Cancer test delays being addressed, says HSE

Patients with urgent referrals for suspected cancer are seen within days in most parts of the State, according to the National Cancer Control Programme (NCCP).

There are delays in some parts of the country with routine referrals of patients for diagnostic tests but “considerable work” is under way to address this issue, it says.

The Health Service Executive's cancer body was responding to a report published by the Irish Cancer Society which says public patients wait up to 25 times as long for tests than those paying privately. Some patients with suspected cancer are waiting up to 480 days to have an ultrasound, it says.

The society said that the report highlighted a “stark divide” between those who can afford to pay for private health insurance and those who cannot.

"The grim reality of our healthcare system is that the difference between life and death can come down to your ability to pay for healthcare," said Donal Buggy, the head of advocacy at the society.

The NCCP took issue with some of the findings of the report while agreeing with its recommendations for broader and better-funded diagnostic services.

It claimed the report was flawed because it failed to differentiate between urgent and routine referrals. It said urgent referrals are prioritised – with an average waiting time of 10 day for a breast consultation, 2.5 days for an urgent pelvic ultrasound and two days for an urgent chest X-ray.

Urgent colonoscopies

Internal research had shown that 99.9 per cent of urgent colonoscopies were carried out within the guideline of 28 days, it added.

The NCCP said not all non-urgent tests have to be carried out immediately; for example, in the case of the yearly scheduled check on a cyst. In other cases, it may be more appropriate to refer a patient to a consultant rather than order a test.

However, it accepted there was a lack of coverage for some diagnostics in some parts of the country. In Cork, for example, there is currently a lack of coverage for ultrasounds.

It expressed disappointment that there was not more collaboration with the Irish Cancer Society prior to the publication of the report and claimed that it failed to adequately acknowledge the achievements of the NCCP in supporting the work of GPs in cancer detection.

Lack of staff

The reason more GPs do not have direct access to diagnostics was due to a lack of qualified staff, it suggested.

Sinn Féin said the report confirmed the extreme depths of inequality in the health service. “This study makes for grim reading. Inability to pay should not deny anyone the opportunity to lead a full, long, healthy life,” said health spokesman Caoimhghín Ó Caoláin.

The Health Service Executive does not publish official figures on waiting times for diagnostic tests, on the basis that the information it collects from hospitals is "unvalidated" at present. It says it will publish data when a new computerised system is up and running.

Public patients wait an average of 119-125 days for an MRI of the spine, musculoskeletal system or brain, while private patients are tested in less than six days, according to the Irish Cancer Society report.

Waiting times for public patients for abdominal or pelvic ultrasounds average between 72 and 81 days, whereas private patients are seen in five to six days.

For CT scans of the brain, chest or abdomen, public patients wait an average of 47-55 days, compared to six days for patients paying privately.

The waiting times for gastrointestinal tests such as colonoscopies averages 58-60 days in the public system, and 10 days privately.