Rose Conway-Walsh urges faster all-island cancer collaboration

I was glad to hear you at the beginning and you are all very welcome to acknowledge the fantastic work and the brilliant work of Professor Paddy Johnson and the key role he played in the signing of the Memorandum of Understanding with the National Cancer Institute in the US and I think it is because of him we can all have the discussions that we are having here today. I know our own Barbara De Bruun worked at the very beginning of the All-Ireland Cancer Consortium in establishing that MOU between Ireland and when the Executive was established in 1999 and I think it is important to acknowledge all of that. I have a number of questions. One is around do we have a central portal for the sharing of this information? We saw with COVID that we can speed everything up. We can do that. We can protect the integrity and we can make things happen a lot quicker. While everybody is in that frame of mind, I think we need to harness that collaboration and communication that you have talked about. How do we speed it up? How do we support the application, the submission that you have made at the moment in terms of having the resources to do what you need to do? And I really want to talk to you about the educational opportunities around all of that and the 40 oncologists that we have at the moment that we need to have 80. How do we actually do that in higher education as well? We have the higher education department there, the institutes. Are there opportunities there in terms of the technological universities? For instance, Mayo University Hospital, Galway University Hospital, McGee and all of that. How do we make it work? And what part do we need to urgently play as parliamentarians across the island to ensure that that happens? How do we do it in, you know, throughout the life cycle in terms of education? You know, there's been wonderful oncology nurses. What prevents them from being oncologists? And what are the blocks and the barriers that we need to undo there? In terms of slaughter care we saw recently where there are blocks to the implementation of that. And I want you to use this form in honesty to tell us if there are blocks there that need to be removed. Are there pushbacks or are we all on the same page there? Because I think it's important if there are pushbacks that we need to address them at this stage. And, you know, the frightening thing is that, you know, on one of the slides, four out of ten cancer patients are not getting their chemotherapy. How big of a problem is it that we don't actually have the beds there, you know, in the hospitals as well? We don't, you know, I hear of stories where there are wonderful professionals and clinicians and oncologists, but if they don't have the bed there to be able to do what they need to do, then they're always going to be limited on what to do. And, you know, lives are put at risk because of that. There's an awful lot there, but maybe in answering the other questions from the others, you might be able to include some answers into those. I think if we refer to everybody, and there are some top class questions there. My little difficulty is the time, 50 minutes is up. I understand. So maybe if, like I'm in your hands, as a committee, I want everybody to get in. If you're happy, they can answer later. If you're happy with that. Or throughout other people's questioning, it's fine. I just had to share. I just had to share. I just had to share. There's been a problem. Yes. Yes. Yes. I was going to respond to Adi Johnson, who is one of my best friends, and that's the reason I went to Queen's. All right. Very good. Okay. Well, that's perfectly helpful. Now I think we have, is it Sarah Hannah from the SGOP? Yes. Sincere apologies, folks. I'm just at the airport and I'm literally boarding a flight. It's the last call that I've been listening in. It's been a really, really informative presentation. I think as Senator Currie said, we're all learning everything you come out with, but it is very clear that health has been one of the most successful components of North-South and hopefully will continue to be. It's just one of the very, very logical things to do on an all-island basis. I wanted to focus briefly on, obviously, a cancer strategy for Northern Ireland is overdue and is a new decade, a new approach commitment. And I wondered what engagement you'd had in terms of potentially ensuring your project becomes a key component of that or that it is built in in the development of that strategy. And then additionally, also focused on the North as well, obviously, you've talked about biotech clusters, and I know that is something that both Queen's University and obviously are involved in. Have you had much engagement with, for example, Invest NI in terms of creating the conditions for that? And apologies, I'm going to drop my camera off, but I am still listening and I really, really appreciate the presentation. Thank you. Thank you. Thanks very much, Claire. Good to see you again. Just an answer to your first question in relation to engagement with the Northern Ireland Cancer Strategy. Very much so, including we presented this vision to the all-party group, the opportunity here. We've also had quite a number of conversations. I presented it to Cancer Focus Northern Ireland, so one of the main cancer charities in Northern Ireland. So definitely there are opportunities there, and this is very much on that agenda in relation to how we can work together. And the biotech sector, again, Invest Northern Ireland, this is particularly relevant to, I'll just explain for other people in the group. At the moment we're in the middle of a Belfast Region City deal, which is a significant investment in infrastructure in Northern Ireland in a number of different areas, including data, creative industries, health and life sciences, clinical trials. And all of these are very relevant to this program. So one of the things we've been feeding in to the Belfast Region City deal, and also the Derry-Straban City deal, is the opportunities to look at ways in which we can work together right across the island. Obviously SME is