Addressing gynecological cancer care: a plenary debate

I would like to start by apologizing to you on behalf of the NHS for where we got your care wrong and where we let you down.

(Eluned Morgan MS, Cabinet Secretary for Health and Social Services)

a Plenary debate to discuss the Senedd’s Health and Social Care Committee report’Unheard: Women’s journey through gynecological cancer‘, shed light on the struggles some women face with gynecological cancer, with their voices not being heard and their concerns being pushed aside.

The Minister of Health, Eluned Morgan MS, started her contribution with an apology to the women who had been let down by the NHS. She acknowledged that “despite people’s hard work and dedication, sometimes things go wrong.”

While the Cabinet Secretary’s apology marked a moment of recognition, some members emphasized that the experiences of the women mentioned in the committee’s report have a broader, the systematic failure to prioritize women’s health needs.

Although the majority of the report’s recommendations were accepted, a number were left out in the Cabinet Secretary’s response Members And stakeholders (including Tenovus Cancer Care, Marie Curie and the British Gynecological Cancer Society) discouraged.

This article explores the nuances of the debate and examines the Cabinet Secretary’s response and any possible shifts in position.

“We listen to women”

The women who courageously shared their stories with the committee it became clear how their health problems were routinely missed by healthcare professionals. Despite their intuition that something was wrong with their bodies, they struggled to be heard. Their symptoms were often dismissed or downplayed, leaving them feeling marginalized and sometimes even labeled as a nuisance.

Despite statements by the cabinet secretary that she listens to women’s voices, referring to the Quality Statement for Women’s and Girls’ Health, and the ongoing development of a women’s health plan within the NHS, a gap remains (i.e. the forthcoming women’s health plan for Wales will not pay specific attention to gynecological cancers).

Cabinet Secretary claims Welsh Government has already set out its policies and actions on gynecological cancer within government Cancer quality statement And the Cancer Improvement Plan.

The Cabinet Secretary has announced that it will hold a national summit in July 2024 to focus the NHS’s attention on gynecological services, including cancer. The initiative will certainly be welcomed by stakeholders.

“Gynecological cancer is a priority”

The Cabinet Secretary stressed in the debate that improving cancer care remains a top priority for the NHS in Wales. She recognized the urgent need to lengthen cancer waiting times and ensure faster access to diagnosis and treatment. She accepts that current performance is not meeting expectations.

In April, only 32.3% of patient journeys met the Welsh Government’s target cancer threshold of 62 days for gynecological cancer (the target is for at least 75% of patients to start treatment within 62 days (without deferment) of first suspecting cancer).

Graph 1: The percentage of patient pathways waiting to start their first definitive treatment in the month within 62 days of first being suspected of having cancer (target 75%)

The graph shows a clear underperformance in meeting the 62-day threshold for starting treatment for gynecological cancer.

Data source: Stats Wales

The graph shows a clear underperformance in meeting the 62-day threshold for starting treatment for gynecological cancer.

While the Cabinet Secretary has outlined Despite broader initiatives aimed at improving cancer care, such as the establishment of rapid diagnostic centers and wait time recovery programs, there remains a lack of targeted measures to address the unique challenges faced by women with gynecological cancer.

The Cabinet Secretary previously announced a national recovery program targeting three types of cancer, including gynecological cancer, worth £2 million.

However, questions about the allocation of funds within the £2 million program remain unanswered, including what proportion of funding has been allocated to gynecological cancers and how they have been used.

Despite accepting in whole or in part 24 of the committee’s recommendations, the Cabinet Secretary’s response does not provide for additional funding or reallocation of existing resources for this purpose.

“I am not dismissive in any way”

In the Cabinet Secretary’s opening remarks in response to the committee’s report, she claimed that “the vast majority of those receiving cancer care for gynecological cancer consistently report high levels of patient satisfaction with NHS services”. This is based on the findings of the latter Macmillan Wales survey into the experience of cancer patients (delivered by IQVIA on behalf of Wales Cancer Network and Macmillan Cancer Support).

An important finding from the research is that 92% of people with cancer in Wales treated during the pandemic rated their overall care highly.

However, Claire O’Shea, a patient herself, marked, “As a patient, at no time was I asked about my satisfaction with the services I received.” Similarly, Sioned Cash, whose mother’s testimony was crucial to the investigation, said: expressed that such a statement at the beginning of the response sets a dismissive tone for the rest of the report.

Committee member, Mabon ap Gwynfor MS, described the study as ‘the most heartbreaking, powerful and emotional investigation,‘ and condemned the Welsh Government’s response as “disgraceful”. He went further and accused the Welsh Government of contributing to ‘medical gaslighting’, a term describing how individuals are led to doubt their own experiences or perceptions. He pointed out that by claiming that the majority are satisfied with services, the government is adding to the suffering of these women by “effectively tricking them twice.”

Jenny Rathbone MS echoed these concerns, highlighting the urgent need to cultivate a culture within healthcare where women’s voices are listened to and their concerns taken seriously. She emphasized that while new services may not be immediately feasible given financial constraints, prioritizing a culture of faith and responsiveness to women’s health concerns is “within our reach” and is essential for the early detection and treatment of gynecological cancers .

While the Cabinet Secretary’s response acknowledges some concerns and the need for improvements in healthcare, it does not address all the specific questions and points raised. However, she emphasizes that change is happening.

Claire’s campaign (Together with Tenovus Cancer Care, Claire O’Shea has launched Claire’s Campaign to amplify the voices of women who have felt ignored by healthcare professionals).

Article by Sarah Hatherley Senedd Research, Welsh Parliament

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