Cancer delays - Must we wait for a crisis before acting?

A MALAISE at the core of our public services surfaced in a recurring theme this week.

Concerns raised about the reliability of cancer tests carried out at Barringtons’ Hospital over the last five years were so great as to provoke the immediate suspension of those tests at the hospital.

That a number of women and their families, who have already endured the stress of undergoing these tests, must consider the prospect of resuming the harrowing process and in the interim wonder if the time lost between tests might have serious consequences, is simply unacceptable.

That the issues involved — the level of resources dedicated to cancer services — have been a constant theme of the health services debate for decades just makes matters worse.

That the director of Cancer Care Services in the mid-west, Professor Rajnish Gupta, could say that his unit’s workload had increased by 60% in two years but that there had been no increase in staff is outrageous. That Prof Gupta had to threaten to quit unless funding improved underlines the depth of the outrage.

That shortfalls have been acknowledged by a cash-rich government and that the torturously slow process of overhauling an unfair and unreliable service has allowed life-threatening situations to persist is equally unacceptable.

That the difficulties began in a relatively small private hospital used, in this instance, because of considerably longer waiting times in the local public hospitals, moves the situation from the realms of farce to scandal.

Seven years ago an expert group recommended that breast cancer care be concentrated in centres of excellence and yesterday Health Minister Mary Harney said that process was continuing.

Continuing? Seven years later?

This lethargy prompted Professor Niall O’Higgins, who led the group which recommended the centres of excellence solution in 2000, to describe the delay as “beyond acceptability”.

The minister has acknowledged that there will be fewer centres where women will be treated but this is necessary to allow a depth of skill to develop to ensure the highest standards of care.

But why does it have to take so very long?

A country that has experienced the pain of the hep C contaminated blood scandal — and the anticipated €1 billion plus bill — cannot have much patience for another health scandal that could have been avoided.

If the prospect of saving more lives cannot energise the process then maybe the spur of litigation might accelerate the response towards some level of acceptability.

During the days that followed May’s election, when pacts were formed and votes bought, the tremendous effectiveness of Ms Harney and her positive impact on the Department of Health was a recurring theme.

That so many members of Fianna Fáil enthusiastically endorsed the achievements of a member of another party as they expressed a “fervent wish” that Ms Harney should resume her “crusade” — including co-location — at health should ring enough alarm bells. Nobody in Fianna Fáil had the courage or the ambition to take on Mr Cowan’s “Angola”.

Ms Harney has demonstrated that she is familiar with those qualities, but is she alone? Why is it that the reform she so ardently advocates takes a long time to implement?

The time scales are just not acceptable, change must be expedited. Can it be that we have to wait until a life-or-death issue knocks on our own door before we get angry about such mind-boggling delays?

Get angry; get it changed.