Minister for Health Mary Harney yesterday defended the Government's failure to implement a plan over the last seven years which would have seen safer breast cancer services put in place for patients.
She claimed it would not have been possible to put in place the Prof Niall O'Higgins plan - which would have resulted in cancer care concentrated at a limited number of hospitals - before the Health Service Executive had been established.
"It would have been impossible with 11 different health boards to put in place a national control strategy. Every health board probably would have wanted to have a major cancer centre and that probably isn't possible," she said.
However, she added that breast cancer care has in recent years been removed from a number of small hospitals like Roscommon, Navan and Cavan. "It would be fair to say that it's not happening fast enough as far as I'm concerned . . . I think the time has now come for the HSE to implement that plan and I've very confidence they're going to do that," she said.
Ms Harney pleaded for public support as well as the support of politicians for the plan as evidence indicates cancer patients have best outcomes when treated in larger centres dealing with large volumes of patients and where they can be treated by a multidisciplinary team.
"We will have to designate a number of key centres at regional and national level and they will be the centres from here on in, where major cancer will take place," she said.
It is expected that under the plan specialist breast cancer services will be confined to eight or nine centres, with four in Dublin and one each in Cork, Galway, Limerick and Waterford.
"Clearly there has to be a lot of consultation and discussion at hospital level because those hospitals that are not designated are perhaps going to be a little unhappy but overall patient safety and our cancer strategy requires us to make those kind of decisions," said Ms Harney.
She was speaking after an international conference on patient safety at Croke Park.
She said she hoped an inquiry into the care given to breast cancer patients at Barringtons' private hospital in Limerick would be established within days and completed within weeks. And she defended the speed with which the Department of Health responded when concerns about breast cancer care in Barringtons were first raised by Prof Rajnish Gupta, a specialist in the mid west back in 2005.
"The deputy chief medical officer was the person that took a phone call from the doctor in question. There were no specifics. There was a complaint about no triple assessment but we know we have no triple assessment in many healthcare settings around the country in the public as well as the private sector . . . the deputy medical officer asked for specifics and none were forthcoming until the start of August of this year," she said.
Meanwhile, the chairman of the Health Information and Quality Authority (HIQA), Pat McGrath, urged the Minister to rethink the fact that HIQA's remit does not cover private hospitals. Ms Harney said the advice when setting up HIQA was that it could not police private hospitals until a licensing regime for these hospitals was in place. She said the Commission on Patient Safety chaired by Dr Deirdre Madden was looking at a possible licensing regime. Dr Madden said her group would not report until next June or July.