Global Insight Perspective | |
Significance | The Irish Minister of Health has unveiled a radical reform to the cancer services under the National Cancer Strategy, in which 55 recommendations have been put forward; chief among them is the establishment of four national cancer-control service networks. |
Implications | The publication of Ireland's second National Cancer Strategy comes into place to reduce the fragmented nature of cancer-care services currently operating in the country. However, the report has been blasted for lack of details and for being a re-hash of the first one published a decade ago. |
Outlook | The radical shake-up envisaged by the new Strategy, once implemented, should help Ireland improve cancer care significantly in comparison to international standards, particularly with regard to European counterparts. |
Radical Shake-up of Cancer Care
A radical reform of cancer-care services was unveiled by Minister of Health Mary Harney on Monday (12 June) as part of Ireland’s second National Cancer Strategy. The report, entitled 'A Strategy for Cancer Control in Ireland' was drawn up by the National Cancer Forum, which was particularly critical about the fragmented nature of current cancer-care services.
The authors of report found that Ireland performed badly with regard to cancer risks, incidence and survival against international standards. On a European Union (EU) 15-country -wide basis, Ireland also performed unfavourably with respect to the duration of cancer-related hospital stays. Most notably, inequity was found within the provision, availability and performance of cancer services throughout the country, according to the document.
Highlighting a somewhat contentious shake-up, Harney said that some smaller hospitals would no longer be providing cancer treatment, since the current provision by 35 hospitals was 'excessive'. Other measures included among the report's 55 recommendations are:
- Establishment of eight centres of clinical excellence across the country within four managed regional networks, each serving a population of approximately 1 million individuals;
- Legislation to make notification of cancer compulsory and for the provision of cancer care through the national system of managed networks;
- Extension of breast screening to include all women aged 50-69;
- Expansion of the Irish Cervical Screening Programme, confined to the Mid-West since 2000, to the entire country;
- Establishment of a colorectal-cancer screening programme;
- Expansion of hospital-based cancer services; and
- An injunction to the government, urging it to meet its 2011 deadline for a national network of radiation oncology services.
Implementation of the strategy falls to the Health Service Executive (HSE), which is already devising a plan do so within the next eight weeks. Besides deciding which hospitals will retain cancer services, the HSE will also crucially be responsible for appointing a national director to oversee the execution of the strategy.
Outlook and Implications
The publication of this strategy follows a pledge made by the government in 2001, committing to a revised implementation plan for the 1996 National Cancer Strategy. However, Fine Gael health spokesman Liam Twomey deemed the strategy ‘high in aspiration, but low on specifics.’ According to Twomey, the strategy lacked a comprehensive implementation plan with costs, a detailed breakdown on funding, and even the location of the new cancer networks and cancer-care centres. Meanwhile, Labour urged Harney to commit funding towards implementing the new strategy. The lack of ring-fencing on funding was also crucially picked up by the Irish Cancer Society (ICS) and the Cancer Care Alliance. The ICS regarded the strategy as a ‘good blueprint’ for the future of the development of cancer care. However, the Society complained about a lack of measures for improving treatment services for men with prostate cancer. Despite the report being regarded as a major breakthrough for cancer services, many believe that it is a rehash of the first strategy published in 1996. The main objective of the 1996 paper was to restructure cancer-care services in order to ensure greater equity and stimulate a strong patient focus.