumours.

For the latest study he had 14 volunteers watch either a stressful 20 minute clip of the war film Saving Private Ryan or an extract from a comedy or stand up routine.

Blood samples taken afterwards showed the reduction in stress hormones and increase in immune T cells for those who watched the comedy. Blood pressure testing showed it was down too with this group.

In 1997, Dr Berk performed experiments with diabetic heart patients. One group watched a television comedy each day for one year, another did not.

The difference in outcomes was stunning. At the end of the year, the comedy viewing group required less blood-pressure medication.

Eight per cent of the comedy viewers had another heart attack, compared with 42 per cent of those who did not regularly view it.

An earlier study also showed that watching just half an hour of comedy a day slashes levels of stress hormones and compounds linked to heart disease.

Levels of compounds linked to hardening of the arteries and other cardiac problems had also dropped, while levels of ‘good’ cholesterol – thought to protect against heart disease – rose.

An earlier study by Dr Berk also showed that the mere anticipation of a good laugh can benefit health.

The expectation of watching a comedy video was enough to raise levels of feel-good endorphins and boost amounts of a hormone that helps our immune system fight infection.

The findings were presented at the Experimental Biology conference.



Health Direct- Health On Net renews our accreditation

Health Direct is very pleased to announce that we were once again been accredited by Health On The Net Foundation (HON) for the third time on April 5 2010.

Health On the Net Foundation‘s origins go back to September 7-8, 1995, when some of the world’s foremost experts on telemedicine gathered in Geneva, Switzerland, for a conference entitled “The Use of the Internet and World-Wide Web for Telematics in Healthcare.”

As the conference wound up, they unanimously voted to create a permanent body that would, in the words of the programme, “promote the effective and reliable use of the new technologies for telemedicine in healthcare around the world.”

HON’s site went live some six months later. On March 20, 1996, www.hon.ch became one of the very first URLs to guide both lay users and medical professionals to reliable sources of healthcare information in cyberspace.

Health On The Net (HON) logoHON in the meantime has become one of most respected not-for-profit portals to medical information on the Internet. They are a Swiss foundation, operating out of Geneva with the generous support of  local Geneva authorities.

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information: verify here.

The Health Direct listing on MedHunt, Health On the Net’s medical search engine: http://www.hon.ch/cgi-bin/update.pl?HON17856

NHS boss gets £68,000 in bonuses- on top of six figure salary

NHS bosses are earning annual bonuses of tens of thousands of pounds on top of their six figure salaries as Anna Walker, chief executive of the Healthcare Commission, got £68,000 in bonuses.NHS boss gets 56K bonus Anna Walker

Hundreds of chief executives, departmental directors and board members of hospitals and other NHS organisations have received extra payments of as much as £32,000 – the largest single year’s bonus unearthed by freedom of information requests submitted by the Liberal Democrats.

The £32,000 bonus went in 2008-09 to Beccy Fenton, deputy chief executive of the Heart of England hospital trust, who already earns £170,000 a year. She received it after generating almost £1m of consultancy work for her employers, including private sector contracts. The trust stressed last night that the £32,000 was a one-off sum for consultancy work.

Anna Walker, who was chief executive of the Healthcare Commission until it was disbanded last year, earned the largest combined amount in the past three years – £68,150 on top of her six-figure salary. She received £22,375 in 2006-07, £23,000 in 2007-08 and £22,775 in 2008-09 for running the then NHS watchdog in England.

Norman Lamb, the Lib Dems’ health spokesman, condemned the payments as shocking. “These bonuses are utterly scandalous. People will be disgusted by the extent to which fat cats in the public sector have been enriched at a time when the NHS has denied people drugs that they need and access to treatments such as in mental health,” he said. “We thought it was just in banking, but the unacceptable bonus culture appears to be alive and kicking in the upper echelons of the NHS.”

This is the first time both the number of bonuses and their size has been disclosed. The Lib Dems sought information from every hospital trust, primary care trust (PCT), mental health trust and ambulance service in England, as well as other NHS bodies such as strategic health authorities.

