Insurers won’t pay for op on Carole’s ‘ticking timebomb’

A WOMAN is living with a ‘ticking timebomb’ inside her head – because health insurance company Bupa is refusing to pay for a potentially life-saving operation.

When a routine scan for an altogether different complaint revealed she had a brain aneurism, it was, paradoxically, a stroke of luck for Thornhill Lees woman Carole Jackson.

Without the discovery, mum and grandma Carole, 53, would have been at high risk of a stroke or brain haemmorhage.

A senior IT manager at Leeds-based Johnson and Johnson, Carole was in the Bupa medical scheme and leading neurological surgeon Stuart Ross swiftly performed open brain surgery. However, Mr Ross discovered that the aneurism had attached itself to an artery, rendering the procedure too dangerous.

An aneurism bleed could bring on a stroke or prove fatal.

A follow-up attempt to deal with the condition via the femoral artery proved unsuccessful too, leaving surgeons with just one option to potentially save Carole’s life – a ground-breaking procedure which has been successful across Europe, but performed only a handful of times in the UK.

Neurology experts Mr Ross and Dr Tufail Patankar were ready to proceed – but Bupa pulled the plug.

“They said there was insufficient clinical data about this operation for them to approve it,” Carole said this week from her home in Lees Hall Road.

“There could hardly be lots of data, given that it’s a quite new treatment for brain aneurisms – but it’s clear to me that Bupa just doesn’t want to pay for the operation.”

Dr Patankar was scathing about the insurers. “If this was Aviva insurance and not Bupa, we would not have a problem,” he said.

Despite the combined expert view of Leeds General Infirmary’s neurologists, Bupa wouldn’t even discuss the matter with Dr Patankar.

“Bupa weren’t even willing to speak to the experts in making a high-handed decision,” he said. “I would never take insurance with Bupa. Most consultants would tell you exactly what I’ve said.”

Dr Patankar said the new method wouldn’t even cost more than higher-risk treatment options. “This is a very stressful time for Carole,” he said.

Although the operation can be done on the NHS, she is on a waiting list and has been told the wait will be “three months-plus”.

Carole, who lives with her partner Mark, has two children and three grandchildren.

“They’re all worried, naturally,” she added. “I’m trying to remain upbeat, I’ve always had good coping mechanisms” – a few years ago she survived a cancer scare – “but I’m starting to worry and get stressed. I’m still recovering from my operation but when you get headaches, you can’t help but worry.”

She added: “This is the only treatment option for me. If the NHS is willing to approve it, why on earth wouldn’t Bupa? It doesn’t make sense, except for saving money.

“Presumably, they’d rather see me die, then wait to deal with a lawsuit from my children.”

Dr Patankar explained that among people who have aneurisms which develop a bleed, one third will never make it to hospital, while another third will suffer long-term injuries.

“Most aneurisms I see in patients who have had a bleed are perhaps only 2-3 millimetres in size,” he said. “Carole’s is 7-8 millimetres, but it is the complexity of hers which makes it difficult. That’s why we decided we need to operate.”

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