Éamon Ó Cuív (Galway West, Fianna Fail)

I thank the Minister for taking this matter, which I accept is at this stage only speculation. However, I believe it is speculation with a basis.

There is speculation that a recommendation will shortly be submitted to the Minister in regard to the withdrawal of oesophageal and stomach cancer services from Galway University Hospital, leaving only two centres in the country providing these services. I understand this arises out of a plan under consideration by the national cancer control programme. If this were to happen, patients from the west of Ireland would be required to travel to Dublin for treatment. I often think people believe everybody in the west of Ireland lives in Galway city. There are people for whom travelling to Galway takes half the time it would take to travel to Dublin. We are speaking, therefore, of many people for whom Dublin is more than four hours away.

Currently, there are four regional units providing this service. I accept that it is not possible to provide every service everywhere. I agree that we need to decide the appropriate level of service for each particular speciality. I have always accepted that. I believe that, as pointed out by the Minister in response to the previous matter, services currently provided centrally will be provided closer to people's homes while other services will be provided in one particular centre. However, I am concerned that despite the intention to provide regional centres of excellence, taking geography into account, the system - I accept this proposal has not yet come before the Minister - will try to recentralise everything. In terms of the medical issues that arise, there is a need to look beyond medical speciality and to ensure that if all services are to be provided centrally all other back up services will be available, including beds, car parking spaces and so on.

I am asking the Minister to consider this proposal, which no doubt will come before him, in the context of whether it is the right decision taking into account quality of life issues and the fact that it is possible to ensure there is peer review when the service is being provided by only four centres in the country. I hope the Minister can confirm to me today that regardless of what recommendation is made to him he will not be inclined in that way. I hope also that he will take into account that the services in Galway also provide investigative services for non-cancerous conditions such as stomach ulcers and so on.

I hope the Minister's vision of the health service will dictate that where there are good quality regional services available, as in this case, he will resist any proposal to centralise those services at huge inconvenience on a human level for people. I am not a doctor. I do not believe there is any overriding medical reason this should be done. Any case put forward on that basis would have to be considered alongside the case that people have a right to the provision of a top class service within reasonable distance in their region.

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