Northern Ireland

Retired nurse feels she was let down by the health service when she needed cancer treatment

Despite assurances that vital tests and treatments would continue during the coronavirus outbreak, delays have severely impacted on those at risk. Health correspondent Seanín Graham meets a woman who devoted her life to the NHS but feels she was failed when she needed it most

Retired nurse Cassie McNeill is currently receiving radiotherapy treatment for cancer. Picture by Hugh Russell
Retired nurse Cassie McNeill is currently receiving radiotherapy treatment for cancer. Picture by Hugh Russell Retired nurse Cassie McNeill is currently receiving radiotherapy treatment for cancer. Picture by Hugh Russell

CASSIE McNeill worked in the Northern Ireland health service for almost 50 years - from midwife to hospital sister to the lead nurse in a busy GP surgery in her beloved Glens of Antrim.

In perfect health, the 77-year-old retired Cushendun woman walked the beach twice a day and headed up a local development group that had her organising yoga and art classes for the community.

In January, she became ill after experiencing rectal bleeding and was referred by her GP for an urgent hospital consultation. She should have been assessed within a fortnight.

READ MORE: GP 'infuriated' by lengthy radiotherapy delays and questions handling of coronavirus pandemicOpens in new window ]

However, three months later she was forced to pay £3000 for private tests to discover she had a large cancerous tumour - and is still waiting to hear about her first hospital appointment with a consultant at the Causeway in Coleraine.

In an interview with The Irish News, she has spoken for the first time of her "anger and frustration" at the health system's handling of patients with suspected cancer during the pandemic.

The Glens grandmother, who was once a ward sister at the former Cushendun hospital and retired from a busy GP surgery 12 years ago where she was the practice nurse, said she has not heard "a word" about a NHS appointment that was due to take place on March 16.

She credits a private doctor with saving her life but said she is upset for others on the north's hospital waiting lists, which were already the worst in Europe before the coronavirus outbreak started.

At the beginning of lockdown, a massive overhaul of the health service took place with thousands of operations suspended to tackle a projected surge in Covid-19. Screening programmes for some cancers were "paused" - but patients were encouraged to seek medical help if they needed it.

"My biggest frustration was every time you turned on the television or the radio you were being told, please do not ignore symptoms, the health service is there for you. I had the symptoms but the health service was not there for me," Mrs McNeill said.

"The other thing that bugs me is that I had the know-how to get on my tablet and find a private doctor. There's an awful lot of people in the country that wouldn’t know how to do that or couldn’t afford to pay it. Not that I could afford to pay it. I’m not rich but it was certainly money well spent.

"I had a colonoscopy, MRI scan and CT scan. I had to pay more than £3000. I worked in the health service from I was 17 until I was 65. I worked in a local hospital where we were on call every other night for years and never got a penny for it. I don’t expect any preferential treatment but it made me really angry when I even saw GPs on the TV urging people to go to their doctors."

The Northern Ireland health service was overhauled in March to prepare for a surge in coronavirus hospital admissions, with thousands of operations suspended.
The Northern Ireland health service was overhauled in March to prepare for a surge in coronavirus hospital admissions, with thousands of operations suspended. The Northern Ireland health service was overhauled in March to prepare for a surge in coronavirus hospital admissions, with thousands of operations suspended.

On the morning of Mrs McNeill's scheduled consultant in mid-March - when 'surge' Covid planning was underway - she received a telephone call to say it was cancelled and to wait for a further appointment.

"They told me there was no consultant to see me that day. They didn’t say it was because of coronavirus. That was the only explanation I got," she said.

"I waited on foolishly, thinking someone would see me. I rang back again, I was told if there was any cancellations I would be one of the first ones to be called. But I wasn’t called. I haven’t heard a word from them since.

"I decided then to go private as I needed to get it sorted and my symptoms were getting worse. I rang the nearest private hospital in Ballykelly, that was on a Friday and they told me I needed a referral from my GP. But by the Monday evening they had stopped seeing people - as they had been taken over by the health service due to Covid. The three main private hospitals in Belfast were the same. The stress that caused me was unbelievable."

In March, the north's private clinics offered their staff and premises to health trusts due to the feared spike and the NHS being overwhelmed by the virus. The projected surge in cases and deaths of "biblical proportions" did not happen.

The former nurse kept researching until she discovered a surgeon based in Hillsborough who was seeing emergency cases out-of-hours.

"What he was doing was ringing up patients and deciding if they needed to be seen. He asked me three questions and said he needed to see me. He was fantastic," Mrs McNeill said.

"He found a large tumour, I had colorectal cancer. That was April 25. He made the diagnosis there and then and told me what I needed to have done. But he also told me there was absolutely nowhere in the health service that he could get me a colonoscopy because of Covid. I needed this test to see how much of the disease was there."

On Monday, Mrs McNeill started the first of five consecutive days of radiotherapy treatment at the main cancer centre at Belfast City hospital. She is hopeful her cancer hasn't spread.

Colorectal and lung cancers are among fast moving forms of the disease, with experts saying that a three-month delay in treatment could make the difference between a tumour being curable or not.

"I’m back into health service now, you can’t go private for radiotherapy. I went to the Belfast City Hospital cancer centre and they were absolutely fantastic," she said.

"I actually slept through my treatment. I haven’t been sleeping at night and was in a lot of pain. If I’d been seen sooner this tumour may not have been so far advanced. My consultant is fairly confident he can remove it all. I have five days of continuous radiotherapy treatment this week that will hopefully shrink the tumour so that I can have an operation in a few months. I'm hoping for mid-August."

The outdoors loving Glens woman, who is a mother of five, is also keen to return to her normal busy life as the chairperson of a Cushendun and District Development Association.

"I was in perfect health before this, I was organising yoga and art classes for all the people in the community. I walked the beach twice a day, I would regularly travel over to see my grown-up children who live between Switzerland and Scotland. I've never had an operation before," she said.

"At least I have a diagnosis now and can get on with my treatment but there are other people stuck on the waiting list. They are much worse off and would not have known what to do. It's a terrible situation."

The Irish News asked health minister Robin Swann to comment on the failings in Mrs McNeill’s care as well as other cancer patients affected by delays during the pandemic.

We also asked if the Department of Health intended to publish a detailed plan for the future of cancer treatment as the first wave begins to recede.

In a statement, a Department of Health spokeswoman said it “acknowledges the severe impact that Covid-19 has had on a range of key services including cancer services”.

She added that a “safety netting” system would allow patients to resume treatment and that “significant work” is underway with trusts to rebuild affected services as the first wave of Covid-19 recedes.

“The need to ensure patient safety and meet the challenges inherent in responding to the pandemic has meant that many procedures and diagnostic appointments have had to be postponed or delayed,” the spokeswoman said.

“However our dedicated staff have worked incredibly hard to ensure that urgent and emergency cancer treatment has continued during this period.  Where difficult decisions were taken to delay diagnostics or treatment during the response to Covid-19, safety netting was in place to ensure that cancer patients can resume treatment on the appropriate pathway as soon as it is safe to do so.

“In parallel with continuing to manage this crisis, significant work is underway to rebuild our health and social care system in the wake of the first Covid-19 surge. Our immediate focus in the coming weeks will be on stepping up any urgent services which were paused.  Trusts have already been tasked with developing service rebuilding plans for respective areas including cancer services.”

The Northern health trust, which was responsible for Mrs McNeill’s care, said it “deeply regrets” that all outpatient appointments had to be postponed due to Covid-19. 

A trust spokeswoman said: “The Trust fully understands the distress and anxiety caused by this delay and is making every effort to ensure patients are seen as quickly as possible.”