Cancer patients from Co Donegal who at present have to endure gruelling 10- and 12-hour round trips to Dublin hospitals for specialist treatment will be among the first to benefit from increased cross-Border co-operation in the health sector.
By the end of the year these patients will have the option of going instead to Belfast City Hospital where an advanced, world-class cancer centre is currently being set up. A consultant to be appointed at Letterkenny General Hospital will also be based in Belfast for one or two days per week.
The arrangement with Belfast City Hospital, which has been under discussion for nearly two years, is part of a general upgrading of acute cancer services by the North Western Health Board (NWHB).
The board's CEO, Mr Pat Harvey, explained that the National Cancer Strategy published in 1996 proposed one regional cancer centre for the north-west, but it was felt Letterkenny and Sligo were too far apart for one centre to be effective.
As an alternative approach the NWHB has opted to link Letterkenny with Belfast City Hospital and Sligo with Beaumont Hospital in Dublin.
Instead of one specialist team comprising a medical oncologist and a haematologist in the region, the hospitals at Letterkenny and Sligo will each have a medical oncologist shared on a 70/30 basis with Belfast or Dublin. A haematologist will also be appointed to each hospital.
These consultants will administer drug treatment at the local hospitals and only patients requiring specialist care or radiotherapy will then have to travel.
The board's service plan for 1999, including details of the new cancer centres, has been accepted by the Department of Health. Over the coming weeks, the Letterkenny/Belfast post will go before Comhairle na nOspideal, which regulates the number of consultants in the State.
The appointment is expected to be made towards the end of the year and, once the consultant is in place, patients will have the option of going to Belfast.
Mr Harvey said the costs involved in having a patient treated either in Dublin or Belfast were "not dissimilar", but that it made sense for practical reasons to link Letterkenny with Belfast.
"It is just more convenient all round for the patients who have to travel long distances, but also from the point of view of staff for training, research and development and secondments," he said.
Mr Kevin Moran, a surgeon at Letterkenny General Hospital and Regional Director for Cancer Services, said the main aim of the new developments was to ensure that all patients in the region had equal access to services.
He stressed that Donegal patients were currently receiving a very high standard of care from Dublin hospitals and that staff from these hospitals also travelled frequently to Letterkenny for clinics. However, the long journeys were very hard on patients.
"There are people who have to get up at 4 a.m. and travel maybe 70 or 80 miles before they even get to Letterkenny. Then they have a four-hour journey by bus to Dublin and when they get there, they have to get a taxi across town to the hospital. They wouldn't get back home until 8 o'clock that night. It is pretty tough going," Mr Moran said.
He said the new centre being built in Belfast would be the first of its kind in Ireland or Britain. "It is based on a North American model, on the lines of the Sloan Kettering Centre in New York, which is regarded as the gold standard in cancer treatment," he said.
"It will be a world-class centre, with radiation, medical and surgical oncology all on the same campus. There will also be people there with international expertise and major research programmes will be run in collaboration with other centres in North America and Europe," Mr Moran added.
The Belfast City Hospital centre will benefit from an additional 120,000 population base, and research projects with a cross-Border element can often attract more funding. While the new centre will not be fully completed for about four years, Donegal patients requiring radiotherapy will, in the meantime, be treated at Belvoir Park Hospital in Belfast.
The CEO of Belfast City Hospital Trust, Mr Quentin Coey, said the linkage, when finalised, would bring real benefits in several areas. He said the regional cancer centre at the hospital would be the focal point of a highly specialist service. The partnership would also benefit research and development and clinical trials, he said.