West left behind in cancer care ‘Eircode lottery’

A meeting was held in Galway on May 8 to update attendees on the most recent developments in delivering a fit-for-purpose cancer centre for the west and northwest. The West and the Northwest have the highest mortality rates for cancer in Ireland, and urgent action is required to put an end to this patient inequality.
A report by the National Cancer Registry Ireland stated that those in the most deprived areas, the highest concentration of which are in the west and northwest, had a 28 percent higher mortality risk due to cancer within five years of a diagnosis than those in the least deprived areas.
It said those living in the most deprived areas also had a higher risk of late-stage presentation for breast and prostate cancers and that the west region has the State’s lowest survival rates in Ireland for breast and lung cancers.
We need to implement the Government’s commitment in the National Development Plan (NDP), which states: “In accordance with balanced regional development, a cancer care network for the Saolta region (west, northwest) with a Cancer Centre at University Hospital Galway (UHG) with appropriate infrastructure will be delivered.”
Prioritising the delivery of the promised cancer care network for the Saolta region and the cancer centre on the campus of UHG has the potential to bridge the healthcare inequality that exists between east and west in this country and will save patients’ lives.
There are three projects on the UHG site all at strategic assessment report stage, but they need to be integrated into one comprehensive project that will deliver a functional cancer ‘hospital within a hospital’. This can be delivered within five years, provided action is taken and a design team is appointed by the Department of Health immediately.
The NDP promised a dedicated, fit-for-purpose cancer centre at UHG and a cancer-care network for the Saolta region which would improve patient outcomes. The project needs to be fast tracked in line with Sláintecare proposals and the National Cancer Strategy target of a 3 percent reduction in population inequalities for cancer incidence and survival by 2026.
The need for a fit-for-purpose Model 4 hospital, including the cancer centre, was called out publicly by Saolta clinical leaders in November 2022. Appointing a project design team is a matter of urgency. The Strategic Assessment Report endorsed by the HSE board in March 2023 awaits action by the Department of Health.
The west and northwest of Ireland are the most disadvantaged and geographically dispersed with the highest incidence and mortality from cancer. The only Model 4 hospital in our region is overcrowded and cancer patients are competing with emergency patients for beds and services daily. The lack of fit-for-purpose facilities means patients do not get the necessary care they need. Some patients are diagnosed too late to receive the appropriate care they could have received if diagnosis had been earlier.
In a modern, advanced country like Ireland, your outcome from cancer should not depend on where you live. Cancer care in Ireland is an Eircode lottery – we know what is required to solve this problem and that solution is already on the NDP.
Delivery of the cancer centre committed in the NDP will require an integrated, comprehensive plan for the Model 4 Hospital site and needs a whole-of-government approach. Support for the proposed plan has been forthcoming from the HSE, the Department of Health and the National Cancer Control Programme, but the remaining hurdles to progressing this project need to be cleared as quickly as possible.
Good cancer care can only be delivered out of functioning cancer centre with appropriate regional facilities. National strategy has positioned four heavy-weight Model 4 hospitals within a ten-mile radius in Dublin but leaves the west and northwest trying to deliver care from outdated, dysfunctional infrastructure. We can no longer accept this.
the cancer centre is arguably the single biggest commitment to health in the west and northwest of Ireland in a generation. This life-saving cancer centre must be delivered across a five-year timescale – in accordance with international norms.

• Prof Michael Kerin is Director of the Saolta/University of Galway Cancer Network