John Perry (Sligo-North Leitrim, Fine Gael)

This is very much part of the Bill. We are talking about the provision of cancer services and this concerns the extended services at Sligo General Hospital. There was no curtailment of previous speakers who mentioned their local facilities. This concerns the mandate I was given. We are discussing St. Luke's cancer services and the regulation regarding their removal but cancer services were removed from Sligo. This is phase 2. Given the demographic profile of the north west region, with its high population of elderly people, it is critical that oncology services are adequately resourced to cope with an increased demand. Oncology was very much part of St. Luke's but the service is now being transferred to other centres in Dublin. I am worried about the removal of services from the north west. North of a certain line there are no services and I wish to put that clearly on the record today.

The geographic location of the hospital also means it is ideally situated to perform as a centre for many regional services, especially now, in light of the roll-out of the national colorectal cancer screening programme. However, under the watch of the Government, Sligo General Hospital will not have the resources to provide these critical services. Oncology and palliative care services at the hospital, under Mr. Merton and his team, provide an outstanding facility. Decisions will have to be made on this in light of the colorectal cancer screening programme. It is very important that the matter be addressed in a clear manner.

To date, budgetary constraints imposed on the hospital have resulted in a reduction of the orthopaedic bed capacity to 24 beds. In the past 12 months a reduction of 72 beds has taken place in medical, paediatric, orthopaedic and surgical wards. This reduction does not take into account the proposed further €12 million cutback. The hospital simply cannot operate under such conditions. The critical services it provides to so many people across the wide geographical region it serves will be severely restricted.

Next week there will be an opportunity for Deputies Scanlon and Devins, the latter a doctor and former Minister of State, to vote against the Government unless they receive assurances that further attempts to curtail Sligo Hospital services, especially in the areas I mentioned, will not take place. One may consider the entire cancer strategy and the issue of the four centres of excellence in Dublin. However, to the dismay of many people, there are cutbacks in the north west region especially with the removal of essential services such as surgical and mammographic facilities. There will be the impact of further curtailment imposed by budgetary cutbacks. I have met the hospital management and seen the commitment of the 1,400 staff in carrying out an outstanding service. Even the emergency facility at the hospital has been curtailed, as has facilitation of services for many people who are referred there. Cutbacks have been immense.

The Health (Miscellaneous Provisions) Bill 2010 provides for the dissolution of St. Luke's and the transfer of its employees and their abilities to the Health Services Executive. This arises from the national plan for radiation oncology under which there will be four radiation oncology centres, two in Dublin, one in Cork and one in Galway, with two satellite centres in Waterford and Limerick. The Bill also provides for the amendment of the Health (Nursing Homes) Act 1990, the Health Act 2000, the Medical Practitioners Act 2000 and the Nursing Home Support Scheme. It also repeals section 44 of the Health Act 1947 and section 36(2) of the Health Act 1953.

This debate draws together a wide range of information from the Department of Health and Children, National Cancer Registry Ireland and St. Luke's Hospital. It is comprehensive legislation. The most important aspect is the development of radiation oncology services in Ireland, on which there is a critical mission statement. When one considers the statistics on the incidence of cancer in Ireland, it is frightening to think that the disease will increase dramatically over the next number of years. With that level of development and the roll-out of services in the country it is extraordinary there is little or no facilitation of services in the north west. The roll-out of services in a fair and equitable manner is not served by the loss of those in the north west and west regions.

For cancer patients, radiation therapy is critical. It is not so long since there was a major campaign in the region for the facilitation of radiotherapy in the north west but now there is removal of the current services. Although this is comprehensive legislation it is regrettable there is to be such a massive cutback, given the demographics of the region and the services provided by Sligo General Hospital for a population of 250,000.

For every action there is a reaction. The removal of the cancer surgical facility at the hospital more than a year ago has had a severe impact on other facilities at the hospital. The threatened removal of coronary angiographic services at the hospital is frightening. Lives will be lost if people are left with a three-week turnaround. If they are referred by a general practitioner to a consultant at Sligo General Hospital they can have an angiogram or other services, as identified, but if they are to be referred to Dublin, with a consequent waiting time, that is frightening for coronary patients with threatened heart attacks.

I am delighted to speak on this very important Bill. Enough is enough when it comes to critical and outreach services, the ambulance service and the size of the vast region covered by Sligo General Hospital, the main hospital in the region, serving 250,000 people. It does not compete with any other hospital and provides an opportunity for cross-Border care with Northern Ireland. That has been discussed but is very much a long-term plan of investment in connection with Fermanagh Hospital and Altnagelvin Hospital in Derry. The big disappointment would be curtailment at the hospital which is the backbone of the north west region. This is why people pay their taxes. They expect to have a service and be able to support the 1,400 staff who work at Sligo General Hospital. One must recognise the outstanding commitment of the doctors, nurses and all supporting staff of the hospital who are totally committed, as I know from visiting the hospital.

Given the statistics on incidence of cancer in Ireland and projections for the future the situation is frightening. As Deputy Ring stated, cancer affects every family. This is frightening but it is reassuring to know that if the disease is diagnosed at the initial stages and correctly treated people can make a very good recovery. It is very important that all the concerns of people be heard. They do not want to have to go to the hospital in Galway to be diagnosed. That is where the mammographic service is but there is difficulty getting into University Hospital Galway because it is over-pressurised and its budgets are being curtailed. There is only one surgical bed for the north west region at that hospital although the Minister, Deputy Harney, stated there would be two.

I hope my two Oireachtas colleagues are listening to this debate which is very important. I appreciate the tolerance of the Acting Chairman. This has been one of the most important issues in the region for some time and is a cause of concern for everybody. While I recognise the importance of ensuring value for money and increasing efficiency in the delivery of services, a curtailment of €12 million, followed by a second budgetary cutback of an additional €12 million, is difficult to bear. Although the overall budget for Sligo General Hospital is €100 million, without taking account of the additional reduction of €12 million, that includes staffing costs for 1,400 personnel as well as the cost of maintaining critical services.

The threatened curtailment of services at Sligo General Hospital has not been adequately debated in the public domain, particularly in the case of cardiological and angiographic services. Up to now the hospital has managed a three-week patient turnaround. Under the cutback proposals, however, cardiological and angiographic patients will have to be referred to St. James's Hospital in Dublin, with associated waiting times of up to six months instead of three weeks. I appeal to the Minister to give this matter serious consideration as what is proposed is a frightening prospect. The wonderful team being led by Dr. Donal Murray has been doing excellent work and the coronary care facilities are the best in the country.

It is bad enough to see the removal of cancer services; it is time now to say that enough is enough. People in the region will not tolerate any more curtailment of critical services. Everybody understands the importance of careful management of financial resources. The hospital is adamant about giving value for money but there is only so much curtailment it can endure. I appeal to my Oireachtas colleagues who are outside the Fianna Fáil Parliamentary Party and have power to influence this issue. All they have to do is to inform the Taoiseach that their support is conditional on this situation being rectified.

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