While some pay no bonuses, many do. However, the figures do not reveal the full picture because some refused to disclose theirs and a few simply gave their chief executive’s salary band.

The £32,000 one-off bonus and the £68,150 over three years are large but not atypical.

Laura Roberts, chief executive of the Manchester PCT, received £25,732 extra in 2008-09, while Dr Patrick Geoghegan, her counterpart at South Essex Partnership mental health trust – who earns £170,000-180,000 – received £20,573 in the same year for helping it do well against NHS targets.

South Essex trust spokeswoman Maxine Forrest, said: “In 2008-09, to recognise the trust’s exceptional performance in national ratings, a one-off bonus was paid. Dr Patrick Geoghegan is chief executive of one of the most successful and highest-performing NHS organisations in the country.”

Paul O’Connor, a former chief executive of Birmingham Children’s Hospital, received a one-off £15,000 bonus in 2007 for helping it to achieve semi-independent foundation trust status within the NHS. He resigned late in 2008 after the Observer revealed doctors’ concerns that some care was sub-standard.

The chief executive of the Royal Berkshire hospital trust received £54,611 in bonuses over three years in 2007-09, while the chief executive of the Human Tissue Authority was given £37,895 in 2006-09.

Many chairmen, divisional directors and both executive and non-executive directors of NHS bodies also receive bonuses. The Royal Berkshire hospital trust spent £240,728 on bonuses in 2007-09, more than any other NHS body that provided figures. Eight executive directors shared another £186,117, as well as the £54,611 payment to the chief executive.

Large payments to senior figures in those three years were also made by the Healthcare Commission (£215,550), the London Ambulance Service (£130,646), the Hertfordshire Partnership mental health trust (£122,465) and Portsmouth Hospitals (£105,000).

All three main parties have pledged to slash NHS management and bureaucracy. “This is the first real analysis of the bonus culture at the top of the NHS, and it’s shocking,” said Lamb. “Bonuses of £20,000 or more are more than many NHS staff receive as their full year’s salary.”

From: http://www.guardian.co.uk/society/2010/apr/25/nhs-bonus-liberal-democrats

Nurses warn NHS health trusts plan thousands of job cuts by stealth

A survey by the RCN found thousands of jobs were already earmarked for cuts in an attempt to slash costs.

Health trusts are planning to cut thousands of staff “by stealth” to deliver £20bn of “NHS efficiencies”, according to a survey by the Royal College of Nursing. Labour reacted by promising that there would be more jobs in the health service at the end of the next Brown administration if it wins the election.

The move comes as Gordon Brown addresses the RCN’s four-day annual conference today. More than 4,000 nurses have gathered in Bournemouth for the event, which is expected to be dominated by NHS finances.

The nurses’ union has been riled by a warning from Sir David Nicholson, the chief executive of the health service, that up to £20bn of savings will have to be found by 2014.

A survey by the RCN of 26 of the 168 English health trusts revealed that 5,600 jobs were already earmarked for cuts in an attempt to slash costs. That figure could rise to more than 36,000 in a “worst-case scenario” if the trend was replicated across all hospital trusts, said Howard Catton, head of policy at the Royal College of Nursing. The loss of posts – including redundancies and staff not being replaced if they leave or retire – could happen over the next three years, he added.

In an online survey of 287 nurses earlier this month, the RCN said hospital wards were already operating with an average of 13% fewer staff than officially needed. Nine out 10 nurses said that patient care was being compromised by short staffing.

There is little doubt that the nurses’ union, which has 400,000 members, has political clout. Last year Brown became the first prime minister to speak at the conference in its 93-year history – to a warm reception by delegates.

Although health has not been a major focus of this election campaign, the issue of NHS job cuts is an explosive one for Labour. In 2006 the then health secretary Patricia Hewitt was jeered and slow-hand-clapped by nurses as she tried to address their fears about NHS deficits.

