By GREG NIKKEL of the Weyburn Review
A Weyburn resident, Howard Spencer, seeking compensation for his cancer treatment from Saskatchewan Health has again met with a brick wall, and is now considering his options of how to proceed, including the possibility of taking the provincial government to court.
Spencer underwent an extensive surgical procedure on his neck at the Mayo Clinic in Rochester, Minn., and has sought coverage from the province for what the procedure would have cost if it had been performed in Saskatchewan, but Health Minister Pat Atkinson has denied the request in a letter last week, said his brother, Barry.
He explained Howard underwent a 13-hour radical neck dissection to deal with a form of cancer affecting the neck, called squamous cell carcinoma, and this was followed up by radiology of his neck which ended three weeks ago today. Barry has undertaken the role as spokesman for the family as Howard has difficulty in talking while he is recovering.
"Howard's first choice would've been to have it in Canada," said Barry, adding his brother is asking for an amount equivalent to the procedure's cost had it been performed in Canada, estimated at around $30-35,000. The actual cost of the Mayo Clinic operation was $76,000, not including travel and other expenses, he said.
In an interview with the Review on Tuesday, Health Minister Atkinson said there isn't anymore she can do for the Spencer family.
"I reviewed this case three times very carefully, and I concluded that it would be inappropriate for the province to pay for the procedure at the Mayo Clinic," said Atkinson, adding that due to legislation governing ministers' conduct, particularly in relation to patient confidentiality, she cannot go into detail about the Spencer case.
"One of the things I find really frustrating is I can't talk about the details. This is difficult for me, in that I can't talk about it; but there's always two sides to a story," said the minister.
Asked if partial reimbursement for the procedure at the Mayo Clinic would be considered, Atkinson said, "That's something that's never been done in the past. Many people have made the trip personally to the Mayo Clinic and haven't been reimbursed for it. In a general sense, you can't redirect yourself to the U.S. and expect the taxpayers to pick up the cheque for the treatment. We have a publicly-funded system in Saskatchewan and in Canada. In a general way, if a procedure isn't available here, they're referred to a facility in Toronto or Vancouver or wherever it's available, and if it isn't available in Canada then Saskatchewan Health will pay for treatment in another country."
She added that treatment at another facility outside of the province or country would be by referral by the specialist involved with the patient.
"The trip to Mayo wasn't a pleasure trip. There simply wasn't any time; even the specialists here were saying that. He was not given any options, and was never properly referred to the Allan Blair Cancer Centre. At the 11th hour, he was called by one of the specialists, but that was for radiology only," said Barry Spencer.
Barry said the minister's letter says, among other things, "no attempt was made to obtain the medical procedures in the province, and that's totally not true." He added the Spencer family consulted with the minister's office for a week prior to committing to the Mayo operation, to get some guidance or a referral here in Canada, although the family has never met personally with the minister.
Barry noted he has tried on four different occasions since Oct. 6 to have a meeting with Minister Atkinson, but to this date has been unsuccessful in reaching her.
"We are considering our options, one of the options being litigation," said Barry, adding that the advice from some of the people the family has consulted with is such a litigation would be successful.
In addition to the Spencer family's lobby efforts, including a news story broadcast nationally on the CTV network, the minister's letter was released to the Liberal Party, and the Saskatchewan Party has reviewed Spencer's case and has made efforts to convince the minister to give the family some consideration.
"It's pretty obvious at a time when the Spencer family was under a great deal of stress and had to make a decision in short order, the minister and health system fell short in terms of providing the Spencers with information," said Elwin Hermanson, leader of the Saskatchewan Party.
The family has since learned, in recent investigations, that there is a team of doctors in Saskatoon who could have performed this procedure, and a Toronto facility as well, both of which would have been preferable to making the trip into the U.S. The family turned down the services of a Regina specialist, as the doctor told them he only performs one procedure a year of this magnitude, and the family was not comfortable with that level of experience.
Hermanson said the family was not informed of the Saskatoon team's availability, nor of the fact that Saskatchewan Health has covered procedures done at the Toronto facility.
The health minister also said in her letter that the Spencer family should have taken part in a multi-disciplinary committee meeting at the Allan Blair Cancer Centre, but Howard was unable to attend it as doctors had set a CAT-scan appointment for him at the same time at the Regina General Hospital, said Barry. A request to reschedule the meeting at the Blair Centre was refused, as the family was told it would have to be reset by the family's physician. The committee is set up anytime there is a divergence of opinions of what kind of treatment would be best for the patient, and the committee usually involves the patient.
"If they believe this is going away, they've got another thought coming. I said at the beginning, they should've been quite aware what was going on. They could've solved this at the start. This isn't over, not for a long time," said Barry.
If litigation is pursued, Barry stressed, none of Howard's personal funds nor any funds from the Howard Spencer Trust Fund would be used for any legal costs. The trust fund is administered by a group of Howard's friends.
"You hate to point fingers in these kinds of situations, but it would appear the minister's office fell short. I think the family is at least entitled to the cost that would've been incurred if the procedure was done in Canada or in Saskatchewan. There would be no questioning the competency of the Mayo Clinic, certainly the treatment was not a wasted one. We would certainly press the minister to reconsider her blatant response that in no way would her department be covering those costs," said Hermanson.
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