Death by poverty

A NEW report from the Annals of Oncology shows that the rich-poor gap in cancer survival rates remains unchanged in spite of improved cancer survival rates generally. The crucial factor in survival chances is early diagnosis but in England 5,600 people every year miss out on having their cancer diagnosed at an early stage because of social inequality, according to the report.

The Cambridge University team that carried out the research analysed data on 98,942 patients and looked at 10 common cancers: breast, bowel, bladder, lung, prostate, womb, ovarian, skin, kidney and rectal, which are responsible for more than two-thirds of all new cancer diagnoses in England.

Patients living in poorer neighbourhoods in eastern England were less likely to have their cancers picked up early than those living in more affluent parts of this region.

The researchers estimate that closing this gap could benefit, each year, 2,000 men with prostate cancer, 1,300 people with lung cancer, 1,000 women with breast cancer, 700 people with skin cancer, and 600 people with other types of cancer, who are currently diagnosed at a late stage.

So why do poor people tend to have their cancers diagnosed too late? They are more likely to be working long hours to make up a little for the low hourly rate of pay; more likely to have financial problems; less likely to have enough rest and recreation and less likely to be able to afford good quality food. It is stress and anxiety that drive people to smoke, drink a bit too much and eat junk foods and people on low incomes suffer proportionately more stress because they have less control over their lives and are more at the beck and call of others.

And of course GP practices in poorer areas are more likely to be understaffed and oversubscribed with less time in consultations for patients to bring up niggling worries — patients who may feel embarrassed at wasting the doctor’s time over “something that is probably nothing”. The middle classes have few such inhibitions.

But cancer is only one factor in the widening gap in life expectancy between the rich and the poor. And there is a new factor that is likely to widen that gap considerably: being interviewed by the notorious agency Atos for the Work Capability Assessment.

This French-based company has been hired by the Government with a brief to reduce by billions of pounds the total cost of payments made to the disabled and long-term sick. It operates mechanistic computer based assessments that show someone capable of work if they can so much as lift a pencil.

People with very serious health conditions and even terminal illnesses have been judged fit for work, meaning their sickness benefit is cut and replaced with Job Seekers’ Allowance. But to keep Job Seekers’ Allowance they have either to attend regular sessions “to prepare them for work” or be able to prove they are actively seeking work. People who are very ill just cannot do this and stand to lose all support.

Those who appeal against the loss of benefits have a high rate of success in getting the decisions overturned, especially if they have legal advice and support — though such support is vanishing with the cuts. But even then they may not get their benefits back; the appeal procedure takes time and by the time they have won they can be due for another Atos assessment — which will again find them fit for work.

The firm was first brought in under the last Labour government but has been working overtime under the Con-Dem Coalition. And now every week more than 70 people die through illness or suicide shortly after an Atos assessment that has said they are fit for work.

The Nazis used to gas the seriously disabled and mentally ill, describing them as “useless mouths”. Our current Government, aided by the gutter press, is labelling them as “scroungers” and condemning them to death by destitution, slow starvation and suicide.

Public anger is growing at the realisation of what is going on. Atos has been called to account by the Scottish government and its directors are to face questioning by a Westminster parliamentary committee.

But the real blame must rest with the governments that hired Atos and gave them the brief to cut the benefits budget by so much. It is a task that cannot be accomplished without horrendous brutality.