Bertie Ahern (Dublin Central, Fianna Fail)

I will try to answer as many of the Deputy's questions as possible. In June, the Minister for Health and Children approved the national quality assurance standards for symptomatic breast disease services under the Health Act. The aim of the standards is to ensure that every woman who develops breast cancer has an equal opportunity to be treated in a centre that is capable of delivering the best possible outcome. In September, arising from the designation of cancer centres and to comply with those standards, the HSE directed 13 hospitals with low case volumes — fewer than 20 procedures — to cease breast cancer services immediately, to be followed by a further staged reduction in the number of hospitals providing cancer services from 22 to eight.

Several of these hospitals have in practice already discontinued or are in the process of discontinuing symptomatic breast services. The National Hospitals Office has already planned the redirection of this symptomatic case load. Additional groups of hospitals will be similarly directed, and this process will go on, as the Deputy observed, for the next year or two. That will be done in line with the further development of quality assured capacity in the eight designated centres. The HSE plans to have completed 60% of that transition from the current 22 to eight designated breast centres by the end of next year, and 90% by the end of the following year.

Discussions between the HSE and the four managed cancer control networks will focus on identifying the capacity issues for the eight designated centres so that a detailed transitional plan can be put in place to facilitate a progressive and carefully managed transfer of services in the next two years. That work has not yet been undertaken but it is the next issue. The HSE announced last week that within weeks, breast care services will be transferred in some of these hospitals and this will happen progressively.

In regard to cost, the development and improvement of diagnostic and treatment services for breast cancer patients is a major priority development for cancer care services. The national breast screening programme, combined with the quality-assured symptomatic breast disease services I have mentioned, is a key element of the cancer control programme. Resources totalling €60 million have been put into this already.

The next stage begins when Professor Keane takes up his role on Monday. When he examines the work over the next six weeks or so, he is expected to designate the national clinical leaders for radiation, surgery and medical oncology. Arrangements are in hand to enable him to take control of all cancer services between now and the Christmas period. From 1 January he will take charge of all existing cancer services and related funding and staffing.

He will start with the work done to date and take over everything as it progresses into 2008. As I understand it, he intends to designate the locations for a range of cancer specialties by early January, so he must make that call at that time when he is fully briefed on the position and the ongoing work. As soon as he arrives, he will engage in detailed planning to facilitate these designations and the orderly phased transfer of services between the locations. He plans to have completed 50% of that transition of services to cancer centres next year and 90% of the transition by the following year.

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