Position of APOZ in connection with the journalistic investigation of the activity of KOC – Plovdiv


To the attention of the broadcast team “Masters of the air” on Nova TV

Thank you for the opportunity to state our point of view. Upholding civil rights, incl. the right to medical treatment safely and effectively, in 21 century deserves all our public energy. I claim it as a public figure with many years of practice and a modest asset of policy changes, providing care for cancer patients in Bulgaria.

The position of APOZ and friends on the topic you raised was sent to health institutions and professional medical organizations, after the Executive Agency's review is complete “Medical audit”. In our opinion, medical errors can only be confirmed or denied by specialists. It's like that everywhere in the world. The specific patient cases, that you showed, are legal in nature and require professional expertise, to be decided by law. Regarding them, for regrets, there's nothing we can be of use to, except with human sympathy and with some relief, that after allare not in the cancer statistics. We sincerely believe, that you wanted to help with this campaign, therefore, we suggest that you broaden your perspective on the topic of oncology.

Primarily, we would be grateful, if you switch the ironic-offensive tone, with whom you conducted this serious controversy, for weeks.None of your opponents denied it, that there is a legal case. No one refused to take blame and responsibility. There is no reason to add ugliness to their images, but rather to direct the controversy to the real problem solely for the purpose of seeking solutions. Pitting doctors against patients goes against our core belief as an organization, namely, that doctors and patients achieve an effective impact on disease only when they work as a team. We cannot afford to undermine trust in doctors, which are everything, that we can hope for, when cancer got us.

Your inquiry has been successful, no doubt. But partial. Within a few specific case studies, behind which lies a far more serious set of problems, led to these case studies.

With sincere respect for your unadulterated drive for justice, We suggest you continue your investigation nationally. You will see for yourself, that the system of organized oncology care functions on autopilot, suffers from a chronic staff shortage, incl. administrative and in general there is a need for reforms and introduction of order and control, but not before to build lean and sustainable, secured with specialists and subject to iron rules structure, which can be upgraded over time, keeping up with the latest in modern cancer medicine. Otherwise, oncology will sink more and more into financial definitions and move away from the value of human life. We will lose doctors and patients, we will lose people…

If we return to the case study of KOC Plovdiv, it is appropriate to ask why the function of the pathologist is so important, who determines with his judgment the volume and scope of the treatment, is entrusted to a specialist of retirement age? The answer is disturbing.  Because there is no one to replace him.According to the National Cancer Care Level Survey, which APOZ did in 2006 year, the pathologists were 37 a number of, number and letter. As of today, there are hardly many more. We are not informed that any of the health institutions have updated this data with a new study, but it is well known, that pathologists are becoming extinct. For 10 years, this fact has in no way disturbed and committed the health institutions to specific actions, which now categorically define the work of Dr. Maslev as a systematic crime… Criminal, according to us, is the neglect of the glaring need for a long-term and sustainable strategy, related to cancer, which is called the Anti-Cancer Plan around the world. For your info, such a plan, institutionally represented, has been available since 2008, when APOZ and friends provided the working anti-cancer plan to another government, donated to our organization, to serve as a model in Bulgaria. With all due respect to the medical community, we have provided this plan to all scientific societies, we asked for their references. Experts and national consultants from all medical fields signed a memorandum, with which they united around the need for such a strategic document, declared their readiness to work for the Bulgarian model. Since then, N number of expert groups and commissions have been established in the Ministry of Health, some of the experts came to the workshops straight from the operating rooms, with the operating suits. There was some enthusiasm, that they will be heard and their suggestions taken into account. Developments were being collected, opinions were written, … which in the end no one read, did not consolidate and submit to the Council of Ministers as a completed document, and submitting documents and proposals of this scale to the Council of Ministers is the sole prerogative of the Ministry of Health.

We regret to admit, that despite serious investment, which were done in oncology, useful no doubt,  cancer or rather the effective measures to limit it, are not yet a priority of health policy in Bulgaria, since today we don't even have organized prevention and screening, with which any reasonable long-term strategy against this type of disease begins. Fact! We think, that a national media, as Nova is, has all the power to ask on behalf of the whole society,  why?

As a patient, I remember the time, in which the oncology budget was barely 1/5 of the funds now spent in this important health sector. At that time, there was no talk of oncology at all, and oncology centers – the then dispensaries – they looked like morgues. Even the thought was killing, that you will come in to be treated there. It's paradoxical, but at this very time I am being treated for cancer (in KOC Plovdiv, by the way) and that's it 18 years later I am alive and well. Obviously, it's not all about money. But let us return to the controversy and consider another paradox – investments in oncology are growing at breakneck speed (budget exceeded 250 million. BGN), and patient confidence is declining, inversely proportional to them. Other important metrics such as physician satisfaction are also declining, as well as respect for their skills.It isthe thread, on which it seems useful to us to walk, in search of the rights and welfare of patients and doctors, who diagnose and treat cancer in Bulgaria. And this thread inevitably leads to untaken or missed institutional decisions. Some of them also concern the management of these specific hospital facilities. We've seen where this all leads…

A few words personally: As a patient I willingly devoted years, that separated me from the disease,  of active public work and sincerely believed, that any new investment, every innovation and expansion of treatment options leads to good– and doctors, and patients. Unfortunately I have to admit, that investment is not a sufficient condition. И ако Вашето упорито разследване върне в общественото пространство дискусията за Национален антираков план, цялото Ви усърдие ще има повече смисъл, отколкото ако продължи да търси престъпници там, където болните хора търсят помощ, утеха и надежда да оцелеят от болестта. От рак.

В заключение бихме желали да Ви помолим, в името на обективността, да коригирате поднесената информация, that 51 % от диагнозите, поставени в КОЦ Пловдив, са сгрешени. В доклада на ИАМО става дума за 51% от разгледаните в рамките на проверката случаи, а това е нещо съвсем различно.


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