A review of the quality of breast cancer services provided in public hospitals across the State is to be undertaken by the Health Information and Quality Authority.
The review, announced yesterday, comes in the wake of mounting public concern about the quality of care delivered to breast cancer patients following a number of incidents in which patients were misdiagnosed and a number of cases where mammograms were read incorrectly.
The authority's review, however, will be confined to the quality of services in public hospitals. It does not have a remit to look at services in private hospitals such as Barringtons' Hospital in Limerick, where serious concern has been expressed in recent days about the quality of care given to 10 breast cancer patients in particular who were treated there.
The chief executive of the authority, Dr Tracey Cooper, said the review would begin in the coming months and would make recommendations for action where standards for best practice in breast cancer care were not being met. She added the authority would also be meeting private health insurers to discuss the need for patients with symptomatic breast disease to be treated only in facilities that can meet the standards.
Under current guidelines for best practice, consultant surgeons should treat at least 50 new patients with breast cancer each year to maintain their skills and to ensure best outcomes. But there were 11 hospitals in the State in 2005 - the latest year for which full data is available - that were treating fewer than 20 cases per year.
Dr Mary Hynes, assistant national director with the HSE's National Hospitals Office, told The Irish Times yesterday that these centres treating fewer than 20 breast cancer patients a year - whether by way of surgery or mammograms - would be closed down "within weeks" by the HSE if they hadn't closed already. She refused to name them, however, saying the data had to be validated. Ms Hynes said the hospitals seeing more than 20 cases a year but not sufficient cases to meet the guidelines would be consolidated in the medium term. "It can't be let drag on," she said.
But she stressed there had been significant improvements in recent years. As a result, 71 per cent of patients treated for breast cancer had procedures carried out by clinicians who performed at least 50 procedures per year in 2005, compared to just 23 per cent in 1997. "That is quite a shift . . . but we have to acknowledge we still have a way to go," she said.
In relation to the review of 3,000 mammograms and 2,500 ultrasounds on breast cancer patients who attended the Midland Regional Hospital in Portlaoise since late 2003 - which was announced on Monday - she said that to her knowledge the problem there was one of "over-diagnosis" with some patients receiving false positive results.
But she said, to her knowledge, "there is no woman who had either a missed diagnosis or an inappropriate procedure" as a result at the hospital. A consultant radiologist at the hospital has been sent on administrative leave pending a review of the scans.
Meanwhile, Patient Focus has called on both the HSE and the Department of Health to immediately put in place a process that will support all patients affected by the controversies involving the care of patients in both Barringtons and Portlaoise.
The Irish Cancer Society welcomed the announcement of a review of centres providing symptomatic breast disease services.
The society's Action Breast Cancer Helpline can be contacted on 1800 309040 (open weekdays 9am - 5pm).