Cancer patient condemned to die with no relief

Suffering from terminal cancer, Enrique Conesa, aged 55, has been given less than one month to live by the doctors from his local hospital in the Catalan town of Mataró. But a combination of red tape and staff shortages, prompted by spending cuts, meant that until the media became aware of his case, he would likely have died without the intravenous morphine injections he needs if he is to pass away in relative peace. He has been waiting eight months for an appointment at the hospital's pain relief unit to be given his first injection, along with guidelines so that his wife, Antonia Benegas, can administer the morphine at home.

"He is suffering, he's hanging on, but he is in terrible pain. I don't want him to die like an animal," Antonia says.

"If a newspaper hadn't called them, they would have done nothing"

Enrique was diagnosed with a Klatskin tumor, a particularly painful cancer that affects the area between the pancreas and the liver. He has lost 30 kilograms since March, and has been taking morphine orally since September. The hospital in Mataró, with a catchment area of more than a quarter of a million people, had arranged an appointment in November. But a strike by medical staff, in protest at spending cuts by the regional government, meant the appointment was cancelled and automatically reset for March 28, four-and-a-half months later.

"It would be a miracle if he were still here in March," points out Antonia.

Last week she went to the hospital to try to explain the situation. Her husband already takes 800 milligrams of morphine orally each week. "But it has less and less effect, all I can do is watch him suffer, and it's killing me. I can't sleep, I can't eat," she says.

Antonia says that staff at the hospital ignored her, and refused to look at her husband's paperwork. Eventually she says she was given a complaints form and escorted out of the building. "We don't have the resources and you'll just have to get on with it," she says she was told. A hospital spokesman later spoke to EL PAÍS, saying: "We told her that there was nothing we could do. The appointments are managed by a computer system, and they can't be changed."

But within an hour, the hospital called Antonia Benegas, and rescheduled the appointment for November 30. "We have looked at your husband's notes. There has been an administrative error; we apologize," a member of the hospital's administrative department told her. EL PAÍS contacted the hospital afterwards, and was told that the delay had been due to an accumulation of administrative mistakes.

"The appointment was not rescheduled because of the strike, but because Mr Benegas' doctor was ill that day," said a spokesman.

Following the introduction of cuts by the regional government of Catalonia, headed by the right-wing Convergence and Union (CiU) nationalist bloc, earlier this year, several cases of patients who have been let down by the healthcare system have made the headlines.

Catalonia's health service, which serves 7.5 million people, is cutting the salaries of 40,000 public health professionals in the region's eight university hospitals and more than 300 primary care centers to save around 10 percent, an estimated 100 million euros, from the regional health budget until the end of 2011.

It is the regions that are responsible for healthcare in Spain, not the central government. CiU is trying to repair a regional budget deficit that is forecast to hit 2.66 percent of gross domestic product this year - well beyond a 1.3-percent target set by the central government.

Spain's healthcare system is ranked seventh best in the world by the World Health Organization. The system offers universal coverage as a constitutionally guaranteed right and no out-of-pocket expenses - aside from prescription drugs. Patients do complain, however, about the long waits to see specialists and undergo certain procedures.

"I cannot forgive them," said Antonia Benegas after being told her husband would be seeing a doctor this week. "They have had months to sort this out. Don't they understand what it means to have terminal cancer? On Monday I was told that they could do nothing. They didn't even bother to look at the paperwork. If a newspaper hadn't bothered to call them, they would have done nothing. My husband would have died, wracked with pain. I can only imagine how many other cases like this there must be that nobody hears about. All I want is for my husband to die with a little dignity."