B777 Captain reported the failure of the cabin attendants to report a medical emergency to the flight crew; fearing this may be a growing problem because of the elevation of status of the Purser position.

Narrative

Just after getting out of the pilot rest bunk shortly before descent is not the time to find out that we have had a medical emergency onboard and none of the flight attendants have notified the pilots. I was awakened in the bunkroom at 55 minutes out from landing; and then went to the lavatory; then to the galley to get a cup of coffee. While in the galley; one of the flight attendants asked me if I knew about the emergency. No; I had not been informed; I told her. I immediately called the flight deck and they had not heard anything whatsoever about the medical situation. I am concerned that it is becoming an informal; but accepted practice to only tell the purser; considering that they now are being told that the purser has a different (higher) status than the non-purser flight attendants. Mostly; what concerns me is that we are going to have an ill passenger's condition deteriorate; or worse; because the flight attendants do not follow correct procedure. In this particular situation; the passenger had very bad pain in his/her leg. A doctor advised him/her to take an aspirin. I never had time to personally find out from our purser why someone in my crew had not properly advised the cockpit; as I needed to coordinate; plan; and fly our approach and landing. The short amount of time that I normally have to effectively transfer control of the aircraft from the two Relief First Officers; to my myself and the Flying First Officer; then brief for our approach; was partially spent on telling Dispatch that we had this medical emergency earlier on our flight. Dispatch acknowledged our ACARS message immediately. Before landing I was given the flight attendant's report to fill out my employee number and domicile; next to where she had filled out my name. On a previous flight; I was awakened by the flight attendants announcement requesting a doctor. No one woke me up; but I decided to get up and investigate the situation. As it turned out; we had a passenger that had a seizure; and he was put on oxygen. We were over Siberia; so I quickly notified the pilots in the cockpit. The passenger's condition improved markedly; so no assistance was necessary on arrival. I don't know if anyone had informed the pilots before I called them and had them send a message to our Dispatcher.