Mary Harney (Dublin Mid West, Progressive Democrats)

I will deal with the Deputy's last question first. Ms Ann Doherty, the acting head of the National Hospitals Office, highlights at the start of her report the fragmented nature of the service which is spread across three hospitals. The report should not be confused with that of Dr. Ann O'Doherty who did the clinical review which is also being published today. The Doherty report mentions that although there was supposed to be a policy of providing services in one location in the midlands, the Midland Health Board decided to provide services at three locations. The manner in which services were spread across three sites, contrary to medical advice, made it impossible to obtain the expertise needed. Until recently, over 30 hospitals were dealing with breast cancer. Such services were recently withdrawn from 15 hospitals because it was not safe to have such a large number of hospitals dealing with 2,500 new cases each year. It is not possible to recruit specialist clinical staff, or to put multidisciplinary teams in place, at so many hospitals. It is important that we implement the national control plan which recommends that we concentrate on eight designated cancer care centres. I have huge confidence in Professor Tom Keane who is overseeing the plan.

Serious issues are raised in the reports which I asked for and which have been published today. As I appoint the board of the HSE, it is accountable to me. I have huge confidence in the board which is responsible for the management of the HSE. The Fitzgerald report which I asked the board to produce after the ultrasound issue arose on 21 and 22 November 2007 states "problems arose from systemic weaknesses of governance, management, and communication". I said in my response to the board of the HSE, which I made public this morning, that I wanted it in the first instance to put a protocol in place to deal with these issues and ensure patients came first. The first thing that should happen when incidents of this nature occur is that there should be personal and direct communication with patients. It should not happen through the media or the political system. I want to ensure one person is in charge of ensuring the protocol is implemented. While I do not suggest the person should undertake the reviews in such circumstances, he or she should be responsible for ensuring the protocol is implemented.

I also want the board to be centrally involved in risk assessment. I have asked the chairman to ascertain whether the issues which arose in Portlaoise have wider application across the HSE. In particular, I want permanent personnel to be appointed to management positions which are currently vacant with acting personnel in place.

See this speech in context