I have a nice, flat stomach. However many chips I eat, I still have a nice, flat stomach. I’d like to say it’s flat because I do a lot of sit-ups. But I don’t. I have a nice, flat stomach because, six years ago, a surgeon chopped a great big chunk of it off. He put the flesh, and some blood vessels, in the space where another surgeon had just removed my breast. I lost a bulge and gained a breast, or something that looks very like a breast. I also gained a life.
There were other good things about having cancer. Readers wrote me nice letters. Friends brought me soup, and cake, and books. And I got to watch The West Wing. What I didn’t like so much were the letters for appointments that arrived after appointments, the scans that got mixed up, the files that got lost. What I didn’t like was the heart-thumping, brain-freezing, stomach-churning wait to discover whether I was likely to live or die.
In the 13 years since I found a lump in my breast, that wait for many people has got worse. According to the government targets, you’re meant to see a consultant within 14 days of your referral by a GP and start treatment within 31 days of diagnosis or 62 days after the first consultation and tests.
This week, new research from Cancer Research UK has shown that more than 130,000 cancer patients weren’t seen or treated within the targets. More than 6,000 patients had to wait longer than 104 days to start their treatment. That’s nearly 15 weeks. And let’s remember that a day when you have, or think you might have, cancer, is like a cat or dog day. A day when you think you have cancer can feel like a year.
I had my first operation on the first day of the Iraq war. The days that followed were a mix of pain and panic. When you go back to the hospital to get the results of the operation, it’s like waiting to find out if you have passed the most important exam of your life. And then being told that the examiners haven’t got round to marking it. When I finally got the results, which weren’t great, I saw a second surgeon, who also asked to see the pathology reports. They took six weeks to travel 30 miles. I was waiting to go down to the operating theatre when he tried to check the mammograms – and found an X-ray of an ankle.
The second time I got cancer, I thought things would be better. I was sent to a “one-stop” clinic, full of lovely art. I thought a “one-stop” clinic might be quite quick. It might, for example, mean that you got several things done in “one stop”. Unfortunately, it turned out that none of the four appointments I’d been told had been made for me had actually been made for me. Nor, it turned out, had the next two. Then someone told me about something called “patient choice”, and I got myself referred to a different hospital, where I lost a breast and gained a nice flat stomach.
I was lucky. I didn’t feel it at the time, but I was very lucky. In spite of all the confusion, I did actually get my diagnosis and at least some of my treatment within the targets. I went through it at a time when Labour had doubled its spending on the NHS. I didn’t go through it at a time when the government has said it’s meeting the demands of NHS England’s chief executive, Simon Stevens, but actually seems to be doing some interesting things with smoke and mirrors.
It was the Tory MP and GP Sarah Wollaston, who chairs the health select committee, who wrote 10 days ago to the chancellor demanding that the government drop its “incorrect” claim that it’s putting an extra £10bn into the NHS. The real sum, said the committee, was much smaller and came from cuts in spending on public health programmes, medical education and training. The real sum, in fact, is just not enough.
There is, of course, never enough money for the NHS. We’re getting older, fatter and more prone to diabetes. We’re not keen on exercise. We’re not keen on tax. Politicians have to deal with the cards we give them. And no one seems brave enough to tackle the ticking bomb of social care. Cut that, and funds to local authorities, and old people who would be fine at home with a bit of care end up for weeks on hospital wards. And all of this is without the £25bn Brexit “black hole” that the Institute of Fiscal Studies has just predicted by the end of this parliament. Yes, it’s a challenge you wouldn’t wish on your worse enemy. But we still have to do better than this.
If you were born after 1960, you have a 50% chance of getting cancer. You’re as likely to get cancer as you are to get married. No one expects anyone to bring out the bunting, but we do need a government that sticks to its targets and will give us all the best chance. Afterwards, we can look for silver linings or flat stomachs, but first we need a healthcare system that’s on our side. Trust me. Cancer is enough of a foe to fight.