Gynecological Cancer Crisis: Urgent Need for Investment in Northern Ireland
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The Gynaecological cancer treatment system in Northern Ireland is on the edge of collapse. Hans Nagar, a prominent figure from the Royal College of Obstetrics and Gynaecologists, has issued a warning, highlighting the need for immediate investment.

The Looming Crisis

Hans Nagar’s concern is not groundless. Recent data paints a big picture. With only 19.8% of patients receiving treatment within the recommended 62 days of referral, far from the target of 95%. These statistics, collected over 12 months end in March 2023. It exposes the reality of gynaecological cancer patients in Northern Ireland.

The Department of Health also sets a target that at least 98% of patients diagnosed with cancer should begin their first definitive treatment within 31 days.

The Human Toll

Mr Nagar highlights the need to recognise the impact of profound physical and psychological on extended waiting times. Patients navigating the system experience anxiety, frustration, and uncertainty, underlining the urgency.

Frustrating Delays

The Department of Health acknowledges that the current performance targets for cancer waiting times are far from being met. The department labelled the situation “extremely disappointing.” Despite the launch of a cancer strategy in March 2022, it seems that the system is under pressure hindering its implementation.

A Glimpse into the Crisis

Gynaecology services in Northern Ireland are overwhelmed. The reason is that an independent and rapid review by the Getting it Right First Time (GIRFT) programme is now underway. This program intervenes when services are struggling and underperforming. And statistics are certainly concerning.

In the Southern Health Trust, there has been a staggering 41% increase in gynaecological cancer referrals between 2019 and 2023. The Northern Health Trust follows closely with a 25% increase during the same period. Shockingly, none of the five health trusts in Northern Ireland complies with the cancer strategy waiting time targets.

Staffing Woes

In response to these alarming trends, health trusts have expressed their struggles. They mention ongoing theatre nursing workforce gaps and staffing pressures as significant hurdles. The Belfast Health Trust, responsible for the regional Northern Ireland Cancer Centre, admitted that waiting times for its gynae oncology service are more extended. They emphasise it is due to the high referral rate and staffing challenges across the local health and social care sector.

The Impact on Patients

The situation described in the Northern Ireland Public Services Ombudsman’s report on waiting lists, aptly named “Forgotten,” is deeply concerning. The report identifies “significant and repeated failures across the system” amounting to systemic maladministration, impacting the health and well-being of those waiting.

Dr Frances O’Hagan, an Armagh GP expresses particular concern about gynae cancers. These cancers often remain hidden until a late diagnosis, worsening the frustration and anxiety of women.

Hope on the Horizon

Hans Nagar suggests that increased investment could encompass using advanced treatments and technologies. It includes Parp Inhibitors and targeted cancer drugs effective in treating ovarian cancer. However, he underscores that early diagnosis is vital to successful treatment. 

Regrettably, the absence of a concrete plan to address these pressing issues casts doubt on the possibility of a swift resolution.

The Path Forward

The Department of Health has received the initial draft of the GIRFT report. It has committed to taking action within existing budgets to reduce waiting times. In September 2023, we anticipate finalising the report, after which we will actively shift to implementing the recommendations.

The gynaecological cancer system in Northern Ireland is in dire straits, with patients facing long waiting times and health trusts struggling to cope. Urgent investment and a comprehensive strategy are essential to ensure timely treatment

Mahantesh Karoshi
Mahantesh Karoshi

I'm a Consultant Obstetrician & Gynaecologist and Women's Health Expert. I believe in educating my patients to contribute to achieving the best possible clinical and holistic outcomes. By taking this approach, I enable and empower my patients whilst addressing their issues and concerns. I run a private practice with an extremely high standard of professionalism. My patients are directly involved in their care and management in all stages. My approach to my patient's problems is built on dedication and passion, drawing on analytical thinking and my on-time honored reading, teaching medical professionals nationally and internationally.