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Thursday, 10 April 2014

The European Cancer Patient's Bill of Rights - from a patient's perspective.




Introduction

We are all aware of Una Crudden and all the lobbying she is doing for a solo ovarian cancer awareness campaign in Northern Ireland. As such, we need to start thinking about the timing of the creation of the magic words “cancer patient” from an "ovarian cancer" point of view. What do I mean by this? From a legal point of view we need to answer the question as to when exactly does someone become a “cancer patient” and benefit from the rights enshrined in the European Cancer Patient's Bill of Rights. More specifically, at what point does a woman who is unaware that she has ovarian cancer become a “European Cancer Patient.”?
 In their article "A Catalyst for Change: The European Cancer Patient's Bill of Rights", the Society for Translational Oncology reference is made to the fact that strengthening health care systems is key to delivering strategies that will gain traction in optimising cancer outcomes. It is further stated that under-resourcing of cancer health care, particularly in the context of an increasing cancer burden, will lead to increased morbidity  and mortality, spiralling associated health costs, and significant loss of productive life years and will negatively affect the health of European citizens and economies.
Professor Lawlor warned of a "cancer epidemic" in the future at the launch of the European Cancer Patient's Bill of Rights.  In my opinion this will be like a big "cancer tsunami.".  So what will be the  difference  between surviving and being destroyed? 

 Maybe  our health care leaders should take some inspiration  from the late Mayor Wamura who was laughed at because he spent £20 million building a big sea wall and floodgates to protect his village Fudai  from a future tsunami. It took 12 years to build and had been regarded as a £20 million folly.In the rubble of Japan's north east cost the village of Fudai, 320 miles North of Tokyo stands as tall as ever following the tsunami .The 3000 residents owe their lives to the late Mayor Kotaku Wamura because he wanted to defend his people from the tsunami. At his retirement the late Wamura stood before village employees to bid farewell. He said:
"Even if you encounter opposition, have conviction and finish what you start. In the end, people will understand."
1. The  background to the European Cancer Patient’s Bill of Rights.
Before getting into the nitty gritty of the European Cancer Patient’s Bill of Rights it is worth mentioning the two “medical geniuses” that walk amongst us here in Belfast, Northern Ireland. Professor Mark Lawler is a Professor of Translational Cancer Genomics and is based at Queen’s University Belfast. He is the project lead with European Cancer Concord. Translational medicine is a discipline which aims to improve the health of individuals and the community by “translating” findings into diagnostic tools, medicines, procedures and education.
Professor Lawler has a very impressive CV and in short he is a professor with  at least 20 years experience in cancer research with a significant record of research achievement having won numerous national and international awards. He describes himself as a “passionate advocate for development of outreach activities and fostering increased public understanding of science/medicine.” 

Professor Patrick Johnston has been described as a world renowned cancer specialist from Queen's University Belfast and as someone who is leading the fight to improve cancer survival rates in Europe. It is stated that his work has culminated with the launch of the Bill which aims to address the disparities that currently exist in cancer care from one European country to the next. At the time of the launch Professor Johnston was the dean of the School of Medicine, Dentistry and Biomedical Sciences at Queen's University Belfast and has been at the forefront of cancer research for the past 25 years. The Professor is now Queen's University Belfast's new president and vice-chancellor.

Professor Johnston co-chairs the ECC which involves 17 countries and represents more than 1000 national organisations and millions of cancer patients and survivors. He said "In Northern Ireland we have seen the difference that a comprehensive cancer care and research programme can have on patient outcomes....the bill of rights aims to set a standard that all European countries can aspire to, ensuring that all citizens are entitled to optimum cancer care regardless of where in Europe they live."
Gabby Cruze, Executive  Director of the Society of Translational Oncology kindly provided me with a copy of the full article  “A Catalyst for Change: The European Cancer Patient's Bill of Rights”  and the link to the full article is below. The Society  have set out in a table the disparities in cancer health care across Europe. Topping the table is (i) patient-oriented cancer education (ii) access to information and support.  

2.      The launch of the European Cancer Patient’s Bill of Rights
The European Parliament chose World Cancer Day on 4th of February, 2014 to launch the  European Cancer Patient’s Bill of Rights in Strasbourg, France. Health care leaders, Members of the European Parliament against Cancer (MAC) and a group of patient advocacy organisations were present at the launch. The European Commissioner for Health Tonio Borg, stated the following at  the launch of the Bill of Rights:

..what better day to do so than on World Cancer Day –a day which draws world attention to cancer, and the need to pursue our efforts to improve the lives of all those who live with cancer.”

