Wednesday, June 11, 2008

Another victim of NHS pennypinching: 'I was told I was too young for a smear test but now I am dying of cervical cancer at just 24'

Twice Katie asked for a smear test, but was told she was 'too young' to need one. Now 24, she is dying from cervical cancer, one of many young women who have fallen victim to a scandalous change in health policy.

One year ago Katie Hilliard was a typical 20-something - working in the City, going out with friends from university and generally just having fun. But the 24-year-old now has cervical cancer and despite a hysterectomy, chemotherapy and radiotherapy, the disease has spread to her lymph nodes and lungs. Doctors have given Katie at best two years; at worst 11 months. 'They have not been very positive about the future,' she says simply.

What makes her story even more tragic is that cervical cancer, if detected early, is a preventable disease. In fact, Katie had actually requested a smear test - used to detect the pre-cancerous cell changes linked to the disease - twice in the four years before her diagnosis. Yet each time she was refused, because she was 'too young'. Too young to be eligible for a smear test, though not too young to contract cervical cancer.

She says: 'If I'd had a smear test when I was 21, all of this could have been avoided.' Instead, Katie is now undergoing more chemotherapy and is desperately researching alternative ways of fighting the cancer. She is in a lot of pain and has trouble walking. 'I feel old before my time, but I want to live. I'm not going to give up,' she says. 'I wanted to have children and buy a house, but getting a mortgage is now impossible,' says the insurance broker from Haywards Heath, West Sussex.

She and her fiance still plan to marry this October, and she has had her eggs saved in the hope that she goes into remission. 'Some days I'm really hopeful, other days I don't know how I'm going to do this. This should never have happened. I am too young to be dealing with this. 'It is something that a simple smear test should have sorted out.'

Like Katie, Claire Everett, 22, a married mother-of-one, is terminally ill with cervical cancer. She has no doubt that a smear test 'would have made all the difference'. An otherwise healthy young woman, when she developed worrying symptoms (an unusual discharge) last year she immediately went to the doctor; the cancer was diagnosed and initially chemotherapy and radiation were thought to have been successful. Yet last summer, two months after the treatment finished, Claire was told the disease had spread through her pelvis and the cancer was now incurable.

'My mum was crying her eyes out,' she recalls. 'She asked if the cancer was terminal and I walked out of the room. Sometimes I think that if I ignore bad news, it's not happening. 'My initial thought was not for me, but for Alex, my little boy, who's two. The thought that I might not see him grow up broke my heart.'

Both Katie and Claire had fallen foul of a recent change in government health policy. Until a few years ago, all women in the UK were offered regular screening for cervical cancer from the age of 20; then in 2004 the screening age in England was raised to 25 (it remains at 20 in Scotland and Wales). This was because the risk of cervical cancer in younger women was thought to be negligible. But experts believe this change in policy means the condition could go undiagnosed while it is still highly treatable. It was 'a very poor decision', says Professor John Shepherd, surgeon and gynaecological oncologist at The Royal Marsden Hospital in London. 'Approximately 10 per cent of patients diagnosed with invasive cervical cancer are women aged 30 or younger, and these numbers are likely to increase.' ...

Screening at 25 is far too late, says Professor Shepherd. He believes women should ideally have their first smear test as soon as they become sexually active and certainly no later than the age of 20. This is in line with America, where screening begins at 20 or within three years of first sexual contact - whichever comes earlier. In other countries, such as Australia, screening begins at 18.

'I think it is inappropriate in 2008 that the NHS screening programme in England does not acknowledge and thus protect young women who are sexually active before they reach the age of 25,' says Pamela Morton, director of the cervical cancer charity Jo's Trust. 'Frankly, it's disgraceful.' ...

Quite what impact the decision to postpone the screening age to 25 has on cervical cancer rates won't be known until the figures become available around 2010. But Professor Shepherd is clear: 'I appreciate that there is a health economics issue here - it will cost money to screen younger women - but I still think it should be a priority. 'Cervical cancer is a preventable disease and catching it early will save lives.'

More here

Equality has made dunces of British children

The bid to iron out differences by imposing one kind of school, one class and one syllabus has been tragically wrong

Education, education, education? For shame, for shame, for shame. New Labour's failure to rescue state education, let alone improve it, will be its most disgraceful legacy. The Conservatives should not crow; when in office they also failed to take on the forces destroying education.

Each week the news is full of reports of stagnating standards, more university dropouts (one in seven students, despite government "investment" of 1 billion pounds since 2003), a shortage of teachers, particularly in maths and science, and a majority of underqualified teachers. However, two dismal stories stood out last week, both as symptom and explanation of what is wrong.

One of the three leading universities in the country, Imperial College London, announced that in 2010 it would introduce an entrance exam for applicants because it cannot rely on A-level results. Sir Richard Sykes, the college's rector, suggested that grade inflation in A-levels made them almost "worthless" as a way of choosing between candidates: "Everybody who applies has got three or four As."

