Mary O'Rourke (Longford-Westmeath, Fianna Fail)

Members are very kind. This is my allocated slot for voting; it was hard earned and I am very pleased to be here.

I am glad to speak on the cancer reports. I thank the Minister for coming into the House, as is her duty, because Members often bewail if Ministers do not come into the House to speak on such reports.

I attempted to listen to the Minister's contribution in my office but my telephone kept ringing. Did the Minister say that the money allocated to Professor Keane for cancer care will be kept safe from the Health Service Executive? It will be a separate budget. It would have to be kept safe from the HSE because if it gets its bumbling — and that is a kind word — hands on it, it will be dissipated with no responsibility. I hope the cancer care budget remains with Professor Keane and his secretariat under the Minister's guidance and not of the HSE. The Minister might clarify that matter when replying.

The Minister has come into the House to report on the various mishaps, which were major, that happened to women. It is not just women who speak here today but men also who feel deeply about the women who were misdiagnosed or had to wait their turn in that regard, to quote Deputy Ó Caoláin, because they were second class citizens but we must look forward. I have found in life that we should always look forward and not be forever looking back.

I very much approve of the centres of excellence outlined by the Minister. That is the purpose of my speaking here today even though Mullingar, which is in my constituency, had one such good cancer care centre. The centres of excellence make sense. That is the reason they should be encouraged. A previous speaker said they should be located geographically where they are needed. It is not possible to give the complete level of care, including multidisciplinary teams, that is needed to treat cancer in a comprehensive way. To think we can have cancer care units anywhere we want them is ridiculous.

I approve of the proposal for centres of excellence. They are the signpost for the future not just of cancer care but I hope also of heart and stroke care and the care of other prevalent illnesses. These centres would embody the multidisciplinary teams, research and development, training and the outlook needed to conquer and keep pace with developments in illness. We will always face illness in our lives and I strongly agree with these centres.

I take the opportunity to talk about hospice care because while we propose to have centres of excellence there is a need for hospice care throughout the country. Somebody asked me recently if hospice care was only for people who, sadly, have terminal cancer. I would have thought hospice care was for those who need it in their dying days or who need palliative care of a certain kind. The Minister has kindly agreed to meet with a hospice care group from south-west Meath whose members are doing great work on a voluntary basis to set up a hospice for those who come to use it.

As well as giving my support to the centres of excellence I wish to refer briefly to the issue that has riven this country recently, namely, Nuala O'Faolain's interview on the "Marian Finucane Show" on a Saturday morning. I am not aware if it was mentioned in this House already but I have not met a man or woman who listened to her speak who was not instantly struck by her searing honesty. We know her, and I know her in a peripheral way, as I am sure the Minister and others in this House, from meeting her as she went about various assignments here and listening to her broadcasts from the United States where she followed the Hillary Clinton-Barack Obama campaigns. We know her always as a very forthright person. I do not believe she spoke in despair but out of a wish to let people know what it is like to be in that dark place and to wish to find an echo with people. I found her searing honesty tremendous and I applaud it, as I have often applauded statements she has said or written. Throughout her writing life she has forced us to examine issues in a way we did not know we were capable of doing and that made us face up to issues. In this way, as she has faced up to her own, she is true to her career and to the way she has managed herself throughout all those years. She was met with strong, dignified probing by Marian Finucane. There is no doubt it was a very difficult interview but both women, and I do not wish to sound in any way patronising, should be applauded for the way they conducted themselves. Ms O'Faolain has given inspiration to all people who suffer from cancer.

It is interesting to note the way she was told the news in a New York hospital. She was told by a young functionary going by that she had secondaries all over her. That was the way the knowledge was imparted to her.

Her first impulse was to get back to Ireland, which was very telling. To return home is, I suppose, an animal instinct in everyone who is out of sorts, so she returned to her beloved County Clare. I understand she is now in a hospice in Galway, or at least that is what we garnered from the interview. It had an emotional impact throughout the country and it is only proper we should talk about it and face the issue.

Those of us who studied and taught students thought immediately of Dylan Thomas and his poetry:

Do not go gentle into that good night,

Old age should burn and rave at close of day;

Rage, rage against the dying of the light.

That is exactly what she is doing and were ever words more appropriate? She does not want to leave life, but who would? I would not have regarded her debate as a case for euthanasia, far from it. She wanted to stay with life. It clearly shows what people with a terminal illness are going through, as well as the need for properly developed hospice care throughout this country.

I expect the Minister will make a reply at the end of the debate. I would be glad if she could respond to the points I have made. One concerned whether the budget for these centres of excellence would be kept separate from the marauding hands of the HSE. It could later indicate it does not know where the budget has gone or it has been allocated to some other subhead. This must be kept with Professor Keane, whom I have not met, for its purpose in setting up the centres of excellence. He sounds utterly sensible.

There cannot be a centre of excellence at every crossroads in Ireland. How could this happen as we would not have the required expertise? Will the Minister in her reply give some details of plans for hospice care, now and in future? Will they all work through voluntary effort? People, both those who raise money and those from whom they expect to raise it, must be worn out sometimes through voluntary effort.

I am sure in some sections of the Department of Health and Children there are some plans for hospice care, and perhaps various care centres could be placed right throughout the country. These would of course be centres of excellence, although not in the same vein as what we need for cancer diagnosis and care. They would rather provide care for the dying with dignity, strength and humanity.

Will the Minister explain if hospices are solely for cancer care, or if anybody with a terminal illness can call upon palliative or hospice care? I am aware of a wonderful palliative care nurse who came to a home on our road every day where a young woman died recently. She cared for that woman throughout the night. I hope to get replies on these issues.

I do not share the sentiment of the previous speaker, despite what I say about the HSE. I have no time for that body, as nobody appears responsible for anything when we call them. We are passed from Billy to Joe to Jack to Mary, and in the end we do not get a reply. Answers to parliamentary questions are disgraceful. I sometimes forget the question by the time I get an answer because the matter has been going on so long.

I wish for the Minister to stay in her Department because she has guts and competence. Those two qualities are very necessary for the stewardship of the Department of Health and Children.

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