Ruairi Quinn (Dublin South East, Labour)

I thank my colleague, Deputy Jan O'Sullivan, for allowing me to intervene in this debate. I have seldom spoken on health matters because, quite frankly, I know very little about the medical side of health and I would hate to have to deal with the complexity of the problems in our system. Therefore, I do not propose to try in any way to second guess those who have put much more effort and consideration into these matters.

I wish to offer some observations, from a personal point of view and from a constituency point of view. I will start with the HSE itself. I do not think any of us, certainly I did not, opposed the concept of the HSE at the time. However, I do not think any of those who vigorously proposed its establishment, including the former Minister for Health and Children, Deputy Micheál Martin, and the present Minister, would ever have believed it would become the unmanageable monster it now is. In the course of that transition from inefficient and various health boards to what became an integrated single unit, the credibility of our ability in efficiency terms to deliver an efficient health service, or the perception that - and frequently perception is more important than reality - is that it is a dysfunctional body.

The Minister proposes to implement the Hollywood report and, as she stated to me in reply to a question in March 2007:

It is my objective, and that of the Health Service Executive (HSE) and St. Luke's Hospital to see the earliest delivery of the Government's Plan for Radiation Oncology. I am determined that the HSE will deliver on this Plan in 2011 as originally scheduled. The HSE and my Department are considering options to speed up the pace of delivery. This is a challenging timetable and I will provide the HSE with the necessary support to deliver on it.

As regards the future use of the site and facilities at St. Luke's Hospital, my objective is to ensure that these resources are utilised in the best interest of the health services. I will discuss this issue in due course with the HSE and the Hospital Board.

At the time, that reply sent shockwaves and fear across the cancer community I encountered who visited St. Luke's on a regular basis and among many of the residents who live there. I never encountered a resident in the Rathgar area who was worried or upset by the excessive car parking that took place on occasion or gave out about it. I never encountered a resident who felt his or her privacy or the tranquility of a residential area was marred or disrupted by people walking manifestly sick and dying relatives because of the haven of calm, to use the phrase referred to by Deputy Jan O'Sullivan, that was Rathgar and that still is St. Luke's.

Let me declare a personal interest. I am a graduate of cancer treatment and I can still remember, five years on, that extraordinary sense of total inner panic and fear that came right through me when my doctor said to me that one of the six samples tests which took place out in Tallaght was cancerous. The word "cancer" for my generation has the same resonance as "TB" for my parents' generation. The health outcomes, as the Minister knows much better than I do as she has the statistics to hand, are wonderfully positive. It is not the TB of our generation; it is a curable disease. We know a great deal about what cures it but a framework and context in which those around one can be reassured is critically important.

I had my full total body assessment after I went to the consultant when he told me that the first task was to find out if there was any cancer anywhere else in my system. I went through a long process. Going to St. Luke's was like going to a religious retreat. It was not like going to accident and emergency in St. James's. It was not like trying to find a parking place in the vicinity of St. James's and then negotiating something akin to a bazaar in Istanbul to get to the right place.

The best architecture in the world will not transform St. James's into a place which will provide the sort of calm which already exists in St. Luke's. In her speech and in the overall report that has been produced, I understand the Minister is bringing the facilities that were offered by St. Luke's to the National Oncology Centre. I am sure the medical treatment will be of the best possible quality. I consulted with some colleagues in my constituency who are medical professionals and they said from a medical point of view the recommendations are the best, but we do not know everything about medicine. Our present standing in the world does not mean we are the most knowledgeable or that future cohorts of population and expertise will not discover anything new or different.

We do not know what psychosomatic elements contribute to recovery from prostate cancer for some people and a failure to recover for others. In sports psychology the whole area of mind over matter is discernible and has been observed but given the limitations of science and knowledge it cannot be quantified. When I was a young athlete my coach gave me a book which described an incident in a garage in England. A man who was an athlete and had a young child had a Morris Minor up on a block. Something happened, the block shifted and the child was trapped under the car. The man let a roar out of him, bent down and lifted up the Morris Minor to save the child. When it was all over somebody asked him if he knew what he had just done. He said, "No, is my kid all right?". The person said, "You have just lifted this car. Try and do it again". Of course he could not/

There are aspects of the human condition, physiology and emotional drive that we know about but cannot yet measure. I am putting to the Minister that what we know but cannot measure is the healing calm that is St. Luke's. I respectfully suggest, with the comfort of ignorance because I am not a medical scientist, that there are components of the campus in St. Luke's that provide that healing calm. After the diagnosis in my case, which took place in St. Luke's, I had regular treatment. I cycled up to St. Vincent's on the Merrion Road at 8 a.m., got my 15 minutes of treatment and came in here on the bus or by bicycle. It was in July five years ago. I was the lucky one because I was not very sick as they got it very early.

Other people were receiving chemotherapy and serious radiotherapy and had to be driven from different parts of the country. I met people who flew down from Donegal. There is a string of bed and breakfasts on the Merrion Road which cater for outpatients of St. Vincent's for that kind of thing. Where are they going to find that close to St. James's? The Minister's medical report examined the X-rays and the medical inputs. It is one-dimensional world. They do not travel with a relative who has to come and stay in a bed and breakfast on the Merrion Road. I ask the people down the road to reconsider and not to throw out the healing haven which is there.

I share the concerns of Deputy O'Sullivan regarding undertakings given in all good faith by the Minister, her colleague sitting beside her or the HSE. Things change and those guarantees cannot necessarily be honoured. They were not given dishonestly or in bad faith, but things change. We know that ourselves in our personal and professional lives. In the answer the Minister gave to me as regards the future use of the site and facilities at St. Luke's she said her objective is to ensure the resources are utilised in the best interests of the health service. What does the health service need? More cash. What is the most valuable site in Dublin 6? St. Luke's. It was a no-brainer in terms of making a decision to sell the site.

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