Liz McManus (Wicklow, Labour)

I wish to share time with Deputies O'Shea, Wall and Breda Moynihan-Cronin. I welcome the opportunity to speak on this motion on cancer services and I thank the Members of the Technical Group for tabling it.

On World Cancer Day 2006, the Irish Cancer Society highlighted predictions that cancer numbers will increase from 22,000 a year at present to 43,000 by 2020 and that the number of potentially fatal cancers will more than double from 13,800 to 28,800. The Government's policy documents acknowledge the need for comprehensive cancer services.

Far from delivering a world class cancer service, however, a confidential Health Service Executive document exposed last month that the cancer treatment plan launched by the Minister for Health and Children 18 months ago is in total disarray. It is beset by a catalogue of errors, delays, and what the report describes as "lingering complexities" over cost. In short, the cancer plan is a shambles. Despite the commitment to spend €400 million on 36 centres by 2007, the report makes it clear that none of this is going to happen on time. Moreover, the interim plan to increase capacity in Dublin at St. James's and Beaumont Hospitals by 2008 will also not be achieved by that date.

Yesterday, we were alerted to the news that St. James's Hospital in Dublin was forced to postpone 20 surgical operations because of a lack of intensive care beds. St. James's is one of Ireland's best run, best managed and best operated hospitals but even it cannot perform vital, potentially life-saving operations because of insufficient numbers of intensive care beds. This has a direct impact on the survival chances of patients. I note that in another major Dublin teaching hospital there are intensive care beds that have not been commissioned because of staffing issues. On one hand there is a hospital that cannot keep up with demand while on the other, another hospital cannot provide for demand because the Government has not put the resources in place.

Site identification issues are creating problems in Limerick and Waterford, despite the fact there are private facilities available for public patients. In the north west, the plan to allow patients to access services in Belfast cannot be realised, meaning very sick patients must still endure a ten hour round trip to Dublin for treatment.

The radiotherapy plan was designed to alleviate the distress of those who are extremely sick. It was roundly welcomed and supported by this side of the House. Tragically, it has fallen victim to the Minister's unfortunate habit of announcing grandiose plans for the health service without adequate consultation, advance planning or any idea of what the final costs will be.

Among the Minister's cancer strategy goals was an aspiration to have a national cervical screening programme yet at present the results of smear tests are taking over six months to process. These delays are causing real risks where no risk should pertain because the treatment is so simple. It is about time the Minister dealt with the existing inequity and shortcomings before making further grandiose unfulfilled promises.

Figures for cancer in this country show mortality rates from cancer are often determined by socio-economic background and geographic location. For years, activists campaigning for improved cancer services have argued the obvious, that patient outcomes are reflected in access to quality treatment. A report by the National Cancer Registry, however, two years ago confirmed the geographical discrimination that exists in Ireland is "striking". Ireland's incidence of breast cancer is below the EU15 average but the rate of death from breast cancer in 2001 was the highest reported in the EU15. The Institute of Public Health in Ireland in its report entitled "Inequalities in Mortality" found that all the rates of mortality for cancers in the lowest occupational class were 100% higher than the rate in the highest occupational class.

Most of us are no doubt familiar with the tragic circumstances of Rosie who spoke out on "Liveline" in January. The day before she appeared on "Liveline", she was getting chemotherapy alongside a man with the same diagnosis. He too had bowel cancer but had got his colonoscopy within three days of seeing his GP. He was a private patient but, like half of the Irish population, Rosie does not have private health insurance.

The HSE has radio advertisements directed at alerting people to the early signs of colon cancer. "Early diagnosis can save lives", the radio advertisement says. Early diagnosis can only save lives if the services are there to diagnose those using them. Rosie, along with 2 million other Irish people, is treated as a public patient in the bottom half of a two-tier health system where the delays in accessing treatment can cut a person's life short.

A further inequality is geographic. BreastCheck was introduced seven years ago but it is still not available nationwide, access to a lifesaving screening programme depends on a person's address. It has been estimated that 65 women a year are dying in Ireland for the simple reason that breast cancer screening is lacking in the west and south of the country. "Early diagnosis can save lives", that is the slogan but there are parts of the country that have four times more cancer specialists than other parts.

The lack of cancer services imposes horrific travel journeys on people at the most vulnerable time of their lives. Journeys from Donegal to St. Luke's for essential radiotherapy can take up to ten hours, hours which are gruelling and difficult for people who are so sick.

It is now clear that the Government has broken its promise to patients requiring radiotherapy treatment. The most tragic aspect of this is that there are cancer patients who have simply given up any hope and do not expect to receive this vital and life-saving treatment in their community, allowing them to access it while dealing with the other demands on their daily lives.

After 12 years of prosperity, we have failed to capitalise on our economic well-being to improve our social well-being. Nowhere is that more manifest than in the health sector. A fairer society is a healthier society. In developing our thinking on health, Labour has committed itself to a number of simple principles: quality, fairness and value for money. It is important that it is recognised that there are inequalities as we speak in cancer services, geographically, particularly with BreastCheck, but also in class and socio-economic terms when it comes to cervical cancer screening. These issues could and should have been addressed by the Minister but instead there is deep disappointment after such hope being generated by the Minister's pronouncements.

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