Jan O'Sullivan (Limerick East, Labour)
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Question 77: To ask the Minister for Health and Children the resources that have been and will be allocated for the implementation of the national cancer control programme; the immediate resources available to ensure continuity of care for patients affected by the ending of symptomatic breast services and surgical treatment in 13 hospitals in different parts of the country; and if she will make a statement on the matter. [24089/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Implementation of the national cancer control programme is a major priority for me and the Government. I fully support the appointment by the Health Service Executive, HSE, of Professor Tom Keane as interim national cancer control director. The delivery of cancer services on a programmatic basis will serve to ensure equity of access to services and equality of patient outcome, irrespective of geography.

The recent decisions of the HSE to designate four managed cancer control networks and eight cancer centres will be implemented on a managed and phased basis. A detailed transitional plan will be put in place to facilitate the progressive, gradual and carefully managed transfer of services during the next two years or so. The HSE plans to have completed 50% of the transition of services to cancer centres by end 2008 and 80% to 90% by end 2009.

To comply with the national quality assurance standards for symptomatic breast disease, the HSE has directed 13 hospitals with low case volumes to cease breast cancer services immediately. The 13 hospitals concerned performed a combined total number of 55 breast cancer procedures in 2005. A number of the hospitals had in practice already discontinued symptomatic breast services. The National Hospitals Office has planned the redirection of this symptomatic caseload. Further staged reductions in the number of hospitals providing breast cancer services will occur in the next two years in line with the development of quality assured capacity in the eight designated centres.

Professor Keane and the HSE have emphasised the importance of mobilising existing resources and redirecting them to achieve the national cancer control programme objectives. An additional €20.5 million was allocated to the HSE this year for cancer control, an increase of 74% on the comparable 2006 investment and includes €3.5 million to support the initial implementation of the national cancer control programme. Further investment in cancer control will be based on the reform programme now being implemented by the HSE.

Jan O'Sullivan (Limerick East, Labour)
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I did not hear the Minister mention the resources that will be available in the future, although she did speak about those that will be available this year. The brave fight by Susie Long, who sadly passed away at the weekend, has shown how essential it is that there are adequate resources available in the public health service for cancer treatment services. I want a commitment from the Minister that there will be adequate public resources to address the development of this programme. What she said and what was contained in the press release following Professor Tom Keane's appointment appears to relate to a redirection of existing resources. We know that the incidence of cancer is growing at a rate of 4% to 5% per annum. Clearly, this will result in increased demand. I am concerned that the Minister is again setting up something that will be at a distance from herself as Minister for Health and Children and that as such, we will not be able to raise questions with her in respect of accountability to the public for the provision of adequate resources to address this most important issue which affects every family in the country.

Mary Harney (Dublin Mid West, Progressive Democrats)
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The issue of standards is one for the Minister. Even with the establishment of the Health Information and Quality Authority, HIQA, standards have to be signed off on by the Minister. I appointed Professor Higgins who, if not the leading Irish expert in this field, is certainly at the top of the class in this regard. His recommendations on standards were endorsed by the Government earlier this year and have now been implemented.

Two issues arise. A great deal more money will be invested in cancer treatment services because as the Deputy said, many more people will suffer from cancer. One in three of us will suffer from some form of invasive cancer during our lifetime. This will be a big challenge for the health service. In addition, we will need to redirect resources. The provision of additional resources is not always the answer. Professor Keane did a good job in Canada and is the ideal person — he was educated in Ireland — to oversee implementation of the programme, which I welcome.

In the context of next year's budget for the health service, the existing level will be announced by the Minister for Finance tomorrow. Other initiatives will be announced on budget day. In that context, cancer services have a high priority, both in terms of screening, as the Deputy acknowledged, and on the service delivery side.

The death of Susie Long was a dreadful tragedy. Her situation should never have happened. She went to a public hospital, totally funded by the taxpayer, and was told if she had health insurance, she could have had her procedure the following week. Because she did not have insurance the procedure was not carried out until six months later.

Mary Harney (Dublin Mid West, Progressive Democrats)
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Changing this has been central to my approach and that of the Government in the context of the consultants' contract.

Jan O'Sullivan (Limerick East, Labour)
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I do not understand how co-locating public and private hospitals on the same site with different doctors will change it. However, I do not have time to deal with that issue today.

On the list of hospitals which have been told they must cease immediately the provision of cancer treatment services, will extra resources be made available to the so-called centres of excellence in this respect? For example, a general surgeon who performs a small number of cancer related operations cannot be transferred to a centre of excellence. Will the Minister clarify that the required resources will be made available and that those patients currently being treated in the smaller hospitals will have access to services?

Mary Harney (Dublin Mid West, Progressive Democrats)
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The Deputy referred to general surgeons. In 2005 one procedure was carried out at the Midlands Regional Hospital, Tullamore; two were carried out at St. Columcille's Hospital, Loughlinstown; two were carried out at Mercy University Hospital, Cork; two were carried out at St. Michael's Hospital, Dún Laoghaire, and three were carried out at Mallow General Hospital. The number of procedures carried out at the Mid-Western Regional Hospital in Ennis was seven. Portiuncula Hospital had the highest number, having carried out 17 procedures. No procedures were carried out at the hospitals located in Naas, Roscommon, Cavan and Navan. Clearly, as the volume of activity increases, resources will follow as far as possible. University College Hospital Galway has a staff of 2,674. The number has increased rapidly in recent years as a result not only of the availability of cancer treatment services but also cardiovascular and other specialties.

John O'Mahony (Mayo, Fine Gael)
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What about the hospital in Castlebar where 70 procedures were carried out last year?

Mary Harney (Dublin Mid West, Progressive Democrats)
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That is not one of the 13 hospitals listed, as the Deputy well knows.

John O'Mahony (Mayo, Fine Gael)
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It is under threat.

Brendan Howlin (Wexford, Labour)
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The Minister should confine her remarks to the questions asked.

Mary Harney (Dublin Mid West, Progressive Democrats)
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I am always nice to new Deputies.

James Reilly (Dublin North, Fine Gael)
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When do we become old Deputies?

Mary Harney (Dublin Mid West, Progressive Democrats)
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Not until after at least one term.