Cancer strategy favours centralisation

RADICAL plans to centralise hospital cancer services are expected to be firmed up when Tánaiste and Health Minister Mary Harney receives the Government's new cancer strategy next month.

It is understood that the strategy retains a controversial proposal made in an earlier draft for radical reforms of hospital cancer care, including greater centralisation of services.

"Generally I would be supportive of what is being suggested. I do not think there will be issues there," said Minister Harney, who was guest speaker at the Irish Health Foundation's annual fundraising luncheon in Dublin yesterday.

The foundation was established two years ago to combat cancer by funding research and patient support with special consideration given to those living in rural areas who have to travel long distances for cancer treatment.

Ms Harney pointed out that while an enormous amount of money had been spent on hospital-based cancer care - one of the areas of greatest improvement in the health service in recent years - a lot more had to be done.

"In particular, I am concerned about cancer surgeries taking place in too many hospitals. In Northern Ireland, they have reduced the number of surgeons involved in cancer from 41 to 10 and the number of places from 19 to six," she said.

Ms Harney recently appointed Professor Niall O'Higgins, president of the Royal College of Surgeons in Ireland (RCSI), to examine performance indicators for cancer care.

"The local hospital might not be the best place where the patient achieves the best outcome," said Ms Harney who plans to publish the strategy within a short timeframe.

The strategy says there are too many hospitals and too many consultants involved in the provision of cancer care. It points out that survival rates from most forms of cancer are lower in Ireland than the EU average and that, even within the country, they vary considerably between regions.

The Irish Cancer Society (ICS) said they would support the proposal to establish four cancer care networks, incorporating eight licensed dedicated cancer care hospitals, each catering for one million people. It is concerned, however, that there is no mention in the strategy of how cancer services would be funded and manpower increased to deal with increased capacity.

The National Cancer Registry estimates that 21,500 people will develop cancer this year and that cancer numbers are increasing about 1.5% every year - indicating there will be 25,000 new cases by 2015.

ICS chief executive John McCormack said a crisis point had been reached in providing effective A&E services, largely due to lack of planning. "We cannot let a similar situation occur with the provision of cancer cervices," he warned.