Noel Dempsey (Meath West, Fianna Fail)

I am replying to 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 on cancer services at Sligo General Hospital. Deputies may recall a previous debate relating to the transfer of breast cancer diagnostic and surgical services from Sligo General Hospital to University Hospital Galway last April. In that debate, the Minister of State, Deputy Seán Haughey, outlined the rationale and objectives of the restructuring of cancer services under the national cancer control programme. As he stated then, the goals of the programme are better cancer prevention, detection and survival through a national service based on evidence and best practice for all cancers. This involves significant realignment of cancer services to move to a system which is consistent with best international practice in cancer control. Diagnosis and treatment planning for all cancers will ultimately be directed and managed by multidisciplinary teams based at eight cancer centres, but much of the treatment other than surgery, including chemotherapy, may be delivered in local hospitals.

The reorganisation of breast cancer diagnosis and surgery, which was the first priority for the national cancer control programme, is now almost complete with just one hospital awaiting transfer of these services. In the case of Sligo General Hospital, breast cancer diagnosis and surgery were transferred to University Hospital Galway on 6 August 2009. New patients are now referred to the symptomatic breast cancer service in Galway, which receives 15 to 20 referrals per week from Sligo-Leitrim and the surrounding area. A small number of women from the area are being referred to the Dublin centres.

Diagnosis and treatment planning are directed and managed by the multidisciplinary team in University Hospital Galway. Patients have their surgery and radiation oncology, if required, in University Hospital Galway. Medical oncology, for example, chemotherapy, which constitutes the majority of cancer services at Sligo General Hospital, continues to be provided there and the medical oncologist in Sligo General Hospital participates by video-conference in the multidisciplinary team meetings in University Hospital Galway of both the symptomatic breast cancer service and BreastCheck. The breast care nurse based in Sligo General Hospital follows up women with minor complications locally and provides ongoing support and breast care if necessary.

Other cancer services at the hospital are not affected. Other than skin cancer, which usually involves minor surgery, and a limited volume of bowel cancer cases, the vast majority of other curative cancer surgeries have never been undertaken at Sligo General Hospital, but are routinely referred to one of the eight designated cancer centres.

All resources associated with the breast cancer service in Sligo General Hospital were left in place until 1 November to facilitate the hospital in fulfilling its obligations to patients who were referred prior to 6 August but had not yet been seen. This process is now almost complete and it is anticipated that the remaining patients will be seen by the end of this week.

For review patients, follow-up mammography has been provided in the hospital since 6 August. The national cancer control programme is satisfied that a safe service can be provided in the short term with the equipment and experienced radiology and radiography personnel in Sligo General Hospital, as has happened in the case of other transitions. Follow-up mammography will continue to be provided in Sligo General Hospital into the future, as an outreach service from University Hospital Galway.

It is the responsibility of the relevant consultant and the hospital to arrange appropriate follow-up care for pre-existing patients following the transfer. The national cancer control programme has offered any assistance to the hospital that it may require in arranging these follow-ups.

The transition period for the transfer of breast cancer diagnosis and surgery from Sligo General Hospital is almost complete and the national cancer control programme is available to provide any assistance to the hospital that is required in arranging appropriate follow-up care for its pre-existing patients following the transfer. Only breast cancer diagnostic and surgical services have been transferred from Sligo General Hospitals and all other services, including medical oncology, remain in place.

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