Andrew Burnham, the health secretary, told the Guardian that savings would come from wage restraint, cutting management costs by a third, and asking “some nurses and doctors to take on different roles in different locations outside of hospitals”.

“It is unlikely that we would need fewer people in five years in the health service. Labour will ensure sufficient funding to frontline NHS services so that they do not need to make any compulsory clinical redundancies and we will ask the NHS to co-operate across organisational boundaries and work towards ensuring this basic guarantee,” he went on. “Cutting doctors, nurses and frontline staff would be costly, counterproductive and would risk a return to the kind of NHS we saw under the Tories.”

The problem for Labour is that decisions on savings are being made at a local level. The RCN points out that managers at some trusts are already openly equating efficiency savings with job cuts.

In an open letter to staff, the chief executive at Salford Royal, a foundation hospital, said: “We are about to enter a financial crisis that could ruin all that we have achieved … this means reducing costs by about £16m a year [and] providing safe standards of service with about 250 fewer people for each of the next three years.”

The market reforms that Labour implemented have made it possible for hospitals to identify savings easily. Dorset county hospital, which made 28 posts redundant in March, admitted that its strategy to “attract more patients” with 300 new staff had failed, leaving a putative black hole of £11m in next year’s budget. The hospital issued a blunt press release: “These extra patients never came and so we are left with rising costs but without the income to cover them.” .

The Conservatives say that their promise to outspend Labour on the NHS insulates them against the charge that the health service is not “safe in their hands”. They say that thousands of NHS medics will lose their jobs over the next five years under Labour’s “secret” cost-cutting plans, which would see 651 fewer doctors and 2,050 fewer nurses across England.

Disclosures made under the Freedom of Information Act at the request of the Tories show half of NHS trusts that responded were planning reductions in the numbers of full-time equivalent doctors and nurses.

The shadow health secretary, Andrew Lansley, said: “We will back the NHS. Conservatives will increase funding for the NHS each year in real terms. So instead of Labour’s cuts to doctors and nurses, we will support the recruitment of staff we need, like specialist nurses, midwives and health visitors.”

From: http://www.guardian.co.uk/politics/2010/apr/26/health-trusts-planning-job-cuts

Quarter of NHS trusts failing hygiene tests

A quarter of health trusts failed to meet standards over hospital infections while five were warned over blood-spattered walls and mouldy instruments under a toughened regulatory regime.

Of particular concern was the state of ambulances, which were inspected for the first time. Investigators found dirty forceps stored in some vehicles as well as bloodstains.

The Care Quality Commission (CQC) used its sweeping powers last year to assess how well NHS trusts were coping with hospital infections – which affect 300,000 patients a year.

Of the 167 trusts inspected, 42 were found by the commission to be in “breach” of NHS registration requirements by not meeting standards.

All 11 ambulance trusts in England were assessed – and four found to have violated the terms of their NHS contracts.

Things were so bad that ambulance services in the north-west, east of England and east Midlands received formal warnings for the state of vehicles and stations.

The CQC, derided by critics as a toothless watchdog for “naming and shaming but not paining”, revealled that it has been granted the power to impose tough sanctions that could see failing hospitals warned, prosecuted, fined up to £50,000 and ultimately closed down if they fail to comply with the regulator’s edicts.

As a test-run of this regime the commission was authorised to examine the risks in the NHS of healthcare- associated infections and the results revealed that a minority appeared to take a cavalier approach to safety.

The reasons for failure were worrying: 36 trusts were not providing areas to decontaminate instruments; in three trusts there was a failure to regularly flush unused water outlets – crucial for the control of legionella infections; and 13 trusts were criticised for not keeping clinical areas clean.

Nigel Ellis, the CQC’s head of national inspection, said: “Good infection control takes constant vigilance – and meeting that every day, for every patient, is an ongoing challenge for the NHS.

“We have found evidence of a direct risk to patients and have intervened using our new enforcement powers to ensure swift improvements were made.”

