Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 82: To ask the Tánaiste and Minister for Health and Children the agreement she has reached with British Health Minister in the Six Counties, Mr. Shaun Woodward, regarding the treatment of cancer patients from this jurisdiction in Belfast; if this access is confined to patients from County Donegal or if it will apply on a wider basis; and if she will make a statement on the matter. [35537/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I am glad of this opportunity to advise the House on the very positive outcome of my meeting last Tuesday with the Minister for Health for Northern Ireland, Mr. Shaun Woodward, MP. We agreed that the new Belfast Cancer Centre, which is to open next March, will treat patients from County Donegal. Details of the arrangements will be finalised in discussions involving the Health Service Executive, Belfast City Hospital and our respective Departments. This will involve assessment of the specific radiotherapy needs of the different cancer patients in County Donegal and the development of clinical treatment protocols, including appropriate transport arrangements, to ensure best patient care. Discussions will also be necessary on the funding arrangements involving the hospital and the HSE.

This initiative is a further and practical example of North-South co-operation on health and will be of significant benefit to patients who will be treated at what I consider to be one of the best facilities in Europe. This agreement also progresses the Government's plan on radiotherapy which I announced last July. Both the Minister, Mr. Woodward, and I are committed to developing additional co-operative initiatives for the benefit of our respective health services.

On access for cancer patients in other Border counties, we need to ensure that access by County Donegal patients to the Belfast service is working effectively and is properly grounded in effective clinical referral protocols involving the relevant clinicians both North and South. This is essential before I could realistically consider the question of additional access.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I take this opportunity to welcome the agreement the Tánaiste reached with the health authorities in Belfast. We need to see much more co-operation and integration of health services where that is feasible. I give the Tánaiste every support in that pursuit in the interests of all the people of Ireland.

However, there are serious questions about the Government's proposed roll-out of radiation oncology services, specifically the focus on Dublin, Cork and Galway with possible public access to a private facility in Waterford. In the context of the agreement, what is the position of the Border counties? I listened carefully to her reply. Is the agreement reached with the Minister, Mr. Shaun Woodward, to apply only to County Donegal? When the Government's plan for radiation oncology centres was rolled out last July, it was indicated at that time that the north west was to be the focus of discussions leading to access to facilities in Belfast, and even possible access to facilities in Derry was mooted. The north west, as I understand it, includes counties Donegal, Sligo and Leitrim. Am I to understand from the Tánaiste's reply that counties Sligo and Leitrim are not covered in the agreement she reached last week?

Patients from counties Cavan and Monaghan are supposed to access radiation oncology services in Beaumont Hospital in Dublin, yet those two counties which I represent are more distant from Dublin than they are from Belfast. That is true of all of County Monaghan and the greater part of County Cavan. Why was the Belfast option not considered for those for whom the shorter distance would be welcome? Equally important, why is there no intention on the part of the Tánaiste and her Department to provide in situ radiation oncology services for the rest of this jurisdiction north of a line drawn from Dublin to Galway? Provision of services north of this line has been completely excluded from her plans, with the exception of this recently reached agreement in respect of services in Belfast.

Is the Tánaiste not aware that people throughout the rest of this island who are not being catered for again feel very much that they are viewed as being of less worth than citizens in other parts of the State? That is the case especially in the north-east region. The Tánaiste spoke of accessing services for people in County Donegal and the possibility of extending access to such services to the whole of the north west. What about access to such services for people in the north east? In terms of ballpark figures for the roll-out of radiation oncology, is the Tánaiste aware that the population in the north east is growing at an enormous rate, as has been shown time and again, more recently with the break-up of the Meath constituency to provide an additional representative seat in this House? What will the Tánaiste do to help address access to health services for people in those counties who, despite being desperately ill and in need of urgent attention, face long distances to access such services?

Mary Harney (Dublin Mid West, Progressive Democrats)
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I thank the Deputy for his comments. A number of issues are involved. I understand that Belfast will have spare capacity for approximately 100 or so patients a year. Some 500 new cancer cases occur in County Donegal annually and approximately half of those, some 250 people, require radiotherapy. They are the furthest from either Dublin or Galway. Therefore, they were the priority in terms of seeking access for up to 100 of them to appropriate radiotherapy in what will be the best facility on this island next March with eight linear accelerators and a huge complement of staff. In Northern Ireland it was decided to have one single centre. Deputy Ó Caoláin's colleague, the Minister, Bairbre de Brún, was responsible for centralisation to get critical mass and provide a really good facility. The people in the North will have the best facility on this island when the centre there is opened in March.

In time, the centre in St. James's Hospital and our other centres, as they develop, will also be of that standard. I hope the centres in St. James's and Beaumont hospitals will be the larger centres. This provision is about being realistic and pragmatic. When the centre in Beaumont Hospital is completed, it will be much more convenient with the new road network to patients from counties Cavan, Monaghan and Louth.

Access to services for patients in County Donegal was and is the priority. However, I hope this experiment works well and I heard what the Deputy said about introducing more such initiatives. If it were not for partition, political instability and violence, health services on the island would be very different for the northern part of this island. There is no doubt about that. There are many initiatives we want to explore together. This one is a start and I hope that is the case. I hope we can do more. It may well be that further capacity could be installed in Belfast to facilitate the treatment of other patients, but for the moment access to these services is being provided for patients in County Donegal. We hope shortly to be able to pin down the political agreement that was made with the appropriate protocol in order that the treatment can begin as soon as possible.

Séamus Pattison (Carlow-Kilkenny, Labour)
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That concludes priority questions.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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If I may ask a brief supplementary——

Séamus Pattison (Carlow-Kilkenny, Labour)
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We have extended the time allowed for this question.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I will ask a brief supplementary, if the Chair will accommodate me.

Séamus Pattison (Carlow-Kilkenny, Labour)
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That is unfair to other Deputies who have questions tabled.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I only want to ask——

Séamus Pattison (Carlow-Kilkenny, Labour)
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The Deputy must be brief.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Will the Tánaiste accept that we are not comparing like with like in regard to the Six Counties and any other comparable region within the jurisdiction of the Twenty-six Counties, given the reality of the infrastructure? Will the Tánaiste also——

Séamus Pattison (Carlow-Kilkenny, Labour)
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That completes priority questions. We must proceed to Question No. 83.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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As I cannot pursue any other line of questioning, I wish to say to the Tánaiste that I agree with her that partition has been more than a damned nuisance.