Margaret Carr: Why on this, World Cancer Day, we need a new strategy to tackle the disease in Northern Ireland
With our poor performance on waiting times, plus a predicted 50% rise in the number of people diagnosed with cancer by 2035, there is an urgent need to go back to the drawing board, says Margaret Carr
In 2017 just over 9,250 people here were diagnosed with cancer. The Northern Ireland Cancer Registry projects that, by 2035, the figure will rise to around 13,600 - that's a 50% increase.
Cancer has affected or will affect pretty much every family in here in one way or another. It's the biggest killer. Yet we are the only part of the UK and Ireland without a current cancer strategy.
So, what's the big deal about Northern Ireland not having an up-to-date cancer strategy? Surely we have services that can diagnose and treat cancer, so what difference would it make?
Our cancer strategy has not been updated since 2008. This is despite the World Health Organisation's recommendation that every nation should have a cancer strategy.
We know from other parts of the UK and Ireland that strategies can help target finite resources effectively and drive vital service improvements for patients. And patients here deserve to have world-class cancer services.
Cancer survival has improved, but that's mostly because research has developed new and improved tests, treatments and technology. Improvement in survival here has been slower than in other European countries, so we still lag behind the best.
And while the health service provides cancer diagnostics and treatment to the population here, these services are not always as joined-up as they could be.
Patients can face a confusing path through the health service and often have to wait too long to receive the treatment they need.
A new cancer strategy would identify these issues and develop a plan to organise cancer services more effectively, so that patients have a smoother journey through the health service and receive more effective care when they need it.
Comparisons would be made against nations which perform better in key areas to identify potential ideas for change.
It would be one comprehensive look at all aspects of cancer, including prevention, screening and diagnosis, care and treatment and research.
We don't always plan far enough in advance. A new strategy would outline plans for improving all these areas for both now and into the long-term - five to 10 years - setting ambitious goals and ways to track performance against them.
It would also identify the leadership and investment necessary to achieve these changes.
It is a fair question to ask why we should spend time identifying issues, some of which we might not be able to afford to fix.
But the reality is we can't afford not to fix cancer services. And we need to start now.
With an increasingly ageing population, we must find better ways of working if our health service is to have any chance of properly serving the many more cancer patients it will need to.
Some parts of the system have trouble coping with the current levels of cancer patients - just look at our poor performance against cancer waiting times.
The current target is for 95% of patients who are urgently referred by a GP with a suspected cancer to begin their treatment within 62 days.
This target was introduced in 2009 but has never been met and performance against it continues to deteriorate.
The 62-day waiting time includes the time for patients to undergo tests - for example scans, colonoscopy, or endoscopy, or blood or tissue tests - that will help clinicians make a diagnosis of cancer.
So, the poor performance here particularly indicates that our diagnostic services are under huge strain.
A cancer strategy would interrogate all the factors behind these challenges and bring together service-wide solutions.
Patients can often wait for a long time to see expert medical staff; tests or treatments may be delivered using dated machines and they may have to repeat their stories to doctor after doctor because IT systems don't talk to each other in the way that they should.
A new cancer strategy for Northern Ireland would review not just diagnostics, but also prevention, treatment, care and research.
We have excellent healthcare staff, who are committed to the best for their patients.
But we need more of them and to make sure they are properly supported into the future.
There are huge benefits to starting to look at a strategy now, but not everything has to be done at once.
It is important that early changes and improvements can be made which are inexpensive or even cost-neutral.
The strategy would identify priorities and the costs, over the timeframe of the strategy, so it's clear what would need to be spent and when.
But there should be no doubt that ultimately significant new investment will be vital to success.
It is usual for a minister to be the one who calls for the development of any new government strategy.
And there has been concern that, without a devolved Assembly and a Health Minister, there may be no means of creating a new strategy.
This, however, is against the background of the five main Assembly parties publicly supporting the need for a strategy.
It was encouraging to hear the permanent secretary at the Department of Health Richard Pengelly say in November that the department wished to see cancer progress continue.
He indicated that his department, in light of the recent Westminster legislation clarifying what civil servants could progress in the absence of an Assembly, would revisit the Health Minister's commitment to consider the need for a new cancer strategy for Northern Ireland.
At Cancer Research UK we welcome the permanent secretary's comments.
Our hope is that a decision to begin a cancer strategy will be made soon.
And that it will be comprehensive and plan for the long-term; that it will cover the entire cancer pathway, and that it will identify leadership and funding to ensure it is implemented.
Simply developing a cancer strategy for Northern Ireland is not a guarantee that things will improve - that's down to the hard work of the strategy's implementation.
But without a comprehensive strategy we stand no chance of improvement.
We urgently need a commitment to develop a new cancer strategy.
And, hopefully, World Cancer Day 2019 will help to focus the minds of the decision-makers even more firmly on what is needed.
Margaret Carr is public affairs manager of Cancer Research UK in Northern Ireland