Of these failing trusts, five had to be issued with a warning notice – the first step towards losing the right to operate in the NHS. Investigators pinpointed several serious transgressions, especially in ambulances.

In the north-west vans were stocked with dirty neck braces that were continually reused despite health guidelines urging disposal after one patient’s use.

At Stockport ambulance station, vehicle interiors were “seen to have stains (which appeared to be bloodstains) on the walls as well as visible dirt on the floor and walls”.

In Essex “hand wipes were not available” and “poor levels of cleanliness” were found in 22 out of 23 vehicles inspected. Ambulance equipment in the East Midlands was singled out for being “visibly dirty, including suction units, defibrillators and the tips of forceps”.

The hospitals highlighted for poor practice were both foundation trusts: Basildon and Thurrock university hospitals, and the world-famous Alder Hey children’s foundation trust in Liverpool.

In Basildon, where the commission’s old ratings system had come under fire last year for labelling the hospital “good” weeks before it emerged that dozens of patients might have died after receiving substandard care, investigators found a dismal scene: “Procedure trays used by staff to carry equipment when they take blood samples or give injections had blood spattered on them … a commode soiled under the seat.” Out of date equipment was also found in the emergency stores.

In Alder Hey, one of Europe’s largest children’s hospitals, the inspection revealed dirty toys, hair stuck to medical equipment and “nappy changing mats stored on the floor next to a toilet … and a dirty baby bath was inside the full-size bath”. The water “ran brown” from taps in rooms ready for patients to be admitted.

The commission said the threat of further measures had pushed the offenders into cleaning up their act. Hospitals and ambulance trusts were forced to set up better procedures, buy new equipment and “deep clean” wards and vehicles – or face a rolling wave of inspections. The last of the conditions imposed for infection control was removed only last December.

Under the new regime CQC can send teams of investigators, accompanied by groups of patients, to hospitals to see whether they match “client” expectations. The bolstered regime is capable of 2,000 unannounced visits a year – three times the current level. “We want to put the patient at the heart of what we do,” said Dame Jo Williams, acting chair of the commission. “Doesn’t matter if it’s the health service, the banking system or Tesco, there is something about the way you are treated as a patient or a client or a customer.”

From: http://www.guardian.co.uk/quarter-nhs-trusts-failing-hygiene-tests

How the NHS covers up fatal blunders

NHS hospitals are covering up fatal blunders by doctors and issuing misleading information about accidents to patients’ families.

Deaths are sometimes blamed on natural causes or untreatable injury, when in fact patients have suffered a drug overdose, a surgical error or misdiagnosis.

New laws came into force last month requiring hospitals to send anonymous reports of mistakes to a central database. Failure to comply will lead to prosecution. However, the new reporting system by the Care Quality Commission, the health watchdog, has angered patients’ groups because it does not require doctors to share the information with victims or bereaved relatives.

Medical negligence lawyers say they have dealt with cases in which hospitals have tried to cover up errors by changing or destroying records.

“We see many instances of alterations of handwritten medical records, seemingly in an attempt to mislead,” said Clair Hemming, a solicitor from Exeter. “You get additional wording squeezed in and no proper explanations offered.”

Although many millions of successful procedures are carried out annually, Department of Health statistics indicate that about 500,000 patients a year are accidentally harmed in NHS hospitals. Only 30,000 of these incidents lead to complaints and only 6,000 to litigation.

“The NHS Litigation Authority says it faces liabilities of £10 billion based on reports it receives from hospitals of accidents where people would have the right to compensation,” said Peter Walsh, chief executive of the charity Action for Victims of Medical Accidents. “Yet only £870m, including costs, was paid out last year, suggesting very large numbers of patients must have no idea they are entitled to compensation.”

Bowen, 34, of Cricklade, Wiltshire, has been asked to speak at a forthcoming conference by the National Patient Safety Agency (NPSA). She will talk about the failure of hospitals to come clean when tragedies occur.

Her daughter had been due to undergo a serious, but routine, operation to remove her spleen because of an inherited blood disorder. The same procedure had been done successfully on her brother, who had a similar condition.

