Plan to transfer care of breast cancer survivors to GPs attracts the ire of the IMO

Plans to transfer the care of survivors of breast cancer to general practice after five years have incurred the wrath of the Irish Medical Organisation (IMO).

The National Cancer Control Programme (NCCP) wrote to GPs and affected patients last week informing them that continuing care of breast cancer survivors will be transferred to the primary care system. The letters were accompanied by leaflets explaining the details of the change.

The IMO says it is unacceptable that it is taking place in the absence of proper consultation and adequate transfers of resources.

"While we welcome in principle plans to transfer secondary care workload to general practice, the method by which the NCCP has gone about implementing it falls short of ensuring it is being done in a planned manner with the provision of appropriate resources and funding to ensure equitable availability of care nationwide," said IMO GP committee chairman Dr Ray Walley. "This can only happen through discussions and agreement with IMO as the representative body for GPs."

Sense
The NCCP says the only change involved is that women will attend their GP locally instead of going to see a specialist when they are well. "It makes no sense for well women to be seeing consultants for the rest of their lives," said NCCP national director Dr Susan O'Reilly.

She said a wide range of practices were occurring in Ireland at present and the aim of the current change was to standardise arrangements for breast cancer survivors. Aftercare required a GP to see patients once a year, but they were likely to be seeing affected women anyway for other reasons.

Dr O’Reilly said Ireland was unusual internationally in terms of the length of time cancer patients continued to be seen by consultants after they had been successfully treated.

There are about 25,000 breast cancer survivors in the State and 2,000 new cases are diagnosed each year.

Although survival rates are improving, breast cancer survivors are at risk of recurrence. About 80 per cent of recurrences occur within five years of cancer diagnosis.

Under the new arrangements, women will continue to receive an annual mammogram, which will be analysed by hospital radiologists, with the results forwarded to the GP.

Dr O’Reilly said the work issues involved had been “sorted out” with the Irish College of General Practitioners and the NCCP had written to the IMO last December.

However, Mr Walley claimed the ICGP had said his organisation should be consulted about the extra workload involved before any changes were made. The IMO is now seeking an urgent meeting with Dr O’Reilly about its concerns.