Dinny McGinley (Donegal South West, Fine Gael)

I thank the Chair for affording me the opportunity once again to raise this important matter. The most important element in the successful treatment of cancer is early diagnosis. Unfortunately, early diagnosis and standards of treatment seem to depend on geographical location. Since 2000, BreastCheck screening has been available only in parts of the country. If one is aged 50 years or over and lives in Dublin or the eastern region, BreastCheck is automatically available. I am sure this programme has saved the lives of many women who are fortunate to be living in these areas. We all know and accept what a tragedy it can be for a family to have a member, particularly a mother, diagnosed with breast or cervical cancer, especially when it is at an advanced stage. Late diagnosis means more radical and severe treatment, often with limited success.

It is unbelievable that six years after its introduction, BreastCheck cancer screening is confined to so few counties. As usual, the west and the north west in particular are well and truly out of the loop. According to the latest information, places such as County 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. In County 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. The medical board of Letterkenny General Hospital has taken the unprecedented decision that in the absence of an agreed permanent resolution to the issue of breast cancer services, no support services will be provided for new patients referred with systematic breast disease from 1 June next. Furthermore, all breast health clinics including review services will cease from 1 September. This is a serious development and illustrates the sheer frustration of the medical personnel attached to the hospital.

The new inpatient oncology unit in the hospital, which has been lying idle, will be used to increase medical capacity to address the current overcrowding crisis in the hospital, which is a daily occurrence. A total of 17 people were on trolleys in the hospital today. While any move that gets patients who are currently on trolleys into beds must be welcomed, it must be recognised that this is not the solution to the hospital's long-term problem or the improvement of cancer services in Donegal.

There are three main priorities in addressing the cancer treatment needs of County Donegal. It is absolutely essential to appoint a permanent breast surgeon for Letterkenny General Hospital, to ensure the roll out of BreastCheck and the designation of Letterkenny General Hospital as a satellite radiotherapy unit. 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, in particular those receiving palliative care, are refusing radiation treatment because of the exhausting travel involved — anything up to six hours at a time to Dublin. Being a regular visitor to St. Luke's Hospital in Dublin, the number of Donegal patients journeying there for radiotherapy never ceases to amaze me. They are far removed from their families and natural environments for the duration of their treatment, which can often last up to seven or eight weeks. While many try to go home for the weekend, the Minister of State can imagine what a harrowing ordeal that long journey must be 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 County Donegal or Malin Head to Galway than it is to Dublin. I am publicly calling for the provision of a radiotherapy unit in the north west, preferably in County Donegal, to serve the needs of cancer patients in that region. I am also calling 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 an act of commission. For example, if a permanent breast surgeon is not appointed, breast cancer services will go.

I am also suggesting that the Tánaiste should visit Letterkenny General Hospital to witness how inadequate and critical the situation is, not alone in the area of cancer treatment, but also the daily crisis throughout the hospital mainly due to inadequate accident and emergency facilities and a critical shortage of beds. Having been in charge of her Department for over a year, she is due a visit.

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