“You are in so much pain and despair after the death of a child that you don’t have the strength to fight a hospital, but that’s what we had to do,” Bowen said. “A year after Beth died we were still having meetings with the hospital and they kept changing their story.”

Bowen believes the strain led to her husband, Richard, 31, a design engineer, having a fatal heart attack, leaving her to raise her children, Will, 6, and James, 4, on her own.

Managers at the John Radcliffe hospital in Oxford, where Bethany died almost four years ago, have acknowledged the error that killed her and paid £10,000 compensation. The hospital is now taking up Bowen’s suggestion to train doctors to communicate better with patients.

Next month Great Western hospital in Swindon is expected to face a £20,000 fine after claiming that Mayra Cabrera, 30, had died from natural causes an hour after giving birth.

In fact her heart stopped because she was injected with bupivacaine, an anaesthetic infusion that was mistaken for saline solution. Her husband, Arnel, discovered the truth 14 months later. Last week the hospital insisted the death had not been covered up because the police and coroner were informed within 24 hours, although it conceded the husband knew nothing of the police inquiry.

Bupivacaine continues to be involved in hundreds of medical accidents. Between June 2006 and the end of February 2010, 453 anonymous cases were reported under the voluntary NPSA system; 22 of those cases caused “permanent harm”.

There is opposition, however, to making doctors legally obliged to own up to mistakes. “They would fear being targeted with disproportionate blame and anger,” said Stephanie Bown, policy director at the Medical Protection Society. “We want a culture of openness, but that sort of law would just drive mistakes further underground.”

From: http://www.timesonline.co.uk/tol/life_and_style/health/article7078866.ece

Ambulance ‘waiting rooms’ cost NHS £11m

The NHS has wasted more than £11m using ambulances as “waiting rooms” to get around Labour’s target that patients should be treated within four hours of entering casualty.

New figures reveal the time spent by crews waiting outside hospitals for their patients to be admitted last year was the equivalent to funding 31 fully staffed ambulances to do nothing for 24 hours a day.

The statistics released by NHS ambulance trusts show the amount of time ambulances are forced to remain idle is increasing each year. In the first nine months of 2009 the total so-called “dead time” in England reached 284,000 hours — more than the whole of 2007.

The four hour target was introduced in 2004 in an effort to end the scandal of patients left on trolleys overnight waiting to be seen by doctors.

However, it has led to hard-pressed casualty departments refusing to admit patients until they can be sure they can be seen within the four hour limit. Waits of more than two hours occur in hundreds of cases each year.

Mike Penning, a shadow health minister, said: “It is a scandal that desperately needed frontline paramedics are trapped at hospitals around the country because of Labour’s fixation with the target culture.

“It can’t be right that bureaucracy has taken over from clinicians being able to put patients first, rather than watching the clock. Millions of pounds are being wasted and patients are suffering.”

The Conservatives have promised to slash the number of NHS targets and hand more power to doctors.

From: http://www.timesonline.co.uk/tol/news/politics/article7078867.ece

NHS admits failings in IT records plan

The National Health Service’s £12.7bn scheme to create an electronic patient record will “no longer provide the comprehensive solution” originally promised, says a top NHS executive.

Until now, health ministers and officials have acknowledged that the world’s biggest civilian information technology project is running four to five years late, and have said they want to make £600m savings on the £4bn-plus worth of contracts held by CSC and BT to deliver it.

Up to now, however, no one has conceded that the programme will fail to deliver everything that was promised back in 2003 when the contracts were signed.

Following a revamped deal with BT – the London supplier, which has cut £112m or about 12 per cent off its contract – Ruth Carnall, the chief executive of the London strategic health authority, has said the spending reduction means “it will no longer be possible to provide the comprehensive solution that was anticipated in 2003”.

Not all NHS organisations in London will now receive the software needed to deliver the records, Ms Carnall makes clear in a letter to London chief executives.

