Poorer survival rates for cancer patients in the Republic than in other European countries may have something to do with fragmentation of policy in this area in the State, the Minister for Health said yesterday.
Addressing a cancer conference at Dublin Castle, Ms Harney said if it was the case that cancer treatments were being delivered in places where they shouldn't be "and in circumstances which do not deliver the best outcome for the patient" then changes had to be made.
She said that required courage. "But it would be very foolish and irresponsible of anybody to stand over a situation where they know that people are being treated in circumstances which are damaging to their health and putting their life at risk and not giving them the best possible outcome as far as they are concerned," she warned.
She said service provision had to be based on best evidence. "In the area of cancer care, and in other areas, too, that will mean we have to do things very differently in the future than in the past. Every town or every county cannot have an acute hospital," she said.
Earlier, the conference was told by Prof Mike Richards, national cancer director for England, that evidence continued to grow that centralisation of services for treating cancer led to better outcomes for patients.
He said services were currently being centralised in the UK for the treatment of oesophageal and stomach cancers, but breast cancer treatments would still be provided at local district general hospitals.
"Naturally people might say 'I want the service in my own locality', but once you've explained that they are more likely to get a good outcome by travelling a bit further, in general patients that I've talked to about this have said: 'What matters to me is to get the best outcome'," he said.
In the Republic the Government's advisory body on cancer care, the National Cancer Forum, is recommending a radical restructuring of how hospitals treat cancer.
It has proposed the establishment of four integrated networks of specialist cancer units, each with a catchment population of around one million people. Smaller hospitals could lose out on some services under the restructuring.
It will overcome a situation which sees some surgeons treating tiny numbers of cancer patients every year.
Ms Harney said that with early diagnosis and appropriate treatment cancer was curable.
Ten million new cancer cases were diagnosed and up to six million deaths from cancer occurred around the world every year.
If those trends continued there would be 15 million new cases by 2020 and probably 10 million people a year dying from cancer.
"To put that in perspective, that would be almost four times the population of this country dying in one single year from cancer," she said.