Cancer statistics published last week mask the true extent of inefficiencies in the health service, according to a consultant at the south-east's largest hospital.
Mr John Stratton said the approach to date had been to "throw good money after bad" and he saw no indication the problems would be addressed in a meaningful way. Mr Stratton, a consultant gynaecological oncologist and obstetrician at Waterford Regional Hospital, said he did not want to distress people who were ill and who needed to believe in the existing health service.
"Unfortunately, though, the health service they have isn't great. The standard of care in Ireland is bad because things are not set up to provide a proper service. And it's frustrating not to be able to provide the service we want to provide," he said.
Figures published last week by the National Cancer Registry showed that access to radiotherapy treatment, which is required by about half of all cancer patients, can depend in part on where a patient lives.
Mr Stratton said this was only part of the picture, because many patients who did receive radiotherapy were not getting it in time. Radiation required within a few weeks of surgery was often not available for several months.
"By that stage it's too late, it's no use, it takes up someone else's slot and all you do is cause side-effects." Cervical cancer patients in Ireland, he said, were having chemotherapy while waiting for radiotherapy. "That doesn't happen anywhere else in the world. Elsewhere you get the chemotherapy and the radiotherapy at the same time, you don't get one first because you have to wait four months for the other."
The Irish approach, he said, "might turn out to be great" but "it's not tried and tested, it's not recommended management. The standard treatment is you get chemo/radiotherapy up front as a combined modality treatment, and that has been of proven benefit".
He also questioned the need for pilot projects, such as the screening programme for cervical cancer in the Mid-Western Health Board area, when there was enough experience from other countries to tell us what was required. "There are pilot projects all over the place. What do you want a pilot project for when you can go and see how it should be done, and just do it?
"Cervical cancer is a preventable disease. No one should get it. They have halved the incidence of it in the UK by screening; in the United States they've reduced it by 80 per cent. Why are they putting in a pilot project when it's been of proven benefit wherever it's set up properly?"
Emphasising the need for regions to have their own radiotherapy units, he said a cancer centre, to be effective, needed to have all of the expertise available in one location. "The day that one cancer specialist could do everything is gone . . . what you want is all the experts getting together to discuss each patient, to discuss how best to investigate them, how to manage them and then to plan appropriate treatment and to co-ordinate that treatment so it works together for that particular person."
