Áine Ryan
PROFESSOR Tom Keane confirmed to The Mayo News last week that the controversial Mayo and north-west cancer care services will not be transferred to University College Hospital Galway (UCHG) until the HIQA standards have been achieved.
“I have made a commitment that I will not transfer the services until I’m satisfied that everything is in place. Basically, if I felt we hadn’t met the HIQA standards, I wouldn’t transfer the services,” said Prof Keane.
Established in 2007 as part of the Government’s health reform programme, the Health Information and Quality Authority (HIQA) is charged with driving ‘quality, safety, accountability and the best use of resources in our health and social care services’.
The authority is also invested with powers to inspect services and act forthwith on breaches of patients’ safety.
At a presentation to last week’s monthly Regional Health Forum meeting, Prof Keane said that the incidents of cancer are set to double between 2000 and 2020. He acknowledged that the selection of the eight designated centres of excellence was controversial, but that radical changes were required if Ireland was to copy programmes that had been a success elsewhere throughout the world.
Currently on leave of absence from the British Columbia Cancer Agency in Canada, he observed that British Columbia has a similar population to Ireland, and it had rolled out its cancer care strategy 60 years ago.
Ireland’s poor cancer outcomes in relation ‘to risk, incidence, mortality’ was reflected in statistics revealing that between 1999 and 2004, the estimated survival rate was 45.5 per cent as opposed to the European average of 50.2 per cent and the Swedish one at 58 per cent.
He observed that our system was ‘disorganised and fragmented’, had ‘limited accountability’, ‘outmoded processes of care’ and an ‘absence of clinical leadership’.
The creation of a single National Cancer Programme – already signed off by Government as a separate business unit within the HSE – would bring about the necessary structural change, he said.
“The reason why we are doing this is that there is a strong relationship between surgical and cancer outcomes and increased surgical and hospital volume. This is because of the skill effect of surgeons who carry out such procedures more often,” explained Prof Keane.
He continued: “If there is one point I want people to understand today it is that a cancer centre is charactersied by the geographic concentration of all oncology disciplines with sub-specialised expertise on a tumour-specific discipline basis to provide critical mass and support to achieve best practice in cancer care.”
“This is not something being made up in the Irish context; the evidence is there internationally,” he added.
Allaying concerns about increased travel demands on patients, he said that the strategy addresses the development of links between the new cancer centres and primary care services in the community. This will involve oncology nurses working in both the hospital and the community, with the piloting of increased electronic links between general practices and hospitals, he explained.
“We plan to maintain the ongoing care of cancer patients – chemotherapy, support, follow-up, palliative care – as close to home as possible,” said Prof Keane.
Regarding travel arrangements and costs, he noted that existing arrangements will be supplemented by a grant of €780,000 to the Irish Cancer Society, which will further expand its volunteer driver programme.
“In general, in the Canadian system, those people who have to travel the furthest have their visits concentrated around one or two days,” he also said.
Prof Keane also cited the model of follow-up care in British Columbia which is concentrated in the local community as being part of the proposed Irish model.
