Letter exposes chronic state of cancer services
Frustrated and angered by the underfunding of specialist services, which has led to the resignation of three consultants this year alone, Dr Seamus O’Reilly outlines how efforts to highlight the seriousness of the situation have been ignored for years.
In the letter, which was also sent to Health Service Executive chief executive Professor Brendan Drumm, Dr O’Reilly said:
* Dying cancer patients are being left in pain in their homes as they cannot access hospital beds.
* Up to 10% of cancer patients are not being recorded on consultants’ patient lists as the system can’t handle the numbers.
* There is a three-week waiting list for curative cancer therapy due to staff shortages.
* There is a higher-than- normal need for breast cancer treatment in the region as the failure to roll out BreastCheck means cancers are being diagnosed later.
In the letter, Dr O’Reilly said that despite having a population of 500,000, there is no seven-day dedicated cancer ward in any of the four acute hospitals in the region. As a result, it is regularly impossible to find beds for dying patients.
On some occasions, he wrote, terminally ill patients have found themselves in wards with people recovering from alcohol intoxication.
“Last weekend alone I received two phone calls, one from family members in exasperation who had gone to another hospital as their wife and mother was dying and could not accommodate her in hospital here.
“An additional patient was left at home in pain over the weekend because our only alternative was to admit her on a trolley in the Accident and Emergency Department,” he writes.
Dr O’Reilly also outlines how patients have already been directly affected by the “dangerous” and “inadequate” information technology (IT) system at the hospital which lags more than 13 years behind technology in the US.
The letter also highlights how cancer services at the city’s three acute hospitals are under-funded leading to “suboptimal” patient care.
When contacted last night, Dr O’Reilly would not comment on the contents of the letter beyond wishing it be made known that he had not leaked it.
A spokeswoman for the HSE Southern Area said approval has been secured for the development of the next phase of a cardiac, oncology and renal unit with a 30-bed oncology ward.
“The HSE is also working on a regional group compromising all acute hospitals in the area to ensure unified delivery,” she said.
Dear Ms Harney
I am writing to you as the remaining Consultant Medical Oncologist in the area formerly known as the Southern Health Board to express my concerns regarding the quality and safety of cancer care in our region.
As these issues are occurring on your watch I want to make it absolutely clear that you are aware of the significant problems we have. My letter to you is after repeated efforts by myself and my former colleagues over the past four years to resolve them at local level. These efforts, up to and including the former chief executive officer of the health board, with local politicians, national politicians and local and national media, have been fruitless so far.
As I write I am serving a population of 500,000 people, providing cancer care in four acute hospitals in the region. None have a dedicated seven-day inpatient ward. Last weekend alone I received two phone calls, one from family members in exasperation who had gone to another hospital as their wife and mother was dying and we could not accommodate her in hospital here.
An additional patient was left at home in pain over the weekend because our only alternative was to admit her on trolley in the accident and emergency department.
In previous times we have had patients who were dying from cancer and were admitted to a ward surrounded by patients recovering from alcohol intoxication.
I discussed these and other deeply upsetting events with representatives of the Department of Health earlier this year when they came to Cork for a meeting regarding cancer services here, but this has failed to resolve matters.
Since that time my colleague has resigned related to this issue. In response to the outcry this resignation caused management at Cork University Hospital put a proposal together to set up a ward but my understanding is funding for this has not yet been sanctioned. A purpose-built ward was proposed as part of the cardio-renal building in gestation since 1993 but again not yet sanctioned.
At this time I have patients in more than 10 wards in CUH alone, our computer systems are inadequate and, as a consequence, more than 10% of the patients who are admitted under my care will not appear in a computer-generated list.
This practice is dangerous.
Our region has been under-resourced. We are reaping the harvest of this legacy. In 2003, more than 90 consultant posts were approved by Comhairle na nOspidéal - our region got three of these posts. We have fewer consultants, fewer junior doctors, and fewer liaison nurse support than colleagues in Dublin and elsewhere.
Additional issues related to cancer care include the repeated delays in the rolling out of National Breast Cancer Screening Programme. These delays are costing lives, they are also resulting in greater treatment being required for patients that I see in the clinic.
Because of this geographical discrimination, more extensive surgery, more extensive radiotherapy, more extensive chemotherapy, more extensive hormonal therapy are needed for those with breast cancer in Cork compared to Dublin. It has been calculated that 65 women a year are dying in Ireland because we lack breast cancer screening in the West and South.
Earlier this year five children were tragically killed in a school bus accident in Meath. By September, all households in the country were made acutely aware of the new regulations required for seatbelts in school buses. I wish a similar level of urgency could be shown in addressing the plights of patients with breast cancer.
I sincerely hope this letter leads to constructive results for patients with cancer and their families in our region and I would be sincerely grateful if you would take the time to read the letter and act on its contents. I would be happy to meet with your or any other interested parties that can help.
This is an edited version of Dr O’Reilly’s letter.