Professor Lawler gave a presentation at the launch of the European Cancer Patient’s Bill of Rights on behalf of  the ECC. This presentation can be viewed here and believe me he is worth watching  https://sto-online.org/ecp-bill-of-rights Professor Lawler stated that the Bill of Rights is a patient focussed initiative and an equal partnership between patients and health care leaders. He explained that the bill is a “catalyst for change” and “ we really need a change”.   

        What is the Cancer Patient’s Bill of Rights/Patient Charter.  
The Bill of Rights is a patient charter to empower European citizens to achieve both equity and innovation in cancer care and research. What do these “big words” actually mean in layman’s terms.The word “equity”  simply means fairnes and “innovation”means a new idea or way of doing something. The word “charter” by definition is simply a written statement of the rights of a specified group of people.  Indeed, the word “Charter” is commonly used for documents which set out rights of patients. It is common to find patient care charters now in GP practices, Hospital Trusts websites and they set out what you can expect from your GP , the  surgery, doctors and hospitals and in return what the GP or hospital trust expects from you, the patient.

Therefore, I understand the European Cancer Patient’s Bill of Rights to be a powerful document for patients which they can use to ensure (i)  they receive fairness with their cancer care and (ii) benefit from new developments in research.   
4.      What are the European Cancer’s Patients Rights.

Three patient centred principles (called articles) underpin the European Cancer Patient’s Bill of Rights.

Article 1:        The right of every European citizen to receive the most accurate information and to be proactively involved in his/her care.

Article 2:        The right of every European citizen to optimal and timely access to appropriate specialised care, underpinned by research and innovation.

Article 3:          The right of every European citizen to receive care in health systems that ensure improved outcomes patient rehabilitation, best quality of life and affordable healthcare.

5.       Why do we need a European Cancer Patient’s Bill of Rights.
European Cancer Concord  stated in their press release relating to the Bill  that there are significant differences in cancer incidences and mortalities within Europe reflecting inequalities in access to optimal cancer care between different national healthcare systems. Dacian Sarbu ( MEP, Romania) stated “In the current socio-economic circumstances in Southern, Eastern and Central Europe, where the public health systems are under constant pressure from austerity measures, cancer patients and their families are the first to feel the impact on their health, finances and quality of life.”

 6.      Analysis
A number of things struck me when I started doing my research for this article. Professor Lawler opened his presentation on behalf of the ECC with a reference to the Roman Poet Virgil and in particular stated “The Greatest Wealth is Health”. He referred to the increasing economic cancer burden in Europe and opined that “cancer is an epidemic waiting to happen.” Professor Lawler stated that the bottom line is that “cost effective cancer care and cancer research excellence can contribute significantly to the wealth and health of the European citizen.” 

We are all aware of Una Crudden and all the lobbying she is doing for a solo ovarian cancer awareness campaign in Northern Ireland. As stated at the beginning of this article, we need to start thinking about the timing of the creation of the magic words  “cancer patient” from an "ovarian cancer" point of view. What do I mean by this? From a legal point of view we need to answer the question as to when exactly does someone become a “cancer patient” and benefit from the rights enshrined in the European Cancer Patient's Bill of Rights. More specifically, at what point does a woman who is unaware that she has ovarian cancer become a “European Cancer Patient.”?   

Does she become a cancer patient on the day she is given her terminal prognosis  or does she become a cancer patient on the first day she seeks medical help and is given a misdiagnosis? In my view, the answer to the two questions raised above is "no". A woman becomes a cancer patient on the very day that the ovarian cancer starts in her body. As such, she is entitled to have her rights set out in the European Cancer Patient’s Bill respected and honoured not from the date of diagnosis but on the date that the cancer starts.

In my view, the woman who has ovarian cancer (whether she knows she has it or not)  is a European Cancer Patient with the (i) the right to receive the most accurate information and to be proactively involved in her care (ii) the right to optimal and timely access to appropriate specialised care, underpinned by research and innovation and (iii) the right to receive care in health systems that ensure improved outcomes, patient rehabilitation, best quality of life and affordable healthcare. Itis my view that this "optimum cancer care" includes information, education and awareness in the form of solo campaigns in order to avoid misdiagnosis or late diagnosis
Leaving Europe aside, lets look at the city of Belfast. We have two medical geniuses with a combined experience of at least 80 years or so in cancer research on one side of the city. These two men are giving their all to cancer patients locally, at  a European level and globally. On the other side of the city  we have our health care leader, our "partner"  who won't approve a solo awareness campaign for ovarian cancer.  Where is the equity/fairness in this decision for our European Ovarian Cancer Patients? How are European Ovarian Cancer Patients being empowered as per the articles in the bill?

