Dáil debates

Wednesday, 7 November 2007

Cancer Services: Statements (Resumed)

 

12:00 pm

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)

Perhaps it was not a theatre but that does not take from the fact that there was major investment in two theatres that cannot be used because the doors do not operate. It is like an episode from "Keystone Cops".

The Minister then told us that cutbacks were being made but that they would not affect patient care. However, they clearly have affected it. Patients' procedures right across the country have been cancelled. Surgery has been cancelled in Beaumont Hospital and Our Lady's Hospital in Navan and we are told surgery has also been cancelled in Tallaght Hospital, although this has not yet been confirmed.

How much more must go before we open our eyes? The people on the ground do not need to open their eyes because they see surgeries for them and their loved ones being postponed and cancelled. I know of a lady in the south east who had a brain tumour removed several years and who was booked into Beaumont Hospital three or four weeks ago. The couple have seven children and her husband took three weeks off to mind them while she went up to Beaumont because, given her symptoms, it is likely that there has been a recurrence of her problem. She is having fainting fits at home and badly needs to be seen. She was told there was no bed for her on the day before she was due to go in.

I rang the surgeon about this and asked him whether he could look after this lady. His words to me were "my choice is between this lady who shouldn't have to wait but who can and a man who is unconscious or somebody else who's got an intracranial bleed". This is 21st century Ireland, supposedly the second wealthiest country in the OECD, and this is reality of our health service. The Minister talked about facts. These are facts which affect real people; they are not figures in the ether.

We already mentioned the Midland Regional Hospital in Portlaoise, which was designated in a report by Professor Niall O'Higgins as a centre for the treatment of breast disease in the midlands, but which has been starved of resources. We have seen the consequences and so, sadly, have the women of the midlands. We saw the cancer specialist in another designated centre in Cork resign in frustration three years ago because there was not even a cancer ward at the hospital. When we begin to look at commitments and promises for action and we have this sort of history to back it up, I am afraid it does not give any of us any faith or confidence in the Minister's ability to deliver.

There are so many examples of broken promises in respect of health that the list seems endless. What seems to be the spin that the Minister and the HSE are broadcasting to the good people of Ireland is that "we will build you centres of excellence some time in the future but in the meantime, we're taking away your existing service". This is the reality for people on the ground. Where will the people of the midlands go to now for their breast cancer services? Where will the people in Ennis, whose mammography unit was closed down, go? They are supposed to go to Galway, which has been designated as a centre of excellence, yet a letter from the medical board there states that the cutbacks mean there will be more patients on trolleys, less beds available in the hospital and the breast cancer service may have to be reduced from a five to a three-day service. This is our centre of excellence. The Minister can see that words are cheap but real action is a bit more difficult. The people on the ground in the west and south east are seeing for themselves the result of the mismanagement of our health service.

I was told that yesterday on the radio an individual from the HSE referred to Cancer Care Alliance as being one of the groups who, with their protests, delayed the implementation of these centres of excellence. This is the group that, through public protests in 2004, triggered the release of funds for BreastCheck around the country, a programme which still remains to be rolled out.

While we are dealing with the issue of credibility, I will refer to cervical cancer screening. The Minister told this House some weeks ago that this would be rolled out in January 2008. It is now the middle of November. Christmas will intervene so there are not even six weeks left to that point. Can we really believe this is going to happen when there is only one accredited laboratory in the country and the HSE's commitment has been not to resource further laboratories and build up facilities and resources, but to ignore them and outsource to the US? Furthermore, as far as I know, no arrangements have been made with those who must administer the smear tests — family planning clinics and GPs. Credibility is becoming a serious issue here and everywhere we look we see very little to give us hope that theMinister's credibility is something she can stand over.

The scenario of "live horse and eat hay", which involves telling people that they can have everything they want tomorrow but that we will take away what they have today, cannot go on. It can no longer be tolerated by people who have paid their taxes and who expect a health service that delivers safe, efficient, reliable and timely care. What is required is to put in place digital scanners which will allow for cross checking of scans by a second expert either locally or at a second centre down the line, for example, as I mentioned earlier, in Dublin, Cork or Galway. This is common practice in the world now and in the Whitfield Hospital in Waterford where scans are read remotely by a leading world expert. Distance is no object with current technology. We need to think outside the box.

I return to what the Minister said a few minutes ago. A report in today's edition of The Irish Times says that the BreastCheck service double reads mammograms for safety. However, the Minister and the HSE say that double reading is not a requirement at symptomatic breast disease centres. The logic defeats me. Somebody has a lump, it is symptomatic and she is worried. Her mammogram will only be read by one person but in the screening service for the country, it would be read by two people. The Minister had better correct that because it is wrong and is putting patients at risk. We have seen how it has put patients at risk.

I do not want to blame any single professional. The Minister's inquiry will show up the truth of the matter at the end of the day but the bottom line remains that the risk of human error must be reduced in a system by cross referencing and cross checking. That is what the airline industry, which has the best safety record of all, does. It will tell one straight up that if different people are making the same mistakes, it is the system that is wrong, rather than the individual. The Minister can try to hang out the Midlands Regional Hospital in Portlaoise as the bad place for cancer services but the reality is that the problem is found in Galway, Cork and Limerick and nothing has been done about it.

I will now discuss a matter which was mentioned earlier in the House by the Taoiseach and echoed by the Minister, which is that triple assessment does not take place unless the cancer is diagnosed.

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