Joe McHugh (Donegal North East, Fine Gael)

I welcome the Minister to the House. From speaking to members of the new health structures, I know there is a feeling of frustration and disenfranchisement. The overall health service is moving towards a centralised system. Previously, it was a more devolved local system, a model other European states are following. The new health structures are becoming more like talking shops. The officials are courteous and respond to questions. The frustration, however, lies in the downgrading of services. Will there be a downgrading of cancer services at Letterkenny General Hospital?

There is frustration between the workings of the HSE and the Department. For example, it is believed BreastCheck and the National Treatment Purchase Fund work as autonomous bodies. There is a lack of communication and, therefore, trust between these structures.

I welcome the Minister's cross-Border efforts in providing 50 hospital beds at Belfast City Hospital for patients from County Donegal as it is only one and a half hours by road. Up to 1.7 million live in the Six Counties. The models used in the Twenty-six Counties have catchment areas for 1 million people. By this model, Belfast City Hospital will not be able to facilitate the people of Donegal. A more imaginative and creative approach needs to be taken in providing health services in the north west. Counties Donegal, Sligo and Leitrim have a combined population of 300,000 people. If taken with the population of Northern Ireland, the region has a population of 2 million people. Using the Minister's model for catchment areas, it is logical there should be a satellite radiotherapy centre in the region.

I know the Minister has spoken to the management of Altnagelvin Hospital and Letterkenny General Hospital in providing health services to people from County Donegal. Communications between both hospitals broke down at a time when the political climate was not as good as it is now. Will the Minister examine establishing a forum where players in the health services can come together? There is a fantastic team in the breast cancer service at Altnagelvin Hospital. They have been providing breast checks for women in Derry for a period of 15 years. They have the expertise, the knowledge and the energy and they do not like the fact that five miles across the Border in places such as Muff and Quigley's Point, women from Donegal cannot be facilitated because they are not in that jurisdiction. The energy exists at local level and among the professions, but it is up to us to be creative in what we try to provide for that natural region of the north west.

On a concluding point, last year a woman left Letterkenny for Dublin and the journey took her seven hours. It merited attention in the national media at the time. During her journey the only opportunity for a stop was either at a garage or a pub. At the time of night she was travelling she could not access any toilet facilities on that route. I am suggesting to the Minister, that given the very good infrastructure which she and her Department have helped to put in place, along the entire N2 network from Letterkenny to Dublin, through Monaghan and Carrickmacross, that we make such centres accessible for patients who have to travel that distance in the short to medium term.

It is important to review this situation. I come from a farming background and I know the good manner in which we treat animals that are being exported live. We should be treating patients travelling for cancer treatment with the same concern.

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