Barry Andrews (Dún Laoghaire, Fianna Fail)

I thank Deputies for their participation in the debate. The main purpose of the Bill is to give further effect to the Government's cancer control strategy and, in particular, the development of radiation oncology services under the national plan for radiation oncology. It also provides for the discontinuance of the infectious diseases maintenance allowance, which was originally introduced in 1947. The Bill makes technical amendments to the Nursing Homes Support Scheme Act 2009 and the Health (Nursing Homes) Act 1990 to assist in the interpretation of these Acts. It also makes a technical amendment to the Health Act 2007, which relates to decisions taken under section 55 of the Act. It also makes textual amendments to the Medical Practitioners Act 2007 to correct typographical errors.

It is clear that if appropriate radiation oncology facilities are not available to meet the need for these services, then outcomes for cancer patients, including survival rates and quality of life, may be seriously compromised. By the beginning of 2011 with the establishment of St. Luke's network with radiation oncology services at St. James's Hospital and Beaumont Hospital, the number of linear accelerators will increase from the current number, which is eight in St. Luke's, to 12 in the network. High quality radiotherapy services will be delivered in an integrated fashion across the three sites in Dublin by the network, which will report to the director of the national cancer control programme.

The Hollywood report on the development of radiation oncology services in Ireland noted that optimal treatment outcomes are achieved through the close co-ordination of radiation oncology, surgical oncology, medical oncology and palliative care services. Effective treatment for patients will often require the different treatment modalities to be combined at the same time or at different stages during the management of illness. Single modality radiation therapy is curative in certain situations, however, combined modality treatment uses radiation therapy in combination with chemotherapy surgery and other treatments. In advanced cancers and in conjunction with palliative care, palliative radiation therapy often offers quick and effective relief from pain and other difficult symptoms. It is therefore essential that radiation oncology services and expertise operate side by side with surgical and medical oncology and palliative services. The integration of these services provided at designated centres under the programme should result in best outcomes for patients.

As the Minister has stated, St. Luke's will continue to provide radiotherapy services until at least 2014. She looks forward to receiving proposals from the friends of St. Luke's and board on possible future uses for the hospital. She has previously stated that she believes St. Luke's has a future within the public health service and has indicated that she will consult the friends, the HSE and other interested parties on how the site could best be used for the benefit of patients in the future.

During the debate on this Bill Deputy Reilly requested a briefing on the national plan for radiotherapy. The current Bill relates to a significant element of phase one of the plan whereby adequate radiotherapy capacity will be available up to 2015 with the development of the radiation oncology centres at St. James Hospital and Beaumont Hospital. Phase two involves further expansion at these hospitals and also at Cork University Hospital and Galway University Hospital and the development of satellite facilities at Limerick and Waterford hospitals. The Minister will shortly brief Government on the public sector benchmark for this phase, which will be delivered by public-private partnership.

In regard to comments made by Deputy Ó Caoláin regarding patients in the north west, the Minister is awaiting approval of the business case for new radiation oncology facilities at Altnagelvin Hospital by Minister McGimpsey in Northern Ireland. She has agreed to make a capital contribution to the project, which will address the needs of patients in the north west and significantly improve access and travel time for patients. Approximately 30% of patients will be from the Donegal area.

St. Luke's network model will provide a single clinical governance and management structure across the eastern region and will allow for the most efficient use of resources to deliver a service to patients in line with best international standards. Because staff at St. Luke's will become HSE staff on the enactment of this Bill, they will be able to work across the other hospitals in the network under this single governance structure. This enables the new facilities at St. James's Hospital and Beaumont Hospital to tap into and emulate the successful patient centred model that St. Luke's represents. At many Deputies have stressed throughout this debate, a key aim is to ensure that the ethos and spirit of St. Luke's pervade into the broader St. Luke's network.

While St. Luke's site will be transferred to the HSE, under the legislation the HSE will not be able to sell or dispose of the land without the permission of the Minister for Health and Children. That was a concern raised by one of the Deputies.

I thank Deputies again for their contribution. The Minister looks forward to the further Stages of this Bill at which time the views put forward will be considered in detail. I therefore commend this Bill to the House.

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