Significant progress on National Plan for Radiation Oncology – Minister and HSE press for rapid implementation
The Minister for Health and Children, Mary Harney, T.D., today set out the progress to date on the implementation of radiation oncology services. She rejected claims that she and the HSE have allowed the implementation timetable to slip.
Minister Harney said, “Considerable progress is being made in implementing the National Plan which I have supported by substantial additional investment. The Health Service Executive is delivering on this Plan and is currently examining best options to speed up its delivery. I have already, and will continue, to support the Executive in the early delivery of much needed additional capacity to treat cancer patients.”
She said earlier internal analysis from the HSE was now surpassed. Neither she nor the HSE management had subsequently accepted that the only option for full delivery was 2013 or 2014.
The Minister said, “There are no grounds for political scaremongering among cancer patients based on one earlier HSE document”.
“In December I met with the Chairman and Chief Executive Officer of the HSE and we discussed the timelines for the delivery of the National Plan for Radiation Oncology. I agreed with the HSE that it should look at options to speed up the pace of the delivery. The HSE is currently examining the options and will make recommendations to me shortly. It is my objective and that of the HSE to see the earliest possible delivery of the Plan in the best interests of cancer patients throughout the country.”
She continued, ‘A central part of the Government’s decision in 2005 was to ensure that capital funding was allocated using PPP finance for the entire network of radiation oncology. We will not be relying on incremental funding year by year, which has often been the cause of delays in the past.’
The National Plan
The National Plan for Radiation Oncology consists of four large centres to be delivered mainly on the basis of Public Private Partnership (PPP) as follows: in Dublin at St. James’s and Beaumont hospitals, Cork and Galway.
In addition to the four large centres, the plan will include two integrated satellite centres at Waterford Regional Hospital (two linear accelerators managed by Cork University Hospital) and Limerick Regional Hospital (two linear accelerators integrated with University College Hospital Galway).
Progress to date
- Rapid progress has been made in the procurement of additional capacity (two linear accelerators) for St. Luke’s Hospital Rathgar. This is scheduled to be delivered around the end of 2007. The revenue costs of this expansion amount to €1.0m in 2007, including 8 Radiation Therapists and 3 Physics staff.
- In November 2006, the Minister approved the provision of interim facilities at Beaumont (2 linear accelerators) and St. James’s (2 linear accelerators) Hospitals. These facilities will be delivered by early 2009. The capital requirements of the interim facilities amount to €45m. The revenue (€8.9m) and staffing (35 posts) consequences will be accommodated within the normal Estimates process for the health services, commencing in 2008.
- Until recently, cancer patients in Donegal requiring radiation oncology treatment were referred to either St. Luke’s Hospital Dublin or to University College Hospital Galway. A Service Level Agreement is now in place for the referral of about 50 radiation oncology patients annually from Donegal to Belfast City Hospital and patients are being referred for treatment. It has also been agreed that the number will be increased if there is sufficient demand from patients in Donegal.
- Additional revenue funding of €20.5m had been allocated for cancer control in 2007, including €3.25m to support the implementation of the National Plan. This funding will support the appointment of five additional Consultant Radiation Oncologists, 7 Specialist Registrars and five support staff. The funding will also support the two linear accelerator capacity expansion at St. Luke’s Hospital.
- In October 2005, the HSE established a Clinical Output Specification Group. The Group presented its final report to a special meeting of the Project Board on 11 December last. The Report comprises an assessment of population needs and catchments, resulting linear accelerator requirements by site, bed issues, specialty distribution, supplier mix, equipment specification, functional specification and contract flexibilities.
- In February 2006, the HSE appointed a Project Director. A project team was also established comprising representatives from the HSE, National Development Finance Agency and the Department’s Hospital Planning Office (HPO). The team meets twice monthly and is progressing all procurement and planning issues.
- Four leading international experts have been appointed by the Project to validate the population needs assessments, technical specifications, process mapping and other COSG outputs as the project progresses.
- A Project Board has been appointed by the HSE to provide overall governance and resolution of policy issues as they arise. It includes HSE, NDFA, and DoHC participants as well as expertise from outside the state. The Project Board meets six weekly.
- The Project Director is working with the HSE National Hospitals Office to ensure appropriate integration of the privately operated facility in Limerick, subject to compliance with quality and service guidelines and public procurement standards.
Progress on National Radiation Oncology Manpower Resource Plan
In March 2006, a Senior Project Manager in HR/Workforce Planning was appointed. A significant scoping exercise has been undertaken with regard to recruitment, training and retention issues across the service. A Skill Mix Review Scoping Group has been established and the HSE has contracted an international Radiation Oncology Expert to advise on process re-engineering and workforce efficiencies.
Progress on National Management Mechanism to ensure that radiation oncology centres operate as part of a national system, including network protocols
The HSE is developing the National Radiation Oncology Programme as a single business unit within the National Cancer Control Programme with responsibility and accountability for all human, financial and other resources related to radiation oncology. It is envisaged that the Director of the Cancer Control Programme will be appointed by mid 2007, after which a Director of Radiation Oncology will be appointed as a senior member of the National Cancer Control Programme, with responsibility for all radiation oncology issues.
The Project Team is establishing nationally standardised operating and ICT systems and national data and Quality Assurance systems will be developed.
Progress in exploring better value for money by an extended working hours model of service delivery
The HSE will utilise the opportunities presented by the Social Partnership Agreement, Towards 2016 to progress more flexible working arrangements in the context of improving the delivery of radiation oncology that best meets patient needs.