Professor Risteárd Ó Laoide:

There were a number of elements to the private sector involvement and cancer services being sent to private hospitals. Some of the chemotherapy and day care wards were transferred in total to the private institutions. For example, St. Vincent's University Hospital went to St. Vincent's Private Hospital and University Hospital Waterford went to UPMC Whitfield, and there are a number of other examples. A significant amount of day care oncology activity was transferred for the safety of patients because, in the environment at that time, a risk of Covid was a significant concern to us. Where the day care units were not sufficiently separated in the hospitals, they were transferred to the private sector.

The second area was in surgical oncology. Again, because at the time there was a significant concern and we had seen what had happened in northern Italy, a lot of the theatre capacity and the ICU capacity was being kept for Covid patients and the potential Covid wave we were expecting. A lot of the surgical oncology was sent out to the private sector. Different hospitals went to different private sector locations.

They were the two main areas that went out. Since then, most of the surgical oncology has returned to the public hospitals. This is what the national cancer control programme wants. We have spent a lot of time in the past pushing centralisation because of its importance for patient care and patient outcomes. The idea that we would be involved in an element of decentralisation by sending out surgical oncology was a concern to us. Occasionally, however, there are patients who still go out for surgical oncology.

For example, some patients from St. James's Hospital are going to the Beacon Clinic for oesophageal surgery at the moment. That depends on whether there is a stress on the system within the hospital, secondary to Covid, at that time.

Most of the day-care units have come back to the public hospitals now. The exceptions include the Waterford unit, which is remaining in UPMC Whitfield Hospital, the Wexford unit is in Ely Hospital, and the Kilkenny unit is still in Aut Even Hospital Kilkenny. The reason for that is capacity in the public hospitals and their ability to deal safely with a vulnerable group of patients.

There is also a framework in place for the private hospitals as part of the winter and pandemic plans. This will allow us to access the private hospitals, acutely if necessary, depending on the Covid situation. That is what we would use.