Bertie Ahern (Dublin Central, Fianna Fail)

Professor Keane will take over the entire budget. Every year we have allocated more resources, both in capital and on the current side. Much of this relates to staff. Last week I may have said 120 consultants were taken on, but 111 consultants have been taken on. The problem is these consultants are spread about in the system. It is important to emphasise that the decision to reorganise the service is about achieving optimum outcomes. It is not in itself a value judgment on work being done in the existing centres, some of which have a relatively large caseload at present but will not be part of the future centres.

The bottom line is that to achieve the very best outcomes, we must concentrate all cancer work in just the eight centres. That necessarily means that there must be reorganisation and resources must be applied. The discussion on management, designation and operational procedures must take place before these centres move. The relevant individuals will be involved with that.

We have progressively been reducing the number of centres, and we have already moved the number to 13. The object is to quickly designate the clinical national leaders for radiation, surgical and medical oncology. This is to ensure that in each centre there will be people who will be responsible, who will have a primary role along with Professor Keane. They will be responsible for radiation, surgical and medical oncology services.

We have been told there are multidisciplinary teams in some centres at present but this will bring such teams to work together. They will have the resources and the throughput. The argument is that the more patients being dealt with in centres, the more expertise is built up and we get quality staff. Without denigrating staff at any centres, this system attracts people with expertise and competence who can carry caseloads. They clearly need other facilities but that issue is being dealt with by the management of the various hospitals and the HSE.

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