Sir, - Since his return to Ireland in 1993, Dr John Crown of St Vincent's Hospital Dublin has persistently pointed out that the mortality rate from cancer is much higher here than in most of the developed world. He gives as an example in his interview with Dr Muiris Houston (An Unhealthy State, October 4th) the fact that breast cancer here has a mortality rate of 45 per cent, while in Australia the rate is 33 per cent. In case anyone thinks one has to go to the Antipodes for such an improvement, it is 35 per cent in France.
Everyone who looks carefully at the results of the treatment of breast cancer can see, as he says, that specialised centres with numbers of about 200 or more cases a year do get much better results than smaller centres, but political implications are preventing this happening here. As approximately 1,600 women die from breast cancer each year in the Republic, this means that up to 200 of these women would not have died if treated in many other developed countries.
I have repeatedly raised this issue in Seanad Eireann but I have not managed to convert many of my colleagues, who know that the closure of a small hospital, or even a unit, is one of the surest ways to lose votes. "Patients from my area will not have to travel for treatment" is the response. I have some sympathy for them because the arrival on the scene of an independent, "Keep Our Hospital Open" candidate is a sure vote-catcher.
The medical profession and politicians must make a huge effort to educate the public about the value of specialised centres. Recently a colleague in the Seanad told me a person berated him because the local small hospital did not have the facilities or staff to re-attach the arm of a man injured in a harvesting accident. There is too much watching medical soap operas, I think. - Yours, etc.,
Senator Mary Henry, MD, Seanad Eireann, Baile Atha Cliath 2.