Wednesday, 21 November 2007
National Cancer Strategy.
Question 44: To ask the Minister for Health and Children if Professor Tom Keane has arrived here; when he will commence his work of implementing the national cancer strategy; the audit that has been carried out of the capacity within the service; the budget agreed for the implementation of the strategy; the funding that will be made available for it in 2008; and if she will make a statement on the matter. [30018/07]
Professor Tom Keane took up his position as interim director of the national cancer control programme last Monday. Implementation of the programme is a major priority for me and the Government. 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 in respect of four managed cancer control networks and eight cancer centres will be implemented on a managed and phased basis. Professor Keane will be engaging in detailed planning to facilitate the orderly phased transfer of services between locations.
To ensure we improve our planning and evaluation of cancer needs, my Department has asked the HSE to prepare a robust needs assessment for cancer control for the period to 2012 to reflect priorities in this area. The needs assessment will address regional disparities in cancer treatment, identify gaps in the provision of existing services and develop a national approach to timely access to diagnostic services for cancers.
Professor Keane and the HSE have emphasised the importance of mobilising existing resources and redirecting them to achieve the national cancer control programme's objectives. I understand the HSE is putting arrangements in place to enable Professor Keane to take control of all new cancer developments from 1 January 2008 and, progressively, all existing cancer services and related funding and staffing. An additional €20.5 million was allocated to the HSE this year for cancer control. Further investment will be phased in during the reform programme.
When will the women in Portlaoise who are still awaiting results have those results and thus alleviate their worry?
The Minister did not answer my question on the budget. She has stated what is available for Professor Keane to implement his strategy for this year but not what is available for next year and the year thereafter. It is essential that we know where the money is coming from and that there will be sufficient funds to transport patients when their local centres are closed. We must be absolutely clear that when the Minister is at arm's length from the process, that is, when Professor Keane is reporting to Professor Drumm, Professor Keane will not be scrambling around looking for funds to address this most important issue. What audit has been done of funding and how much will be provided? We cannot buy into the process if we do not know how it will be funded. The Minister has stated existing services will remain in place until the new ones are available. This cannot happen, unless new funds are allocated. How much will they amount to and for what will they be provided?
There are serious geographical concerns over the distances patients must travel in the north west. It takes two hours to travel between Sligo and Galway and even longer for those further afield. I urge the Minister to reconsider her proposals.
On the question of women awaiting test results from the Midland Regional Hospital in Portlaoise, all 3,037 mammograms have been reviewed and nine women have been diagnosed with cancer, all of whom are now receiving treatment or counselling.
The original number was seven; the figure is now nine. The media were referring to eight women but, as far as Dr. O'Doherty is concerned, she diagnosed nine women as having cancer among the 3,037 tested. When we were debating this matter two weeks ago, we were relying on a figure of seven.
Two more were diagnosed, resulting in a total of nine, all of whom are receiving treatment and counselling. I reiterate my apology of some weeks ago to the women concerned for the delay in diagnosing their cancers. We are trying to minimise the possibility of this happening again.
An additional €1 billion has been invested in cancer care in the past ten years. This is a considerable investment. The task for Professor Keane will essentially, but not exclusively, involve the redirection of the available resources, just as he did in British Columbia. New resources will be made available also. I had a long meeting with Professor Keane last night and have asked him to identify the new resources he will require in the next year. He will begin to take responsibility for all cancer care developments from 1 January. He is to inform me of his requirements in the next few hours because the Minister for Finance will be making budgetary announcements in this area two weeks from today.
Our cancer service has excellent clinicians. It is, therefore, the manner in which the service is organised that is in question. Transport and accommodation issues must be addressed. When I was in British Columbia, I was impressed by the number of lodges built close to hospitals or treatment centres. Patients can stay in these lodges and do not have to be in the hospital environment. Most prefer not to be in such an environment, unless it is absolutely necessary.
On the Deputy's question on cancer care in the north west, the centres were not selected by me but by an expert group, mainly comprising clinicians but also officials from patient representative bodies such as the Irish Cancer Society and Europa Donna Ireland. They all remain strong fans of the locations selected. Professor Keane is strongly supportive of what we have done. All international evidence, comprising some 250 publications, suggests that volume amounts to quality. I hasten to say it is not a question of the quality of individual centres. To say "centres of excellence" implies the other centres are not excellent but this is not my implication since it is a matter of volume and environment.
In British Columbia all the tests are read at the centre. Those diagnosed at outreach locations experienced a level of diagnostic error in the order of 20%, as discovered when they came to the centre for follow-up treatment or further diagnosis. All the evidence has been compiled. Professor Keane is to put in place a clinical support team. I understand he intends to appoint a medical oncologist, radiation oncologist and cancer surgeon to assist him in the development of the control programme nationwide.