No room for complacency as cancer strategy nears end

A recent meeting of the Oireachtas joint committee on health discussed cancer care. At the beginning of the meeting, the Director of Advocacy, Communications and Technology with the Irish Cancer Society (ICS), Mr Steve Dempsey, made some comments worth highlighting.

According to Mr Dempsey, the ICS believes “a complacent notion that we are doing very well has crept into the dialogue around cancer”.

While cancer services and outcomes have improved in the past 30 years, Mr Dempsey pointed out the Society still regularly hears about delays, issues with staffing, and other serious concerns.

As examples, he cited statistics relating to January to July of this year. During this period, 4,100 people were waiting more than the recommended 28 days for urgent colonoscopies; 5,800 women were not seen within the recommended 10 working days at urgent symptomatic breast disease clinics; and some 880 people did not start radiation therapy within the recommended 15 days.

In addition, Mr Dempsey said not enough patients with pancreatic, prostate, breast or lung cancer were getting their cancer surgery within recommended timeframes.

“These issues, while startling, are a direct result of the lack of consistent ringfenced funding for our national cancer services,” according to Mr Dempsey.

“They indicate a dire failing, and it is not a failing of the strategy itself, the HSE or the National Cancer Control Programme (NCCP) but, rather, a political failure of successive Governments which have not adequately funded the National Cancer Strategy.”

Mr Dempsey pointed out the current strategy comes to an end next year.

“Our understanding is that over its lifetime the projections for the strategy should have resulted in incremental increases in funding year on year and this would have allowed it to scale up and facilitate long-term planning in relation to staffing, infrastructure, capital expenditure, and other [initiatives].”

However, he said these increases occurred in fewer than half of the past nine Budgets.

Mr Dempsey also expressed dismay about the lack of clarity over funding for 2026.

“Weeks after the Budget, we have no notion of the funding for next year’s cancer services and we may never get that detail. This is due to a new budgetary process in health, which we are told is designed to empower the REOs [regional executive officers].”

The ICS has received reassurances from the Department of Health that it is committed to a review of the National Cancer Strategy 2017-2026 and a successor document will be developed.

Mr Dempsey noted the Department has also stated “there is no desire to undermine the role of the NCCP in the next strategy” with the new regional structure, which he said was “really good to hear”.

“However, we do have a real concern that the good work that has been done to centralise cancer services in previous cancer strategies will be undermined in a push for regional subsidiarity.”

The committee also heard from HSE Chief Technology and Transformation Officer and Deputy CEO Mr Damien McCallion and National Director of the NCCP Prof Risteárd Ó Laoide.

Mr McCallion admitted the cancer budget for 2026 had not been finalised as “we are still waiting on our letter of determination”.

Echoing the Department, he said that the new health regions will strengthen the NCCP, not weaken it.

“The regions effectively will have autonomy, but the [National] Cancer Control Programme will set out clearly the parameters and what needs to be improved in outcomes for patients,” Mr McCallion told committee members.

On funding, Prof Ó Laoide pointed out that many of the projects the NCCP oversee are continuous. As a result, recurrent funding, which is predictable and ongoing, is preferable to the current process of annual allocation.

“That is a really critical issue.… I hope that will be part of the next strategy,” he said.

There is plenty of great work happening in cancer care in this country. As highlighted in an interview with Prof Michael Eamon Kelly in this edition of the Medical Independent, earlier this year, the Trinity St James’s Cancer Institute became the first and only cancer centre in Ireland to be accredited with comprehensive status by the Organisation of European Cancer Institutes.

Hopefully this designation will be awarded to other centres in the near future. And at a national level, real progress will depend on an ambitious new strategy – one matched by the sustained funding to make it work. There should be no room for complacency.