particularly important in Northern Ireland in terms of the SME community. We've been working very closely with them, both in general in relation to both Queen's and Ulster University, but also highlighting this potential opportunity. Hopefully the Belfast Region City deal will finally be announced at the end of next month. And it's been something we've been working on for the last three years. It's essentially a one billion program right across Northern Ireland in the Belfast Region. There's other, as I said, other deals as well. But they really provide that opportunity for innovation. And certainly we see cancer research and cancer care being an intimate part of that. And just to go back maybe to your question in terms of answering just part of it in relation. Thank you very much for the questions. Yes, I mean, really that 1999, I was there in 1999 in government buildings in Stormont, and the sense of excitement, the sense of this was something different, really permeated that. That was to do with Paddy and his vision. And thankfully we're bringing along that vision and bringing it hopefully to the next level. So hopefully he's up there looking down on us proudly. I believe his brother is watching us. So I think it'll be nice for him to see that, that we're recognising that today. I'll just be very quick as unconscious of colleagues. But just to assure Clare and everyone here, Mark and I both sit on the implementation committee of the Ireland, Northern Ireland, US consortium. And we're very happy to say the first meeting took place last week. And so you have Department of Health officials north and south on that committee. And the cancer strategy from both sides of the border is well represented on that. I suppose we'll be complementing the learnings from that with this institute and what we're trying to do. And I know that with the Northern Ireland strategy, I think it would have been nice to see a little bit more about trials and research. So I suppose that's some feedback to say we haven't said that it can be written in a strategy and you mightn't get there, which is what's happening in the Republic of Ireland. You know, we have a target of 6% and we're probably only at 2 of patients on clinical trials. So we have a way to go. But I just, you know, I think, you know, now is the time because we have everyone at the table. And we have to, you know, in terms of that committee at the departments, you know, we have to congratulate the people involved in that, like people like Marisha O'Connor in the Irish Department of Health in Gay Ireland in the North. And then people like Bill de Hoot from the National Cancer Institute in Washington who are giving their time and expertise and commitment to this. And at the back of all of that, we've got the Sherrod Ireland, you know, strategy within the Department of Taoiseach where, you know, a key item in that is research. So we really do see synergies here and everyone's coming together. So it's very positive. So I might pass back to our Chair Liam to see if there are other questions to be answered. Well, yeah, I don't have any more comments. So I don't know if there's any additional questions I can. Okay, well, we'll move on to Stephen Ferry, Dr Stephen Ferry. Yeah. Thank you very much, Chair, and good afternoon, everyone. Just to pick up on the last set of questions to an extent in relation to funding issues, and just to slightly broaden it out, and maybe just a type of comments, particularly from the Northern perspective in this regard, given I'm a Northern MP. So first of all, in terms of any support direct from the Northern Ireland Executive Department of Health and how you solve that is going to be particularly in light of uncertainty around budgets over the coming years and other pressures in relation to health. You've really also made reference to the City Deal issue and some of the projects in that regard. I'm not sure whether from the Queen's perspective as well you want to talk about some of the other funds that are potentially available from the UK Government, which are allocated on a competitive basis, and to what extent they can be brought to the table to reinforce some of this work. And then more directly in terms of the research pots that are available on a cross-border collaborative basis. First of all, to what extent is Horizon Europe as the successor to Horizon 2020, a potential source of support, and obviously there's a very strong collaborative foundation to begin with in that regard. So is that a potential door? And then also on the US angle, in addition to the very Pacific health tripartite relationship, to what extent can the more general US-Ireland research partnership also be used to support this initiative? So sorry about that. Cocktail soup of funding pots. So I might tackle the first part of the EU programmes in Denmark, probably compliment that. So I suppose the first thing to indicate is that our researchers have really taken a leadership role in cancer research programmes which have been funded at a European level. For example, I've led five EU programmes, large-scale cancer research programmes, and there are similar colleagues out there. So we're good at coordinating these types of complex network programmes at a European level, and we're considered, you know, we were able to do it. And we have equivalents in Northern Ireland. In terms of the opportunity, I guess, again, there is an EU beating cancer plan, which I think is allocated about four billion euro. It's one of the very significant projects at a European level. There's a dedicated, I think there's five missions, one of which is cancer. And again, these activities span from, again, from basic research towards the clinical arena. It's important that we position ourselves for participation. While we've had a good track record of participation in these programmes, the kind of, the process has changed. You do have to actually become clustered and become really more centralised as a team-based approach. Again, a good example of that would be the, again, maybe Maeve could comment on it in terms of, there's a push towards comprehensive cancer centres at a European level. We