Mary Harney (Dublin Mid West, Progressive Democrats)

Deputy Kenny stated today that Fine Gael leaders always put the country first. As a doctor, Deputy Reilly will know about cancer survival outcomes and that we now have a cancer registry whereby we can measure survival rates. It is a fact that the survival rate of people treated in the north west for breast cancer is 25% lower than that pertaining to those treated in specialist centres in Dublin. I refer to the last period for which we have results. Anyone who puts the country and patients first cannot but act in the face of this convincing fact. I will not talk about multidisciplinary teams or use complicated language; suffice it to say that when women with breast cancer are treated by a number of different experts in a single place, outcomes improve by 20% to 25%. There are 250 medical publications worldwide that back up that fact. Our reorganisation of cancer services is about outcomes and delivery and nothing else.

Last week in Galway I had the pleasure of meeting a group known as Helping Hands, whose members joined together voluntarily some years ago because their friends had a child with cancer. The mother of the child was in Dublin with that child for almost a whole year. The group, with which I was really impressed, helped out the family and developed into an organisation. The mother of the child told me she was devastated when her child was diagnosed five and a half years ago. She said she and her husband were prepared to sell their house and go anywhere they could to obtain treatment for their child. She also said they did a lot of investigation and discovered there was nowhere better than Crumlin hospital. She said she was so happy their child was treated in that hospital.

When I listen to these debates, I get so upset when Members do not support the inevitable concentration of services where experts can be brought together. With regard to children's campuses, we are top of the class worldwide because of the way in which we have organised the services. We all have experience of illness among loved ones and we would bring them almost anywhere if we could get them cured. Therefore, when reorganising services, it is not a question of budgets. Our performance has but one driver and that is patient outcomes and patient safety.

A very encouraging report was published recently on MRSA for the third quarter of last year. While it is but one report, it shows a dramatic improvement in our performance. Some years ago we could never have known how we were doing in this regard because we never measured our progress. Hospitals must now report individually and thus we are able to measure progress, set targets and drive improvements in the interest of patient safety.

I could list many examples of where the health services are improving without any additional resources. Let me cite the example of the winner of one of the health innovation awards last week, St. Vincent's Hospital in Dublin. Without any additional resources, its neurology unit increased its service level twofold. It was seeing 2,500 patients annually and is now seeing nearly 5,000. The doctors are spending twice the time with patients that they used to spend with them. They are doing so because innovative doctors, nurses and managers got together to change the way they were dealing with their patients. Instead of patients having to wait one year to see a neurologist at the hospital, they now only need to wait a matter of weeks.

These are some examples of what the reform agenda is seeking to achieve. We have amalgamated many organisations into the HSE. If any Member tells me that services were better when we had the health boards with their 273 members, I will challenge his facts.

The HSE is not perfect and considerable efforts are being made by the management of the executive and the board — the board includes very dedicated women and men who have agreed to sit on it and give it their everything — to get the organisation right, establish the lines of accountability and ensure we know who is responsible, when they are responsible and who reports to whom. We have never had a change process of this scale in the public or private sector.

Deputy Gilmore's former party, the Democratic Left, said of Deputy Howlin when he produced his health strategy in May 1994 that he had slavishly given in to the private sector. The words may be different but the same is said of me. If services are put in place, my obligation and that of the Government is to make them available to patients.

Consequently, at present privately funded radiation oncology services in Limerick and Waterford are made available to all patients. Moreover, Deputy Reilly should note there will be access for all patients to any facilities built.

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