Consultants angry over pace of cancer service reform

PLANS to reconfigure cancer services under the direction of cancer ‘tzar’ Prof Tom Keane have angered a number of hospital consultants, among them cancer specialists.

A series of documents obtained by the Irish Examiner under the Freedom of Information Act outline the growing concern among some consultants with the pace of reform and with existing cancer services.

In one letter, Prof Stephen Lane, consultant respiratory physician and allergist at Tallaght Hospital, wrote to Dr Philip Crowley, deputy chief medical officer at the Department of Health, warning there were “grave concerns” at Tallaght Hospital with proposals to transfer cancer services to St James’s Hospital.

Prof Lane, clinical professor at Trinity College Dublin (TCD), said there was “no mandate” to move cancer services to St James and there were growing concerns at the “rigid” NCCP (National Cancer Control Programme) implementation timeline. He said the numbers of patients attending Tallaght had been seriously underestimated.

Prof Lane also claimed that because up to 60% of work at Tallaght is involved in cancer, “unless a magic wand can fill this gaping downgrade in services... this effectively means closure of the hospital as a viable facility”.

Prof Keane also received a copy of a letter written by consultant general surgeon at Kerry General Hospital (KGH), Tom McCormack, to Gerry O’Dwyer, hospital network manager for the HSE South, outlining his frustration in treating bowel cancer.

“I colonoscoped a young patient from south Kerry last week. She has a large bowel cancer,” Mr McCormack wrote. “She has been waiting four months for a colonoscopy. Nothing has been done to prevent these cancers being diagnosed at a late stage. It is happening time and time again.”

The letter was written in August 2008, 10 months after the controversial death of Susie Long, a public patient whose seven-month wait for a colonoscopy meant treatment for bowel cancer came too late. Mr McCormack said his patients also faced a seven-month wait, and warned that the HSE was exposing itself to litigation.

In Sligo, consultant radiologist Dr Patricia Fitzsimons wrote to the HSE warning that ending mammography services at Sligo General could lead to delayed breast cancer diagnosis for which the HSE could be held liable.

A spokesperson for the NCCP said issues in relation to Tallaght Hospital and Sligo General had been resolved. In relation to Tallaght, she said they were currently working closely with the hospital to complete the transfer of breast surgical and diagnostic services Regarding Sligo, BreastCheck, the national screening service has since been rolled out, ensuring regular screening.

In relation to KGH, a spokesperson for HSE South said patients deemed clinically urgent are seen within a couple of weeks and routine cases are seen within six months and a statement of need has been finalised for the expansion of the endoscopy unit.