Mary Harney (Dublin Mid West, Progressive Democrats)

We spend a considerable amount of money on transport, with €20 million spent on taxis alone last year. Yesterday, when I spoke with a group from County Donegal I made the point that €100,000 is spent on radiation transport from Donegal. The HSE has put together a group chaired by Mr. McClintock from the ambulance service to examine transport issues. It includes people from other public services. We need transport for reasons other than health and synergy could be achieved with other public services in developing a more modern and responsive transport system, particularly for those who live farthest away from the centres.

The HIQA data for 2006 indicate a figure of 43 in Mayo, 57 in Sligo and 42 in Portlaoise. I am not questioning anybody because I am not an expert in this matter and was not involved when the experts chose the centres in consultation with patient groups such as the Irish Cancer Society. However, while I have seen references to a figure of 80 since the announcement of the centres, this has not been confirmed by any data available to me or the HSE. HIQA will do a baseline study and Professor Keane is coming here. The number of operations carried out by individual surgeons is one of the factors which must be considered. The number of new cases presenting to the unit is also relevant because it is not a matter of one person working alone. The recommendation is that two breast surgeons should work alongside two radiologists with relevant expertise. Deputy O'Reilly will also be aware that not all radiologists are experts in needle biopsies, an essential capacity for breast radiology. As well as these experts, pathologists with relevant knowledge are needed. It is not just a matter of having one breast surgeon with a high volume of cases.

More resources will be allocated to HIQA which was established on a statutory basis in May and is already making its mark. It does not want to be solely an inquiry agency, although it commenced its operations by being involved in two inquiries. It is essentially a standards setting and enforcement agency and will have a major impact on health services. As is the case elsewhere, health services in Ireland will increasingly be driven by quality and standards. When we have the data, everybody will sign up to the standards.

Professor Keane will start in two weeks time. He will consult widely and have responsibility for controlling and allocating the budget for cancer services. We will be migrating some work out of the centres of excellence, or the cancer centres for those who do not like the word "excellence", to the hospitals from which cancer services are being withdrawn. Half of the surgical patients and 30% of the medical patients from the north east are treated in Dublin hospitals but many could be treated in regional hospitals. The intention is to transfer activity and ensure safety in regional units.

Deputy Varadkar is correct about the Radiological Protection Institute of Ireland and radiation safety. I am not sure who tested the machinery last May, but I do not think it was investigated from that perspective. I will revert to the Deputy with the information.

All of the cases were symptomatic, none arose from screening. Presumably, people were referred by their general practitioner because they had symptoms.

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