don't currently have a comprehensive cancer centre in Ireland. And we obviously have the OECI Cancer Centre Statistat, Trinity St James Cancer Institute, and there's other similar institutions pursuing that. The challenge is to become a comprehensive cancer centre, because that's really the kind of, the requirement for, becoming the requirement for participation. And again, it's called out in the National Cancer Strategy. I think, again, ACRI can potentially provide at least one mechanism or plank in terms of supporting that, because what's critical for a comprehensive cancer centre is not only cancer care, but research is an integral component of that. You need to have a very strong research agenda to be able to become a comprehensive cancer centre. So again, you know, you can have an argument about whether it be one site or a distributed site, but ultimately, and what accreditation system, but ultimately, we need to come together to be able to participate at a European level. It's critical that we do that. Mark, I don't know if you want to comment on it. Yeah, I'd have a take, and then Maeve then. So, Stephen, thanks very much for your question. And obviously, your previous involvement in health has been very relevant in this regard. Yeah, I mean, I think we need to think north-south, but also east-west. And I think, you know, there's a significant opportunity, particularly when the comprehensive spending review finally happens in the United Kingdom in relation to opportunities there, both from an all-island basis, but also from that sort of east-west perspective. And we see this as being a significant opportunity in relation to ways in which the shared island unit, and the Taoiseach actually visited us in Queens last week, among the things we talked about was specifically in relation to this, and how can we leverage that for something like cancer, which affects us all? And then, certainly, you know, partnership in Europe is something that we've done a lot of in the past, as Liam said, and I think we have significant opportunities. And, you know, it's really important to us, or certainly an advantage to us in a way, that cancer is the only health mission in the EU mission. So, five missions identified. The only one that's related to health is the cancer one. So, therefore, we have the opportunity. But working together, I think, is going to make us better than the sum of our parts. And then the other question you had in relation to, I think, the opportunity of the city deals, and what that's going to drive in terms of innovation, is very significant. And part of that will be, you know, how do we deal with data? And you'd asked that question earlier on, and I think that's a conversation we need to have. And Sean O'Neill is the chief reporter for The Times. And he wrote an article about two months ago where he said, that we get data every day in relation to COVID. So, every day we get the statistics in relation to COVID. Why can't we get the same for cancer? And I'd ask the same question. Why can't we get the same for cancer? If we had data every day in relation to cancer, I can tell you we would have much better opportunities in relation to driving the research agenda and using it to actually influence how we treat our patients. And there's no actual technical reason why we can't do that. So, we need really to work together to look at what are the barriers that, again, back to your question, that we need to overcome to make that a reality. And examples like where we've worked together in the context of COVID and cancer, where we've actually been able to bring together eight different bodies, all of them contributing their data sets. And I hate people who silo their data. You know, it's actually, it should be a criminal offence in that regard, because, you know, it's the public who are providing the data in a lot of cases, the hospitals, the patients. So, therefore, that data should be available to allow us to make rational decisions in relation to the care of our patients and our citizens. I'd like to come back to the comment on the comprehensive cancer centres and the importance of us working together and joining it up on an all-Island basis. I would take that point, Mark. I mean, we forget that. So, cancer is still the number one killer in Ireland ahead of COVID, ahead of cardiovascular disease. Sometimes we forget that. And sometimes, unfortunately, you know, our patients don't have such a strong voice. So, I think it's really important to make that point, to make it clear, the number one killer of Irish people, north and south. So, back to Liam's point. So, I'm the academic director of the Trinity St. James' Cancer Institute. So, I have an academic appointment at the university and a clinical appointment in St. James'. And I was part of the team that drove the accreditation process of the cancer centre on the James' Trinity campus. And really what that meant is that we started at the beginning and we were the first, hopefully not the only, but we've been the first accredited cancer centre, where we drew those lines across the campus and said, well, how can research facilitate better clinical care pathways across all of our cancer types? How facilitate better education for our nursing staff or other frontline healthcare staff? And even those of us who were not on the front line, perhaps. And that was a difficult process. International benchmarking, of course, and we finally achieved our accreditation. And it doesn't stop there. Because what we would see ourselves as being maybe an exemplar of how we can achieve step one. But our goal is to, across all of Ireland, improve cancer outcomes nationally and take our seat internationally at the table as a country, not a centre, a country that contributes to the global problem of cancer care. So I suppose that I'm here because I want to work with all my colleagues in North and South. I don't see how we could ever achieve the goals that we want to achieve for our patients alone. Not in one hospital, not in one county, not in one academic institution. We need to extend the hands across to each other. And that's the only way any of us will achieve the