Caerphilly woman takes health board to court over refusal to pay for life-saving cancer surgery

A mother-of-two with a rare form of cancer has taken health bosses to court over their decision not to pay for her to have potentially life-saving surgery.

Maria Wallpott, 50, from Caerphilly, South Wales, has stage four appendix cancer which, since her diagnosis in April, has spread to her ovaries.

A medical panel in Wales has twice refused funding for a type of invasive treatment recommended by her NHS doctors.

The procedure, which involves flushing the abdomen with heated anti-cancer medications, is automatically available to patients in England, Scotland and Northern Ireland, but is only granted in exceptional circumstances in Wales.

Ms Wallpott has taken Aneurin Bevan University Health Board and the Welsh Health Specialist Services Committee (WHSSC) to the High Court in Cardiff to fight the decision.

Her legal team argue the panel’s decision was unlawful and it should reconsider approval of the treatment because the surgery could extend her life, potentially save her life, and at least improve her quality of life.

The Welsh Individual Patients Funding Requests (IPFR) panel, responsible for the decision, maintains Ms Wallpott does not meet the criteria, and it does not see how the surgery would benefit her.

At a hearing on Wednesday, Vikram Sachdeva QC, representing Ms Wallpott, said: “I don’t want to be unrealistic here – they (the panel) have the hardest job you can imagine.

“On the other hand, patients are entitled to a lawful decision-making process, especially when these decisions could mean the difference between life or death.

“The court’s function is to uphold the rule of law and ensure public bodies stay within the law.

“Ms Wallpott is a young cancer sufferer. One wouldn’t know passing her on the street that she was ill at all, yet she has advanced cancer.”

Mr Sachdeva said his client had, some time before her diagnosis, received a scan which showed the possible presence of malignant cancer, but it was not followed up.

“She has advanced cancer because she was given a scan that was not followed up. And when she turned up a year later with malignant cancer they have refused to provide her with palliative treatment for the spread,” he said.

“They’ve (the health board) just said ‘sue us then’, which is not the most compassionate response.

“I’m not asking you to consider negligence here, but you can see why my client is upset.”

Despite the late stage of the cancer doctors believe there is a good chance of removing a large amount of the tumour, Mr Sachdeva said.

Before the hearing, Ms Wallpott said she had found the panel’s judgment “incredibly difficult to understand”.

“I feel like I’m the victim of an NHS postcode lottery,” she said.

“It’s devastating to know that if I lived in England, rather than Wales, I would be able to receive the surgery without having to go through all this.

“My NHS doctors and nurses have been lovely, but I was distraught by the news that the panel and hospital management have overruled them.

“Within the last few months, I’ve found out that my cancer has continued to spread and it’s impossible to put into words how distressing this is.

“I’m profoundly worried about my future and the future of my children.

“All I want is to be given the best chance possible at surviving this.”

She urged the health board panel to reverse their decision.

The treatment, which costs £73,000, is said to result in patients having a 40% chance of surviving for five years, the court heard.

Without the treatment, it is said the life expectancy of people with cancer of the appendix is nine months.

The case is being heard in front of Mrs Justice Steyn over two days at Cardiff Civil and Family Justice Centre.

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