Mary Harney (Dublin Mid West, Progressive Democrats)

There is more analysis coming from the National Cancer Registry of Ireland in the autumn. I understand it is currently collating its report. The advice available to me is that the pattern will continue. Either we can ignore that or we can do something about it. I believe this debate is about the truth. If we are sick and go to our doctor we want the right diagnosis and a good prognosis — we want to be told the truth. We have a moral obligation to tell people the truth. Already there is significant evidence that people are moving to specialist centres even when local facilities are available. Yesterday I visited South Tipperary Hospital. I went to the oncology ward where some men but mainly women who suffer from breast cancer were receiving chemotherapy. Many of them had their surgery in Waterford because the service has been withdrawn from South Tipperary Hospital and the surgeon has gone to Waterford as a full-time breast surgeon. When I asked for their opinions, each and every one of them was hugely satisfied with the service and very happy they were having their chemotherapy in South Tipperary Hospital. Of course, chemotherapy services will continue to be provided in Sligo and Mayo. Some 55% of breast cancer patients will require chemotherapy and those services will be provided locally in Sligo and Mayo.

What are we suggesting in the designation of eight specialist centres? In this instance we are talking about breast cancer because those are the services provided in these two hospitals. For a patient's initial diagnosis and surgery, she will be treated in the specialist centre and thereafter her care, having been planned in the specialist centre, by way of chemotherapy will be delivered locally. That can provide for cancer patients a quality-assured service. Ireland is 18th out of 23 in our performance on cancer in Europe. Our survival rates are improving and as we saw from the recent OECD report in breast cancer they have improved by just under 7%.

However, in treatment of children's cancer we are ahead of the United States and Europe because we have one specialist centre at Our Lady's Hospital for Sick Children in Crumlin which has been there for 50 years. All the diagnosis happens there. The initial surgery happens there. The follow-up treatment, although planned there in accordance with a protocol can be delivered in 16 other hospitals around the country. We have proved with children's cancer when we keep the expertise and specialist doctors together dealing with high volumes of patients, we get better outcomes and results. That is what this debate is about.

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