A radical shake-up of the way in which cancer care is delivered across the State has been announced in an attempt to ensure better survival rates.
It will result in some smaller hospitals no longer providing cancer treatment.
At present cancer treatment is provided at 35 hospitals and Minister for Health Mary Harney said yesterday this was "excessive". However, she could not say which hospitals will lose cancer services.
Her comments came at the launch in Dublin of the State's second national cancer strategy. The document, drawn up by the National Cancer Forum and entitled A Strategy for Cancer Control in Ireland, has recommended that cancer care in future be delivered at eight centres across the State in four regional networks, each serving a population of about one million people.
The Health Service Executive (HSE) has responsibility for implementing the strategy and will devise an action plan to do so within the next eight weeks. It will decide which hospitals retain services and will appoint a national director to oversee implementation of the plan.
The cost of implementing the strategy has yet to be worked out.
Prof Brendan Drumm, chief executive of the HSE, acknowledged there will be resistance to the plan. But he said it was the responsibility of clinicians across the country to start accepting that they had to operate systems which were evidence-based and focused totally on quality of outcomes for patients. He believed people would travel for the best treatment. "Very rich people fly across the world for the best treatment," he said.
Prof Paul Redmond, chairman of the cancer forum, said what was required now was "strong political, medical and executive leadership", as well as significant investment.
The strategy points to "our relatively poor survival rates" for many common cancers when compared to other European countries. In part, this can it said be attributed to the fragmentation of cancer services "which leads to too many hospitals and too many consultants being involved in the provision of treatment for cancer sufferers".
It said there was "considerable uncertainty about the ability of smaller hospitals to adapt and implement future changes in the delivery of cancer care" especially for complex cancers.
"It is clear that the hospital sector must address the need for continued expansion of capacity while limiting cancer care to a smaller number of cancer centres which then come together in managed cancer-control networks to pool knowledge, expertise, experience, skills and technology. There is clear evidence that people who have surgical treatment for many common cancers in centres with higher throughput, experience better quality of care and better survival rates," it added.
While the loss of cancer services at some smaller hospitals is likely to be a contentious issue, the Irish Cancer Society said the public should not see the reforms as a downgrading of services at local level but rather the introduction of best practice which will improve survival rates for a disease fast becoming an epidemic.
About 20,000 Irish people develop cancer each year and 7,500 die from the disease.