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Up in arms over cancer confusion

Speaking as your average lazy, stupid GP, Copperfield rails at the half-arsed information available on cancer prescription charges

Speaking as your average lazy, stupid GP, Copperfield rails at the half-arsed information available on cancer prescription charges

The Up In Arms brigade are up in arms because two-thirds of the 'cancer patients' in England who should be claiming back prescription charges aren't. It's not because they're lazy and/or stupid and/or have bigger things to worry about - it's because their GPs are too lazy and/or stupid and/or have bigger things to worry about. We are, according to a report by Macmillan Cancer Care, failing to 'promote' the scheme.

Speaking as a typical lazy, stupid and easily distracted GP, I'd like to stick my oar in. It's not my fault if a lazy, stupid and distracted Government comes up with a half-arsed and unworkable scheme designed purely to divert attention from the fact that prescription charges have been abolished in Wales and are being phased out in Scotland and Northern Ireland.

Neither is it my fault that when patients check the NHS website for information about prescription exemptions they find that cancer isn't mentioned anywhere in the list of qualifying medical conditions.

Anybody Googling 'NHS cancer prescription' is faced with a selection of happy-clappy self-help hyperlinks rather than the information they need and anyone trying to download an up-to-date FP92A exemption form 'which must be clearly marked January 2009' is on a hiding to nothing. I tried for half an hour then gave up. And I'm not feeling nauseous and dizzy after a chemotherapy session.

Pedants will have noticed the quotation marks around the words 'cancer patients' back in the opening paragraph. For once, I'm not being 'ironic'.

Cast your mind back to the incredibly helpful Department of Health document (Gateway reference 11188 for the obsessive-compulsives among you) that arrived on your desk or in your email inbox in January. With admirable clarity and precision it defined who is and who is not a 'cancer patient'. Like hell it did. 'No charges shall be payable by a person… undergoing treatment for cancer, the effects of cancer or the effects of cancer treatment.'

Which means what? In an enthralling set of sub-sections it's conceded that the interpretation of the term 'cancer' is far from straightforward. One thing is crystal clear. If a patient has had cancer but is better now, they don't qualify, even if they are still trekking off to outpatients every year or two for a check-up. Unless they are still suffering from the after-effects of the treatment that made them better, in which case they might, or might not. Qualifying patients have to be undergoing (or have undergone) a course of treatment. This seems jolly unfair on skin cancer sufferers because they're usually sorted out by a single excision or blast from the liquid nitrogen cylinder.

However, if they can prove that they're suffering from mental stress as they adapt to life as a 'cancer survivor', then they're quids in. Unless they want prescriptions for sunscreens to prevent further lesions from developing, because those are excluded. That is, unless they can blag free factor 30 for some other reason.

Clement Attlee, who as Prime Minister oversaw the inception of the NHS, said: 'It is essential for Cabinet to leave in its wake a trail of clear, crisp, uncompromising decisions. That is what Government is about.' Not this one.

Dr Tony Copperfield is a GP in Essex


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