GPs unhappy with access to cancer tests

Patients may be missing out on timely screening for cancer and other illnesses because their GP lacks an established relationship with the hospital consultant conducting the test, a study suggests.

One-fifth of family doctors believe other GPs have direct access to cancer tests to which they do not have access, according to the study commissioned by the Irish Cancer Society. This sense of others having a fast-track to diagnostics was most pronounced in relation to CT scans and MRIs.

Most Irish doctors, whether GPs or hospital staff, are educated together in one of six medical schools in the Republic, but overseas-trained and newly qualified GPs are less likely to have such established connections to colleagues elsewhere in the health service.

“Although professional collaboration is highly estimable, there is cause for concern that access to diagnostics may be influenced by established relationships, particularly considering that newer GPs may not have had the opportunity to develop such associations,” the report states.

Streamlined process Access to cancer tests should not be dependent on the relationship between a patient’s GP and hospital specialists, but on a clearly defined and streamlined referral process offering timely access to relevant tests, it says.

The report calls for the introduction of symptom-based guidelines for referring patients for tests, similar to those in place in the UK, where access is recommended within two to four weeks.

Although hospitals operate fast-track systems for urgent referrals of suspected breast, prostate, lung and melanoma cases, almost half of all GPs report having no access to these systems. Almost 40 per cent had no rapid access for any patient with suspected cancer.

The study does not find any significant relationship between living in an area of deprivation and lack of access to tests. “This suggests all GPs, including those with practice populations of higher socio-economic status, find it difficult to access diagnostics for suspected cancer out of the four rapid access clinics for breast, prostate, lung and melanoma, if their patients are unwilling or unable to pay through the private system.”

Asked what would most assist in the early detection of cancers in their practice, GPs most frequently called for guaranteed direct access to diagnostic tests, followed by the establishment of additional rapid-access clinics for all suspected cancers.

Consistent with findings internationally, the report also found men and private patients were more likely to delay going to the doctor when experiencing symptoms. Most GPs also perceived men as more likely to delay attending than women. The report suggests these findings show the need for greater “universality” in the primary healthcare system to ensure all categories of patients get the services they require.

The research was conducted by the Irish College of General Practitioners, which received completed surveys from practices representing 592 GPs, or 22 per cent of its membership.

One in three men, and one in four women, will develop cancer during their lifetime. About 37,000 new cases are diagnosed each year.