Preventing Predictable Death; is General Practice liable?

Some diseases cause death; others just alter quality of life.

A disease that is currently curable and, if untreated, frequently leads to untimely death, often preceded by a protracted unwellness and sadly undiagnosed, is Hepatitis C.

Hepatitis C comes with a legacy of prejudice. This prejudice relates to the community view that all Hepatitis C sufferers are IV drug abusers.

This view is far from the truth. A considerable number of victims are from unscreened blood transfusions, have unknowingly had intimate contact with people who (maybe unknowingly) have Hepatitis C, or were born to a mother with Hepatitis C. Others got infected through a tattoo gained in their exuberant youth or later, or through medical treatment perhaps in another country.

The current group most at risk of being denied testing are those baby boomers who, through their behaviours and contacts in the early years, have unknowingly contracted the disease. They are often living with a lesser quality of life and are at risk of passing this disorder on to others and, in the end, meeting an unnecessary demise.

Irrespective of the route of transmission, there are estimated to be some 40,000 New Zealanders who have Hepatitis C undiagnosed. Many of these will almost certainly go on to have severe liver disease, which, if detected, could be cured. A simple regime of eight weeks of taking medication in nearly all cases cures this condition.

This drug has been available for several years. Unfortunately, there is a resistance to test –  probably built on ignorance, arrogance, prejudice, denial, and thoughtlessness by those able to do so.

With the cost of a test being somewhere under $10, and the cost of long-term management of hepatocellular disease (cancer that begins in the liver cells) secondary to Hepatitis C being in the hundreds of thousands of dollars, the results of this unhelpful behaviour are future and unnecessary costs to the community.

Current and past efforts by gastroenterologists specialising in liver diseases have had limited traction. As a Canterbury GP, I am aware of the resistance to adequate general practice education.

Which brings me to the question: If indeed there is an obvious cure for a disease – that is known to result often in significant illness and death – at what point does the General Practice community become liable for that death?

The Health and Disability Commissioner needs to take action to turn around this somewhat stagnant response of the profession to Hepatitis C.

Tests Save Lives.