Background:
The National Cancer Control Programme (NCCP) was established in Ireland in 2007. The NCCP centralised breast cancer surgery for public patients into 8 cancer centres in 2009, which encompassed referral guidelines and electronic referral to designated cancer centres, with rapid access breast clinics and multidisciplinary teams. The NCCP does not have responsibility for provision of private hospital services.
Aim:
The aim of this study was to explore Family Doctor (GP) views on the quality of the breast service in specialist cancer centres following centralisation of cancer surgery in Ireland.
Methods:
28 randomly selected GPs were interviewed using in-depth semi-structured interviews. Primary selection criteria were geographic location and GP gender. Secondary criteria were type of GP practice (urban/rural), practice population (public/private), number of years practicing as a GP and structure of GP practice (single handed/group practice).
Results:
The majority of GPs stated a preference to refer their patients with suspected breast cancer to the specialist cancer centres in the public hospitals, regardless of private health insurance status.
GPs further than 25 miles from a cancer centre and those with more than 10 years experience were more likely to cite their preference for a cancer centre.
There were no differences according to GP gender or between urban and rural practices. However, GPs reported that some of their patients opted for care in private hospitals, which are not designated cancer centres “to get value from their health insurance”.
The overall preference for public hospital care was replicated for some other cancers but not for other diseases. GPs recommended breast cancer services in specialist cancer centres as an example for other health services in Ireland to adopt.
Conclusions:
GPs have confidence in public hospital care for their breast cancer patients since the establishment of specialist cancer centres in Ireland.