Radical reforms proposed in cancer strategy

The introduction of new and extended national cancer screening programmes, higher tax on tobacco products, and a ban on children using sunbeds are recommended in the Government's new cancer strategy.

The strategy has also retained a controversial proposal in an earlier draft for radical reforms of hospital cancer structures, including greater centralisation of services.

The strategy - to be presented to the Minister for Health next month - is strongly critical of aspects of current services saying there is inequity of access and services are fragmented.

It maintains that there are too many hospitals and too many consultants involved in the provision of cancer care. It says survival rates from most forms of cancer are lower in Ireland than the EU average and that even within the country they vary considerably between regions.

The strategy recommends that all cancer care should be provided through a system of four networks each catering for a population of around one million people. Each network would provide integrated primary care, hospital care, palliative care and psycho-oncology and support services.

The strategy calls for hospital care for cancer patients to be provided in around eight cancer centres each serving a minimum population of 500,000 people.

It says that the hospital sector must expand capacity to cater for a projected increase in the number of cancer cases in future years. However, it suggests that cancer care should be limited to a smaller number of centres which would come together in the networks to pool knowledge, experience, skills and technology.

It maintains that there is considerable uncertainty about the ability of smaller hospitals to adapt and implement future changes in the delivery of cancer care, especially for complex cancers.

The report says that the HSE should designate the proposed new cancer centres as soon as possible and that it should also review the number of hospitals required for the management of symptomatic breast disease.

It proposes that all cancer units, both public and private should be licensed. It also recommends the extension of breast cancer screening to all women aged 50-69 years. It also proposes a national screening programme for colo-rectal cancer - the second most common type in Ireland - and urges a speedy roll out of the cervical cancer screening programme.

However, it states that there is insufficient evidence to recommend the introduction of a screening programme for prostate cancer.

The strategy urges that excise duty on tobacco products should be increased each year by more than the rate of inflation. It calls for regulation of the use of sunbeds and proposes that these should only be used by adults.

The report also suggests that the Government should pay for the testing for radon gas in houses as well as for any remedial action required. It says naturally-occurring radon gas is responsible for 9 per cent of lung cancer cases.