Calls for ‘record breaking budget surplus’ to be used to tackle cancer care in Ireland

The west and northwest regions have the highest cancer incidence and mortality rates in Ireland, according to campaigners who are calling on the Government to use “record breaking budgetary surpluses” to deliver a promised cancer centre at University Hospital Galway (UHG).

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 per cent 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.

Cancer Care West and the National Breast Cancer Research Institute say the mooted Galway project needs to be fast-tracked in line with Sláintecare proposals and the National Cancer Strategy target of a 3 per cent reduction in population inequalities for cancer incidence and survival by 2026.

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Richard Flaherty, chief executive of Cancer Care West, said the centre has the “potential to bridge the healthcare inequality that exists between east and west in this country and will save patients’ lives”.

He said the appointment of a project design team for the centre should be viewed as a matter of urgency as the Strategic Assessment Report (SAR), endorsed by the HSE board in March, awaits action by the Department of Health.

The Department of Health said that the SAR is being incorporated into the updated SAR/Preliminary Business Case (PBC), as required in the first stage of the shortened public spending code process which was announced by Minister for Public Expenditure, National Development Plan (NDP) Delivery and Reform, Paschal Donohoe, at the end of March 2023.

“In line with the updated PSC, this process will be managed through the HSE capital development process,” a spokesperson said.

The NDP promised a new, fit for purpose cancer centre at UHG and a cancer care network for the Saolta region, which Cancer Care West believes will improve patient outcomes.

‘Competing’

“The only model four hospital in our region is overcrowded and cancer patients are competing with emergency patients for beds and services daily,” said Prof Michael Kerin, director of Saolta-University of Galway Cancer Network.

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A model four hospital is defined as a hospital which provide 24/7 acute surgery, acute medicine, critical care, tertiary care and, in certain locations, supra-regional care. UHG is the busiest model four hospital in the country, serving a population of some one million people.

“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,” Prof Kerin said.

“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,” he said.

“National strategy has positioned four heavyweight model four hospitals within a 10-mile radius in Dublin but leaves the west and northwest trying to deliver care from outdated, dysfunctional infrastructure.”

There are three projects on the UHG site at SAR stage but Cancer Care West says these need to be integrated into one comprehensive project that will deliver a functional cancer “hospital within a hospital”. The group believes this can be delivered within five years, provided action is taken and a design team is appointed by the department immediately.

The charity hosted a third information evening on the matter, alongside the National Breast Cancer Research Institute, on Monday evening at the Clayton Hotel in Galway.

The Department of Health spokesperson added that the numerous capital investment projects under way at UHG reflect the hospitals important role as the sole model four tertiary referral hospital for the Saolta University Health Care Group and “will support patients and staff in both the delivery and ongoing development of healthcare services at the hospital”.

‘Torturously slow’

Padraig Burke, of Cancer Care West and of the Maura Burke Memorial Fund – dedicated to his wife who died of cancer in 2006 – said that the pace of delivery is “torturously slow”.

“Despite the fact that we have record breaking budgetary surpluses and all sorts of things, it just seems to be difficult to get people to recognise the need for this and to progress with it,” he said.

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“When you look at what was recently done in the Mater hospital, where, during the Covid pandemic, they got the green light for a 100 bed extension and they delivered it in two years. The process seems to have been fast-tracked for some reason and we are just wondering why we can’t apply the same.

A spokesperson for the Department of Health said that the Minister for Health has allocated funding in the 2023 Capital Plan to progress the design process for the Galway Cancer Centre and that the plan is due to be published shortly.

“Proposals relating to the Galway Cancer Centre are significant and, as they are expected to be in excess of €200 million, the consent of Government must be sought at the SAR/PBC stage and Final Business Case stage of the project life cycle,” the spokesperson said.

“This is to ensure PSC [public spending code] requirements, including value for money and affordability within the existing National Development Plan funding envelope are met.

“This Government has allocated significant investment in the health service over the past two years and it is expected that investment, which has also facilitated a large increase in hospital beds and staffing, will deliver meaningful improvements for patients,” they also said.

The spokesperson added that a timeline cannot be estimated until after the completion of a tender competition and the submission of the final business case for approval.