Seán Haughey (Dublin North Central, Fianna Fail)

I will be taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. I welcome the opportunity to set out the current position to the House regarding the restructuring of cancer services, with particular reference to Sligo General Hospital.

Although Ireland's cancer survival rates have been increasing faster than most other countries, they are still lower than those in other OECD countries and we must focus on improving them. The goals of the national cancer control programme are better cancer prevention, detection and survival through a national service based on evidence and best practice. This involves significant realignment of cancer services to move from a fragmented system of care to one which is consistent with international best practice in cancer control. There are eight hospitals in Ireland which have been designated by the HSE as cancer centres, in line with the recommendations of the 2006 cancer control strategy. These eight hospitals will operate within four managed cancer control networks, within which cancer diagnosis and surgery are to be located.

The designation of cancer centres aims to ensure that patients receive the highest quality care while at the same time allowing local access to services, where appropriate. Diagnosis and treatment planning is, or will be, directed and managed by multidisciplinary teams based at the cancer centres, but much of the treatment other than surgery may be delivered in local hospitals. In this context, chemotherapy and support services will continue to be delivered locally.

The HSE has designated University Hospital Galway and the Mid Western Regional Hospital as the two cancer centres in the managed cancer control network for the HSE western region, which includes Sligo. Recognising the particular and unique geographical circumstances applying to Donegal, and on a sole exception basis, an outreach service will also operate from University Hospital Galway to Letterkenny General Hospital.

As the House is aware, Professor Tom Keane was appointed in late 2007 to lead and manage the HSE national cancer control programme. Since then, he has made significant progress in implementing the programme. By the end of 2008, 50% of cancer diagnostic and surgical services were located in the eight designated centres. By the end of this year, 100% of breast cancer services and 80% to 90% of services for other cancers will be located in the designated centres.

The implementation of the national quality assurance standards for symptomatic breast disease is designed to ensure that every woman in Ireland who develops breast cancer has an equal opportunity to be managed in a centre which is capable of delivering the best possible results. While the standards provide that each specialist unit should manage a minimum number of 150 new breast cancer cases per annum, Sligo General Hospital carried out 79 procedures on women with a principal diagnosis of breast cancer in 2007.

Professor Keane met in March with representatives of management and the medical board at Sligo to discuss the transfer, which is expected to take place within the next three months. The necessary planning has the full co-operation of hospital management and the national cancer control programme very much wants to engage with clinicians to plan a smooth transition. This is absolutely in the best interests of patients. Following the meeting between Professor Keane and representatives from Sligo General Hospital in March, a transition team is being set up and University Hospital Galway and Sligo have been asked to nominate representatives for the team. I sincerely hope there will be full participation by clinicians in Sligo.

Medical oncology will continue to be delivered at Sligo General Hospital, as will outpatient radiation oncology clinics. Current arrangements to provide supportive or palliative care will not change. On accommodating breast cancer diagnosis and surgery for Sligo patients in University Hospital Galway, the symptomatic breast unit there has expanded considerably in recent years. Funding was provided in 2008 by the national cancer control programme for additional staff to support the expansion of the service, while funding was also provided for additional pathology equipment and for theatre equipping.

The current volume of breast cancer patients at Sligo has been assessed and can be accommodated in University Hospital Galway. In addition, the roll-out of BreastCheck in Sligo, which commenced in March, will further reduce the numbers of breast cancer patients requiring access to symptomatic breast disease services. It is important to note that the national cancer control programme has at all times stated that the service provided to women in Sligo will not transfer to Galway until it is satisfied that adequate resources are in place and GPs in Sligo will also have the option of referring patients to Dublin.

In conclusion, the Government is committed to making the full range of cancer services available and accessible to cancer patients throughout Ireland in accordance with best international standards. The restructuring of cancer services aims to improve outcomes for all cancer patients, through a national service based on evidence and best practice in Sligo as in all other parts of the country.

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