The Department of Health has indicated public patients requiring radiotherapy in the south-east or elsewhere may be referred to private facilities. If this were to happen it would represent a significant shift from current policy which is based on the recommendations of the Hollywood report, published last October.
In response to questions from The Irish Times asking if - in the event of a private hospital offering radiotherapy in Waterford - the Department would refuse to avail of these services as an alternative to patients going to Dublin or Cork, a written response reiterated Government policy in line with the Hollywood Report.
But it also noted that a national co-ordinating group established as a result of that report "will also advise on quality assurance protocols and guidelines for the referral of public patients to private facilities".
The Hollywood Report, written by an expert review group chaired by Dr Donal Hollywood and published last autumn after considerable delay, recommended the development of large centres in Dublin, Cork and Galway and this approach was adopted by the Minister for Health, Mr Martin. The possibility of developing satellite centres in Waterford, Limerick and the north-west in the longer term would be "further considered".
Since then a plan to build a private radiotherapy centre on the grounds of Limerick Regional Hospital has made progress and in recent weeks the Tánaiste, Ms Harney, said the use of private radiotherapy facilities should be considered. However, Mr Martin, in response to a Dáil question in June said that there was no undertaking to use private facilities as the policy is that all patients go to the three large centres.
The Department's statement this week said the Minister had created five new consultant radiation oncologist positions "involving significant sessional commitments" to the health boards in the south east, mid-west and north west. It said recruitment for these posts was under way.
Leading cancer specialists, including the south east's director of cancer care, Mr Gordon Watson, and radiation oncologist at St Luke's Hospital in Dublin, Dr Ian Fraser, have supported campaigners in rejecting the Hollywood findings and in calling for regional radiotherapy services.
Cancer Care Alliance (CCA) spokeswoman Jane Bailey said that even using the report's own criteria, the south east now had a large enough population to support a radiotherapy service. The report's population figures were outdated, she said. She also questioned a finding that travel was not a major issue for patients.
Independent Mayo TD Dr Gerry Cowley, who has campaigned for regional radiotherapy services, said the logical solution was for the State to provide a service at Waterford Regional Hospital. Otherwise, there would continue to be "apartheid" within the system because those getting the three treatments on one site would have better outcomes, he said.
It was, he said, not a particularly expensive treatment, and that he was also concerned that only a limited number of public patients would get to use any private facility.
"I think it is very wrong if the only way people are going to get a better service is through people in the private sector making a lot of money out of it," he said.