Brian O'Shea (Waterford, Labour)
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On Monday last week an article appeared in the Irish Independent quoting from an internal Health Service Executive document, dated April 2006, entitled Framework for Progressing Co-Location of Private Hospitals on Public Hospital Sites. The article was headed "Plans for Private Clinics on Hospital Sites Shelved", with the subheading, "HSE to pilot two centres before scheme go-ahead". The article stated:

The paper reveals that the HSE plans to pilot up to two private hospitals on public hospital lands before deciding whether to continue with the project . . . . . The four hospitals seen by sources as most likely to be the first in line for private hospitals are St. James's Hospital and Beaumont Hospital in Dublin, Cork University Hospital and Limerick Regional Hospital.

Having campaigned for years for a radiotherapy unit at Waterford Regional Hospital, I found the report extremely alarming. On 25 July 2005, the Tánaiste and Minister for Health and Children, Deputy Harney, announced that the Government had approved a national network for radiation oncology services to be put in place by 2011. This network would include two integrated satellite centres for Waterford. Most of the funding for the approximately €400 million plus for the national capital investment involved was to be through a public private partnership.

On reading the article, I immediately tabled a parliamentary question asking about the development of the satellite unit at Waterford Regional Hospital. The same day, a press release came from the HSE stating that the Irish Independent article was without foundation and was based on an outdated internal document, despite a HSE clarification of the matter when speaking with the publication involved.

The press release also stated:

Expressions of interest are to be submitted to the National Hospitals Office by June 30th, at which time short-listing will take place. After the competitive dialogue stage, successful consortiums will be invited to tender for the provision of a private hospital on the above sites [those were the 11 sites that were named]. Depending on the number of successful applicants, the HSE will move forward with the co-location of private hospitals on all or some of the above sites.

When one examines the HSE statement, one is struck by the highly qualified nature of the final paragraph. There is no certainty as to how many co-located private hospitals will go ahead. Elsewhere in the press release there is mention of a competitive dialogue stage after which successful consortia will be invited to tender for the provision of a private hospital on the 11 sites.

Having queried this by means of a parliamentary question, I was insulted by the threadbare nature of the response that did not advance my knowledge of the matter in any way. On behalf of the people I represent, I demand to know what type of radiation oncology service is going to be provided and when it will be put in place. Various dates have been given for the provision of radiotherapy at Waterford Regional Hospital, from 2008 to 2011. I want to know if we are all being misled by the HSE and the Minister. Is the provision of radiotherapy through public private partnership at Ardkeen simply a gimmick by the Government parties to get them over the next general election?

Access for public cancer patients to radiotherapy can be provided this year at the University of Pittsburgh medical centre at the new Whitfield Clinic in Waterford, if public funding is provided. I am demanding an undertaking from the Tánaiste that cancer patients from the south-east region will not be denied this access, pending what may or may not be initiated by this Government at Waterford Regional Hospital. Such patients should not be forced to suffer gruelling journeys to Cork and Dublin when they are at their most vulnerable. Failure to cater for public cancer patients in this way is absolutely inequitable and unacceptable.

Síle de Valera (Clare, Fianna Fail)
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I am taking this matter on behalf of the Tánaiste and Minister for Health and Children. She has asked me to assure the House that the Government is committed to making the full range of cancer services, including radiation oncology services, available and accessible to cancer patients throughout Ireland in accordance with best international practice.

As the Tánaiste advised the Deputy in response to his question on 22 June, the Government's plan is for a national network of radiation oncology services consisting of four large centres in Dublin, Cork and Galway, and two satellite centres at Waterford Regional Hospital and Limerick Regional Hospital. In order to ensure that the same standard and quality of care is delivered in the satellite locations, it is important that they be fully integrated with the main centres. The same clinical staff will work in both the main and the satellite centres. This will enable patients to receive the best possible diagnosis and treatment from multi-disciplinary teams covering surgery, chemotherapy and radiotherapy. It is intended that the service at Waterford will be linked to the existing radiotherapy facility at Cork University Hospital and that the service at Limerick will be linked to that at University College Hospital, Galway.

The capital investment involved in providing the national network is estimated at over €400 million, most of which is to be funded through a public private partnership. The PPP will be a single design, build, finance, manage and partially operate project. It is anticipated that the bundling of radiation oncology developments on a number of hospital sites into one contract with a large capital value will offer greater synergies and innovation, will transfer risk to the private sector and will ensure that all centres are compatible so that they can deliver integrated cancer care across the State.

There is a significant amount of work to be done in preparation for a public private partnership. Towards this end, the Department of Health and Children is working closely with the HSE and the National Development Finance Agency. The NDFA has assembled a team to progress the financial and procurement aspects, and the HSE has appointed a project manager to lead out on its input.

A clinical output specification group, which includes leading experts in the field, is well advanced in specifying the clinical aspects of the development. Technical advisers will be appointed shortly to advise on the construction and other technical aspects of the project.

The precise phasing of the development at Waterford and at the other locations will be addressed when the output specifications have been drawn up as part of the PPP process. The aim is to have the national network in place in 2011. This is an ambitious target but the Tánaiste is determined that access to radiotherapy services for people in the Waterford area will be enhanced at the earliest possible date.