Professor Deirdre Heenan:

The north west cancer service is known to most people across this island. The key benefit of it is that people who are in the north west of this island are not asked to travel unrealistic distances for their services. If you are living in Donegal, no one is asking you to travel to Dublin when you can cross the Border six miles away and get services because of an agreement between two Governments. Regardless of what your constitutional view is, geography is geography and this is logical. The logical answer is to go to the services that are closer to you, particularly with cancer when you may be going for multiple treatments, you may not be feeling particularly well and it can be a huge strain on an individual and their families.

When we talk about that north west cancer service, we talk about the logic of it. At one time in Northern Ireland, we had cancer services spread very thinly across up to almost 17 hospitals. When we look back on it now, we ask how we ever thought that was a good idea. In the North, we have moved to a model of specialisation where we have a cancer centre in Belfast and a cancer centre in Derry. It means that people who are specialists are working on a team with specialists. It means that individuals know when they go there, they will be able to see the people who are expert in the cancers they are dealing with and, it is to be hoped, they will be dealt with in an appropriate manner. It is part of a wider discussion in the North about how we need to move from spreading services thinly to having specialist centres. The data exists to show there are better outcomes for people who are travelling those short distances and a high level of satisfaction from people who have used the services.

I was involved in discussions about the congenital heart disease network with the then minister, Edwin Poots. It is often said we cannot develop these services because of political obstacles. The then health minister was in the DUP and he was very supportive of the idea of an all-island congenital heart network because of logic, common sense and the realities of asking people with sick children to get on helicopters and go to services in Birmingham or ask them to go an hour and a half down the road to special services in Dublin. I firmly believe that health is one area where we can no longer say this is because of political sensitivities. I do not know any politician, North or South, who could say I do not want to do this because of a constitutional issue. This is about better health outcomes for people across this island, regardless of their political persuasion. It is important to put that on record because sometimes that is held up as an obstacle or a barrier. That is not my experience.

On the congenital heart disease network, it happened because of very invested individuals who worked night and day to make sure this happened. They were doing this on top of their day job. They were doing it because they believed in it. That is how we largely ended up with something we have now. The difficulty is if that is the system we have developed, when those people invariably retire - it is to be hoped they get a retirement - or move on, that impetus is gone. That is not a sustainable health model. What I would like to see is, using those two as exemplars, some serious policy discussion to see where are the other areas that we could identify where we would at least have ministerial support to have a scoping exercise in the first instance that could examine what are the possibilities for sharing resources, knowledge and ensuring better outcomes for our population in the end.