Tim O'Malley (Limerick East, Progressive Democrats)

I welcome the opportunity to address the issues raised by the Deputy and to set out the current position with cancer services in Letterkenny General Hospital.

In a public statement made earlier this week, when the Tánaiste visited the Donegal area, she said everyone in this country, regardless of where they live, should have access to the best possible health services. This is especially so for cancer services. The most important thing for patients is getting the best treatment. Outcomes for patients are what drive our policy and investment in cancer care. I am determined that everyone diagnosed with cancer will get top quality treatment, as near to home as possible. The Tánaiste and I remain confident the HSE can achieve these objectives.

The Deputy has raised the appointment of a permanent breast surgeon at Letterkenny General Hospital. A stand alone breast service at Letterkenny General Hospital is not an option as it does not, according to recognised cancer experts, have a large enough volume of new patients with breast cancer to achieve the high quality of services that the women of the area are entitled to receive. The preferred option of the HSE is for a true partnership to be developed between Altnagelvin Hospital in Derry and Letterkenny General Hospital. There are already strong links between these two hospitals. Altnagelvin Hospital is wholly committed to developing a workable solution with Letterkenny General Hospital.

The director of the national hospitals office and the network manager for the HSE western area are to meet with the respective management and clinical teams next week to seek to progress a partnership arrangement that can best develop breast care in the region. It is understood the model of care being sought will include combined multidisciplinary team meetings to discuss patients in both jurisdictions. Decisions on each patient will be examined collectively involving the appropriate treatment and follow up. The HSE advises it will also explore the option of a similar model with University College Hospital Galway.

The medical team at Letterkenny General Hospital will continue to attend to breast cancer patients referred to them before today and awaiting their first appointment. However, medical consultants at Letterkenny General Hospital are refusing, as of today, to accept any new referrals of breast cancer cases. Discussions at hospital level have taken place to seek a deferral of this action. Last Friday, the director of the national hospitals office wrote to the chairman of the medical board at the hospital advising that the HSE is actively pursuing a resolution of the issue of how best to provide breast cancer care to the population of Donegal. The director gave a commitment that the matter will be drawn to a definitive conclusion before the end of June, just over four weeks from today.

The Tánaiste has urged the HSE management to complete discussions on the future organisation of breast services by this date. The director also asked that any proposition to cease existing services be withdrawn in the interests of assuring best patient care. I understand that medical consultants refused to rescind their decision. The HSE, in the interests of women who will be diagnosed with breast cancer has made alternative arrangements.

Letterkenny General Hospital has advised general practitioners in Donegal that urgent new referrals of breast cancer patients should be referred to Sligo General Hospital or University Hospital Galway. Arrangements have been made with these hospitals. There is a tradition of patient referral to these hospitals.

General practitioners have also been advised that they may wish to refer patients to other hospitals, if appropriate. This clarity is essential to ensure there continues to be a service in place for women with breast cancer in Donegal.

The action of a small number of medical consultants is most regrettable, especially as the HSE is making significant efforts to resolve the issue in the best interest of women with breast cancer. I am asking that the consultants involved reconsider their decision and participate fully in the discussions next week. These discussions should take place in a positive environment and not against the backdrop of a refusal to continue to provide services to vulnerable patients.

In the coming years, almost €50 million will be invested in health facilities in Donegal, with almost €28 million being spent on additional beds and a new accident and emergency department at the hospital. This Government has quadrupled the budget of Letterkenny General Hospital since 1997, enabling the appointment of more than 550 additional staff. This is a clear expression of our confidence in the health services in Donegal and we will spend more to make the services even better in the coming years.

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