Doctors in the Republics are sending their own family members to centres of excellence across the State or even abroad for cancer care but when it comes to other patients in their own communities they have a different standard, the Oireachtas health committee heard yesterday.
Prof Tom Keane, the State's newly appointed director of cancer control, referred to the conflict, branding it "a double standard".
He stressed he needed the backing of clinicians working in cancer care if the new cancer control strategy is to be implemented over the next two years.
One of the main elements of the strategy is to centralise the diagnosis and surgical treatment of cancer care at eight centres of excellence, with four of them in Dublin. The others are in Galway, Cork, Waterford and Limerick.
Prof Keane said this would improve patient outcomes and he has no plans to change this strategy. While some seemed to believe if he only visited Sligo General Hospital or Mayo General Hospital, which want to maintain all their cancer services, he would change his mind this was not the case, he insisted.
He said Sligo hospital only treated about 1.5 per cent of the cancers in the State every year, mainly breast and colon cancers, and therefore could not be a designated a cancer centre.
When asked during a three-hour meeting if he agreed with having four centres of excellence in Dublin, he said he believed one or two would be ideal but in practice this was not an option. He believes there will be fewer hospitals in Dublin in 15 years.
Many members of the committee questioned Prof Keane about providing transport to the centres of excellence for patients from the northwest. He said he hadn't expected transport to be such a big issue here. In British Columbia, where he worked up to now, there were five cancer centres for a similar size population as the Republic but covering a land area the size of France and Germany.
Yet the government did not provide patient transport - this was provided by the cancer society there.
He promised to look at the transport issue and at innovative ways to deal with the problem. It was a possibility money could be injected into the service provided by the Irish Cancer Society.
Speaking about the deficits in the cancer care system in the Republic, he said services were fragmented and resources were stretched across many areas. The time from when a patient presents until treatment was very long and there was no single medical record, which creates "endless duplication" of tests and "lots of delay".
"In many situations in Ireland the clinicians are flying blind - the system is flying blind."