Pay, travel or simply give up: impossible choice for cancer patients

User pays: No public treatment on Central Coast

I’ve been part of a campaign calling for public radiotherapy facilities for the cancer patients of the Central Coast since it was launched in early 2007.

With signs cancer patients on the Central Coast are starting to give up on life-saving treatment because they can’t afford it, this campaign is more important than ever.

Cancer patients on the Central Coast have two options:

1. pay a fortune for private treatment; or

2. travel to Sydney for public treatment.

For patients to access private treatment locally, they are faced with payment of the “out of pocket” expenses charged by the private operator, which can add up to thousands of dollars.

For people in this area, with many on low incomes and a high number of retirees, this can mean taking on debt that will take years to repay. One lady told me it will take her 10 years to pay off her debt private treatment.

Those who can’t pay have to travel for public treatment. This can be an onerous prospect. If patients are fortunate enough to have private means of getting to Royal North Shore – a car and someone to travel with them – the round trip will probably take them between 3 – 4.5 hours (depending whether they live north or south end of the Central Coast and traffic on the F3).

Of course many don’t have private transport – especially the elderly – and public transport is then their only option. To make this journey patients first have to get to a railway station, which can mean one or two buses. Patients then have to alight at Hornsby and cross platforms for the North Shore line to St Leonards railway station.

This round trip can easily take 4.5 to 5 hours and can be a horror experience for patients who may be elderly or weak or frail following cancer treatments. Patients may still be suffering the after-effects of chemotherapy. It is a frightening experience for many and the jostling and rush of other passengers battling to get to work or school can become overwhelming and result in patients considering ceasing treatment.

People spending each and every day for up to 7 weeks travelling for treatment will find it hard to continue working in order to support families. This can result in debt and missed mortgage repayments. Not all young mothers or families can find childcare or before and after school care in order to spend their days travelling. The obstacles are myriad.

Of course, if people cannot afford private treatment and cannot travel for public treatment, they have a third option.

They can decide against having potentially life saving radiotherapy treatment altogether. What a dreadful decision to have to make with one’s life, but anecdotal evidence shows this option is very much on the increase.

There is also a dramatic increase in women, young and old, choosing to have a mastectomy when faced with breast cancer. This avenue is taken in the hope of bypassing the need for radiotherapy.

People are often surprised to find that their private health funds do not cover them for radiotherapy treatment. As is usual with these funds, payment is only made when treatment is received while the member is a hospital inpatient. A very low percentage of radiotherapy patients receive their treatment while in hospital.

In 2010 one wonders if we are speaking about a third world country, but no, it is an area of over 300,000 residents with an above state average rate of cancer diagnosis each year.

Patients from the Coast don’t qualify for reimbursement for travel or accommodation costs under the Isolated Patients Transport and Accommodation Scheme because we aren’t far enough away from treatment centres. However, as can be seen above, it is a long and cruel battle for Central Coast residents to get to their treatment.

Our campaign has been intense and has involved direct interaction with politicians at local and ministerial level, Federal and State; paper and email petitions; and has attracted media coverage.

With Federal and State elections looming, I hope that we can work together to pressure our politicians into providing a public radiotherapy service on the Central Coast.

Kathy Smith is the Central Coast representative for CANCER VOICES NSW