Dáil Éireann Debate, Thursday - 1 June 2023
48. Deputy Peadar Tóibín asked the Minister for Health if his attention has been drawn to a differential in cancer survival rates between patients diagnosed in the public and private health services in the State; and if so, if he will provide details on the differential. [25791/23]
View answerSuccessive National Cancer Strategies have delivered continuing improvements in outcomes for Irish cancer patients in terms of earlier diagnosis, better treatment, and improved rates of survival. This Government’s commitment to implementation of the National Cancer Strategy is evidenced by significant investment in recent years. €20m new development funding was allocated to cancer services and €15m was allocated for new cancer drugs in both 2021 and 2022. This increased total funding for cancer services to €139m in 2022.
Effective prevention, early diagnosis, access to quality treatment, survivorship, patient involvement, and safe high-quality patient-centred care are key aims of the National Cancer Strategy. The Government has already initiated policy to improve our nation’s health through 'Healthy Ireland - A Framework for Improved Health and Wellbeing 2013-2025', which sets the overarching context in which a focus on cancer prevention will be driven as a cornerstone of this Strategy. The National Cancer Control Programme (NCCP) has published the 'Early Diagnosis of Symptomatic Cancer Plan 2022-2025', which aims to increase the number of symptomatic cancers that are diagnosed at early stage disease.
The model of care for hospital cancer treatment is centred on eight Designated Cancer Centres serving a defined population and geographic area. The centralisation of specialist services into Designated Cancer Centres aims to optimise patient outcomes, through case volume, multidisciplinary working and infrastructural supports.
The National Cancer Registry (NCRI) published a report in 2019, Cancer care and survival in relation to centralisation of Irish cancer services: an analysis of National Cancer Registry data 1994-2015 . This report provides comparisons of five-year cancer-specific survival between three categories of hospitals (designated centres, other public hospitals, and private hospitals), based on where patients were first treated or diagnosed. Comparisons are made for cancers of the oesophagus, stomach, rectum, pancreas, lung, breast, prostate, and brain/central nervous system.
The report found that cause-specific survival of patients improved over time, both nationally and within most hospital categories, for the majority of the cancers and other tumours analysed. There were differences in survival rates between designated centres and private hospitals, depending on the cancer or tumour-type involved.
A number of factors may influence and help explain differences seen in survival, such as stage differences and, to a lesser degree, deprivation status of the patient. The report notes that differences in the appropriateness or quality of treatment and unmeasured differences in general patient health affecting suitability for treatment may contribute to survival differences between hospital categories.
It should be noted that all comparisons are based on hospital category, not on patient status, i.e. whether the patient's care is publicly funded or privately insured. Therefore, figures for cancer centres, and to a lesser extent other public hospitals, include any private patients whose first treatment/diagnosis was in a public hospital.
A full copy of the report including a summary table detailing cause-specific survival of cancer patients diagnosed 2008-2014, by category of hospital where first treated or diagnosed, can be viewed and downloaded from the NCRI:
www.ncri.ie/sites/ncri/files/pubs/CancerCentralisation_NCRI_Jan2019_fullreport_29012019_final.pdf.
