UP TO 70 per cent of cancer care funding was spent in the unnecessary long-term follow-up of patients, the director of the National Cancer Control Programme, Prof Tom Keane, told the Irish College of General Practitioners in Galway at the weekend. DR MUIRIS HOUSTON, Medical Correspondent, reports from Galway
Prof Keane also said the actual number of designated cancer care centres was "immaterial" and there could have been four, rather than the agreed eight.
He described radiotherapy practices here as one example of the poor use of resources. "The number of people receiving radiotherapy as in-patients [in the Irish system] is five times that found in Germany and other western countries." He said that despite a four-fold increase in health funding since 1993, resources were still being wasted.
"There is no value in terms of survival outcome for prolonged follow-up [of cancer patients]. It defies clinical evidence." To applause from the audience of family doctors, he predicted that when, in the future, the health service is consultantprovided rather than consultant-led, "and they have to see all these [follow-up] patients themselves, the practice will stop".
Prof Keane said he wanted to see general practice provide follow-up care to cancer patients. He hopes to introduce community oncology programmes here, staffed by GPs with additional training in cancer care, which he said had been shown to be both safe and highly acceptable to patients in British Columbia, Canada.
In a wide-ranging address to doctors at the annual meeting of the ICGP he criticised the "huge imbalance" in the number of beds and other resources for cancer patients here.
He also expressed concern at the "opportunistic" distribution of healthcare resources in the Republic and said "any attempt to reallocate resources will be resisted, but it will clearly have to happen for there to be appropriate access and a proper level of care for patients".
Prof Keane told doctors that, despite recent controversies about the location of eight new cancer care centres, "we could have agreed to four, six or eight centres - in many ways the number of designated centres is immaterial".
He questioned why those people who have expressed concern at the length of travel time cancer patients may face in getting to the new centres are not equally concerned at the prospect of having to travel long distances for life-saving cardiac surgery.
He told doctors that Mayo General Hospital in Castlebar, from which breast cancer services are about to move to Galway, will lose just two cancer operations a week.
Reflecting on his experience of the Irish health system since he arrived from Canada last November, Prof Keane said he found the distribution of healthcare resources here "opportunistic".
Despite healthcare professionals being "incredibly creative" in securing adequate resources, he said the result of this opportunistic approach was the creation of a "huge patchwork of service provision".