Pragmatism and not ideology should determine the relationship between public and private hospitals, argue five consultant oncologists - John Armstrong, Tom Crotty, David Fennelly, Jennifer Westrupand Graham Wilson
Throughout all the discourse concerning the misdiagnosis of women with breast cancer, many eminent medical practitioners chose to use the opportunity to question the quality of cancer services provided by independent and private hospitals. In some instances, sweeping generalisations were made about quality and control checks within cancer centres, based on badly researched and factually incorrect information.
According to the Irish Cancer Society, cancer rates are on the increase in Ireland by 4 to 5 per cent year on year. The most serious challenge that the Government faces relates to the scale and quality of services required to tackle this problem.
A large part of the focus of the debate on quality has been unfairly pointed at independent and private hospitals. What is not made known is that many of the independent and private hospitals are fastidious in their approach to the provision of the highest quality cancer services.
At least seven of these hospitals have already achieved, or are about to achieve, voluntary international quality standards such as the quality and safety accreditation from the Joint Commission International, a not-for-profit organisation dedicated to improving healthcare services throughout the world.
In the pursuit of enhancing medical quality and research here, many independent hospitals have endeavoured to make associations with leading academic medical centres in the US and other countries. For example, the Beacon Hospital Cancer Centre in Sandyford, Co Dublin, and Whitfield Clinic in Waterford have developed strong links with the University of Pittsburgh Medical Centre (UPMC) which treats more than 36,000 new patients annually at 43 centres in the US.
It is very important that we take a partnership approach between the independent private sector and the public sector to maximise the use of resources. It is essential that ideological considerations are not placed ahead of pragmatic practical approaches that are in the best interest of patients.
One aspect of cancer care that received much attention recently is the necessity of a multi-disciplinary diagnostic team. Unfortunately, it was inferred that this approach was strictly the preserve of the eight new centres announced by the Health Service Executive at the end of September.
This premise is incorrect. Many independent and private hospitals, such as Beacon hospital, take pride in their multi-disciplinary team approach, where patients are assessed by specialists in surgery, radiology and pathology, medical oncology and radiation oncology.
Independent and private hospitals continue to lead the way in funding for state-of-the-art equipment and services. The benefits have been spread across a broad spectrum of cancer patient services.
For example, critical to the management of cancer is an accurate assessment of the extent of the cancer prior to treatment. Recognising this, independent and private hospitals were the first to introduce magnetic resonance imaging scans and positron emission tomography (PET) scanning, which pinpoint cancer with unprecedented accuracy.
These services were made available to public patients To date there is no PET scan available in the public sector and public patients routinely avail of this technology through the Beacon Hospital, the Blackrock Clinic in Co Dublin, and clinics in Galway and the Whitfield in Co Waterford.
The Whitfield Clinic also operates a state-of-the-art radiation oncology facility. This service is provided by UPMC. Approximately 40 per cent of patients treated in the southeast receive intensity modulated radiation therapy through linear accelerators, which makes a real difference in terms of reducing adverse side effects and providing positive outcomes.
In contrast, in other locations in Ireland, the number of public hospitals delivering this type of advanced radiotherapy technology is lamentably low. The HSE pays for public patients to receive radiation therapy in the southeast and to date twice as many public patients have done so there as have private patients.
Much has been written and said about independent and private hospitals changing the health landscape in Ireland. But, regardless of one's personal opinion, we have to accept that we have changed remarkably as a nation. We travel more, see how other countries operate and have higher standards of living, and we now expect higher standards here. Over 50 per cent of Irish people have private health insurance. The challenge for healthcare providers is to meet their demands, while still providing an excellent service to public patients.
The independent and private health sector will never replace the public hospital system. However, with close collaboration, a symbiosis can exist that can benefit all patients in Ireland, both public and private.
Professor John Armstrong is a consultant radiation oncologist, Dr Tom Crotty is a consultant histopathologist, Dr David Fennelly is a consultant medical oncologist, Dr Jennifer Westrup is a consultant medical oncologist and Dr Graham Wilson is a consultant radiologist