Ireland

There are 4.25 million people living in Ireland. Between 2002 and 2006, the population increased by 8.1%. Complete data on cancer incidence and mortality are available from 1994 to 2005. In Ireland, there are about 20,000 new cases of cancer of all types diagnosed and there are approximately 7,500 deaths each year. Cancer numbers are increasing by about 1.5% each year.

On June 12, 2006, the Minister for Health & Children launched 'A Strategy for Cancer Control in Ireland 2006' which was prepared by the National Cancer Forum.

The evaluation by the National Cancer Forum of the 1996 Cancer Strategy found that the target to reduce the death rate from cancer in the under-65 age group by 15% in the ten year period from 1994 was achieved by 2001. The key achievement of the 1996 Strategy was that it provided a framework for the development and funding of cancer services in Ireland. In summary, the review concluded that the 1996 Strategy had delivered:

• A major reduction in premature cancer mortality ahead of target
• Increasing activity in chemotherapy, radiotherapy and surgery
• More coordinated and structured approaches to the delivery of cancer care.

A recent report of the National Cancer Registry of Ireland, 'Patterns of Care and Survival of Cancer Patients in Ireland, 1994-2001', showed that there have been improvements in survival for breast, colorectal and prostate cancer in line with the rest of Europe. The Report also noted some regional variation in survival which is one of the most significant strategic issues facing cancer services within Ireland, and also noted our relatively poorer cancer survival rates for many common cancers when compared with other European countries. In part, this can be attributed to the fragmentation of cancer services when too many hospitals are involved in the provision of treatment for cancer.

The Strategy for Cancer Control 2006 makes recommendations about organisation, governance, quality assurance and accreditation across the continuum of cancer care from health promotion, prevention and screening, to treatment services, supportive and palliative care and research. There is a strong emphasis in the strategy on health promotion, and on addressing inequalities and quality assurance.

The Government is committed to significant investment in the implementation of the Strategy to build on the improvements which have been made in recent years. The Health Service Executive is conducting a national needs assessment for cancer control to set out priorities in the medium term. The HSE will develop four Managed Cancer Control Networks consisting of primary, hospital, supportive and palliative care. The Programme will provide the necessary leadership, governance and integration to create an essential framework for cancer control. It will be led by a National Programme Director and will host a single national budget for all cancer control activities.

On January 1, 2007, a National Cancer Screening Service was established which merged BreastCheck and the Irish Cervical Screening Programme. BreastCheck, the national breast screening programme, is currently available in fifteen counties in the Eastern, North Eastern, Midland and parts of the South Eastern and Western regions. Screening is offered free of charge to all women in the 50-64 age group in these counties. Under the Irish Cervical Screening Programme, cervical screening is currently offered free of charge to approximately 74,000 women in the 25 to 60 age group in three counties in the Mid-Western region. Both BreastCheck and the Irish Cervical Screening Programme will commence a national roll-out at the end of 2007. The National Cancer Screening Service will also advise on other cancer screening programmes, initially about colorectal cancer screening.

The Department of Health & Children is working closely with the Health Service Executive to progress the delivery of the National Plan for Radiation Oncology. The plan consists of four large centres in Dublin (at St. James's and Beaumont Hospitals) Cork and Galway, and at two integrated satellite centres at Limerick Regional Hospital and Waterford Regional Hospital.

The Minister is convinced that the reorganisation of cancer care delivery as outlined is essential in order to meet the government's commitment to quality of care, and to meet the statutory requirement of the Health Service Executive so that its resources improve and promote the health of the public. The Minister's response to the strategy is based on the need to ensure that:

• Comprehensive and co-ordinated cancer control exist across the continuum of care including prevention, screening, diagnosis, treatment, and supportive and palliative care
• Cancer is prevented or detected early whenever possible
• Diagnostic, treatment, supportive and palliative services are consistent, accessible, and equitable, and that high quality persists throughout the country irrespective of geography or ability to pay
• Effective planning, evaluation and monitoring of performance in cancer control takes place
• Ambulatory care is maximised, to reduce unnecessary dependence on inpatient care, and on patients having to spend more time than is necessary away from home
• Cancer research is developed and is integrated into all the activities of cancer control.

The Strategy for Cancer Control recognises the key role of the All-Ireland-NCI Cancer Consortium and sees significant opportunities to develop this partnership to further support the development of cancer control on the island of Ireland.