Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

I have listened carefully to all the contributions thus far and I regret and I am the first to state I oppose this Bill. I do so for several rational reasons. It implements the closure of St. Luke's Hospital to facilitate the putting in place of a so-called national plan for radiation oncology which provides for four radiation oncology centres, two in the city of Dublin, one in Cork and one in Galway, with what are termed satellite centres in Waterford and Limerick. This is not a national plan by any yardstick. It is not a national plan in the first instance because it is not an all-Ireland plan. It is not a national plan because none of the proposed centres is north of a line from Dublin to Galway.

I represent first-class Irish citizens from a constituency which, irrespective of what excuses or arguments are offered, is not being primarily provided for in this proposed arrangement. Huge swathes of the country will not be served and cancer patients in those regions will have to travel unacceptably long distances to access radiation oncology treatment. The health care rights and needs of the people of the Border counties and most of the western seaboard are being neglected yet again. Let us be in no doubt about the magnitude of transport and access issues for those seeking radiation oncology services. Most Deputies who have already spoken in this debate have given personal testimony in regard to their and their families' experience. I can say in my experience that it is a harrowing prospect to have to travel long distances for radiation treatment. It simply is not good enough that almost half the island in terms of this jurisdiction is to be left without a service.

We should not be surprised at this. Fianna Fáil health policy, as implemented by the so-called Independent Minister, wherever she might be, and the Health Service Executive, is denying the rights and failing to meet the needs of people every day in our health system. Today again we see the outcome of the savage health cutbacks being imposed. It has been announced that 60 beds at the Mater hospital are to be closed. This follows the closure of 62 beds at Beaumont Hospital. We learned yesterday that a whole range of services at Cavan and Monaghan General Hospitals in my constituency are to be closed for long periods during the summer. For a full 29 working days, from 28 June until 20 August, barely a two month period, these services will be closed. So much for the false promises of the Minister and Health Service Executive in regard to the range of care services that would be provided at Monaghan General Hospital following its being axed as a acute hospital almost 12 months ago in July 2009. These services can now be opened and closed at will as if the HSE were running a corner sweet shop rather than a vital health care facility.

The health care needs of the people I represent are a 365-day requirement, as is the case everywhere else in this country. They are not a water tap that can be turned on and off to suit management or budgetary requirements. People's health care needs are a daily need for address by the State. The situation gets worse. Figures supplied by the INMO show that as of 28 May there were more than 1,000 beds around the State closed. The HSE is discharging long-term care patients and then closing beds despite the Minister and HSE having spent years telling us that the discharge of such patients would free up acute beds in our hospitals. These beds are now being closed, which is an absolute outrage. It baffles me that there is not greater anger being expressed in regard to all of these developments.

I wish to raise here with the Minister as a matter of urgency an issue directly relevant to section 14 of the Bill, namely, the plight of residents in Loughloe House, Athlone and their families. This particular matter has been raised in different ways here during the past number of weeks but there has not been any real or substantive address of the core issues involved. As the Minister knows, the recent HIQA report on Loughloe House did not recommend closure. It recommended important improvements, mainly in management, that can and should be made to keep this home open for current and future residents. I must report to the Minister, as she may not know this, that the response of the HSE has been nothing short of scandalous. Since the HSE announcement on Thursday, 6 May, of its disgraceful decision to close Loughloe House two of the residents have suffered strokes, one of whom is currently gravely ill in the Midland Regional Hospital, Mullingar. Another two residents had heart attacks, one of whom died in Loughloe House four days after the HSE announcement. One resident died having been moved from Loughloe House to St. Vincent's in Athlone.

Residents have been warned not to talk to the press or public representatives. The question that must be asked is why would residents be so warned? Residents are threatened that they will be moved to Roscommon or Ballinasloe if they do not take the nursing home offered to them. I am reliably told that one resident was threatened with the street if she did not take a bed in another nursing home. On another occasion, staff were instructed to awaken a man from his sleep to tell him that he was leaving that day. Another resident was threatened with the door for "inciting other residents to get them to stay put in Loughloe House". The stress on residents, their families and staff is unbearable. Only last week I met with a significant number of those families campaigning and staff at Loughloe House who attended the Dáil.

Prior to the announcement, the last person in the home to die suddenly was a man who died from a heart attack a couple of years ago. Look at what has happened since. I implore the Minister to intervene now to protect the residents, to prevent the closure of Loughloe House and to prevent the eviction of residents from what is for them unquestionably their home. If the Minister doubts anything I stated on the record of this House this afternoon, I urge her to order an independent investigation by the Health Information and Quality Authority and-or another agency she deems appropriate into the HSE's treatment of these vulnerable elderly people.

On the Bill before us, Sinn Féin has supported the retention and further development of St. Luke's Hospital. We hear much from the Government about centres of excellence. St. Luke's has clearly been a centre of excellence for cancer care for many years, yet the Government wants to close it. Like so many other Deputies I, too, had a personal experience of St. Luke's when my brother-in-law was a patient there last year, Go ndéana Dia trócaire ar a anam dílis. He was a young man. I was impressed by St. Luke's. This was undoubtedly a place apart, a hospital not like any other I had known. The Government has, therefore, in my view failed to heed the testimony of current and former patients and staff at St. Luke's Hospital in regard to the need to review and reverse the decision to close this facility.

The experience of St. Luke's is replicated in hospitals around the country which this Government wishes to downgrade or close. The Government is following a policy of over-centralisation of services and the privatisation of services. This policy is driven by commercial interests rather than the interests of patients. It is a policy that rewards the private health care sector with land on public hospital sites and tax breaks to develop private for profit hospitals. At the same time, the Government wishes to close long-standing, tried and trusted facilities such as St. Luke's. Cancer patients have been denied life-saving treatment because successive Governments have failed to provide the radiation oncology facilities required. This dire need has been recognised for many years. The Government had ample time and a booming economy to plan and budget for the provision of radiotherapy centres. The State could and should have taken the lead and provided these centres directly as public facilities open to all on the basis of need alone. Instead, the Government committed itself to public-private partnerships to deliver them. When it was found that this would take to long a review was ordered. This is what has led to the delay in delivery to 2014 or 2015.

The Minister, Deputy Mary Harney, told us that the planned centres may have to be provided entirely by the private sector. Professor Drumm has on the other hand told us that the public sector can do it. Delay is piled upon delay and patients are dying. This Fianna Fáil-led Government is attempting to shirk its responsibilities for the chaotic state of cancer care services. Fianna Fáil-led Governments have for the past decade presided over a catalogue of failures and delays in cancer care. What is needed urgently is comprehensive public cancer care provided in the public health care system and available to all based on need, regardless of ability to pay and without discrimination based on geographic location. What is needed urgently is a comprehensive public cancer care provided in the public health care system and available to all based on need alone, regardless of ability to pay and without discrimination based on geographic location. St. Luke's Hospital should have a central role in such a renewed and reformed system.

The Government has ensured that there will be no democratic accountability for these decisions. It has insulated the HSE from any responsibility to the local communities it is supposed to serve and the Minister, Deputy Harney, has insulated herself from proper accountability to the Dáil. For all these reasons, and for many more I could add but time will not allow, I restate once more that I will oppose the passage of this Bill and I declare now that I will reject it.

See this speech in context