Dáil debates

Wednesday, 7 November 2007

Cancer Services: Statements (Resumed).

 

4:00 pm

Photo of Beverley FlynnBeverley Flynn (Mayo, Independent)

I welcome the opportunity to speak on this important issue. On 1 November, not realising what happened in Portlaoise, I tabled a motion asking that Government time be allocated to a discussion on the national cancer strategy because it is a huge issue in my area. What happened to the women in Portlaoise is dreadful and one's heart would go out to them and their families. It is hard to even begin to imagine what they are going through. It is a terrible situation which I hope is not repeated anywhere else. Our sympathy goes to those women.

Some 7,000 people marched through the streets of Castlebar and 2,000 people marched in Galway. Instead of criticising them, we should commend them. In the past we have spoken about satisfaction ratings. The Minister mentioned the satisfaction of the majority of people who go through the health system and the fact so many of them are satisfied. Some 7,000 people walked through the streets of Castlebar to show their confidence in their local health service. They are people who have been through the system, who have had surgery, who have survived and who are telling the world what a wonderful system exists. We should not knock these people — we should applaud them for doing so because of the confidence it demonstrates in what is, in many ways, an excellent health service.

Will the outcome of the HIQA audit due to take place in April next year in any way alter the national cancer strategy as outlined? If it cannot have any impact on the strategy, why is the audit taking place in the first instance? I refer to the eight centres of excellence. It has been highlighted that the country can only justify eight centres of excellence with a population of 500,000 per centre. I understand that but what I cannot understand is the location of those eight centres and why not one of those centres is located north of the Galway-Dublin line. Even if there is one centre of excellence per 500,000 of population, there could be a greater geographical spread throughout the country. It is completely unjustified that four of those centres would be based in Dublin.

What will Professor Tom Keane's role be when comes to Ireland? Will it be purely the implementation of the national cancer strategy and the decisions which have already been made or will he be able to recommend changes based on the outcome of the HIQA review next April?

Why is it acceptable to have a satellite in Letterkenny as part of the centre of excellence in Galway modelled on Mayo General Hospital when we are closing the services in Mayo and in Sligo? I do not believe it is about geography or social or economic groupings; it is about women getting the best possible outcome and an excellent service. If we can justify the location of a satellite in Letterkenny, then surely if similar excellence is being provided in Mayo General Hospital and in Sligo, that should also be acceptable.

There was much talk today about Portlaoise and the fact it was a designated breast centre. Mayo General Hospital, which has operated a breast clinic since 2000, has one consultant surgeon who specialises in breast surgery and who will carry out 80 procedures this year. We have three radiologists, all of whom are trained in breast ultrasound and two of whom are trained in breast ultrasound biopsies. Each mammogram is read twice. We have two pathologists, both of whom are trained and are specialists in breast pathology. We have a medical oncologist from Galway who does two sessions per week. He sits in on all the conferences on every new cancer case which occurs in Mayo General Hospital. We have excellence. I make this point not only because it is my local hospital, although the cynics might say it is. As a woman, I would not recommend to the people of my county a substandard service. However, it appears they are getting a far better service than that in Portlaoise where there is only one radiologist reading mammograms. It is also quite obvious given the waiting times. In Mayo, if one has an urgent referral, one can be seen within a week. If one has an early referral, one is seen within six weeks. A definite diagnosis is given to an urgent referral within two weeks of being seen. This is the service to which the people of Mayo have become used and in which the women of Mayo have expressed confidence. If something is working, why are we changing it? Are we changing it for change sake?

The Minister quoted some very interesting statistics. She mentioned that the survival rate from breast cancer has improved from 72.9% to 78.2%. How do those figures break down between the various hospitals carrying out breast surgery? Mayo General Hospital has contributed to the improvement in those services. Are those statistics available? How can we close a service with which the people are satisfied and in respect of which 7,000 people were prepared to march on the streets to demonstrate their satisfaction if we do not have statistics telling us that service is inferior? If I have to go back to my constituents to explain to them that the service is inferior and if the Minister has statistics to back that up, I will discuss that with them because I do not want them to get an inferior service.

We should wait until April when HIQA carries out is review. I am confident, as are the consultants and staff of Mayo General Hospital, that they will come through that review with flying colours. If they do, will the Minister amend her national cancer strategy and agree with a managed cancer network in the west taking into consideration Mayo General Hospital, Sligo and Letterkenny as part of a managed network?

Two years ago the Minister recommended that the Oireachtas Committee on Health and Children visit Sloan-Kettering, the finest cancer hospital in the world. We took the Minister up on that and in May 2006, we visited Sloan-Kettering where we met Dr. Thomas Fahey who is head of the international breast centre there. I spoke to him today specifically about the networking arrangement which currently operates in New York. Sloan-Kettering has been held up as the finest cancer hospital in America and we are holding it up as a shining example. It has satellites around the periphery of the city in which diagnostic, chemotherapy, radiotherapy and day surgery take place.

I discussed with him the arrangements we have in this country, specifically in my local hospital, Mayo General Hospital, and he said it is very significant that 80 surgeries take place every year. Professor Niall O'Higgins said in his report that if a consultant is doing more than 50 and less than 100 surgeries, he or she is deemed to be proficient in his or her area. Like all women in County Mayo, I am confident that Dr. Kevin Barry, who is the consultant surgeon in Mayo General Hospital, has the requisite proficiency. Having seen media reports of women who say they do not think they can have confidence in their local hospitals anymore, I assure the House that 7,000 people in County Mayo have confidence in Mayo General Hospital. As their public representative, charged with coming to Dublin to express their interests in the Dáil, how can I tell them that the service in Mayo is not good enough and will close? I ask the Minister, in the interests of excellence, to retain a cancer management network in the west. Such a network will provide for the best possible outcomes for the people of the region.

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