Oct 6 2008 by Madeleine Brindley, Western Mail
Wales faces an “explosion” in patients suffering liver failure if nothing is done to improve services for people with hepatitis C, experts have claimed.
Leading clinicians have criticised the Welsh Assembly Government for delaying the publication of a vital action plan for the disease. The plan, which would outline improvements in community and hospital-based services for people with hepatitis C, was initially supposed to be published two years ago. But despite further promises that it would be available at the end of last month, clinicians and support groups are still waiting.
Charles Gore, the chief executive of the Hepatitis C Trust, said: “This history of endless postponements is unacceptable. Patients need action, not promises.”
And Dr Ruth Alcolado, a consultant physician at the Royal Glamorgan Hospital in Llantrisant, said: “In 40 years’ time we will have an explosion of end-stage liver disease that will cost the taxpayer a fortune.
“Liver disease as a result of hepatitis C is slow and progressive, but in the future we could need a liver transplant centre or two in Wales.
“We are in a relatively privileged position at the moment as Wales’ numbers of hepatitis C are not as high as in England or Scotland.
“If we can start treating people and educating those at risk, then we can probably make a difference.”
Hepatitis C mainly affects injecting drug users in Wales, although a number of people developed the disease as a result of receiving contaminated blood products. It is estimated that 0.5% of the UK population is affected – it is thought that 14,700 people in Wales are infected, but the majority are unaware.
The disease is more infectious than HIV and can be easily transmitted between people sharing drug paraphernalia, such as spoons for preparing drugs to be injected.
About one in five people with hepatitis C will develop cirrhosis of the liver, which can lead to end-stage liver failure. There is no vaccine to prevent the infection, unlike other forms of hepatitis, although there are effective treatments available.
But Dr Alcolado said that services for people with hepatitis C, both in hospitals and the community in Wales, are “patchy”.
“Cwm Taf NHS Trust is a prime example – we have had a hepatitis C treatment service at the Royal Glamorgan for seven years, but there is no treatment going on in North Glamorgan.
“The only people being treated from North Glamorgan are those who have been picked up because they are already unwell and are referred to us.
“And for these people it means a couple of bus journeys for them every week, which can be a struggle.”
The Hepatitis C Trust said that the Welsh action plan was written and supposed to be published two years ago – former deputy health minister John Griffiths promised it would be published in 2006 during a National Assembly debate on hepatitis C; the National Public Health Service for Wales website said it would be published in the summer 2007. And Health Minister Edwina Hart said in a written answer to a question from the Liberal Democrats that it would be published by the end of September. It is understood the action plan will outline what community and hospital treatment services are needed, but it will also improve education for people at risk of hepatitis C and those who work with injecting drug users, such as needle exchange staff.
An Assembly Government spokesman said: “Mrs Hart is committed to meeting the challenge of blood-borne viral hepatitis and ensuring we address the public health issues.
“A significant amount of work has been undertaken in the development of an action plan.
“Officials have worked with the NPHS to refine the plan, to prioritise its recommendations and to consider where future investment would make the most immediate impact.
“The process for setting budget allocations for 2009-10 and beyond is under way and the costs and timetable for implementing the plan is being considered in that process.
“The minister expects to publish the plan for consultation in the coming weeks.”
