Analysis: It is not surprising the review group recommends that radiation oncology be provided at four centres, writes Dr Muiris Houston, Medical Correspondent.
The importance of today's report on radiation oncology services in the Republic cannot be overstated. It identifies a profound deficit in the availability of radiotherapy for cancer patients, and sets out how to address this deficit.
The report is obviously the work of long and detailed discussion. And while its recommendations will be a disappointment to some, it cannot be faulted in terms of the depth of analysis underlying its conclusions.
The expert committee has not attempted to hide the perilous state of radiation oncology here. With just two centres and a small number of linear accelerators (the machines for giving therapy) it is no wonder that many cancer patients miss out on an essential component of modern treatment.
Surgery, chemotherapy and radiation therapy are used in varying combinations and sequences in the treatment of cancer. It has been shown that patients who avail of all appropriate treatment modalities within an accepted timeframe have a much better chance of surviving cancer.
There can be no greater argument for the creation of supra-regional cancer centres in the Republic. It is not surprising, therefore, that the review group has recommended that radiation oncology be provided at four such supra-regional centres.
University College Hospital Galway and Cork University Hospital have been chosen, along with two centres in the eastern half of the country.
Interestingly, the report does not identify the location of these units. Nor does it say whether St Luke's hospital - the present site for radiotherapy in Dublin - will become the southern centre for radiation oncology services in the eastern region.
The review group does set out guidelines for those who will make such politically-sensitive decisions.
"The group believes that this will require a detailed and sensitive analysis of existing public treatment facilities, and the potential resources of specific hospital sites, the existing stage of development of oncology services at individual hospitals . . . and issues of patient access."
And the group calls for the earliest possible identification of the best locations in which to expand the radiotherapy service.
Probably the most disappointed group this morning will be those who have lobbied hard to have a radiotherapy unit based in the south-east. They have mounted a vigorous campaign since before the last election to have a radiotherapy centre.
The Cancer Care Alliance was subsequently formed, and it has campaigned for a decentralisation model of radiotherapy. Its argument has been based on the regional under-provision of radiation oncology, and the difficulties faced by patients having to travel long distances.
However, two elements in today's report appear to contradict this group's argument.
One is the finding from specially-commissioned patient research that geographic consideration were only ranked 13 in a list of 15 important qualities of a radiotherapy service when rated from a consumer point of view.
The other is the finding that for breast cancer the highest take-up of radiotherapy by patients at present is in the south-east.
The expert group also makes it clear that its recommendations are aimed at providing a backbone of radiotherapy service in the State. It does not rule out further development once a basic four-unit structure has been put in place.
Having established that we have the weakest radiotherapy service in Europe, the experts have plumbed for a radical plan that will restructure radiation oncology as a major component of cancer services.
If we are to improve our poor position in the EU league of deaths from cancer it is vital that multi-annual funding is provided to ensure that the proposals contained in this report are realised.