Speech by Micheál Martin T.D., Minister for Health and Children at CANCER 2003, the Inaugural Conference of the St. James´s Hospital Cancer Strategy Group

I am very pleased to join you here this afternoon at this Inaugural Conference of the St. James´s Hospital Cancer Strategy Group. I would like to express my sincere thanks to St. James´s Hospital for inviting me to speak here today. St. James´s hospital has been to the forefront of developing multi-disciplinary care for cancer patients in this country. This multi-professional, multi-national gathering of experts underlines the commitment to the future development of cancer treatment, not just in this hospital, but throughout the entire system.

The range of experts represented at this Conference is evidence that the treatment of cancer must involve multidisciplinary teams with expertise in surgery, oncology, haematology, molecular medicine and clinical and nursing support. This Conference brings this diverse group of experts from Ireland, the UK, continental Europe and the United States together to listen, challenge, engage and examine new advances in cancer care on a shared and participative basis. This is the primary aim of CANCER 2003.

I especially welcome the attendance at this conference of delegates from the US and particularly members of the renowned National Cancer Institute. The NCI has played a central role in the development of cancer research in this country, and in the strengthening of ties between the two health jurisdictions on this island.

Dr. Joe Harford, Associate Director of the NCI and Dr. Ruth Barrington, CEO of the Health Research Board will earlier have outlined the details of the trilateral research and fellowship programmes involving the NCI, Northern Ireland and cancer services in this jurisdiction.

The principal objective of this initiative is to enhance the capacity of our cancer research and service delivery systems to improve the lives of cancer patients. The establishment of the Consortium gave a very practical effect to the closer links which had been established in a range of public policy areas between Ireland, North and South. This initiative was welcomed right across the political spectrum as a healthcare initiative in its own right and drew the support of the many disciplines involved in cancer care and research in Ireland: doctors, nurses, scientists and managers.

Last month, the first all-Ireland Cancer Network was launched by Dr. Andrew von Eschenbach, Director of the US National Cancer Institute. The network is being formed by the Irish Oncology Research Group in Dublin, the Clinical Research Support Centre in Belfast, nine cancer centres in Ireland and one in Northern Ireland.

The new cooperative group will be jointly funded by the Health Research Board in Dublin and the Research and Development Office in Belfast. The group will receive €1m over the next two years to carry out its work. Its principal role will be to initiate and coordinate clinical trials in cancer hospitals in both parts of the island.

My own Department has demonstrated its support by investing significant resources in this trilateral programme. Under the second phase of the cancer clinical trials scheme, awards to the value of €1.6 million were made available in 2002 to allow four hospitals to recruit and train staff, improve facilities and take part in world class clinical trials.

In November 2001, under the first phase of this scheme, awards to the value of €1.9million were made to 6 hospitals. This was the first time that public funding had been made available for cancer clinical trials in Irish hospitals.

Hospitals that have benefited under this initiative include St. James´s Hospital, the Mater Hospital, The Adelaide and Meath incorporating the National Children´s Hospital, Tallaght, St. Vincent´s Hospital, St. Luke´s Hospital, Beaumont Hospital, University College Hospital Galway, Cork University Hospital, Limerick Regional Hospital, and Waterford Regional Hospital.

Clinical trials are an essential part of developing better cancer prevention and therapeutic strategies and are acknowledged worldwide as the best way to advance patient care at the bedside. Irish hospitals will be able to participate in world-class clinical trials involving the latest advances in cancer chemotherapy, radiotherapy, vaccine therapy and surgery, helping to ensure that these new and effective treatments are available more readily to patients across the island as a result of this funding.

It is important to acknowledge that without the dedicated support of the National Cancer Institute, none of these developments would be possible. The NCI provides access to cutting edge research, prestigious clinical expertise and innovative technologies. The health services on this island are the principal beneficiaries. I am confident that given the commitment of those involved in the respective health services, the programme is well founded and will continue to develop.

There is no doubt that cancer is a major challenge to our health services. Approximately 21,000 new cases of cancer are recorded annually in this country and one in three of our citizens will develop cancer in the course of their lifetime. Cancer is more common in older people and as the population gets older, we can expect cancer cases to increase accordingly.