Meanwhile, Christine Connelly, the health department’s chief information officer, has said that only about half of London’s 32 big acute trusts will now get the full solution. Others will be able to add clinical systems to existing patient administration systems.

In place of a dedicated means of sharing records across hospitals, and between hospitals and primary care – a key goal of the programme – London will have to rely on the national summary care record, Ms Carnall says. However, this contains little other than allergies and current medication, and does not yet carry referral or discharge information.

On top of this, the Tories have said they will scrap the national record if they win the election.

BT will no longer have to deliver new systems to London’s ambulance service or GP practices. And London can afford to pay for Map of Medicine, a decision support tool for treating patients, for only one more year, says Ms Carnall.

In much of the country, installations in acute hospitals are stalled after CSC missed a deadline to get its solution running at Morecambe Bay NHS Trust. The supplier risks being fired, but is likely to sign a similar, more restricted, deal if it does hit a new deadline for a successful installation.

Glyn Hayes, president of the UK Council for Health Informatics Professions, said it had been clear for some time that the programme was to be reduced. “But this is the first official admission that there are things it will not do that it was intended to do.”

It was unclear, he said, whether the Conservatives would in fact scrap the national record if they won. “But if they do, it knocks a hole in London’s plans,” because without it the capital had no easy means of transferring patient information between settings.

From: http://www.ft.com/cms/s/0/fba8e660-436d-11df-833f-00144feab49a.html

NHS bars cancer sufferer after she saw doctor privately

A woman has been denied an operation on the NHS after paying for a private consultation to deal with her severe back pain after cancer.

Jenny Whitehead, a breast cancer survivor, paid £250 for an appointment with the orthopaedic surgeon after being told she would have to wait five months to see him on the NHS. He told her he would add her to his NHS waiting list for surgery.

She was barred from the list, however, and sent back to her GP. She must now find at least £10,000 for private surgery, or wait until the autumn for the NHS operation to remove a cyst on her spine.

“When I paid £250 to see the specialist privately I had no idea I would be sacrificing my right to surgery on the NHS. I feel victimised,” she said.

The case will reopen the debate over NHS policy towards patients who pay for some of their care privately. Following a Sunday Times campaign in 2008, the government ordered the NHS to stop withdrawing care from patients who received additional private treatment or drugs.

Cancer sufferers were being barred from further NHS treatment after buying potentially life saving medicines not offered by the health service.

Whitehead’s case, which has shocked her local Labour MP, reveals that patients who go private in despair at long waiting lists still risk jeopardising their NHS treatment. Department of Health officials admit it remains official policy.

Whitehead, 64, a former museum assistant from Yorkshire who works as a volunteer at a hospice, went to her GP in December for back pain. Because of her breast cancer history, she was immediately offered an MRI scan to check the disease had not returned. It revealed a cyst on her spine, pressing against her sciatic nerve. Her GP referred her to a consultant at Airedale NHS hospital.

She was told the next available NHS appointment was in May, so she accepted the offer of a private slot to see him the following week.

“My husband and I are retired and don’t have a lot of money, but I am in intense pain and couldn’t face the thought of waiting months just for an initial consultation,” she said.

The specialist promised to add her to his NHS waiting list for surgery. After two months, however, hospital managers told her she had been barred from the waiting list because she had seen the surgeon privately.

Now her only alternative to paying £10,000 privately is to go back to her GP, seek another referral to the same specialist, this time on the NHS, and face another 18-week wait.

“We will scratch together the money if we absolutely have to, but I feel it’s incredibly unfair,” said Whitehead. “I’ve paid full National Insurance contributions all my working life and feel I should get this operation on the NHS.”

Ann Cryer, who is standing down as Labour MP for Keighley, has written to the hospital urging it to reconsider. She told Whitehead that she had been “badly let down and ill advised”.

Bradford and Airedale NHS trust said it was looking into the case “as a matter of urgency” but added: “Anyone who chooses to pay for a private outpatient consultation cannot receive NHS treatment unless they are then referred on to an NHS pathway by their consultant.”