That is hardly surprising, since it isn't difficult to get an A; last year 25% of all A-level papers were given a grade A. Oddly enough, there are people in the education world who still deny that A-levels and GCSEs have been debased. They must be wilfully blind to the evidence; last week, for instance, many newspapers printed a comparison of an old maths O-level exam paper with the contemporary GCSE one. The fall from rigour was lamentable.

Also last week, Professor John White of the notoriously progressive Institute of Education told us that traditional lessons were too middle class. Instead, he said, schools should teach skills such as "energy saving and civic responsibility" through "theme or project-based learning".

At a conference on the national curriculum he argued that while private schools historically focused on the classics and elementary schools for the working classes concentrated on the three Rs, middle-class schools taught academic subjects such as English, science, history, geography, modern languages and Latin as "mere stepping stones to wealth" via university, which "fed [sic] into the idea of academic learning as the mark of a well-heeled middle class".

This, he feels, was the basis of the Conservatives' attempt to impose middle-class values by introducing a national curriculum of traditional subjects in 1988. Subject-based education like this, he thinks, favours the middle class and alienates many children, especially the disadvantaged. White specialises in the philosophy of education and, readers may be irritated to know, was recently a member of a committee set up to advise ministers on the secondary school curriculum.

It is hard to say which of these two stories is more infuriating. The rector of Imperial College is right. Contemporary A-level results, debased as they are, reveal little about a student's suitability for serious study at a top university, but they never did, even at their most rigorous. When I was a teenager, top marks at A-level, although difficult to achieve, were considered irrelevant to getting into Oxford or Cambridge. Passes at A-level were required but what mattered were the entrance exams that both universities set. These were much harder than A-levels - and different.

It was considered at the time too obvious to mention that this was suitable only for the brightest academic children. All this was hard for teenagers who couldn't get into Oxbridge and automatically excluded gifted children from poor schools and deprived backgrounds.

However, if you want a world-class university, attended by students who are not only bright but also well prepared for study as undergraduates, with a well stocked memory and well trained habits of thinking, reading and writing, there is no substitute for selection, however harsh.

At 18, sadly, it makes little difference why a particular teenager is not a good candidate - whether her bog-standard comp or her family or her natural ability failed her. It is not the proper role of a university to do anything about any of that - for one thing it is too late. It's not the role of a university to experiment with social engineering, although the government forces it on them. It's not the role of a university to offer remedial teaching, although plenty do. Maddening though it is to see people reinventing the wheel, Imperial College is right.

So too, oddly enough, is the infuriating White, at least in one way. Beneath his old-fashioned class hatred and his atavistic loyalty to discredited progressive teaching, lurks an awkward truth. An academic school education - a traditional grammar school education - is not suitable for most people.

It was never a good idea to impose a grammar school-style curriculum on all children in the state sector and subject them to it in large, mixed-ability classes. That served neither the few who were suited to it, nor the many who were not. It has indeed alienated the disadvantaged. Plenty of them would be better served, as White says, by practical vocational subjects. That was the vision of the old secondary moderns and the technical colleges. Can it be that the progressive White is trying to reinvent this regressive wheel?

Behind the rector's story and the professor's story lies the obstinate folly of generations of teachers and theorists of education. Obsessed with equality and social engineering, they refused to recognise the simple truth that children and students vary. Children are born with different abilities, into different environments, which exaggerate those differences: ignoring those differences is no way to help them all, nor is clumsy social engineering.

Imposing one kind of school, one class and one syllabus on everyone, in an attempt to iron out those differences, has been tragically wrong. Encouraging everyone to think they can get a university degree is unforgivably discouraging to the majority of young people who can't and don't.

The result has been a school system that suits almost nobody and public exams that mean almost nothing. As these two stories demonstrate, quality has been sacrificed to the pursuit of equality. It is shameful.


Two British destroyers sail minus missiles to save cash: "Two Royal Navy destroyers have been sent to sea virtually defenceless against air attack after their guided missiles were removed to save money. The Sea Dart missiles, which have a range of 40 miles, used to protect HMS Exeter and HMS Southampton against enemy planes and missiles. Now 4.5inch guns give them their main protection. At least half a dozen sailors - who operated the surface-to-air missiles - have been transferred to other ships because their roles became defunct. Last night, the decision to deny the Type 42 destroyers the missiles was criticised by defence experts. Rear Admiral David Bawtree, the former commander of Portsmouth Naval Base, said: 'It is surprising that the destroyers are sailing without their primary defence, though I would add they still have lesser gun defences."

Bungling British bureaucracy again: "A policeman died yesterday after being shot with live ammunition during a routine training exercise in a disused warehouse. There were reports that officers were mistakenly issued with real bullets instead of blanks. PC Ian Terry, 32, was hit in the chest by a single blast from a shotgun fired by a fellow officer. The shooting happened at 11.35am yesterday in Manchester at a huge warehouse which used to be a distribution centre for electronics giant Sharp. The married officer suffered horrendous chest wounds during the Greater Manchester Police training exercise and was pronounced dead in hospital. Police sources said that the officers should have been issued with blank rounds for the exercise instead of live ammunition. One senior source said: 'All hell has broken out here and no one can understand how this dreadful mix-up has happened."

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