More delays for cancer surgery centralisation

The final plan to centralise cancer surgery has suffered another delay, the Medical Independent  (MI) can report.

The recent National Cancer Strategy 2017-2026 Implementation Report stated that the plan to centralise surgery will be finalised in the first quarter of this year.

However, in response to a query from MI about whether the plan is ready, a spokesperson for the Department of Health said the intention now is to finalise the proposals in the second quarter of 2019.

Developing a plan to centralise surgery for cancer has already been beset by delays. The Department is currently considering the second draft of the National Cancer Control Programme’s (NCCP) proposals.The NCCP submitted the first draft to the Department in 2017, but was asked to make a number of amendments, and the Programme drafted a revised document.

Despite having been submitted a number of months ago, approval has still not been provided by the Department.

When questioned on the subject of the delay, Director of the NCCP Dr Jerome Coffey told this newspaper in a recent interview: “It is okay having a plan but how do you implement, at a Group level, at a cancer centre level, and that is the hardest question to answer. If you look at examples, there would have been large services that would have existed for decades, but don’t have to be in cancer centres. Head and neck cancer in Cork would be an example. You have got a large urology department in Tallaght, so the question is, how do we get that to be part of a designated cancer centre in St James’s. That will require even more detailed planning once we get the plan through the HSE down to the Hospital Group level and to the cancer centre level.”

As surgical centralisation has already happened in breast, pancreas and lung cancers, the chief focus of the document are other cancers such as colorectal, prostate, and head and neck cancers.

Recently, Prof Michael Walsh, National Clinical Advisor for ENT to the National Clinical Programme in Surgery suggested to MI that plans to reconfigure the Hospital Groups could be delaying the designation of specialist centres for head and neck cancer surgery.