Alan Shatter (Dublin South, Fine Gael)

Our health services, particularly our cancer services, have excellent doctors and nurses, many of whom work under appalling conditions with inadequate equipment. Many of them see the need for surgical operations to be undertaken but such operations are cancelled due to the pressures imposed on hospitals. Our cancer services, like the rest of the health service, are essentially dysfunctional. Survival rates for most cancers are substantially below the EU average.

The recent revelations from Barringtons Hospital starkly illustrate these problems and the gross inadequacies of health services administration and the Department of Health and Children. It is extraordinary that in January 2006, an assistant secretary in the Department of Health and Children set out seven specific concerns about cancer services at Barringtons Hospital but for a year and a half the issue was batted between the Department and the HSE while no action was taken. It was not until August 2007 that we learned of the plight of a 51-year old woman who had been given the all-clear in 2005 but was subsequently diagnosed with breast cancer. I do not accept the Minister's claim that she did not know anything of this until August 2007. She is responsible for running her Department. She is responsible for essential health services. If a difficulty of this nature had arisen in January 2006, why was the Minister not informed? Why did she not know what was going on within her Department? Why did she not know that the HSE was refusing to carry out an investigation? How many women's lives were placed at risk by the extraordinary dereliction of duty of the Minister for Health and Children in dealing with the Barringtons Hospital issue? The Minister needs to address this issue to a greater degree than she did yesterday.

In the area of radiotherapy and cancer services some patients are waiting up to five and six months for essential treatment. The HSE has been refusing to send public cancer patients awaiting treatment to nine of the country's 26 linear accelerators, which are run by private operators. This refusal to outsource life-saving radiotherapy is completely illogical in circumstances in which the HSE and the Department of Health and Children are engaging with the private sector with a view to providing co-located hospitals. It is perverse and indefensible as a matter of policy.

Linear accelerators are used to shrink and destroy tumours in cancerous tissues. Best international practice dictates that cancer patients should not wait more than six weeks for such essential radiotherapy. A situation whereby patients may have to wait for up to six months is a national disgrace. Nine machines, which the HSE refuses to use, are based in hospitals where these procedures could be readily provided. They are only being used in exceptional circumstances. These are located in the Mater Private Hospital, the Beacon Hospital, St. Vincent's, the Hermitage Clinic in Dublin and in the Galway Clinic. The Minister should explain why patients' essential treatment is being delayed when facilities are available within the private sector that should be used and could be availed of to protect the health of patients, ensuring they have the treatment they require.

I want to refer briefly to the manage cancer committee strategy. Quite clearly the Minister originally had no intention of announcing it yesterday. Quite clearly she announced it only in response to the motion tabled by this party and it is clear that the thought process and organisation necessary to implement it has not been applied. Extraordinarily, the officials in charge of providing for the strategy announced yesterday that they do not know what the budget is or what the costings are. Ninety days are given for ending cancer services in specific hospitals that up to yesterday had not been consulted and in circumstances where no arrangements had been made. Quite clearly the timeframe promised yesterday will not apply.

I believe in and support the provision of centres of excellence, but it is absolutely crucial that free transport is provided to patients who need to travel long distances. There has been an utter failure to make an announcement in that regard. The call by the Irish Cancer Society for that type of service should be met and the Minister should confirm to this House that it will be provided.

I welcome the comments made by Deputy O'Rourke this morning. Many of us share with her the real concerns she expressed about the use of the public private partnership system to provide essential services that should be rolled out by 2010-11 and which we may not see until 2015. It is an issue that requires further thinking and a reverse course by the Government.

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