Surgery too late for half of breast patients at hospital
Published 26/02/2010 | 05:00
Women diagnosed with cancer should be operated on within 20 days
ONLY half the women diagnosed with breast cancer in one of the country's biggest specialist treatment centres had surgery within the recommended timeline, it was revealed yesterday.
Women diagnosed with breast cancer should be operated on within a maximum of 20 days, but this only happened in 50pc of cases at the Mater Hospital in Dublin, due to the lack of theatre time and beds.
The delays were revealed in the first audit of the eight hospitals which are now the specialist centres for the diagnosis and treatment of breast-cancer patients.
Other hospitals that also failed to meet the time target for surgery were St Vincent's in Dublin, where 79pc were operated on within 20 days, and St James's Hospital, which managed to treat 85pc in the required time frame.
However, the report of the Health Information and Quality Authority (HIQA) watchdog said the eight centres had made significant progress in providing high-quality and safe services, although several further improvements were needed.
It said all the centres now had the crucial elements in place, including core staffing and equipment. Weaknesses exposed in previous cases of misdiagnosis have also been addressed and all centres now offer patients triple assessment and multi-disciplinary care.
The HIQA found that centres which earlier this year had failed to see women needing to be assessed for breast cancer within two weeks were now offering appointments in this timeline in 95pc of cases.
The report said three of the centres -- Cork University Hospital, Limerick Regional and Waterford Regional -- had not made the same level of progress as the others and would be subject to further reviews this year.
It also warned that the growing number of women who were being referred without having clear symptoms was threatening the ability of all centres to meet targets for access.
For every one woman nationally who is diagnosed with cancer, 17 more are given the all clear. In Beaumont Hospital, for each women diagnosed as positive another 22 have no disease and in Letterkenny General the ratio is 37:1.
Since 2006, the service has seen a 50pc increase in new cases referred. Last year, 32,000 women, many of them in their 30s, were seen. Of these, 2,130 were diagnosed with breast cancer.
The report called for doctors to get together to discuss, understand and address the variations in the pattern of referral of women who do not have symptoms of the disease.
Jon Billings, director of healthcare, quality and safety, said the HIQA had also found fault with the failure of the eight centres to share information with one another about patient outcomes and cases of misdiagnosis.
The report said that historically the centres had viewed each other as competitors.
HIQA chief executive Tracey Cooper also pointed to the serious concern at the failure of the hospital centres to ensure that standards were maintained in outside treatment centres, such as radiotherapy units.
She said there needed to be formal agreements with these outside centres and monitoring of standards of care.
The report made 18 recommendations. These are now being addressed, according to the HSE's National Cancer Control programme, which was headed up by 'cancer tsar' Tom Keane before his recent return to Canada.
Health Minister Mary Harney said it was reassuring that the overwhelming message coming from patients was of very high levels of satisfaction and confidence in the care that they had received.