John O'Mahony (Mayo, Fine Gael)

I welcome the opportunity to contribute to this debate on the delivery of services for cancer patients, or rather the non-delivery or late delivery of same if one happens to come from the west or north west. Of course we all welcome yesterday's announcement of the implementation of the national cancer control programme, with specialist centres of excellence for the delivery of treatment. However, the difficulty is the timeframe for its delivery.

No service already in existence should be withdrawn until a better one is provided. Yet we heard the Minister say last night that there had been no breast cancer services at Roscommon General Hospital for the last 18 months. On the basis of that experience, we should not hold our breath regarding the timeframe for these centres of excellence. Services have already gone at some hospitals around the country, even though the new specialist centres are still some way off. This should not have happened.

It is not acceptable that a cancer patient is less likely to have access to essential services such as radiotherapy, chemotherapy or hormonal therapy if he or she lives in the west of Ireland because of the variation of access to services regionally. It is not acceptable that patients are less likely to survive breast, bowel or prostate cancer if they live in the west of Ireland because of the unequal spread of services. The BreastCheck programme, it was promised, would be available to every woman by the end of 2007. This will not happen before 2009 and the last areas to have it freely available will be in the west, including Mayo. Of course we welcome any announcement of mobile units for breast screening in Mayo, as we do the completion of the static BreastCheck unit in Galway. The waiting time has been too long, however, with the 2005 deadline being extended to 2007 and now it is 2009 for some.

The HSE yesterday announced the withdrawal of cancer treatment services in 13 hospitals, including Roscommon and Portiuncula in Ballinasloe. This announcement has increased fears about the withdrawal of services in other hospitals around the country. Mayo General Hospital is providing a top quality specialist treatment service which should continue under the proposed new structures as a managed cancer network such as the Mayo Clinic model in Rochester, Minnesota in the United States. Under this model the Mayo Clinic is the parent centre and surrounding hospitals provide high quality audited oncological practices, working through protocols for patient care decided on at multidisciplinary meetings. Video conferencing facilities are already on site at Castlebar.

Can we be assured that when these specialised cancer centres are up and running there will be well-resourced transport provision for patients who have to travel to such centres, not like the transport services that have been cut to the bone in recent months? Cancer patients have to fork out hundreds of euro for taxis when going for hospital check-ups after their initial treatment.

Are we to be guaranteed that cancer services will not be affected by the range of cutbacks in the health service in general, as we have seen in Sligo and Ennis in recent days and as we have heard about in Galway this morning? We want such guarantees and assurances from the Minister.

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