A right, Not a Privilege!

Abstract

In 1948, when the National Health Service was established in the UK, we were promised health-care ‘from the cradle to the grave’. No-one mentioned much about the in-between years. Here, and in many other countries, health-care is provided separately for children and adults. The age at which one becomes an ‘adult’ in this context varies from 12 to 18 years, and sometimes appears to be an arbitrary line drawn in the sand. In England and Wales this line divides the men from the boys (and the girls from the women) at 16 years. I am not sure why. We make other divisions about other issues; for instance, we may hold a child over 10 to be criminally responsible. In the field of education we separate infants from juniors, and all of them from the secondary stage at 11 years of age, and may even subdivide the 11 to 17/18 age group. In doing this, it is acknowledged that adolescents or teenagers have specific needs and must be dealt with differently. We all know that the commercial world recognizes these ‘in-betweens’ and makes a great deal of money by meeting their needs. However, in the medical context, teenagers and young adults are a neglected group and suffer as a result. It is their right to have their special needs recognized and satisfied. This should not be seen as a privilege. The Teenage Cancer Trust (TCT) was established formally in the early 1990s by a small group of charitably minded individuals who, having set up the first specialist unit for young cancer patients at the Middlesex Hospital, London, realized the yawning gap in the provision of treatment and care for this group of patients. The vision of TCT is to supply a teen-friendly environment in which an expert and highly specialized team of health-care professionals provide their patients with the very best chance of recovery. TCT units are this and more. They espouse a philosophy of putting the patient first. This is not really a new idea, for, as Professor J. B. Murphy (1857‐1916, Professor of Surgery, Northwestern University, Chicago, USA) pointed out some 100 years ago, ‘The patient is the centre of the medical universe around which all our work revolves, and toward which all our efforts trend.’ Within TCT units, the needs of young people are recognized and respected, and not just their needs as cancer patients. The emphasis is on the quality of life as well as its duration.