Joe McHugh (Donegal North East, Fine Gael)

I welcome the initiative of the party leader, Deputy Enda Kenny, and Deputy Reilly in tabling this motion. It is a question of confidence at a time when patient confidence is at an all-time low. I have questions to ask on behalf of my constituents and the general public. Will Government policy on cancer services be of a high quality, co-ordinated and efficient? If past performance is an indicator of the future, I doubt it very much. Will services be population or patient focused? The irony of centralising cancer care is that members of the predominantly healthy 25-44 age group live in the suburbs of these proposed centres, whereas the predominantly ageing population are in the peripheral rural areas. How does international best practice in advanced nations align itself to Ireland's situation? All things being equal, it fits well. However, given the Third World transport infrastructure in this country, all things are not equal. In terms of a cancer vision, will there be a clear direction that improves the patient's journey? I do not mean a journey on the back of a bus or in an ambulance. I mean a patient's journey from screening to diagnosis to rehabilitation and recovery. The people of the north west do not share the Minister's confidence in the vision she holds at the moment.

I want to discuss cancer services at Letterkenny General Hospital. Having secured outreach status from University Hospital Galway, the cancer team at Letterkenny is developing all the time. At present, we have three pathologists, three specialists in neurology, a permanent oncologist, a locum oncologist and a soon to be appointed breast care surgeon, proving that multidisciplinary team meetings are possible with the assistance of advanced communications technology. As the Minister will be aware, every Thursday meetings take place via telelinks to discuss mammograph, ultrasound and biopsy results through advanced communications technology. Why can this not happen also in Castlebar and in Sligo?

Donegal is unique in that it has a cross-Border element. Where the ongoing radiotherapy negotiations are concerned, there is an underlying issue regarding openness and transparency. Serious questions arise over determining a suitable location for a radiotherapy service and the people on both sides of the Border have not been consulted. While we are told a feasibility study is ongoing, the details are sketchy. I welcome the fact that the Minister for Health and Children, Deputy Harney, and the Minister for Health in Northern Ireland, Mr. Michael McGimpsey, are meeting but it is not advisable to pinpoint a location without prior investigation after only two meetings.

The focus of this motion is on patient care and the cancer patient journey. While we accept on this side of the House that specialist cancer surgery requires a conglomeration of experts at a fixed location to where people will travel, there are other elements to cancer recovery that the Government is failing to consider. This is where the Government is losing the argument. So much can happen locally in conjunction with local hospitals with respect to negotiation with general practitioners. I refer to prevention, screening, diagnosis, treatment, rehabilitation, supportive care and palliative care. These comprise the vision on paper but, in reality, the people do not have confidence in the system.

I cite an example of a woman who went for a mammogram last week in Letterkenny General Hospital. While waiting for her test results for 15 minutes, 14 women went for mammograms. I know this because the woman in question was my mother. She went for a check on her own initiative as a private patient because there is no BreastCheck service in the north west. How in the name of God does the Minister expect one centre in Galway to look after the whole north west if 14 women are going through the system in Letterkenny in a 15-minute period? As the Minister well knows, the clinic in question is now operating on a Saturday as well as from Monday to Friday.

See this speech in context