In his report to the Conservative Party’s Economic Reconstruction Group in 1977, Nicholas Ridley wrote that:
"...denationalisation should not be attempted by frontal attack but by preparation for return to the private sector by stealth. We should first pass legislation to destroy the public sector monopolies. We might also need to take power to sell assets. Secondly, we should fragment the industries as far as possible and set up the units as separate profit centres."
Dear Charing Cross (CX) surgeon 7.15 am 23-04-2026
Again forgive me addressing you again but it seems I am dealing with a phantom CX urology unit. I was expecting to hear from 'Emily' - I believed by e-mail, who called me on my wife's cell phone at c. 4.45 pm yesterday. It seemed that she was making a list for admission - she spoke of a referral from my GP requesting investigation of a bladder problem I understood. I told her briefly of the 11 weeks now of haematuria etc as below. And that the original referral from Dr Johnson at Ashburton Surgery was first made 3 weeks ago. I had learned from you that there had been 'teething problems' and you asked that Dr Johnson send his referral letter again. He did that Monday 13th April.
Having had no contact from 'Emily' I attempted to 'phone CX urology unit from 4pm today. I had 02033111334 in our directory but it did not ring out. I found 'admissions' on the Imperial urology website - 02033116611. It was the common - and useless 'voice recognition' and I thought it a probable call centre. The male telephonist's name I did not catch on the second call, the line having closed with the first. He said 'there is no surgical order from a consultant'. I said 'which consultant?' He then advised that I phone urology OPD - 02033135000. Again 'voice recognition' - chose to wait for an operator - 'very high call volume' etc - . I did not use 'ring back' - and it rang on and on.
I had wanted a cure for my bladder cancer and had strong reservations about the TURBT being offered as a day case under GA at Torbay first, and the RD&E next. (See annexe below)) I chose to leave the Torbay service because when I saw Mr John Mekunde FRCS ?Ed at Paignton who carried out a flexible cystoscopy he said he was rightly requesting a CAT scan. He showed me a 'papilloma' overlying a tumour which he took to be a transitional cell carcinoma. It extended down to the left ureteric orifice. I trusted him when he said he could remove both.
I had no CAT appt so called Torbay urology 9 days later. No request had been received and the clerk said that requests came by three ways. My wife Susan said 'phone' the Nuffield, which I did. The CAT scan was requested by Dr Johnson and done 5 days later. The essential finding was a 2cm by 8cm tumour on the left side. As for 'invasion' there was 'stranding' but in the good report this was considered inflammatory. A known cyst in the R kidney was discussed. There were no metastases in this trunk examination.
Because I was already on Mr Donaldson's list from November 2025 for aquablation of a prostate that had undergone the very common hyperplasia, I had asked for my care to continue under the RD&E. I was content that there was a four month wait.
I willingly paid the £1100 for the CAT scan just as I paid £3000 + privately for a very expert indirect and direct laparoscopic herniorrhaphy by Mr Rao at the BMI hospital in Dorchester. I had been run in circles at Torbay; the hernia could be very painful, caused obstruction once and often required me to lie head down on a slope to reduce it manually. I am ever grateful to Sudhindra Rao bcc.
I then had a second flexible cystoscopy under LA by Mr Thomas Minto - (completing his training) at the RD&E. Why this second? The records and images of the first would have been available at the RD&E.
I have several logical reservations of having a Trans Urethral Bladder Tumour removal as a day case under general anaesthetic as a very experienced surgeon who served in the best urology unit of its day at Southmead Hospital. The 'resectoscope' had been invented by one of the surgeons - Mitchell, and had revolutionised prostate and bladder surgery.
But it is not the 'technical' that I am so concerned with. It is the perversity of this. For my prostate which had caused an insensible (unknown) retention of 1.5 litres and dramatic 'dilatation' of ureters and renal pelves in December 2024 - marvelously recovering completely, I saw Mr Donaldson at the 'closed to in-patients' Ottery hospital. The consultation was friendly and full - about a benign condition. He explained two techniques, and I chose aquablation which has a very low incontinence rate.
For mylife threatening bladder cancer, which I know untreated can end with great distress - lymphoedema from lymph node metastasis, ureteric obstruction, skeletal and lung metastases etc. I was being offered an incomplete consultation, a ?consent form at the ready, and an anaesthetist standing by.
I have been very fit in spite of poor 'medicine' with AF the only blemish. As I have said - I love my life and have much to do - including supporting my wife of 64 years who has poor sight and is poor 'on her legs' etc. I wanted to be cured, just as a senior colleague at the Princess Elizabeth Orthopaedic Hospital Exeter was cured. Peter Scott, a heavy smoker ex RN had a cystectomy and ileal bladder performed by John Pocock - senior urological surgeon at the RD&E about 40 years ago. He survives at 96. I know that my chances of cure have lessened with the delay but I still find hope in me, and I 'never give up'.
I am asking Dr Rob Johnson if he will refer me urgently to the clinical lead - Mr Thomas Dutton at the RD&E who wrote back to me 8-04-2026 after I explained why among other things I was 'pass the parcel'. I had had four named surgeons in sequence who were detailed to carry out the day case TURBT. This referral is for urgent assessment - chest radiograph to check for metastases, an MRI as you CX surgeon had advised, and a biopsy of what I believe is a rather 'vascular' tumour via a flexible cystoscope'. It might be 'too late in the day'.
for truth
David Halpin MB BS St Mary's 1964 FRCS England 1969
ps. I have as you see copied in the constituency MP. But I will later bring my concerns to the chairman of the Imperial Board
Mr Bob Alexander MBA https://www.imperial.nhs.uk/about-us/how-we-are-run/our-board#bob-alexander and then ask him how he would prefer to be cared for with a bladder cancer.
ANNEXE
TURBT - some concerns aside from there being no proper consultation with the operating surgeon before surgery
1. As surgeons operating in an attempt to cure a cancer we take a healthy margin of tissue. Currently my wife Susan awaits a visit to dermatology at the RD&E because two procedures done by nurses has resulted in recurrent squamous cell cancer below the closure line.
2. In a TURBT the 'margin' may be indeterminate and cell thick.
3. Invasion of muscle may only be discovered at operation, and if there is tumour necrosis, perforation of the bladder more likely
4. A large 'bare' area in me would be left. How long would it take to re-epithelialise? If good haemostasis was eventually achieved at the end of the TURBT - might later bleeding lead to clot retention and need for washouts. And transport of the patient would be required. More waiting ambulances.
5. What in my case - depending on the UNKNOWN cellular pathology, would be the chance of cure - my central aim?
To CX surgeon via PA. I should be corresponding with an hospital clerical officer - so forgive me.
Dear Sir,
I had a call from an Emily at the hospital. She said that a request had been received for investigation of a bladder complaint. I told her that I had had haematuria for 11 weeks and that a CAT scan about 6 weeks ago had shown a 2cm x 8 cm tumour. I added that I 'knew the ropes' as a surgeon qualifying in 1964 (at St Mary's) and that I had requested care at CX for its likely expertise.
She is contacting the 'team' and will e-mail a copy to me.
I thank you for all your help in this and understand the blip. I believe the infection is persisting in spite of the co-amoxyclav (will e-mail the GP in the morning) and that the tumour might now be having a systemic effect - but gardening pleasantly this pm.
kind regards David Halpin
