Jan O'Sullivan (Limerick East, Labour)

I wish to share time with Deputy Ó Caoláin. The Minister has left but I thank her for welcoming Deputy Reilly and me. I look forward to robust exchanges with her. I note her point that several members of the Joint Committee on Health and Children lost their seats in the election. Thankfully, my predecessor did not lose her seat. I intend to continue the approach of Deputy McManus, particularly in disagreeing with the Minister, Deputy Harney, in her drive to create a two tier health service. The Labour Party is committed to a one tier health service that addresses patients on the basis of need rather than ability to pay. We disagree with the provision of co-located public and private hospitals. I will continue in the vein of Deputy McManus in that regard. I look forward to working with the Minister for Health and Children but will not agree with her in many areas.

The Minister referred to Ireland's spending on health in comparison to other OECD countries. However, we do not receive real value for money in the health service. We do not have enough early interventions which is precisely the issue being addressed in the motion. More early interventions would mean we would not have to spend as much money on the more costly elements of the health service. When there has not been early detection and intervention, treatment is much more expensive. Therefore, I congratulate Deputy Reilly and the Fine Gael Party for tabling the motion which I support.

An integrated cancer strategy is required to include prevention and delivery of services. I agree with Deputy McHugh that integration is not happening across the range of services provided. The Minister referred to the announcement today by the HSE of the national cancer control programme, a subject on which I note she has delivered a speech. She stated she was given clear information on the roll-out of BreastCheck, the figures being 60% in year one and 80% in year two, and 80% to 90% for general cancers by 2009. I am not aware of any timeframes referred to in the HSE announcement, which is a concern. We need to know the timeframes for the programmes announced today. The Labour Party agrees with the Minister on the provision of centres of excellence which will have the required critical mass of numbers using the service, as well as multidisciplinary teams. This is the appropriate way to proceed. I am concerned at the lack of a timeframe in the HSE announcement and an indication of the resources to be provided in these eight centres of excellence within an appropriate timeframe.

I am concerned also about the list of hospitals which must cease performing surgical procedures. There is no indication of what will happen to people living in the catchment areas of these hospitals and whether they will be accommodated in their nearest centre of excellence within an appropriate timeframe. I question whether transportation will be provided for them. This is an incomplete picture of what will happen. There is a concern which was also raised at the time of publication of the Hanly report that the smaller hospitals will suffer and extra resources might not be provided in the larger centres to ensure patients will be properly treated. I do not note a commitment in the document to the welfare of patients in these areas and the provision of resources in the centres of excellence.

In 2003 I shared a platform with Professor Gupta, the head of the centre of excellence in the Mid-West Regional Hospital in Limerick, on the subject of the roll-out of BreastCheck. At the time we were promised a roll-out of BreastCheck by 2006 but now we are informed it will be rolled out by the end of this year. I sincerely hope this timeframe will be adhered to, unlike the previous ones set for BreastCheck. The region where both the Minister of State, Deputy Hoctor, and I live is still not being treated equally in terms of access to preventive treatment of cancers. Early detection makes the difference between life and death and it is not acceptable that it has taken so long to roll out BreastCheck for everyone. We have campaigned on the streets to have this process speeded up and this is coming to fruition. Even at the time I shared the platform with Professor Gupta he was concerned that his centre of excellence was not receiving the resources it needed to provide a full and speedy service. A month ago he publicised the issue of Barringtons Hospital and highlighted his concern that his centre was not being adequately resourced. It is an excellent service for those who are treated but there is a problem with the waiting list. Acute and urgent cases will be treated immediately but it is not as well resourced as it should be. The failure to roll out BreastCheck and the waiting time are the reasons people choose private establishments such as Barringtons Hospital. This is of serious concern considering that there is no quality control system in place in the private health sector.

With regard to the provision of radiotherapy services, Limerick and Waterford were originally to be excluded from the provision of a centre of excellence. As a result the people of Limerick set about fund-raising to provide such a service on a private basis to which public patients were given access subsequently. This was a long battle over a couple of years before public funding was provided to pay for the treatment of public patients in the privately run radiotherapy centre. Health policy should not merely be a reaction to a regional movement but rather should be properly planned from the beginning. Hundreds of reports were published when Deputy Martin was Minister for Health and Children.

There is a lack of quality control in the private sector, for which nobody is taking responsibility. When Professor Gupta made his concerns known to the Department in 2005, the HSE stated it was not responsible because its remit only covered the public service. We need to know where responsibility lies and also who is responsible for pathology laboratories. Many of the concerns expressed in the midlands and other areas are connected with testing procedures. I refer to the Irish Medical Times report on testing being carried out in the United States and the diagnoses which are of concern to Cork University Hospital such as the double checking of mammographies. Quality control and geographical equality are my main concerns.

See this speech in context