A CORK consultant medical oncologist has welcomed the Irish Cancer Society’s call on Government for an investment of €45m to rebuild pandemic-hit cancer services in Budget 2022.
Consultant medical oncologist Prof Seamus O’Reilly said that significant funding is required to develop 21st-century infection control, patient dignity-appropriate infrastructure, increase staffing, and provide psycho-oncology supports.
Speaking to The Echo, he said that the pandemic and cyberattack on the HSE has exposed Ireland’s underfunded health system and caused delays in providing vital cancer care to patients at the earliest opportunity.
Of the €45m figure proposed by the Irish Cancer Society, €15m is to deal with existing service backlogs and an anticipated surge in demand.
The calls come amid warnings from doctors and healthcare professionals about an oncoming tide of later-stage cancer cases that will emerge because people put off seeking medical advice during the pandemic, as well as ongoing delays accessing tests and treatment.
Prof O’Reilly said that the disruption of services had led to a backlog and patients presenting at a more advanced stage, meaning more treatment is required.
“We would encourage people if they are concerned to seek medical attention because sometimes people might be worried about being unwell and coming for medical attention. You could be scared and feel that by ignoring the problem it might go away, but that’s not the case. I can understand people’s reluctance and fear and anxiety, but we strongly encourage people who have issues to come to attention,” he said.
Prof O’Reilly acknowledged that people may sometimes not know where to seek medical attention. He said there is a shortage of 700 consultants in Ireland and one third of GPs will be retired in the next 10 years.
“There’s a significant recruitment and retention issue at all levels of our health system, not just hospital care. Obviously, the consultant’s contract and Sláintecare contract has got a lot of headlines, but general practice has been significantly affected by this, and I think most of us would be very concerned about the degree of pressure general practice is under at the minute with the retirement of various very accomplished experienced people.
“For those that are left, there’s the difficulty in getting local cover, maternity cover. We certainly see when we call GPs about cases and we touch base with them about patients, the pressure of work that they are under,” he said.
He said now that BreastCheck services are available again, those cases are coming to him, as well as symptomatic cases, but that the cyberattack had “significantly impacted” services and patients being diagnosed and assessed.
“People have also been minding themselves at home as well because they’re scared to come to the hospital too, and that has been a problem,” he said.
Prof O’Reilly also spoke about the importance of psycho-oncology supports for patients, and the increase in mental health issues in all age groups, which has been elevated by the pandemic.
“There’s interventional oncology and lifestyle oncology. With interventional oncology, you’re going to look at radiotherapy, chemotherapy and surgery; and with lifestyle oncology, you think of mental health, substances, friendships, and sleep patterns. Survival is linked to all of these things so, if mental health is less, then cancer survival is less, so addressing the psychological impact of cancer care is also important in terms of improving patients’ outcomes and quality of life,” he said.
Prof O’Reilly said that the call for improved infrastructure in the health system is of particular importance.
“Our infrastructure has led us to be vulnerable. Looking after patients in multi-patient wards, single toilets, all of that infrastructure leads to tremendous vulnerability, and probably isn’t really acceptable now to patients and families.
“None of us would book accommodation with five strangers of different genders and ages with one toilet, yet with people who are critically ill, this is the environment we look after them in. So the call for improved infrastructure is excellent and is needed,” he said.
He said that a health infrastructure project for Ireland is needed whereby lessons could be learned from both the children’s hospital and the National Maternity Hospital, and hospitals would be made “more 21st-century appropriate”.
“I think the levels of privacy that people have, the levels of infection prevention that people have in our hospital environments is not what it should be, because it’s impossible to do that with the infrastructure we have.
“I really think the pandemic has exposed our vulnerability in regards to infrastructure, and our patients have consistently highlighted to us that the privacy and dignity that they are afforded because of our infrastructure is not as good as it should be,” he said.
He called for the same unity and sharing of information that occurred when the pandemic hit to combat the issues and concerns surrounding cancer care.
“I think when the [Covid-19] crisis happened in March of 2020, there was enormous unity of purpose that we hadn’t seen in healthcare before. There was information sharing, and it really allowed you to see the huge expertise and human capital there was in our health service, and things were done quickly because they needed to be done.
“We need to bring the same unity of purpose and aura of crisis about this now, and use that to unhinge this. We are one of the highest spenders on healthcare in the OECD. We can’t spend more, so we have to learn how to spend better,” he said.