Nicola Sturgeon has been urged to step in and secure the future of breast cancer treatment in Dundee after the chief executive of NHS Tayside said he cannot guarantee local services will continue.
Grant Archibald told MSPs on Holyrood’s public audit committee he is unable to make long-term promises about care in the region following the departure of several individuals from the health board’s oncology team.
Services are currently being supported by a consultant oncologist from NHS Grampian, who has been seeing all new neo-adjuvant breast cancer chemotherapy patients in Tayside since September 2020 in order to “cover vacancies”.
The health board said the specialist sees around three patients a week and the existing staff in Dundee “continue to see other breast cancer patients”.
NHS Tayside’s oncology team was thrown into turmoil in early 2019 following the revelation that around 200 patients were given lower-than-standard doses of chemotherapy drugs in a bid to reduce harmful side effects.
A Scottish Government-commissioned review said the treatment resulted in a 1-2% increased risk of their cancer recurring but a series of investigations by us revealed one of the experts behind the claim later privately admitted it was “flawed, probably, but the best that could be done, really”.
Physical threats
Doctors in Tayside claimed the review was “deeply flawed” and reported being physically threatened following its publication.
The findings of several other reports were also disputed and last month we revealed a senior doctor at the centre of a botched review voluntarily removed his name from the medical register after being reprimanded over an undeclared conflict of interest.
Mr Archibald acknowledged there had been “challenges around our delivery of breast cancer services in Tayside” and said in recent months one member of the team had “returned to their native country” and another had resigned.
It is understood one of the departing team members has since moved on to a post with another health board.
No guarantee
“Our wish, absolutely, would be that we would provide local services for local women,” Mr Archibald said. “However, I can’t give a guarantee if the staffing is not available.
“I will give an absolute commitment to this committee, as I do to the population of Tayside, that we look to provide excellent, safe services – safe for staff, safe for patients, safe for everybody – and using all efforts that we can to make sure that we provide exemplary services across the range of all NHS care in Tayside.
“In this particular area, it has been difficult, it has been difficult for the staff. I will need to look to find ways to ensure that we can recruit to that service before I could give a commitment absolutely that I can guarantee the service will be there.
“I will guarantee my commitment to wish to have local services for local women.”
A ‘grave shame’
North East MSP Jenny Marra, who is convener of the public audit committee, said she fears some women would not travel outside of Dundee for breast cancer treatment if the service is not sustainable in the long-term.
She said it would be a “grave shame” if the future of local treatment was put at risk “because of these problems at a high level”.
Several reviews have concluded the doctors in Tayside believed they were acting in the best interest of their patients by reducing the chemotherapy dose but found there was a lack of full-informed consent around the practice.
Speaking later, Ms Marra said: “The future of the breast cancer service in Dundee is now in jeopardy because the health secretary and NHS Tayside bosses let politics get in the way and refused to stand with their doctors who, as the scientific evidence shows, were acting in the best interests of their patients.
“The first minister needs to guarantee the long-term future of the breast cancer centre in Dundee. If she doesn’t, the grave danger is that women will go without treatment because they will not be able to travel.
“The end of this vital service cannot be allowed to happen. I hope other Dundee MSPs and MPs will support this call.”
A resolute failure
Patients and families affected by the treatment have repeatedly called on health secretary Jeane Freeman and Nicola Sturgeon to meet with them and help them find answers over their care but to date not a single meeting has been arranged.
A patient group – which calls itself NHS Tayside Cancer Care Support Group – has railed against the series of flawed or disputed official reports commissioned by the Scottish Government and other professional bodies for “resolutely failing to recognise the effects on the patients and families who must live with this”.
Calls for ministers to set up a public inquiry also appear to have been ignored, despite several patients seeing their cancer return since the issue first came to light.
‘Key clinical priority’
A spokeswoman for NHS Tayside said: “Providing safe and effective services for all patients will always be the priority for NHS Tayside.
“To do this, we must have the specialist staff in place to run services.
“NHS Tayside is fortunate to be part of the North Cancer Alliance which connects all the boards in the north of Scotland and provides a regional network to ensure patients across the area have access to cancer services.
“This type of network is invaluable, especially in more specialist areas.
“To cover current vacancies in our local oncology team, a consultant oncologist from NHS Grampian has been seeing all new neo-adjuvant breast cancer chemotherapy patients in Tayside since September 2020.
“The consultant takes part in the local multi-disciplinary meeting and sees around three patients per week.
“Our clinical leadership team is continuing to monitor the situation closely.”
The Scottish Government says it is “fully supportive of a continued cancer service in NHS Tayside”.
“Diagnosing and treating cancer has been and will remain a key clinical priority through the current Covid-19 pandemic and we are supporting services in our new cancer recovery plan, with planned investment of up to £114.5m over the next two years.”