Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

I begin my contribution with a Government health warning, namely, PD-Fianna Fáil ideology can seriously damage one's health.

It has been confirmed by none other than the Minister for Health and Children that the Government's ideological addiction to public private partnerships has delayed the delivery of life-saving cancer services in this State. Extra radiotherapy machines are being provided for St. James's Hospital and Beaumont Hospital outside the PPP model because the Minister has been obliged to accept they could not be delivered until 2012 were the PPP process to be used.

This has been exposed by the leaking earlier this month of the so-called confidential progress report on the delivery of the national plan — again so-called — for radiation oncology from the Health Service Executive to the Minister in July 2006. The Minister was quick to issue a response outlining her version of the progress made under the plan. The HSE was also forced to issue a response, which can only be described as laughable. It described the leaked report, which was prepared in July 2006, as "an historical one". It seems that on the unknown planet on which the HSE management lives, six months ago is ancient history. However, this is only true when its suits the argument. When the other point of view suits the HSE, six months or longer is an acceptable time for a patient such as Rosie from Kilkenny, who appeared on "Liveline", to wait before receiving a proper diagnosis of cancer, even though the lateness of the diagnosis will cost that woman her life.

The July 2006 HSE report to the Minister on the progress of the radiation oncology plan states:

The overall timeline for project delivery suggested completion of the entire plan by 2011. A significant exercise has been undertaken to review this timeline. This has included significant detailed discussion with the National Development Finance Agency, the hospital planning office in the Department of Health and within the HSE. There is consensus that the target date of 2011 cannot be met.

The National Development Finance Agency has responsibility for putting in place PPP arrangements and it is being addressed by legislation that is before the House today. The HSE board was informed in December 2006 that the plan would not be in place until 2013 or 2014, were it to be delivered by PPP. The Minister for Health and Children, Deputy Harney, stated she did not accept the HSE's views. However, it was not simply the HSE's view that the timeframe set for the delivery of the project by way of PPP could not be met. The leaked report stated the overall project could not be delivered by 2011. It made reference to "having regard to current advice of the NDFA and the hospital planning office", which is a section of the Minister's Department.

Despite the clear evidence that reliance on PPP is hampering the roll-out of radiation oncology, the Government, in its proposed amendment to the motion before the House, again commits itself to the flawed PPP process. Overall, the amendment presented in the name of the Minister for Health and Children is nothing short of pathetic and is simply not in the real world. In my view and that of many both in the House or who will watch and read of this debate, it is indicative of a tired and failed Government.

I commend the Independent Members for tabling this comprehensive motion on cancer services. It correctly identifies the failures of the Government and sets out many of the requisite measures to ensure comprehensive cancer care services. While the full and speedy implementation of the Government's plan for radiation oncology is necessary, clearly more than that is required. In itself, that plan is insufficient and fails to deliver radiation oncology on a truly regional and national basis. The expert working group on the development of radiation oncology services in Ireland was established in May 2000 and identified what it called "the profound deficit in radiation oncology services". In 2007, nearly seven years after its establishment, there is still a profound deficit in radiation oncology services.

The aforementioned leaked report will cause further distress to thousands of cancer patients and their families nationwide who, having welcomed the Minister for Health and Children's announced plans for full delivery of services, including radiotherapy centres by 2011, now find the plan is being hampered and will not be delivered on time. The report has raised a major doubt over the Government's entire cancer strategy.

I stress again that the Government's delayed cancer care plan is not in itself sufficient and this point cannot be over-emphasised. It will locate radiation oncology services in Dublin, Cork and Galway, with satellite services earmarked for Waterford and Limerick only. The half of the island that is north of a line from Dublin to Galway will be badly served by this plan. I have made this point, as have others, to the Minister repeatedly. Patients in Cavan, Monaghan, Louth and Meath will be obliged to travel to Dublin. There is a limited plan for patients from one other Border county, namely, Donegal, to be facilitated in Belfast. It seems patients in the predominantly rural counties of Sligo and Leitrim will be obliged to travel to Galway. This is completely inadequate and again demonstrates a failure on the part of the Minister and the Government to deliver health services on the basis of equity and the right of all citizens to equal access on the basis of need, irrespective of their ability to pay or the geographic location in which they live.

A truly all-Ireland and regionally-based cancer treatment service is needed. Radiation oncology should be delivered within all the regions without exception. Cancer sufferers are being subjected to long and painful journeys for treatment. Many patients, who feel too ill to travel, consequently choose not to avail of radiotherapy. These are real cases and the Minister cannot be unaware of their number. The resources exist to deliver radiotherapy on a regional basis and the Government must go back to the drawing board.

On the basis of the Government's record thus far, as well as the Minister's tenure in office, I doubt whether either retains the will or the energy to make that short but imperative journey. Nonetheless, we have a crisis in cancer care that must be addressed. We need a revised, expanded and properly resourced plan that will ensure delivery of such services on time and throughout the regions. Given the significant surpluses already recorded, this not beyond the Government's gift. I emphasise that such a plan should not be reliant on PPPs and should be put in place without further delay.

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