Address by Mr Micheál Martin, T.D., Minister for Health and Children on the launch of the Regional Psycho-Oncology Unit at St. James’s Hospital, Dublin

Good Afternoon, Ladies and Gentlemen.

I am very pleased to join you this afternoon to officially launch the Regional Psycho-Oncology Unit here at St. James’s Hospital. I would like to thank Mr. John O’Brien, Chief Executive Officer of St. James’s Hospital and Dr. Anne Marie O’Dwyer, Consultant Psychiatrist and Dr. Sonya Collier, Principal Clinical Psychologist for extending this kind invitation to me.

When we talk about cancer we talk about a reality that touches each and every individual in this country at some time in their lives. One in three of us will develop cancer and with an ageing population the incidence of cancer will increase over the coming years. Despite advancements in cancer control in recent years cancer still remains one of the most frequent causes of disease and mortality. Each year more than 21,000 people will develop cancer, and almost 8,000 will die from the disease. I have placed improvements in cancer care as a major priority in the development of healthcare in this country. We must ensure that cancer patients are supported from the time of diagnosis and during treatment programmes, including rehabilitation and palliation.

There is a growing recognition of the need for a more holistic approach to cancer care. This is especially the case as we have about 100,000 survivors of cancer in Ireland at present. Cancer is not only a physical disease. A diagnosis of cancer can be associated with significant psychological morbidity. A diagnosis of cancer affects patients in different ways both physically and mentally. This in turn has resulted in an increased focus on the development of psycho-oncology care. Psycho-oncology is increasingly being recognised as an important part of the multidisciplinary care of cancer patients. It should therefore be incorporated into routine cancer care.

The impact of a diagnosis of cancer affects more than a patient’s physical well-being. A diagnosis of cancer naturally results in fear and anxiety which in many cases can be managed by the individual. However, more severe reactions, including clinical depression can also occur that results in psychological illness that also requires on-going medical and supportive care.

The Psycho-Oncology Unit here at the hospital is an excellent example of the modern role of psychological medicine in the treatment of cancer patients. The central aim is to ensure that the level of intervention is aligned with the level of clinical need. I am particularly impressed that the service is designed to respond in an appropriate manner to the patient’s needs. It is structured in such a way that it is integrated with existing medical and surgical disciplines. Such integration allows timely access by patients. It also minimises the stigma associated with referral to a psychological medical service.

The National Review of Support Services for Patients with Cancer recognised the psychological problems associated with cancer and recommended that the management of a patient’s psychological health should be an integral part of cancer care. It also proposed that regional centres develop psychological care by providing multi-disciplinary teams to manage psychological ill health in cancer patients. This Unit is the first regional psychological Unit to be developed. It provides services to patients in the Eastern Regional Health Authority area and also from other health board areas. This is an important element of its regional remit and it provides a model that can be examined and replicated in other regions.

The development of this Unit will result in major benefits to patients and their families, including the provision of training, education and support. It aims to reduce distress levels in patients, improve their quality of life and assist in better compliance with treatment. The service enhances existing multi-disciplinary teams in the management of cancer related psychological morbidity in patients. The Unit also acts as a regional centre in helping to develop guidelines for psycho-oncology, and as a training, research and resource centre for staff within the region.

Since 1997, an additional cumulative investment of almost€550 million has been made in the development of oncology services nationally. The investment has provided for the appointment of an additional 92 consultants in the area of cancer care and also for the appointment of 245 cancer care nurse specialists.

Since 1997, the total additional cumulative investment in cancer services in the Eastern Regional Health Authority area amounts to€183 million. The investment has enabled the funding of 26 additional consultant posts together with support staff in key areas such as Medical Oncology, Radiology and Palliative Care.

Considerable investment has also been made in recent years in the development of cancer services here at St. James’s Hospital. For example, last year €1.1 million was made available to the hospital to develop the posts of Consultant Medical Oncologist and Consultant Histopathologist.

My Department has also made funding available to St. James’s Hospital under the All-Ireland-National Cancer Institute Cancer Consortium to enable the hospital to develop its infrastructure to allow it to carry out high quality clinical trials. A sum of €1.7 million over three years has been made available to St. James’s Hospital under this initiative. I am aware of the positive feedback from clinicians and nurses involved in clinical trials about the benefits to patients who participate in such trials.

The Washington based National Cancer Institute has played a central role in the development of cancer research and clinical trials in this country, enhancing the capacity of our cancer research and service delivery systems to improve the lives of cancer patients.

In addition to the revenue investment there has also been considerable capital investment in cancer services. Since 1997, approximately €95 million in capital funding has been allocated specifically for the development of cancer related initiatives.

This level of investment has resulted in significant achievements in cancer treatment services. I am particularly pleased that the key goal in the 1996 Cancer Strategy to reduce the death rate from cancer in the under 65 age group by 15 per cent was achieved in 2001, three years ahead of target.

The benefit of this investment is seen in the substantial increase in activity levels in the three modalities of cancer treatment that has occurred. For example, since 1996 the annual number of discharges of patients receiving chemotherapy has more than doubled, from 22,000 in 1996 to over 50,000 in 2002. There has been a 36% increase nationally in surgical procedures for breast cancer, with an additional 500 procedures performed in 2002 compared to 1997. This data provides important evidence of the return on the investment in cancer services under the 1996 Strategy.

Over the past two years, the Eastern Regional Health Authority has allocated €180,000 on-going revenue funding to develop this Regional Psycho-Oncology Unit. I wish to acknowledge the support of Eileen O’Donovan and Dr Marie Laffoy of the ERHA in this regard. This afternoon, I am pleased to announce the provision of additional on-going revenue funding of €100,000 to support the development of this service. This will ensure an increase in clinical services and improved access by patients in the region to much needed treatment services.

My aim and that of my Department is to improve the quality of care for cancer patients. The control of cancer can only be effective if it is planned and delivered in a systematic and integrated manner. The key elements of an effective cancer control strategy are prevention, screening, early detection, diagnosis and treatment. Rehabilitation and the psychological support such as this new unit will provide are also key elements.

The National Cancer Forum is at an advanced stage in the development of the new National Cancer Strategy. I would like to take this opportunity to acknowledge the work of Professor Paul Redmond, Chairman of the Forum and the other Forum members for their significant work to date in the development of this Strategy. Professors Donal Hollywood, Shaun McCann and Margaret Codd, Cancer Nurse Co-ordinator, are key experts attached to this hospital and are making important contributions to the development of this Strategy. Dr. O’Dwyer and Dr. Collier submitted a paper on Psycho-oncology which was discussed at the Forum’s meeting earlier this month and I also wish to thank them for their expert assistance in the development of the Strategy.

The new National Cancer Strategy will address all aspects of cancer care, including psycho-oncology. The new Strategy will build on the considerable progress that has been made in the development of cancer services throughout the country under the 1996 Cancer Strategy. I look forward to its publication later this year.

In conclusion, I would like to acknowledge the dedication and commitment of the staff here at St. James’s Hospital and particularly those involved in developing this important service for cancer patients and their families. In particular, I wish to acknowledge the contribution of Prof. John Reynolds, Regional Director of Cancer Services in the South Western Area Health Board to the development of cancer services here at St. James’s Hospital and in the wider health board area.

I wish to acknowledge the significant work and commitment of Dr O’Dwyer and Dr Collier and their colleagues here at this Unit. They have established a model for the delivery of a holistic approach to psycho-oncology services that is already inputting into the national development of cancer organisation and care. On behalf of the patients who avail of this service and the staff who work here it gives me great pleasure to officially launch this new Regional Psycho-oncology Unit.

Thank You