We as European Cancer Patients have the right to solo awareness campaigns and to have our rights respected and honoured by our partners - our health leaders. We are now "partners" as well as "patients" - and partnership means equality. From a patient's perspective it seems that our health care leader is relying on the "floodgates" argument i.e., if one cancer group is successful with their plea for a solo campaign every other cancer group will follow. In my view it seems that the mentality is instead of helping all of them we will help none of them.  This is exactly the type of discrimination that the European Cancer Patient's Bill of Rights is aimed at.

                        Ms Una Crudden has pointed out time and time again the inequalities and injustices that exist  such as (i) Health Minister announced launch of ovarian cancer campaign in March, 2013 but it never happened (ii) If she had access to the cancer drug avastin like English women she would live year(s) more. (iii) Lives at stake in Northern Ireland because of 34 cancer drugs (iv) Research concludes Northern Ireland  has the worst awareness in all of EU at 3%. None of the women in NI questioned in a public survey conducted by the UK wide charity Target Ovarian Cancer were aware of the symptoms (v) Three out of four women (75%) diagnosed have three to five years to live due to late diagnosis (vi) Una's  cancer treatment is costing £ 100,000 (vii) streamlining operational costs in our health services can be achieved by a solo ovarian cancer campaign.
Una has now the support of all political parties as well as the Health Committee. The Society for Translational Oncology have stated that the current disparities between European nations at all stages of the cancer patient's journey are no longer acceptable. Let the European Cancer Patient's Bill of Rights be a catalyst for change. We now need to get Una's campaign over the finishing line. Please sign the petition  referring to the European Cancer Patient's Bill of  Rights. Share the petition and tweet your support for #tealtakeover. Link to petition below. 
I                          
                                        Please defend us against cancer, protect our rights and protect our lives.                              

                                                           #tealtakeover
                                              

http://theoncologist.alphamedpress.org/content/19/3/217

 
http://www.dailymail.co.uk/news/article-1386978/The-Japanese-
mayor-laughed-building-huge-sea-wall--village-left-untouched-tsunami.html

Link to 2013 BBC NI report on Ovarian cancer by health correspondent Marie-Louise Connelly 
http://www.bbc.co.uk/news/uk-northern-ireland-21155100

http://www.bbc.co.uk/news/uk-northern-ireland-26016428
http://en.wikipedia.org/wiki/Translational_medicine.






                                               




Saturday, 21 May 2011

UK Travel Insurance Consumer Guide Launched on 25th April, 2011

I am happy to report that the Association of British Insurers launched a travel insurance consumer guide on Monday 25th of April, 2011. The article can be found at Travel Insurance Consumer Guide
Rochelle Turner, Head of Research at Which? Travel has been quoted on the ABI website as saying:

"Buying travel insurance can be really complicated, particularly for those with pre-existing medical conditions or those wanting more than just medical cover. Which? Travel research shows that, in the last year, 10 per cent of people were disappointed to find that they couldn't make a claim against the policy they had purchased. The work that the ABI have been doing will help in the move to clarify what insurance does and doesn't cover so people are better informed and can buy policies that are right for their travel needs."

Rob Tinline, Director of Consular Services at the Foreign & Commonwealth Office is also quoted on the website as saying:
“Every year overseas Consular staff see cases where people don’t have adequate travel insurance and end up paying out thousands of pounds of their own money to cover their medical and other bills. Getting comprehensive insurance that covers everything you want to do on holiday is a vital part of planning your trip. We welcome the ABI initiative and hope it makes choosing a policy easier for British travellers going
abroad"

The top three things the ABI advises customers to think about when purchasing travel insurance:

• The travel insurance market is very competitive. However, the cheapest policy is not always the best as they often provide the least cover. Customers should shop around and ensure the policy they purchase covers their individual needs.

• Travellers must ensure they disclose their medical conditions to insurers so they can confirm if their policy will cover any emergency treatment they may need abroad, or whether a tailored policy would be better suited to their needs.

