Monday, May 27, 2024

Infrastructure gap the ‘single biggest issue’ for Irish cancer patients

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A national taskforce is urgently needed as cancer patients suffer knock-on effects from overcrowding and outdated infrastructure, according to one of Ireland’s leading oncologists.

Speaking ahead of World Cancer Day, the clinical director of cancer services and oncologist at CUH, Seamus O’Reilly, said patient welfare and staff retention are being affected by the lack of modern buildings.

“We are struggling with Jack Lynch-era infrastructure in the main hospital block in CUH, which isn’t fit for purpose anymore,” said Prof O’Reilly.

“We need a Micheál Martin oncology in-patient unit.

“He’s been very supportive of cancer services, but we really need this to get over the line.” 

 Health bosses have recently pushed for a seven-day health system, highlighting what they say is a lack of senior decision-makers over weekends as a contributing factor to overcrowding.

“In our service, we’ve had consultant weekend ward rounds since 2001, since the service was founded, even when we were down to one or two consultants,” said Prof O’Reilly. “That has been the case and that’s how we’ve been practicing for the last two decades. So it’s not that.

“We need infrastructure to change for everybody’s sake, particularly for the patients.” 

 CUH has submitted a business plan to the Government around funding for expansion.

Prof O’Reilly said of a submission for two floors of 24 single rooms for oncology: “That would be a game changer for us.” 

 World Cancer Day is marked tomorrow, with the theme Close the Care Gap. Prof O’Reilly said the infrastructure gap is the “single biggest issue” for Irish cancer patients.

Overcrowding levels in the emergency department at CUH last month had a knock-on effect on cancer patients.

The hospital was listed by the Irish Nurses and Midwives Organisation as one of the three most overcrowded hospitals in the country.

Cancer patients are particularly vulnerable to covid-19, flu, and RSV.

“Our volumes have increased and the capacity hasn’t. It’s very tough for patients. It’s been one of the busiest months we’ve ever had,” Prof O’Reilly said.

“If the hospital is busy, the capacity of the system is affected, things like getting scans done on time.

“The whole pressure on the system really becomes an issue as well as bed availability in the hospital.” Shared wards are another challenge for seriously ill patients, Prof O’Reilly said.

“Six people, mixed gender, one toilet; if it was a hostel you wouldn’t book in,” he said.

He called for investment in “21st-century buildings” to match modern medical care offered in Irish hospitals and suggested a national health infrastructure taskforce is needed to address these issues across all hospitals.

“If you had a health taskforce that would view an entire region rather than just one hospital here, one hospital there, that would be something that would be looked at,” he said.

He added: “I suggested an Infrastructure Taskforce after covid and I would still suggest that.” 

Patients’ access to oncologists can also be affected by lack of space, he said.

“It is fair to say this happens around the country. In many of the clinics I work in, the challenge is not having consultants; it’s having spaces for the consultants to work in,” he said.

“In many instances, it is not a shortage of consultants, it is a shortage of places for the consultant to work.” 

 Ageing hospital infrastructure also affects staffing, with Irish hospitals competing against international health systems, he said.

“We need new capacity in the system,” he said.

“This isn’t a question of people working better or lack of weekend supervision. It’s about 21st-century medicine, and the needs of 21st-century medicine and 21st-century dignity standards as well.” 

Several units at Cork University Hospital (CUH) were opened by senior government figures of the day, including the intensive care unit (ICU) by former taoiseach Jack Lynch and a separate unit opened by Bertie Ahern, both of which care for the most vulnerable of patients.

“In CUH there are two ICUs. There is the Bertie Ahern ICU, which is in the cardio-renal building, and then there’s the Jack Lynch ICU, which is in the main hospital block. These were opened when they were taoisigh. The staff turnover is higher in the Jack Lynch one than in the Bertie Ahern one.” 

 Jack Lynch laid the foundation stone for CUH in 1973 and was taoiseach again from 1977 to 1979. Mr Ahern was taoiseach from 1997 to 2008.

CUH recently opened a comfort care suite for end-of-life patients, with separate areas for relatives.

Prof O’Reilly said the suites have been “a huge positive.” He sees this as an example of what can be done to support patients with a terminal diagnosis.

“The most vulnerable people are the people who are going to die from cancer, and our society is judged by how it treats the most vulnerable including this group,” he said.

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