Mary Harney (Dublin Mid West, Progressive Democrats)

When the doctor in question, Professor Rajnish Gupta, contacted the Department, he was asked to make a complaint to the Medical Council. He was asked to do so again a few weeks ago, but it has not happened. Some of the complaints made by Professor Gupta also apply to the public system. We do not have multidisciplinary assessment in many of the hospitals in which we are ceasing breast surgery forthwith — they do not have many of the things about which Professor Gupta complained. He did not complain about specific patients until August of this year. I am not making a big issue of it other than to say we do not have any authority, other than through the Medical Council, to take action if a doctor is performing procedures which are unsafe. As things stand, standards, etc., are issues for the council, although they will be issues for the Health Information and Quality Authority in the future. We have initiated an investigation, chaired by the former chief medical officer in Northern Ireland, Dr. Campbell, which could not happen without the agreement of the hospital. I understand that the investigation, which will involve a look back on all the cases which have been dealt with over recent years, will be completed some time in November. Dr. Campbell performed a similar role in Northern Ireland, when 8,000 cases were re-examined. I hope very few patients will have to be referred for further analysis or treatment. It is my understanding that that will be the case. The reality is that breast surgery, mammography and other treatments for symptomatic breast cancer were being carried out in far too many places in unsafe circumstances and without appropriate supervision.

Reference was made to the roll-out of the BreastCheck facility, under which cervical screening and other forms of screening are facilitated. I wish I could roll out a national screening programme by pressing a green button. I know of no country in which such a programme has not been rolled out over a number of years. The facility in Cork will be rolled out next month, which is also when the new facility in Galway will open. The roll-out started in Roscommon a couple of months ago. Much of the screening is done in mobile units. It is obviously more convenient for women to travel to such units than to have to travel to centres. Approximately 4% of the women who are screened are called back, and less than half of those ever have an issue. Those who do are asked to travel to the designated centres at that point for treatment. The roll-out will happen throughout the country from October. It is clear that it will take approximately 24 months to roll the service out to every woman who is covered by the screening programme. The roll-out of the cervical screening programme will start in January. Money has been provided this year to hire the staff who will be needed for the programme. We have increased expenditure on cancer services by approximately 60% this year, mainly to provide for the roll-out of the breast and cervical screening programmes. Time is of the essence in these cases, of course. We want to get the results back as soon as possible from the time the smear test is done. It is expected that it will happen within a month, but it is hoped that it can be expedited. The HSE recently outsourced a number of smears to a company in the United States because it was encountering huge delays, which were not acceptable to anybody.

I was asked about the satellite centre in Letterkenny in the context of a speech about the situation in County Donegal. We have reached agreement with Belfast City Hospital for radiation therapy services to be offered to women from Donegal. No more than a small number of women from that county have been treated in Belfast to date, unfortunately. I will meet my counterpart, the Northern Ireland Minister for Health, Social Services and Public Safety, Mr. Michael McGimpsey, on Friday of next week to discuss, among other things, the provision of radiation oncology services to people from the north west. It makes eminent sense for the authorities on either side of the Border to work together to provide facilities that can be used by people in both jurisdictions, including people in the north west. All of the evidence suggests that if we want to have world-class standards, given that we have a small population, we will have to develop critical mass. I believe we will be able to reach good agreements not only in the area of cancer but also in other areas of the health service.

There are significant opportunities for co-operation on a North-South basis, particularly in the area of tertiary services. It was announced today that just one centre in the country will deal with brain cancer, for example, of which there are 130 or 140 cases each year. It would not be safe or wise to divide brain cancer services among a number of centres. We want to retain all this country's expertise in that area in a single national centre. We might work with the Northern Ireland authorities to develop a single and shared facility on the island to cater for some tertiary facilities. I refer not only to cancer but also to paediatric care and other areas. In such circumstances, the health services on either side of the Border could procure services from each other. I would be strongly in favour of making that happen. I hope the establishment of the new Administration in the Northern Ireland Assembly will allow us to enter into agreements which are in the interests of all the patients on this island.

I will put the recent freeze on recruitment in context. The public health system employs approximately 120,000 people. The Health Service Executive decided to freeze recruitment for September, to help it work within its increased budget of €1.2 billion for 2007. To put that decision in perspective, it will affect between 200 and 300 people. I will respond to the comments which were made in this regard about Sligo General Hospital, with which I am familiar. Some 30 nurses were employed in Sligo over the summer months to cover for nurses who were going on holidays. Almost 700 nurses are employed in the hospital. As the holiday period has concluded, it is no longer necessary to retain the 30 nurses. It has not been made clear publicly that the contracts of the 30 nurses have not been renewed for that reason. A locum consultant was appointed to the hospital to allow one of the orthopaedic surgeons at the hospital, who was a member of the Medical Council, to attend to his duties with the council. When the consultant in question retired, and a new full-time consultant was appointed in his place, there was no longer a need to retain the services of the locum. A consultant in gynaecology and obstetrics at Sligo General Hospital who was planning to retire was asked to stay on for some time as a locum because the person who had been appointed to replace him was unable to take up his new position for a while. His period as a locum has elapsed and his replacement has arrived at the hospital. It is clear that the locum position will not be retained. Two consultants were employed to deal with long waiting lists in the surgery and diagnostic specialties within the ear, nose and throat unit in Sligo. The waiting lists have since been cleared. That is the story in Sligo. It is not the story that is being publicly presented.

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