Séamus Pattison (Carlow-Kilkenny, Labour)
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As the first two items are being taken together, the Deputies will have five minutes each to speak and the Minister of State will have ten minutes to reply.

Bernard Allen (Cork North Central, Fine Gael)
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I thank the Leas-Cheann Comhairle for allowing me to raise the resignation of the consultant doctor, Dr. Oscar Breathnach from his position at Cork University Hospital. His resignation was greeted with disbelief by the people of Cork and Kerry, especially those dependent on the vital oncology services in the region. Dr. Breathnach resigned because of the failure of the Tánaiste and Minister for Health and Children, Deputy Harney, and her Department to provide the resources for a dedicated oncology ward in the area and the lack of a back-up service due to the shortage of consultant colleagues. For four years, Dr. Breathnach informed the health board and the management of Cork University Hospital that such a dedicated ward was vital for an efficient and effective oncology service to be available to the people of the region. He resigned out of disillusionment and frustration at the indecisiveness of the former Minister for Health and Children, Deputy Martin, and his successor, Deputy Harney.

It is ironic that Dr. Breathnach has been offered a job in the Dublin area where he will be one of 12 medical oncologists providing treatment. At the same time, the Cork-Kerry region will have just one. Cork University Hospital is hoping to get a locum consultant for the post in the coming weeks. Realistically, it will be at least 2006 before this post will be filled, if the hospital can manage to recruit anybody given the shortfalls of the service. In the meantime, in Dublin, two additional positions have been advertised and interviews will take place shortly. A further two positions are at the planning stage. These posts are attractive as they offer, at most, two hospital site locations. This is in contrast to Cork, where any position is based on three hospital sites. In Dublin, all units have dedicated oncology wards, while Cork has none.

Dr. Oscar Breathnach's resignation raises two issues. First, there is a need for a dedicated cancer ward for the region. Second, additional consultant posts must be provided. Several efforts to develop an oncology ward at Cork University Hospital have not been fruitful. When the new radiotherapy unit was being built, it was suggested that an oncology ward be built over it. However, this was rejected by the then Minister for Health and Children. That the day procedures unit lies idle is another scandal. If this were opened, it would free up space that could be quickly converted into an oncology ward. The situation at Cork University Hospital is disorganised as cancer patients are situated in nearly every ward, doubling the time required to see them, fragmenting their care and making it sub-optimal.

The chronic climate of under-resourcing in the region is impacting on other consultant posts. A recent consultant radiotherapy post, the first in Cork in ten years, attracted only one candidate for interview. A recent post in one of the other Cork hospitals attracted two candidates. However, a similar post at St. James's in Dublin attracted 22 applicants. Dr. Breathnach's resignation is symptomatic of several key issues in the Cork area that are not just cancer related. I hope the Minister of State at the Department of Health and Children, Deputy Tim O'Malley, will give us positive information and this crisis in Cork can be reversed before Dr. Breathnach finally leaves his position. I blame the Minister for Health and Children, and her predecessor, for an appalling lack of proper planning in the delivery of hospital services in the Cork-Kerry area. I hope it is not too late to rectify the problem.

David Stanton (Cork East, Fine Gael)
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I thank the Ceann Comhairle for allowing me to raise this matter. I hope the Minister of State at the Department of Health and Children, Deputy Tim O'Malley, will show ministerial qualities in making a decision on this important matter instead of reading what has been handed to him by the civil servants in the Department. We are elected to represent the people in our areas. Deputy Allen has outlined the situation at Cork University Hospital. It is now a matter of life and death for our constituents. Cancer is a serious illness that is frightening and potentially fatal. Thankfully, over several decades procedures and services have been developed meaning that most early detected cancers can be treated effectively. As this is a matter of life and death, it is important the best service possible is provided to ensure the medical professionals involved have the best chance to save lives.

A dedicated cancer ward is badly needed in Cork University hospital. However, the people in the Cork area are not getting the best possible care because several Ministers have not made decisions to open such a ward. To make a large difference, it would only cost approximately €1.6 million per quarter to run such a ward.

The medical consultants and professionals involved are frustrated by the Government's indecision and lack of commitment on this matter. I challenge the Minister of State, Deputy Tim O'Malley, to make a decision giving a commitment for the provision of a dedicated seven day cancer ward. This is the only cancer centre in the State with no dedicated ward. Cancer patients are scattered across seven different wards in the hospital, resulting in the specialist doctors involved not operating at the best level. Instead, they spend most of their time going from one ward to another, meaning other specialist services are fragmented. It is difficult for families, teaching purposes and, most of all, the patients. We appeal to the Minister of State to put his foot down, to say "enough is enough". If he does not, there is no point in him continuing as a Minister and he should resign.

