Professor Maeve Lowery:

It is important that when we think about the provision of care on an all-island basis we think about what the future holds. We need to be thinking about cancer care in five, ten and 15 years' time. We know that over the past 20 years cancer care has become incredibly more complex and more personalised, meaning not a one-size-fits-all approach for cancer treatment, but identifying a subgroup of common cancers and targeting of treatment particularly towards a subgroup where we know that treatment might work better. The complexity of the treatment we deliver has become incrementally more complicated. Immunotherapies have their specific side effects. Under the national chimeric antigen receptor, CAR, T-cell programme which has just started at St. James's Hospital, we take immune cells from a patient with cancer, which we send to the US to have engineering done to make them cancer killer cells specific to that patient's cancer and then we infuse them back into that patient. That is an all-island service. It is probably one of the major areas of future development in cancer care.

When we are looking at and thinking about implementing or providing care, we are not thinking about what we have now but about what we need in a decade. On an island of our size, there is no way we will be able to deliver what is needed individually at small silo sites. Given the complexity of cancer care that we know we are going to need to deliver over the next couple of decades, in particular the next ten years, we are going to have to work together. Why should a patient not be able to travel from Belfast to Dublin or Dublin to Derry to have a specialised treatment for his or her cancer? We cannot provide every treatment at every site. If we work together, we better able to provide the infrastructure to deliver that level of care. All of the treatments we now provide in-clinic came from research. They all started off in a laboratory such as Professor Gallagher's and they all had to come through that translation part, such as is provided by Professor Lowery, figuring out what cancer it is best to test it on, following which they were put into clinical trial, operated by all of investigators working with Ms Mulroe. The next step is proving that it works. The pathway to cancer care - I am speaking not only of drug treatment but across the gamut of how we intervene in a patient care pathway - starts with research. If we begin working together, then that will feed into the future development of cancer services North and South.