Dinny McGinley (Donegal South West, Fine Gael)

Everyone agrees the most important element in the successful treatment of cancer is early diagnosis. Unfortunately in this country, early diagnosis and the standard of treatment seem to depend on one's geographic location. Since 2000, BreastCheck screening has been available in limited parts of the country. If one lives in Dublin or in the eastern region, BreastCheck is automatically available from the age of 50 years onwards. I am sure this programme has already saved the lives of many women who are fortunate to live in these areas. We all know and accept what a tragedy it can be for a family if a member, particularly a mother, is diagnosed with breast or cervical cancer, especially when that cancer is at an advanced stage. Late diagnosis means more radical and severe treatment, unfortunately often with limited success.

It is unbelievable that five years after its introduction, BreastCheck cancer screening is confined to so few counties. As usual the west, and particularly the north west, is well and truly out of the loop. According to the latest information, places like Donegal cannot expect to benefit from a screening programme until 2008 at the earliest. This is completely unacceptable.

Letterkenny General Hospital caters for a population of almost 140,000 people. In Donegal, the country's most peripheral county, there are 50 new breast cancer cases, 70 new bowel cancer cases and 80 new prostate cancer cases annually. I accompanied Deputy Twomey, whom I compliment on tabling this motion, on his fact-finding visit to Letterkenny Hospital a fortnight ago. We were presented with a very grim picture indeed of the inadequacy of treatment available to cancer patients there. While the incidence of cancer in the county is increasing, the level and standard of treatment is seriously lagging behind what is available in many other parts of the country. This is not a reflection on the care being provided in Letterkenny General Hospital by a dedicated, committed and caring medical and nursing staff. It is a question of some of the basic elements of treatment being unavailable.

In a shocking indictment of the health service, it has emerged that the absence of a radiation oncologist at Letterkenny General Hospital is resulting in unnecessary mastectomies, in some cases, and dangerous and lengthy delays in the treatment of certain cancers in others. A group of medical professionals in the county maintain that many patients, particularly those receiving palliative care, are refusing radiation treatment because of the exhausting travel involved — anything up to six hours at a time to Dublin.

Like Deputy Ring, I am a regular visitor to St. Luke's Hospital in Dublin and I never cease to be amazed at the number of Donegal patients there for radiotherapy. They are all far removed from their families and natural environment for the duration of their treatment which can often last up to seven or eight weeks. While many of them try to get home for the weekend, one can imagine what a harrowing ordeal that long journey must be for them with their strength and resistance sapped by the severity of radiation treatment.

While I welcome plans to establish radiotherapy units in Limerick, Galway or even Waterford, these will be of no benefit to the north west. It is no easier to travel from west Donegal or Malin Head to Galway than it is to Dublin. We have been told plans are being considered to enable Donegal patients to obtain radiation treatment in Belfast. That is nothing but a red herring. I understand that facilities in Northern Ireland are just about adequate to treat its own patients without any extra influx from Donegal or the north west.

I call for the provision of a radiotherapy unit in the north west, preferably in Donegal, to serve the needs of cancer patients in that county. I also call for the appointment of a radiation oncologist, a permanent breast surgeon and a second bowel surgeon in Letterkenny General Hospital. If this does not happen, it is likely that the existing service, which caters for a population of almost 140,000 people, will diminish and ultimately disappear. There is a genuine fear among medical staff in the hospital that cancer services will disappear by a process of natural attrition rather than by an act of commission. For example, if a permanent breast surgeon is not appointed, then breast cancer services will go. The consequence of this is that medical oncology will go, leaving Letterkenny with a very fragmented service. This is completely unacceptable.

I recognise that the Tánaiste has only taken over as Minister for Health and Children in recent months but we have great hopes that she will address this problem throughout the country, including the north west.

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