The Government has backed the recommendations of an expert group which yesterday proposed that public radiotherapy services for cancer patients should, for the moment, be provided in Dublin, Cork and Galway only.
The Minister for Health, Mr Martin, said that having considered the report, the Government agreed that a major programme was required to rapidly develop radiation oncology treatment services to modern standards.
He was confident, he said, that the estimated €300 million required to provide an adequate service to meet current and future demands at four locations, two of them in Dublin, between now and 2013 would be provided.
The report, The Development of Radiation Oncology Services in Ireland, identifies Cork University Hospital and University College Hospital Galway as two locations, but does not specify the two Dublin locations.
Public radiotherapy services are currently available in Dublin and Cork.
The national treatment centre at St Luke's Hospital, Rathgar, will not necessarily continue as it is, with the report stressing the importance of providing the three modalities of cancer treatment - surgery, chemotherapy and radiotherapy - on one site for best outcomes.
If St Luke's were to match this requirement, it would have to move to the site of a major teaching hospital.
This has already happened in the Northern Ireland context, with full cancer services now provided at Belfast City Hospital only.
Furthermore, the Hanly report on medical staffing in the health service, due to be published next Wednesday if it is approved by Cabinet on Tuesday, has suggested that single-speciality hospitals be moved to the site of major acute hospitals.
Mr Martin indicated that the decision on where radiotherapy will be sited in Dublin will be made by February.
He will meet the board of St Luke's Hospital shortly to discuss its future and stressed that the hospital's expertise was, and would remain, at the forefront in the development of radiation oncology service.
Mr Martin has asked the Department of Health's chief medical officer, Dr Jim Kiely, to advise him where in Dublin the service should be sited. Dr Kiely will accept submissions from interested hospitals.
The Minister said the priority now was to provide a "backbone" service at four centres to make up for major deficits at present, which have resulted in only about 20 per cent of cancer patients getting primary radiotherapy when up to 60 per cent should. This has undoubtedly contributed to the high number of cancer deaths in the Republic, some 7,400 a year.
Mr Martin said the Government would, as part of the second phase of the development of radiotherapy services, examine the provision of satellite treatment centres in Waterford, Limerick and the north-west. That phase is unlikely to begin before 2010.
Prof Donal Hollywood, of St Luke's Hospital, chairman of the expert group which compiled the report, warned that not implementing the report's recommendations was not an option. "It must be done. Anything else is indefensible," he said.
His report identified "profound" shortfalls in terms of staff to treat patients needing radiotherapy. There are 2.5 radiotherapy oncologists per million of population when there should be 8 to 10 per million. There is also a shortage of linear accelerator machines for radiotherapy.
The report recommended increasing the number of linear accelerators from eight to 26 by 2008 and to 35 by 2013. This will allow up to 10,000 extra patients to be treated. By 2015 the number of new cancer cases per year is expected to increase to 27,000.
Mr Martin has approved a doubling of the number of linear accelerators in Cork to four. He said resources would be prioritised to ensure that the Galway centre, with three linear accelerators, begins treating patients by 2005.