It used to be that every medical specialty wanted its own Prof Tom Keane. The establishment of the eight national specialist cancer centres in 2008, through the newly created National Cancer Control Programme (NCCP) under the leadership of Prof Keane, was viewed as a shining example of how the health service should be run. Healthcare in Ireland does not have a great record when it comes to reform. But the cancer transformation programme proved positive change can occur when there is sufficient political will and funding.
However, the NCCP no longer commands the prime position it once held.
An organisational review, conducted by PwC at the end of 2020, found that the Programme’s “influence and impact has regressed in recent years”.
A lack of funding and a loss of political backing are two reasons for this regression. A change in reporting lines within the HSE was another factor.
“There is an opportunity and need for the NCCP to reset and rebuild its brand and reputation with its key stakeholders,” according to the review, which this newspaper obtained through Freedom of Information law.
A number of recommendations were made. A spokesperson for the NCCP told the Medical Independent these have been “advanced”, but implementation has been slower than anticipated because of the Covid-19 pandemic. Two years after the review was submitted, the matter of the NCCP’s organisation “remains work in progress and will continue to evolve”.
The 2021 implementation report for the National Cancer Strategy 2017-2026 was recently published. In that year, €20 million in new development funding was secured for cancer services.
Prof Risteárd Ó Laoide, National Director of the NCCP, said: “The main goals of the strategy are to reduce the cancer burden, provide optimal care, maximise patient involvement and quality-of-life, and enable and assure change, and there has been significant progress in each of these areas since 2017.”
It is true progress has been made over the last number of years. A recent study by The Lancet showed that cancer survival rates in Ireland for lung, pancreas, rectal, and oesophageal cancers have improved. It is important to note that the strategy has recently been implemented in the context of the Covid-19 pandemic and the huge challenges it caused for cancer diagnoses and services.
But the issues raised in the PwC review should be addressed. As reported in this newspaper, in 2020, the Irish Society of Medical Oncology raised concerns that the NCCP lacked power in terms of drug reimbursement and funding allocation. At the time, Prof Ó Laoide shared these concerns about the Programme’s position at the “decision-making table”.
While the HSE has undergone a number of structural changes since the NCCP was established in 2007, the Programme remains unchanged to any significant degree.
With the health service about to undergo yet another transformation with the establishment of regional health areas, now is a good time to revisit how the Programme is positioned to deliver on the aims of the current strategy
As this is the last issue of 2022, we wish all our readers a Happy Christmas and New Year.
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