James Reilly (Dublin North, Fine Gael)

I thank the Deputy for raising this important issue.

The Strategy for Cancer Control in Ireland 2006 recommends that all major cancers, including oesophageal and stomach cancers, be treated in designated centres where patients are managed by multidisciplinary teams, in accordance with the best standards of cancer diagnosis, treatment and care.

The HSE's national cancer control programme, NCCP, recently undertook a quality review of oesophageal cancer surgery in the period 2008 to 2010. This involved an examination of services at four designated cancer centres - St. James's Hospital, Galway University Hospital, University Hospital Cork and Beaumont Hospital. The review examined quality of services against a range of standards of best practice. The outcome of the review was that the overall quality of oesophageal and upper gastrointestinal cancer surgery in Ireland in the four designated centres is within an internationally acceptable range for quality of the procedures, morbidity, mortality and post-operative complications, compatible with the volumes of patients treated in each centre.

In assessing the situation the national cancer control programme was mindful that evidence in international publications indicates that long-term outcomes have been demonstrated to be significantly better in high-volume centres. This necessitates that the programme for managing stomach and oesophageal cancer ensures that it harnesses the strengths of the entire national team of experts in co-ordinating services and monitoring quality in Ireland.

Following the review it has been decided that St. James's Hospital will be designated the national centre for oesophageal and gastric cancer. The national cancer control programme has appointed a clinical lead for upper gastrointestinal cancer. University Hospital Galway, together with Beaumont Hospital and Cork University Hospital will be designated as the three satellite centres for oesophageal and gastric cancer care including radical surgery, radiation therapy and chemotherapy.

The new programme will ensure there is integration within a multidisciplinary service based in each designated cancer centre with access to medical oncology, radiation oncology and specialised upper gastrointestinal surgical expertise; sustainable expert surgical services supported by specialised surgeons, inpatient beds, theatre access and an intensive care unit; sustainable volumes of procedures compatible with maintenance of surgical and nursing skills; implementation of video-conferenced national multidisciplinary team meetings to ensure optimal treatment decisions for selected complex patient management; collaboration with the national cancer control programme's national gastrointestinal tumour group in the development and implementation of national clinical practice guidelines; development and regular reporting of key performance indicators which build on the elements of this recent review; and planning of resources to ensure that money follows the patient.

I am confident the arrangements put in place by the NCCP will help to ensure best outcomes for patients.

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