Jan O'Sullivan (Limerick East, Labour)

Our objective is to save the best aspects of our health services. St. Luke's Hospital has indisputably played an enormous part in many people's recovery from cancer - people from throughout the country - over many years. I say this in the context of being fully supportive of the cancer strategy. Whenever we raise issues at the edge of the cancer strategy, the Minister disingenuously claims we are not supportive of the strategy itself. That strategy is about centres of excellence; it is not about doing away with the elements of excellence that already exist in the system. We are not arguing that St. Luke's Hospital should be a stand-alone centre of excellence. Rather, we are arguing that it should be linked into one of the designated centres for the Dublin area while retaining its unique character and continuing the work it has been doing for generations.

It is difficult to measure the positive benefits for people recovering from or undergoing treatment for an illness like cancer of the type of atmosphere offered by St. Luke's Hospital. A substantial body of research suggests that one's state of mind, one's environment and the way is which one is treated all contribute significantly in terms of recovery and response to treatment. Those elements are uniquely available at St. Luke's Hospital in a way they are not in the large acute hospitals that have been designated as cancer centres.

We are not suggesting that diagnosis or surgery should be available in St. Luke's Hospital, we are suggesting that there is a role for it to be attached to one of the other centres.

As health spokesperson for the Labour Party, I would hate to have been involved in throwing out all of the good elements of our health service to fit it into a straitjacket-style strategy; that is why I am arguing this point even though I support the core of the Minister's strategy with regard to providing excellence in cancer treatment, where we do not do everything all over the place, which was the reality in the past and which needed to be addressed. This is different, it is about preserving something unique and special that could not be reconstructed.

There is protection until 2014 in the legislation and on Committee Stage when I tabled this amendment, the Minister appeared sympathetic to our arguments and said she would come back with a positive amendment. Initially, when I read the amendment she tabled, I thought she was responding to what we had raised. When we look at the detail of the amendment, however, it is subject to subsection (5) - that the executive must use it for the purposes of the delivery of health and personal social services. That subsection states that the executive may not without the consent of the Minister sell, exchange, let or otherwise dispose of any land vested in it by this section. If that is turned around the other way, with the Minister's consent, the executive can sell St. Luke's Hospital. That is why the amendment is meaningless, it simply restates the contents of that subsection, it does not deliver what it promises at first reading. It does not give any reassurance beyond 2014 that St. Luke's will be retained for health services.

Also, the Minister's amendment relates to general health services while ours relates specifically to cancer. I am not satisfied with the Minister's amendment despite the fact that on Committee Stage she seemed to take on board what we were saying.

The Minister of State, Deputy Moloney, might be able to offer a more holistic response on this issue. My experience of debating with the Minister for Health and Children on these issues is that for her it is about winning the debate, not about the health issue. I am trying to get agreement on the unique contribution of St. Luke's Hospital and how to preserve that into the future without in any way interfering with the cancer control strategy.

There is no reason there could not be a centre in the hospital that does not offer surgery or diagnosis but that offers the sort of unique atmosphere in which follow-up treatment can be continued, such as specialist supervision under the auspices of the cancer control programme. That is what I envisage for all patients who will need these services, as well as for those families who are currently involved in treatment and want to ensure we maintain what we have.

We can develop strategies that look great on paper, and which deserve our support, but there are elements that are unique and different that can contribute something extra, which is what St. Luke's Hospital does through its ethos. I do not see any reason why that cannot be incorporated within the strategy.

I ask the Minister to keep an open mind on this and to listen to the arguments of the Opposition and the voices of the public we are responding to on this issue.

See this speech in context