The crisis of confidence affecting breast cancer services threatens public trust in the broader health system. Yesterday's TNS/mrbi poll in this newspaper showed that some 53 per cent of people believe the health service has deteriorated in the last three years.
Public confidence will not have increased following the weekend announcement that a number of women, given the all clear after having mammograms performed at Portlaoise hospital, were misdiagnosed and have, in fact, got breast cancer.
Nor will confidence be helped by the remarks by Health Service Executive (HSE) chief executive, Prof Brendan Drumm over the weekend. He has the most challenging task in politics today: how to improve the quality of the health service for patients, take on the vested interests which governments have been afraid to do for years and, at the same time, win the confidence of the public that major reforms can be implemented.
Mortality from breast cancer in the Republic is 15 per cent higher than the EU average. The disease is the most common fatal cancer in women; international experience has shown that patients with breast cancer are at least 20 per cent more likely to survive if they are treated in specialist centres. These centres of excellence must see a minimum number of breast cancer patients each year and operate a multidisciplinary model of care.
While the HSE has finally announced the location of eight such specialist centres, there is considerable unease among healthcare professionals as to how existing cancer services can bridge the gap until the cancer network is fully operational. Patients, too, are asking, quite legitimately, which hospitals can they now trust if they develop cancer?
While it must be acknowledged that no cancer assessment can offer 100 per cent accuracy, the quality of care at Portlaoise fell below acceptable standards. In cases of symptomatic breast disease, mammograms must be read by two expert radiologists; carried out in conjunction with a clinical examination; and all tests and examination findings discussed at a multidisciplinary meeting.
Minimum acceptable standards were clearly stated earlier this year when the report of the National Quality Assurance Group for Symptomatic Breast Services was published. The reality is that, in the short term, more than eight hospitals will be required to provide breast cancer services. A number of units already operate to best practice guidelines. The HSE must name them and publish available audit figures for each hospital. Only then might peoples' shattered confidence in current cancer services in this State be slowly restored.