Just eight hospitals across the State will provide almost all care for cancer patients across the State in two years time, under a new plan unveiled yesterday.
The hospitals which have been designated for providing cancer care include: Beaumont and the Mater (serving Dublin northeast); St James's and St Vincent's (serving Dublin-mid-Leinster), Cork University Hospital and Waterford Regional Hospital (serving HSE south region); and University College Hospital Galway and Limerick Regional Hospital (serving HSE west region). Each will serve a population of 500,000 people.
A special outreach cancer care service will also be allowed to be provided from the HSE west region "on a sole exception basis" at Letterkenny General Hospital, because of its remote location.
Outcomes for patients attending Letterkenny will be audited to see if they match those of patients attending the eight centres of excellence. If they do not, the plan will be revised.
Some types of cancer such as breast cancer will be treated at all eight centres but rare cancers will only be treated at some of the eight centres.
The plan, announced by the HSE and Minister for Health Mary Harney, has been devised in an attempt to improve patient outcomes. Cancer patients treated in large centres with multidisciplinary teams have a 20 per cent better chance of survival.
The changes will occur on a phased basis but 13 small hospitals have been ordered to immediately stop providing care to breast cancer patients, if they haven't stopped already.
These are at Naas, Tullamore, Mallow, Cavan, Ennis and Nenagh, as well as St Columcille's in Loughlinstown, Louth County Hospital, Our Lady's Hospital in Navan, Roscommon County Hospital, Portiuncula Hospital in Ballinasloe, Mercy hospital in Cork and St Michael's Hospital, Dún Laoghaire.
They were treating small numbers of cases.
In addition, hospitals treating small numbers of patients with other cancers, such as lung and pancreatic cancer, will be told to stop doing so by January.
The overall plan has not been costed but it is thought the larger centres will require extra capacity to deal with more patients. Some staff will be expected to move with patients.
The target is to have half the programme implemented by the end of 2008 and up to 90 per cent of it in place by the end of 2009.
Prof Tom Keane, an Irish cancer specialist who has worked in Canada for many years, will be in charge of implementing the changes. He is coming to Ireland for two years to do the job and will report directly to the chief executive of the HSE, Prof Brendan Drumm. He will take control of all cancer expenditure within the HSE.
Prof Keane said: "The challenge is considerable but there is nothing that is going to be done here that has not been learned in other jurisdictions . . . this is about doing what we know will work. . . it's a choice between closer to home or better outcomes."
He believed that within three to five years, cancer outcomes in Ireland would improve if the plan was enforced.
Ms Harney said she did not believe the changes could happen under the old health board system, where some boards would have been left without cancer centres. There will be no cancer centres in the midlands or northeast.
The Irish Cancer Society welcomed the changes but said 50 per cent of cancers occurred in people over the age of 65 and therefore transport provision for them to travel to the centres of excellence was essential.