Read: Waiting lists are yet another example of health inequality in the UK
‘W’ for waiting lists will loom large in Therese Coffey’s to-do list as the new Health Secretary gets her feet under her Whitehall desk.
New research of the world’s largest primary care database by the University of Exeter shows further concerning disparities in the waiting times for diagnosis and treatment of Black and Asian people in England. The data covered the four most common types of cancer, and three commonly experienced by ethnic minorities, in England between 2006 and 2016.
The analysis of 126,000 cancer cases found that the average time between a white person first presenting symptoms to a GP and getting diagnosed is 55 days. For Asian people that wait is 60 days, 9%, longer and for black people it’s 61 days, 11% longer. Those differences in wait times are even more stark for certain cancers. Asian people have to wait an average of 100 days for a diagnosis of oesophagogastric cancer, six weeks longer than the seven-week wait for white people. The median myeloma diagnosis wait time for black people was 37% longer than for white people. The median for white patients waiting longest is 41 days, for Asian patients it is 56, and for black patients it is 73. It means black patients waiting the longest for a breast cancer diagnosis wait an entire month longer than white women also forced to wait.
We know that delays in diagnosis mean fewer treatment options and later starts in treatment lead, inevitably, to worse outcomes. Not only are patients forced to endure additional stress and worry, they are more likely to suffer avoidable but irreversible complications. That exacerbates the poorer experiences and outcomes that are already experienced by many ethnic minority patients.
With the news that there are over 132,000 NHS roles unfilled – that is 10% of its workforce – the situation is unlikely to improve unless there is an injection of staff and much better retention rates. Recent figures from NHS Scotland showed just how far - and at what cost – it was having to go to plug staff shortages with the bill for private agency nurses tripling to £92m over the past five years. It has doubled in the past two years alone, with a single nursing shift costing the health service £1,900. Recent research from the British Medical Association (BMA) shows that England is next to last in Europe for the number of doctors per capita, requiring 46,300 additional full-time doctors to bring the country in line with the OECD EU average.
Despite the current shortages, last year saw 17,000 applicants to study medicine at university turned away. The Government subsidises courses and it usually caps the number of medical and dentistry students each year to control costs. That cap has been increased for the past two years to accommodate the higher A-Level grades determined by teachers as well as deferrals and disruption due to Covid. Universities in England, for example, offered 8,400 medicine and dentistry places for the entry year 2020, and 9,300 in 2021 but that’s been reduced to just 7,500 again this year. In the UK, more than 10,000 students were accepted to pre-clinical medicine for each of the past two years, but that figure will also fall this year.
Problems in the NHS cannot be solved in isolation from each other. It’s a complex subject but there is no doubt that issues of recruitment, training and retention have a direct impact on the increasing health inequalities we see across the UK and how effectively we can tackle them. Not many people would envy Therese Coffey her in-box, but it is potentially one which can make a huge difference to the lives of people across the UK.
