Patient survey on radiotherapy services biased, says surgeon

A MEMBER of the expert review group asked to recommend sites for radiotherapy services has criticised the methods used in a survey to assess patients’ priorities.

Gordon Watson, consultant surgeon in the South Eastern Health Board, said the manner in which patients were selected to participate in a review of existing services was biased. The patient review formed part of the overall Report on the Development of Radiation Oncology Services in Ireland.

“I don’t think it would stand up to scientific scrutiny or peer review,” Mr Watson said.

Of particular concern to Dr Watson was the finding that those surveyed ranked the distance to travel for treatment as number 13 in a list of 19 priorities. He said the finding certainly did not reflect the feeling among many of his patients, who did not want to have far to travel for treatment.

The absence of radiotherapy services in the south-east has long been a major bone of contention, with patients forced to travel to Dublin or Cork.

Mr Watson was also critical of the lack of commitment in the report to developing smaller radiotherapy units around the country.

“I would prefer to see one big centralised centre in Dublin, rather than the two recommended, and a further distribution of smaller units, particularly a unit in the south-east.

“I am also very concerned about the absence of radiotherapy services in the north-west. Patients living in that part of the country are at a huge disadvantage and are actually flying to treatment sites.”

Only 19 of the 26 counties were represented in the survey of patients, which included a questionnaire and focus group discussions. The biggest representation came from Cork (36%), followed by Dublin (15%) and Kerry (9%). Dublin and Cork already have radiotherapy services.

The seven counties not represented were Carlow, Westmeath, Longford, Galway, Roscommon, Cavan and Monaghan. Of those surveyed, 87 were patients from Cork University Hospital (CUH) and 62 were from St Luke’s Hospital.

South Eastern Cancer Foundation spokesperson Jane Bailey said the lack of representation from the more remote counties showed that the study was skewed.

“If you pick counties that are well served by radiotherapy, then obviously patients are not going to be overly concerned about distance to travel,” he said.

Dr Harry Comber, director of the National Cancer Registry and a member of the expert group, said there was no question of the patient survey being biased.

“It was well worked out in terms of trying to give patients the best quality of service, but it is inevitable that the report won’t satisfy everyone. It does, however, put patient care to the forefront and that is why it recommends centralising services, ensuring a wide range of facilities and skills which are not possible to provide in smaller units,” he said.

However, Ms Bailey said it was clear from the recommendations of the report that vested interests were at work. Of 23 members of the expert group, Cork and Dublin hospitals were most heavily represented, with just one representative from the South Eastern Health Board and one from the Western Health Board.

Local independent TD Dr Jerry Cowley was also critical of the report. He said that if the Government expected people to travel for treatment, then they needed to invest money in providing a proper road infrastructure.

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