People with cancer related illnesses are now being admitted through the accident and emergency department. Cork, the second largest city in the State, must have a dedicated cancer unit as a priority. I admit much good work has been done at Cork University Hospital. However, one of the top medical doctors in the hospital still resigned out of frustration. From talking to patients I have heard praise for the unit at St. James's Hospital. A similar unit should be opened in Cork. The staff of the hospital does its best but it is now time for the Government to make a decision. Instead of bland remarks on what has been done, we want to know the Government's intentions for the ward.

Tim O'Malley (Limerick East, Progressive Democrats)
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I am pleased to have the opportunity to set out the position in regard to the delivery of oncology services for the southern area. The Health Service Executive, southern area, has confirmed that the consultant medical oncologist referred to by the Deputies has resigned to take up a position in Beaumont Hospital after the summer of 2005. He is based at Cork University Hospital and holds a clinic once a fortnight at Kerry General Hospital, KGH, where a registrar in oncology, based at Kerry General Hospital, oversees patient chemotherapy treatment. There is currently one consultant medical oncologist employed by Beaumont Hospital. The consultant referred to by the Deputy will be the second consultant medical oncologist at that hospital.

Cork University Hospital, CUH, is committed to patient care and all steps are being taken to ensure continuity of patient care. The HSE, southern area, has advertised for a locum appointee and the recruitment process for the replacement permanent consultant medical oncologist post has commenced. The HSE, southern area, is working on a proposal for a dedicated oncology ward, which it will submit to the HSE within the next fortnight.

The hospital strategy is to achieve a dedicated oncology ward of 20 beds, that is, the current oncology bed complement, and to open the day procedures unit. The transfer of existing day services to the day procedures unit will allow the vacated space to be utilised for other priority purposes, including a dedicated oncology ward. The hospital is at the relatively early planning stages of a major cardiac-renal facility to include a 30-bed dedicated oncology ward.

The acute hospital planning forum in Cork previously identified the need to additional manpower in this area and, as a consequence, the hospitals have been working on a submission to progress the appointment of two additional consultants.

Since 1997 there has been a cumulative additional investment of approximately €720 million nationally for the development of appropriate treatment and care services for people with cancer. The HSE, southern area, has received an investment of approximately €80 million for oncology services, including this year's allocation of an additional €3.5 million from national cancer strategy funding to address increased regional pressures in oncology services. This funding has provided for the approval of an additional 11 consultants in key areas of cancer care as follows: two consultant medical oncologists, three consultant histopathologists, one consultant radiologist, one consultant haematologist, two consultant radiation oncologists and two consultant surgeons with a special interest in breast care. The funding has also provided for the appointment of 27 cancer care nurse specialists across the southern area.

In regard to radiation oncology services, the supra-regional centre at CUH will provide services for patients in the southern, south-eastern and mid-western areas. Approval has issued for the purchase of two additional linear accelerators for this centre and the necessary capital investment amounting to over €4 million to commission this service as rapidly as possible. These linear accelerators have been ordered and the first one has been installed. The second linear accelerator is scheduled for delivery in April 2005. It is expected that this linear accelerator will be installed and commissioned by the autumn. The expanded unit is expected to provide an extra 5,000 OPD treatment visits a year.

Last year approval issued for the appointment of 29 staff for this unit and additional ongoing revenue funding of €3 million to cater for this expansion. Two additional consultant radiation oncologists will be appointed at Cork University Hospital, with sessional commitments to the south-eastern and the mid-western areas. CUH is also in the process of recruiting other key posts required for the commissioning of the new linear accelerators. In regard to phase two of the development, the design brief for the expansion to eight linear accelerators has been submitted by the HSE, southern area, to the Department and is being examined.

The developments I have outlined describe an overall framework through which cancer services are being developed and provided in the southern area. We are extremely fortunate in this country that those involved in cancer care provide a professional and high standard of care that is broadly appreciated by patients with cancer and their families. I recognise this dedication and commitment. I am glad of the opportunity to place on record the substantial developments that continue to take place in cancer services nationally and in the southern area in particular.