Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

If the opportunity were open to me I would of course wish to move a Sinn Féin amendment to the motion. As amended on our proposal, the substantive motion tabled by both the Fine Gael and Labour parties would read as follows:

That Dáil Éireann, noting:

the announcement of a national cancer strategy;

the proposal to develop eight centres of excellence at various locations around the country;

the intention to provide every patient with the best medical care and clinical attention;

the absence of a centre of excellence north of a line from Dublin to Galway and conscious specifically of the geographical challenge and population distribution of the west-north-west region and north-east region; and

the proposed closures at University College Hospital, Galway, where the centre of excellence is to be located, for the month of August this year due to severe budgetary constraints;

calls on the Government to:

proceed immediately with the provision of centres of excellence, based on an adequate and ring-fenced budget;

proceed immediately with the provision of a satellite unit at Letterkenny General Hospital and under the responsibility of the Galway centre of excellence;

pending the twinning of medical oncology and surgical services at Letterkenny with radiation oncology at Altnagelvin, Derry, to form a centre of excellence for the north-west cross-Border region;

retain existing safe, high quality cancer services as at Mayo General Hospital and Sligo General Hospital as satellite units under the responsibility of the Galway centre of excellence;

pending the establishment of a centre of excellence in the north east retain the Dóchas centre at Our Lady of Lourdes Hospital in Drogheda as a satellite unit under the responsibility of the Beaumont centre of excellence;

ensure that all centres of excellence and satellite units are the subject of an annual HIQA audit; and

significantly enhance cross-Border co-operation between health services, maximising the health-care resources of Ireland as a whole, particularly in the development of cancer care.

Sinn Féin is supporting the substance of the motion in the name of the Fine Gael and Labour Deputies; what I have done is indicate additions to the motion as submitted. We feel it is necessary to highlight the fact that the north-east region is also neglected under the current cancer strategy. It is necessary to set out what we see as the solution for Letterkenny and to strengthen the call for the all-Ireland delivery of services. We of course fully support the retention and further development of cancer services in Sligo and Mayo and at the Dóchas centre in Our Lady of Lourdes Hospital in Drogheda.

With regard to the plans to remove cancer services in Sligo, Mayo and Drogheda, we fully support their retention and commend local communities for campaigning to retain the services. I reject the efforts of the Minister, Deputy Mary Harney, Professor Drumm and others to guilt-trip communities and their public representatives and suggest they are somehow being irresponsible for seeking the retention of these services.

We know from our experience in Monaghan what it is like to be at the receiving end of such an approach. The proponents of total centralisation of all hospital care are far removed from the reality on the ground. Part of that reality is patients dying because there is too great a distance to travel to hospital. It means people choosing not to be treated or choosing less than optimum treatment in order to avoid the disruption to themselves and their families of travelling long distances for that treatment.

Professor Keane is being repeatedly cited by the Minister and others as an all-knowing guru in terms of planning for cancer care. His knowledge and experience are undoubted but he was brought in to implement a plan that was already in place. The Government had already decided to provide only eight cancer centres, four of them in Dublin and none of them north of a line from Dublin to Galway. This leaves large swathes of the country without proper access, and even in advance of full implementation of the plan, services at local hospitals are being cut.

The term "centres of excellence" has been bandied about and I emphasise again a point I made previously on this issue, most recently during the course of our statements last month on cancer reports. We should start from the premise that every centre where cancer care of whatever type is delivered ought to be a centre of excellence. By the Government and HSE placing the emphasis on eight centres only, they seek to promote the belief that care delivery at other sites must therefore be inferior. That is a dangerous fallacy.

Nobody is arguing for radiation oncology facilities and a full spectrum of other cancer services in every hospital in the country. Eight centres with such facilities are too few and they are, as I and others have repeatedly pointed out, totally unbalanced in terms of regional spread, leaving much of the population very badly served or not served at all.

It seems the Minister for Health and Children, Deputy Mary Harney, has her ears closed to these arguments. Last night there was a very important debate on the Adjournment concerning the thousands of men and women in the north-east region who have received letters telling them their chest X-rays and CT scans must be reviewed. They face a torturous two-month wait for results.

Major questions are raised about the conduct of the HSE and the overall responsibility of successive Ministers, including Deputy Harney, and the Department of Health and Children. Yet what did the Minister do yesterday evening at the end of the first part of this Private Members' business and with questions pending? She left the Chamber with a Minister of State not a fortnight in office to take questions on her behalf. That is consistent with the approach of this Minister and Government to health policy and management.

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