Andrew Doyle (Wicklow, Fine Gael)

I am glad to speak on this Bill and wish to preface my remarks by saying that 15 years ago, I had first-hand experience of St. Luke's Hospital as an outpatient. While I was not being treated for cancer, I got a good insight into the role of, and the atmosphere in, the hospital. The first time I was scheduled to go to the hospital I went with a certain amount of trepidation about what St. Luke's Hospital was but as I became more familiar with it, I realised what a wonderful facility it was and how lucky the people were to have a hospital run by a board of directors and with such an ethos and governance structure.

The hospital was established by the Cancer Association of Ireland with a view to taking care of people with cancer and engaging in cancer research and awareness. It has developed from that to being recognised as the prime centre for cancer care for the country. As recently as 2008, there has been significant investment in new and replacement linear radiotherapy units. The suspicion was that when St. Anne's and St. Luke's hospitals were merged, there was an exit plan which would result in St. Luke's Hospital being amalgamated into St. Vincent's University Hospital in Elm Park. That has probably changed now with the plan that it will be amalgamated into St. James's Hospital and Beaumont Hospital.

It is difficult to understand why we are trying to transfer the assets, staff and governance of an area of the health service which is working excellently - I have never heard anyone criticise St. Luke's Hospital - to the HSE, an organisation which has all sorts of problems. That is ironic on the day when a headline reads that the HSE would be better without an arm of responsibility. Child care and child welfare may not be directly associated with health care in the same way as cancer care but it is ironic that we are looking to transfer a significant piece of cancer care into the arms of the HSE. It reminds me of the plans for the Central Mental Hospital in Dundrum. Given that Dundrum and Rathgar are two leafy suburbs and that the real estate of the Central Mental Hospital and St. Luke's Hospital is very valuable, one would have to be suspicious that there is an attempt to relocate both institutions and capitalise on the assets.

That in 2008 St. Luke's Hospital was upgraded and given the most modern facilities in the country when money was probably not as plentiful as it had been is a recognition of its role. It is nice to know that St. Luke's Hospital will remain there until 2014 but one must ask what its future is after that. What is the plan? Will it continue until then with its current ethos? Will it be governed centrally by the HSE cancer care service? I wish the new director of cancer care and the incoming chief executive officer of the HSE the very best.

I was chairman of the former East Coast Area Health Board at the time of the dissolution of the old health boards and I always opposed the manner in which it was done. I agreed that the health boards needed to be reformed but believed that the model whereby the former Eastern Health Board became the Eastern Regional Health Authority with three area boards probably should have been replicated throughout the country. At least primary care could be governed locally while many aspects of the roll out of health care and the management of the health service could have been governed centrally, although not all of them. The chickens are coming home to roost in that regard. Inevitably when the review of the HSE comes to a conclusion, it will revert to four or six regional boards of administration with a central authority for payroll, quality, etc.

Like other speakers, I will mention my constituency of Wicklow which does not have a hospital. St. Columcille's Hospital in Loughlinstown, which is very close to the Wicklow border, serves Wicklow but it has not been upgraded in the manner in which Naas and Blanchardstown hospitals have been. Mental health services are delivered from Newcastle hospital but it has been starved of funding and resources. There was a comprehensive plan for both hospitals but it was not never progressed. That would possibly have meant the provision of a new facility on the grounds of Newcastle hospital which would have incorporated mental health services, some general hospital facilities and perhaps a dedicated Alzheimer's unit which was identified for it. None of that has happened. The affordability of all this now comes into question but for many years the plan was in abeyance and nobody considered it.

I will not speak for much longer other than to say that I understand the miscellaneous provisions of the Bill and I have no problem with them. Deputy Ulick Burke mentioned Crumlin hospital. When a service is working, why should it be changed? The approach being taken is to ensure all the boxes are ticked in regard to service provision, which should be consolidated into a centralised service provided by the HSE. Can the Minister of State honestly say that the service being delivered in St. Luke's will be improved when it is moved? I do not believe the service being delivered in St. Luke's can be delivered better anywhere else under any authority or structure. The model of service delivery in St. Luke's is as good a model as one could find. Rather than taking St. Luke's out of the system, we should consider replicating that model throughout the country. The service delivered in St. Luke's has stood the test of time. That hospital was established 56 years ago and it has developed as needs required over that time. Money has been invested in it. It has an excellent team of surgeons, consultants and medical care staff and other staff.

I ask that this Bill be reviewed and rejected, and that people examine and concentrate on the services within the HSE that need to be improved. Under the cancer review that took place and the rollout of cancer services in the eight centres of excellence throughout the country, four of which are in Dublin and four are outside it, the working group recommended that there should be no fewer than eight and possibly ten such centres. A centre of excellence should have been provided in the north west to allow people from that region to have logistical access to cancer treatment services relatively nearby and even at that many people would have to travel quite a distance. It makes no sense to have no centre of excellence north of the line from Dublin to Galway. The cost of establishing one further centre would not have been exorbitant and would probably have involved very little additional cost.

I urge the Government to consider this Bill. I am aware the Minister of State, at a personal level, knows the workings of St. Luke's quite well. I ask that he consider the matters that have been raised by the Opposition.

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