Frank Fahey (Galway West, Fianna Fail)

I welcome the introduction of the Health (Miscellaneous Provisions) Bill 2010, the main purpose of which is the dissolution of the board of St. Luke's Hospital and the transfer of the hospital's employees, assets and liabilities to the HSE. While a welcome development, it must be noted St. Luke's has in the past provided an outstanding oncology service. When it was the only hospital in the country treating cancer patients, much good work was done there. I recall many times being on to the hospital on behalf of patients from the west waiting for treatment. The staff at the hospital were second to none. I pay tribute to the work they did in difficult times in catering for the whole country. After this legislation is enacted, I am sure the hospital will continue to perform this outstanding work.

Great work is being done by the national cancer control programme. Its head, Professor Tom Keane, has done an outstanding job in health care management against all kinds of political, medical, vested interests' and community opposition. While I accept all of us were involved to a degree because we want to protect our own patch, the necessary changes Tom Keane brought about were essential to providing quality cancer treatment facilities across the country.

For the first time, funding has been increased to required levels. In current economic circumstances, an additional €20 million in funding for cancer care this year is quite adequate. When Professor Keane took up his position, he complimented the quality of the staff involved in cancer care, saying that Ireland is lucky to have a large cadre of well-trained clinicians, nurses, therapists and technicians skilled in oncology. All the oncologists I have met in Ireland usually returned from having been trained in some of the best cancer care centres in the world. The centre of excellence at University College Hospital, Galway, has one of the finest teams of cancer care specialists in the world, many of whom trained in the United States and elsewhere.

The work done in all centres of excellence across the country must be acknowledged. Reductions in waiting times are being addressed in an effective way for the first time. HIQA standards require all eight designated centres see 95% of urgent patients within two weeks and 95% of non-urgent patients within 12 weeks. The most recent data demonstrates all urgent cases in St. Vincent's and St. James's hospitals are seen within two weeks. The overall number of deaths from cancer has been reduced by 10%.

Survival rates for breast cancer have improved to 77.1% for women diagnosed from 2000 to 2004 compared to 72.5% for women diagnosed between 1994 and 1999. The pace in improvement of breast cancer treatment is the fastest in the OECD. The BreastCheck programme, which aims to reduce the number of deaths from breast cancer among women aged between 50 and 64 years of age, has been rolled out nationally. We had a long and tortuous campaign to get BreastCheck rolled out in the west and south west. It took much longer to roll it out there than in the rest of the country. BreastCheck is of the highest quality internationally and it is available in every county throughout the country. Since it started, some 600,000 mammograms have been carried out on women between the ages of 50 and 64 years.

The question of treatment of prostate cancer has been slow to be rolled out. Figures from the national cancer registry show that prostate cancer is the commonest form of cancer diagnosis in men, accounting for 29% of cases. The stark figures behind the percentages are that on average every year more than 2,400 men are diagnosed with prostate cancer and approximately 540 die from the disease. The national cancer programme is putting in place rapid access diagnostic clinics for prostate cancer in each of the eight designated centres. I am pleased that to date clinics have opened in St. James's Hospital, Dublin and University College Hospital, Galway. Two further clinics in Beaumont and St. Vincent's hospitals are due to open before the end of the year and the remaining four will open in 2010. Prevention and early detection are key factors in the national cancer control strategy. As yet, there is insufficient evidence to support a population based screening programme for prostate cancer. The Department of Health and Children and the national cancer screening service are keeping under review emerging evidence about prostate cancer screening, including the results of randomised trials which are being conducted internationally.

Lung cancer is a very significant problem here. It is the biggest cause of cancer death in men. In 2006, the latest year for which we have figures, some 964 men died from lung cancer. In the same year, 585 men died from colorectal cancer and 543 died from prostate cancer. Rapid access diagnostic clinics are now open in Dublin and this year will see the opening of a rapid access clinic in Galway. Unlike other types of cancer, there is evidence to support screening for lung cancer. In Ireland, 40% of all cases receive no specific cancer treatment because the disease is so advanced.

I refer to cervical cancer. Approximately 250 to 300 cases per year are diagnosed and there are between 70 to 100 deaths. In September 2008, the Government rolled out the national cervical screening programme, CervicalCheck, which has the potential to significantly reduce incidence of death from cervical cancer over time. The vaccine will be offered free of charge this year for approximately 30,000 girls now in their first year of secondary school. This is the same group of girls that would have received the vaccine under previous plans in 2009. The reason the programme is now possible is that vaccine companies have offered substantially better prices for Ireland and an innovative tender process conducted in recent weeks by the HSE has resulted in a more affordable cost to the Exchequer.

The colorectal screening programme has two great benefits: early detection of cancer, improving treatment outcomes, and the detection of pre-cancerous growths. Colorectal cancer is the second most commonly diagnosed cancer among men and women in Ireland and approximately 2,200 new cases are diagnosed every year while approximately 100 die from the disease.

Rectal cancer is a terrible disease and if the surgery is not carried out correctly one's chances of cure are permanently compromised. One interesting statistic is that there were 58 general surgeons, some of whom were rectal cancer trained, operating on five cases or less in any one year and some 17 surgeons were involved in only one case per year. Consequently, surgery is being moved to the eight hospitals and the plan is to proceed in two cases. All smaller hospitals will cease performing rectal surgery as of 1 January leaving us with the centres of excellence performing this difficult type of cancer surgery.

The appointment of the new head of cancer care, Dr. Susan O'Reilly, is very welcome. A native of Wales and trained in Trinity College Dublin, she has done a wonderful job in the British Columbia Cancer Agency in Vancouver. I have no doubt but that she will continue the very good work done by Professor Keane.

Cancer is probably an example of how we need to change in this country, how we need to stop with everyone looking for a hospital on their doorstep and how the medics involved need to change and be prepared to take initiatives. Cancer in Ireland is our success story. Let us hope that in other areas we can move on to repeat that success.

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