Ireland spends millions outsourcing cancer care amid staffing crisis
DUBLIN, IRELAND — Ireland’s Health Service Executive (HSE) has faced a significant staffing crisis, leading to nearly €12 million (US$12.5 million) being spent over the past 18 months outsourcing radiotherapy treatments to private hospitals.
This expenditure stems from a severe shortage of radiation therapists, which has left advanced radiotherapy machines and CT scanners in public hospitals unused, forcing the HSE to depend heavily on private clinics for patient care.
Significant spending on private radiotherapy facilities
In 2023, €8.6 million (US$8.9 million) was allocated to private facilities for radiotherapy services. This trend persisted into 2024, with an additional €3.1 million (US$3.2 million) spent in the first half of the year.
A substantial portion of this spending was attributed to the St. Luke’s Radiation Oncology Network (SLRON), which operates centers at St. James’s, Beaumont, and St. Luke’s Hospital in Dublin.
According to an HSE spokesperson, SLRON spent approximately €7.3 million (US$7.6 million) in 2023 and €2.2 million (US$2.3 million) in early 2024 on outsourcing treatments.
Prostate cancer patients benefited from outsourcing
The outsourced services primarily focused on prostate cancer patients who require extensive radiotherapy sessions, which occupy significant time on the already limited linear accelerator (linac) capacity.
Despite efforts to mitigate the impact of linac closures through additional scheduled overtime by radiation therapists, two linacs in SLRON remain non-operational.
International search for cancer specialists
SLRON is actively recruiting radiation therapists internationally and anticipates integrating graduates from Trinity College Dublin into its workforce soon.
Meanwhile, Cork University Hospital and University Hospital Galway have also incurred outsourcing costs of over €2 million (US$2 million) and €185,000 (US$193,000), respectively, during this period.
Notably, Galway’s outsourcing expenses ceased in early 2024 following the inauguration of a new public radiation oncology facility.
National review highlights high attrition rates
The staffing crisis is further underscored by a 30% shortage of radiation therapists across the public health service, as reported by trade union SIPTU to parliament members last October.
This shortage has resulted in four linacs nationwide being underutilized. A recent national review highlighted high attrition rates among radiation therapists, with turnover reaching 12% in 2021 compared to 9.6% among other health professions.
The review proposed 16 recommendations, including a new staffing model that introduces radiotherapy assistants and advances practice roles for therapists.
SIPTU is advocating for the full implementation of these recommendations by the next government and has secured commitments for increased student placements and additional clinical tutors from the outgoing administration.
Offshore outsourcing as short-term solution
Amidst ongoing efforts to address domestic staffing shortages, offshore outsourcing emerges as a potential strategy for alleviating immediate pressures on Ireland’s healthcare system.
By leveraging international partnerships and telemedicine technologies, the HSE could access a broader pool of qualified professionals to deliver timely radiotherapy services remotely. This approach could provide temporary relief while long-term domestic solutions are developed and implemented.
Offshore outsourcing in healthcare offers several advantages, particularly in cost efficiency and access to specialized skills. By utilizing resources from regions with lower labor and operational expenses, healthcare providers can achieve substantial cost reductions without the need for significant investments in infrastructure or talent.
This strategic move allows healthcare institutions to focus on their core competencies, such as clinical excellence and patient care, while outsourcing non-core functions like medical billing and administrative tasks.
Moreover, offshore outsourcing provides access to a global pool of highly skilled professionals who are often trained in the latest medical technologies and practices. This can enhance service quality and operational efficiency, potentially leading to better patient outcomes.