Since 1994, there has been a reduction in cancer mortality rates as a result of improved diagnosis, earlier interventions and improved and more widely available cancer treatments. However, our age standardised mortality rates are higher than the EU average. This is a cause of concern and there is significant scope for improvement to bring our rate in line with other EU countries.

We have been successful in increasing our level of investment in cancer care in recent years. I acknowledge that deficits in manpower and infrastructure still remain. Under capacity in radiotherapy is one important example. The continued development of cancer services is a significant challenge, given the range and complexity of treatments currently available and being developed. Cancer patients deserve appropriate, high quality and timely care. In developing cancer services, there is a corresponding imperative to maximise patient care by ensuring effective and efficient organisation of those services.

In terms of the overall development of cancer services, this Government is fully committed to the further development of quality cancer services at a national level. In recent years, this commitment has been reflected in the increased level of investment provided.

Since the implementation of the National Cancer Strategy commenced in 1997, there has been a cumulative investment of approximately €400m in the development of appropriate treatment and care services for people with cancer. This includes the sum of €29 million which was provided this year to ensure that we continue to address increasing demands in cancer services in such areas as oncology/haematology services, oncology drug treatments and symptomatic breast disease services.

Professor John Reynolds in his presentation this afternoon provided specifics in relation to the key developments that have taken place arising from this significant investment in recent years. This investment has enabled the funding of 80 additional Consultant posts, together with support staff in key areas such as Medical and Nursing Oncology, Radiology, Palliative Care, Histopathology and Haematology. The benefit of this investment is reflected in the significant increase in activity which has occurred.

I recently launched the Report on the Health Effects of Environmental Tobacco Smoke in the Workplace by the Office of Tobacco Control and the Health and Safety Authority. While the tobacco industry has played down any possibility of danger in passive smoking, the advice contained in this report is blunt. Current ventilation technologies are inadequate to give workers full protection from the hazards of tobacco smoke. Exposure can best be controlled by banning smoking in places of work.

Acting on this advice, I intend to introduce a prohibition on smoking tobacco products in places of work and last January draft regulations were published providing for this. Following a consultation period, it is intended to introduce these regulations on January 1st, 2004.

In terms of our achievements in improving cancer care, information has been presented here today in terms of increased manpower and increased acitivity. These are an important measure of improvements in cancer care. However, we also need to develop further our understanding of the process of care.

The ultimate objective in terms of the delivery of cancer care is that those in receipt of services experience outcomes on a par with best international standards. I am pleased to observe that investment in the National Cancer Registry is now beginning to give us important insights into five year survival rates. This will improve over time and will represent a significant improvement in our understanding of the effectiveness of our cancer care system.

Such outcome data would readily assist benchmarking our achievements with those of other countries, notably in the EU and United States. I am aware that this issue is before the National Cancer Forum and I anticipate specific recommendations to address this significant gap in our health care system.

With this in mind, I would like to draw your attention to the work of the National Cancer Forum which, under the chairmanship of Professor Paul Redmond of Cork University Hospital, is currently developing a new Cancer Strategy in conjunction with my Department.

The National Cancer Strategy 2003 will set out the key areas to be targeted for investment over the coming years. As part of this work, the existing Strategy is being evaluated to assess its success and the gaps in cancer services, which now need to be prioritised. A number of Forum members are presenting at this Conference and others are present. It is important that the deliberations of this Conference inform the work of the National Cancer Forum. I would ask Dr. Mark Lawlor to liaise with the Forum in this regard.

The developments which I have outlined here today describe an overall framework through which cancer services can be developed and provided in a co-ordinated and effective manner. This Government is committed to ensuring that the Cancer Strategy will form an integral part of the implementation of the broader Health Strategy which is aimed at ensuring quality and fairness in the provision of services to all.

In conclusion I would like to take this opportunity to wish CANCER 2003 every success in its objectives. While the benefits of this Conference will be immediately apparent to its delegates, I have no doubt that the prime beneficiaries of this exchange of knowledge and ideas will be the wider health service and most importantly, its patients.