In his final article, revered critic AA Gill described how the NHS could not give him a cutting-edge, potentially life-extending cancer treatment but triumphed on a human level where private healthcare does not.
Described as “a giant among journalists”, the Sunday Times columnist died on Saturday aged 62, three weeks after revealing he had the “full English” of cancers.
Gill said he had been denied an expensive therapy - costing up to £100,000 a year - that may have helped him live “considerably” longer and is the weapon of choice for “every oncologist in the First World”.
The former smoker was diagnosed with lung cancer that had spread to his neck and pancreas, with tumours that were inoperable and unsuitable for radiotherapy, after noticing his health was failing in the autumn.
He described how he was told by a consultant oncologist that a pioneering new treatment for cancer, immunotherapy, would give him his best chance at fighting the disease, but it was not available on the NHS.
“The National Institute for Health and Care Excellence (Nice), the quango that acts as the quartermaster for the health service, won’t pay,” he wrote.
The consultant told Gill that the treatment would be “particularly successful” with his kind of cancer, but told his wife Nicola Formby: “If he had insurance, I’d put him on immunotherapy — specifically, nivolumab. As would every oncologist in the First World. But I can’t do it on the National Health.”
Gill said that the prohibitive cost of nivolumab was £60,000 to £100,000 a year for a lung cancer patient, around four times the cost of chemotherapy.
However, he said that “old men who think they’re going to die anyway aren’t very effective activists” and do not see the “public or press pressure that young mothers’ cancers and kids’ diseases get”.
He added: “As yet, immunotherapy isn’t a cure, it’s a stretch more life, a considerable bit of life. More life with your kids, more life with your friends, more life holding hands, more life shared, more life spent on earth — but only if you can pay.”
Gill, who previously said he wanted to have his treatment on the NHS due to a sense of “human connection”, drew attention to the health service’s performance in international oncology rankings.
He wrote: “It was the first question I asked my oncologist, Dr Conrad Lewanski. ‘Why is this such a bad place to get cancer, when we have lots of hospitals, when we teach doctors from all over the world, when we’ve won more Nobel prizes than the French?’. ‘It’s the nature of the health service,’ he says.”
Gill eventually underwent a course of platinum chemotherapy at the Charing Cross Hospital in London.
He told how, in the weeks before he died, he was rushed to hospital in pain “by miles and miles the worst thing I have ever lived through”.
After doctors discovered his pancreatic tumour had grown to the size of a fist they offered more chemotherapy.
Gill finished the article, which was printed before he died and published in the Sunday Times, with a conversation he had with a cancer nurse.
“(She said) ‘You’re supposed to be with me down in chemotherapy. I saw your name. Why are you up here?’,” he wrote.
“’Well, it turns out the chemo isn’t working’. Her shoulders sag and her hand goes to her head. ‘F***, f***, that’s dreadful.’ I think she might be crying.
“I look away, so might I.
“You don’t get that with private healthcare.”