Oncologist warns Covid disruption to diagnosis and treatment could increase cancer mortality for “next decade”

• Consultant medical oncologist Professor Seamus O’Reilly says pandemic has “enormous implications” for “time-dependent” cancer care;
• Health service will struggle to cope with backlog of patients without hiring additional oncologists and other medical specialists;
• 1 in 5 Hospital Consultant posts are not filled as needed; while an additional 73 consultant oncologists will be needed over the next 7 years to meet demand on services; 
• Prof O’Reilly says cancer diagnoses were increasing at a rate of 5% a year even before the pandemic;
• Irish Hospital Consultants Association President: “We simply must appoint additional consultants. Government action now will prevent the current pandemic healthcare crisis drawing out for the rest of the decade.”

A leading consultant medical oncologist has warned that delays to cancer diagnosis and treatment caused by the Covid-19 pandemic could increase cancer mortality for the “next decade”.

Speaking on behalf of the Irish Hospital Consultants Association (IHCA) during European Week Against Cancer, Professor Seamus O’Reilly of Cork University Hospital and the Mercy University Hospital in Cork was citing recent statistics from the National Cancer Institute. 

“The Covid pandemic has impacted cancer services. Patients were concerned about coming into hospital. Services had to be curtailed due to social distancing and redeployment of staff,” said Prof O’Reilly. 

“Our health service still has not returned to normal. This has enormous implications, and our concern as oncologists is of delayed cancer diagnosis occurring as a result.”

Even before the pandemic, cancer diagnoses were increasing at a rate of approximately 5% a year. Prof O’Reilly said that Covid would further impact that number. 

“Cancer care is time dependent,” he said. “For example, colonoscopies are the gold standard of diagnosis for bowel cancers. Pre-pandemic, urgent referrals were seen within one month. Now, as a result of disruptions to service, 60% of referrals are waiting longer than three months.” 

Shortage of oncologists
Despite the known impact of Covid on Ireland’s cancer care, until staffing levels are improved the situation is likely to remain. 

According to the IHCA, 1 in 5 Hospital Consultant posts are not filled as needed, meaning patients must wait longer for diagnosis and treatment. 

While hundreds of new doctors graduate in Ireland every year, many opt to work abroad in places like the United States and Australia, where health services are perceived to be more supportive of their specialist medical staff and treat them in an equitable manner.

“Cancer care is about talent. It is important that our public health system has the ability to recruit and retain the highest talent available. We need an environment that’s supportive. We also need an environment where there is demonstrable equity of treatment for all of our staff.”

Prof O’Reilly also commented on the holistic nature of cancer care. A patient being treated for cancer will receive treatment from a number of different medical specialists, not just an oncologist. Poor staffing in these areas has a knock-on effect leading to a longer treatment and recovery period and worse outcomes overall.

“Cancer care isn’t just about chemotherapy. It’s additional psychological care, radiology, surgery, physiotherapy. Cancer care is an ecosystem, and when one of those fields is weakened, the supporting iron wall keeping patients safe becomes less rigid, and their outcome worsens.”

In a document published last year*, the HSE estimated that it will need to recruit an additional 73 consultant oncologists over the next 7-8 years to meet the demand on services – meaning the creation of and recruitment for an average of 9 additional cancer specialists per year between now and 2028.

Professor Alan Irvine, President of the IHCA, said:

“Treating cancer requires speed and efficiency. While Ireland has some of the best oncologists and doctors in the world, with the sheer number of vacant consultant posts there is only so much that they can achieve. 

“Waiting lists are lengthening. Smaller teams are being burnt out. Older consultants are retiring. Meanwhile, Ireland’s population is growing and ageing, and the general incidence of cancers is increasing. This is a deeply concerning and deeply volatile combination, but we needn’t stumble into health service collapse.

“The solution is obvious: we simply must appoint additional consultants, and quickly. Government action now will prevent the current pandemic healthcare crisis drawing out for the rest of the decade.”

ENDS

Notes to editors: 

*Demand for medical consultants and specialists to 2028 and the training pipeline to meet demand, HSE NDTP, 2020: https://www.hse.ie/eng/staff/leadership-education-development/met/plan/high-level-demand-report.pdf 

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