Full cancer-care standards urged

Campaigners have called for full standards of cancer care to be applied to the State's centres of excellence in the wake of a report that identified shortfalls at Waterford Regional Hospital.

An unpublished report into services at the hospital, one of the designated “centres of excellence” for breast cancer, has found it is failing to meet 36 of 48 national standards.

The assessment of Waterford Regional Hospital was done by the Health Information and Quality Authority (HIQA) on October 2nd; at around the same time, patients from three other hospitals in the region were moved to Waterford.

HIQA measured the hospital against the national quality assurance standards for breast cancer treatment. The data is from April 2008.

Kathleen O’Meara of the Irish Cancer Society said it had to be acknowledged that this was an interim report that was part of the HIQA process but called for assurances that full services and resources would be fully implemented in cancer care.

Noting that the deadline for the full roll-out of the eight specialist centres is the end of the year, Ms O'Meara said: "It is very important that women using breast services there know that this is part of a process, and we're not there yet, but we're getting there."

"We really feel the full report later this year is going to be the vital one in demonstrating that all the hospitals have met the standards and have attained the quality mark, so to speak.

"There is always going to be a gap between the plan and the full implementation of it . . . but it is very important that we receive assurances that the resources that are needed are made available, that staffing positions are filled, and that all the gaps are filled so the full set of standards is implemented."

Ms O'Meara said the move was toward world-class services, a key demand of the Irish Cancer Society. "What we want to see is a consistent set of high-quality standards and safe care across the country . . . survival rates and treatment shouldn't depend on where you live. It shouldn't be different in Dublin, Cork, or Waterford, it should be same in all hospitals, that how you build confidence in people.

However, she said it was "inevitable" people would have concerns against a backdrop of misdiagnosis cases and "perhaps a lack of trust in how the HSE delivers things," adding: "Those concerns will only be met when the full implementation is in place and we see results."

Breast-cancer campaign group Europa Donna Ireland said there had been a lot of progress in developing cancer centres and called for the maximum amount of resources to be put into these.

Deirdre O'Connell, vice chairwoman, said: "We still think it is an improvement for women to be in these new centres . . . HIQA was assessing where the centres were at that point in time . . . and not all the centres at that stage had the necessary data collected. That is part of the plan, ensuring that all centres will have data than can be comparable in Ireland and internationally."

Former independent Mayo TD and health services campaigner Dr Jerry Cowley said the concern was always the centres of excellence were not fully equipped to take patients from other hospitals.

"The hope was the centres of excellence would fulfill all the criteria and there would be no movement of people until things were up to scratch, but I think people had difficulty trying to convince the likes of myself.

"It's would seem illogical removing services totally from one hospital when the new services were not totally set up to cope."

"There has always been a fear it can be more to do with saving money than actually improving services," Dr Cowley said. However, he added he was reluctant to be over-negative about those seeking pursuit of health care excellence, noting there were "very genuine and well-meaning people" involved in this.

Waterford-based cancer-care campaigner Jane Bailey said the report findings were a "major disappointment".

"This was entirely inevitable. There should never have been a single person transferred to centres of excellence until standards were in place. For these centres now to be taking about working towards centres of excellence is absolute nonsense. People leaving Kilkenny, Wexford, Clonmel were promised they were coming to best outcome, best care . . . and the best hope for survival.

"Clearly, it has been shown that all that standards were not in place, and women in Waterford deserve a lot, lot better. These are already women who are at severe disadvantage, especially Waterford women. Years after BreastCheck was rolled out in Dublin, they still don't have access to the service," Ms Bailey said.

"There should be an immediate halt to the transfer of any more cancer patients until the standards of care that were promised are put in place. Communities throughout the country that are fearful have every right to be fearful when you see this. We lobbied for centres of excellence in the southeast, but we lobbied on the basis of best practice."

A spokesman for HIQA stressed the Waterford report was part of several phases of assessments being conducted with the National Cancer Control Programme.

He said HIQA would produce full national reports on the State's eight cancer-treatment centres later this year.