goals we really want to achieve. And I might take the opportunity briefly just to address your comment about nursing, because I think it's really important that we don't have a nurse here today. Our nurses have been at the frontline of cancer care and COVID care. And for the nurses that work with me, both actually. Some of them seconded up to intensive care in the middle of the first and second wave, and then straight back down to the Oncology Day Ward, which did not close. And they were exhausted, stressed, and they kept showing up. And they're still showing up. And I think we have to realise that to maintain morale among our frontline healthcare staff, across multiple disease types of cancers, the one I work in, we have to provide a career pathway that is valuable. Because the level of knowledge and skill and intelligence and achievement, along our nurses, but also our care attendants, our physiotherapists, our dieticians, all those who provide care in the hospital, unless we make their job better by integrating research and education into their day job, then we're not going to retain the best. And it's not just retention, it's attracting the best, training to be the best, and making sure that we keep them. And that's across not just doctors, as everyone has said, but actually across all the staff that work across our universities and importantly within our hospitals. I'll stop there to give Liam a chance to come in. Yeah, I think there was also a comment, maybe Mark could cover it as well, towards the end, in terms of US-Ireland partnership. I think there was a question right now. Yeah, sorry. So one of the things we did just before lockdown, and Evelyn and myself were in the National Cancer Institute in Washington, but one of the things we also did was presented to the US-Ireland Bipartheid Agreement, and there certainly we got a very good reception in relation to the concept of the All-Ireland Cancer Research Institute, but also the opportunity to contribute and actually compete for part of the funding for that. My understanding is, and maybe this is Sarah where you can help us, is that that fund is going to be continued but also potentially expanded. We do have cancer projects that are within that. I'm involved in one with the College of Surgeons and with GE Healthcare in the US, but I think there should be more of them. They've proven themselves to be actually very effective, and what we should look at expanding them and that more cancer projects will be part of that. So I think certainly that if we're looking at an ask, certainly looking at that and what the opportunities might be in relation to research that we're doing together, because there are good examples of how we've already shown that we can work together. And it's looking at expanding those opportunities. And the training piece is very important as well. And just back to your question, and really it's ways in which we can give innovative training so that some of our younger people can really get that opportunity to spend time. For example, we have a PhD program at the moment where our students go from Queens to the NCI. They do a master's in Queens. They then spend three years at the NCI. We'd like to expand that to be an all island program. And so that would be really a great example of how we actually work together, because that's actually how people work together. It's when your students work with each other, then the principal investigators also work with each other. So it's almost a cycle of innovation and bringing people together. And so certainly that would be an example of something that we'd like to bring on an all island basis. So I might follow up on that as a concrete example. So currently, I think I mentioned in my opening address that we're presently putting together a submission under the HEA North-South Research Program. So again, this is the first substantial funding recently for encouraging North-South collaboration. So the specific focus of that application is for PhD and postdoctoral fellow training across the 10 institutions, providing a really exciting training opportunity. And it's a foundation stone for ACRI. So the deadline for that is like the 8th of November. So hopefully it's going to be very competitive. We think there's about 500 applications going in. 10 will be funded. So you can imagine the success rate is pretty small. But ultimately, we think we have a compelling argument. Chair, can I just check, do I have any time in my slot for a supplementary question? I can't really properly see you. Sorry. Sorry. Yeah, no, go ahead. You have two minutes left. We'll give you three. My time slot? Oh, God. Okay. Just very quickly, just to ask the folks from Queen's in relation to this one. Regarding the point around leveraging on an East-West basis to complement what happens on a North-South basis, from your experience of applying to the various funds, does there tend to be exclusionary clauses that would prevent some of the UK-wide funds being applied to support North-South collaboration, even if the money is being spent through a Northern Ireland institution? Are we able to join up effectively, or are there restrictions there that we need to be mindful at a political level? Yes, I mean, it would certainly be useful to look at that, because one of the things we're looking at at the moment, Science Foundation Ireland have said they will fund all island research centres, but the way they're set up, they can only fund the Republic of Ireland part of that. At the moment, we're looking to see how can we match that with funding, either from the North of Ireland or from Westminster. And so far, that's been challenging, and partially, I think, because the comprehensive spending review hasn't been completed yet. But, you know, so we have one funding body who's willing to fund, but it needs somebody to dance with. So, in that sense, if you can help to have a strictly come dancing between our two funders in relation to that, that would be really useful, Stephen, and certainly I can follow up with that with you afterwards as well. I appreciate that. I'm happy to take that away. Thank you, Chair. Back to you. Thank you.