A 50-year-old mother-of-two diagnosed with a rare form of cancer has “no case” for asking the NHS to pay for her potentially life-saving surgery, lawyers on behalf of a Welsh health board have said.
Maria Wallpott, from Caerphilly, South Wales, was told she had stage four appendix cancer in April, which has since spread to her ovaries.
Despite NHS doctors, including a colorectal surgeon and oncology consultant, recommending a type of procedure they believe could extend her life and possibly save it, it was refused funding by a medical panel.
The panel turned down Ms Wallpott’s application for the surgery twice on grounds she does not meet the criteria, saying there is a lack of evidence to show it would benefit her and would therefore “not be cost-effective”.
The procedure, which costs £73,000 and 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.
It is said to give patients a 40% chance of living for five years.
Ms Wallpott has previously said she feels the victim of “an NHS postcode lottery” which means if she lived 25 miles down the road, she would be eligible.
Her legal team have taken the case to the High Court in the hope of overturning the panel’s decision.
Acting on behalf of the Aneurin Bevan University Health Board and the Welsh Health Specialist Services Committee (WHSSC), David Locke QC said: “It’s very sad for Ms Wallpott because effectively it removes hope, and I understand that.
“That’s why it’s so difficult for the panel.”
But he said: “There is no case that this lady, tragic as her circumstances are, will get significantly more benefit from this procedure than other people.”
Mr Locke argued the National Institute for Health and Care Excellence (Nice) guidance only goes as far as not to prohibit the procedure for certain patients because of the serious side effects and risk of death.
“It says it is unlikely to be curative and the survival rates are similar for people who do and don’t have it,” Mr Locke said.
“In the circumstances, there is no point,” he added.
At the hearing on Wednesday, Vikram Sachdeva QC, representing Ms Wallpott, said Mr Locke had wrongly interpreted the Nice guidance and that the evidence showed the procedure could be effective in treating people with colorectal and ovarian cancer.
Mr Sachdeva reiterated how his client is young, fit and relatively healthy in spite of the advanced stage of her cancer with doctors believing much of her tumours can still be removed.
Mrs Justice Steyn, presiding over the case, will give her judgment at 2pm on Friday.