• Do not do anything on holiday that you would not normally do at home. Holidays are perfect for having fun, but travellers should still take necessary precautions to remain safe and not take unnecessary risks. Drink or drug-related incidents and leaving possessions unattended, particularly valuable items, could invalidate a claim.

To view the consumer guide please visit: Travel Insurance Consumer Guide

Please note that I do not endorse any travel insurance product or any other insurance product on this blog.

Thursday, 2 December 2010

Online travel insurance quotations for those affected by cancer

I am very excited as I am thinking about going on holidays after Christmas....... Holidays mean travel insurance and lots of online quotations! The first thing I found out this winter is that it is not possible to obtain a quotation unless you are travelling in the next 30 days. In other words, I can't get an online quotation now at the beginning of December for a holiday in February, 2011.  Quotations are  valid for 30 days and are subject to the usual terms, conditions and exclusions ( which are usually found on the site on the policy document).

I filled out all my personal information and was given a quote of € 52.83 for travel in Europe for up to 35 days...... Happy days. ........! However, when I reached the last page I had to tick a box confirming two things:

(1)             that I meet the eligibility criteria  and
(2)             that I have read the terms and conditions.

So, I duly clicked the link for the eligibility criteria and  the following condition jumped out:

" You or anyone requiring cover under this policy, have no pre-existing medical conditions or have not suffered from any serious chronic or recurring medical conditions"

I am not eligible for this policy at € 52.83 and if  I had proceeded to purchase the policy and subsequently had to make a claim under this policy there is the possibility that the policy would be completely void due to what is called " non-disclosure of a material fact" in insurance law and this is stated on the website.

So that is the end of the online quotation. It looks like I will now have to ring the insurance company to see if I am eligible for any other policy that they have on offer as there is a blanket exclusion for those with a pre- existing medical condition.

Friday, 2 April 2010

Leukaemia and Travel Insurance

Hi Guys,


Back to blogosphere with a bang. Every time we turn on the telly we are faced with more doom and gloom about the credit crunch! Can anything put an end to our misery? Mmmmmm.... a holiday of course... ..... just think about that walk along the beach, someone to grant your every wish,stunning views, magical moments, candelit dinners, sunglasses and smiles!

Then think about travel insurance................ Did I take that smile off your face? We all know that obtaining travel insurance before we head off on our holidays can be difficult. For people affected by cancer it can become a huge problem.

I was diagnosed with Acute Myeloid Leukaemia in November, 2004 and was disappointed to discover that my old reliable insurance company now excludes cover for Acute Myeloid Leukaemia. Shocking!

No, not really. I discovered that several companies have a cancer related exclusion which means that I am covered for everything except medical treatment related to my condition. Then of course, if I am unfortunate to get sick from anything else eg. food poisoning, malaria, heart attack .....I will have to prove that the illness which I developed is not related to my pre-existing medical condition.


It is a huge personal risk to travel without any form of cover. It might seem the easy option - take out a basic policy (approx £20.00 for a single trip in Europe), hop on the plane and hope for the best! Probably not the wisest thing to do though? What happens if you get sick on holidays or need to be flown home? But what do you do if some insurance companies don't want to know ... what if they won't even provide a quotation......?


When I was looking for a quotation, the Insurance Companies usually went through a few standard questions about my pre-existing medical condition (i) what date was I diagnosed (ii) did I go into remission (iii) have I been an inpatient in the last six months (iv) have I got a terminal prognosis.

It was frustrating when I provided all the information, had gone through all the hoops and was then told that acute myeloid leukaemia is simply not covered at all. Why, I asked - when it is almost five years since diagnosis?


It is just another problem that the recession has created. Insurance markets are setting the premiums higher or they are reducing the availability of insurance to those affected by cancer....even five years after diagnosis.


However, all hope is not lost and there are some specialist companies still providing cover for acute myeloid leukamia patients... at a price of course. It seems to be that the average price for a single trip policy for travel within Europe is approximately £20 - £30 ..... that is basic cover... ie., lost luggage, lost passport etc.

In order to get covered for a pre- existing medical condition it is necessary to go through medical screening where you will be asked a series of standard questions like those mentioned above. Hopefully at the end of the conversation you will be provided with a quotation.

I was quoted £52.77 which in the big picture is not too bad and at the end of the day is peace of mind when you are on holidays. So the total cost of travel insurance (to include cover for my AML) was £72.77.

The Insurers would not give me a quotation for the annual multi-trip policy so it looks like I will have to go through the whole process again the next time I am planning some holiday adventures!