Dáil debates

Thursday, 22 November 2007

Adjournment Debate

Cross-Border Health Services.

3:00 pm

Photo of John PerryJohn Perry (Sligo-North Leitrim, Fine Gael)
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I thank you, a Leas-Cheann Comhairle, for affording me the opportunity to raise this important issue. I welcome the Minister of State, Deputy Brendan Smith, who will reply to the matter.

One of the benefits of the peace process has been the growth in co-operation between North and South over the past decade. Co-operation is ongoing and expanding in many areas of economic and social development including trade, education, training, public administration, communications, agriculture, the environment and tourism. There are many benefits associated with investing and developing cross-Border activities. These initiatives receive considerable financial and political support from the Irish and British Governments, the EU and international bodies. Cross-Border co-operation is delivering real and practical benefits to the midland and Border counties. As a Deputy for a Border region himself, I know the Minister of State will fully concur with this point.

We already have some co-operation in the area of health care. Under EU regulations, a cross-Border worker is entitled to sickness and maternity benefits in both states. Other aspects of cross-Border health care co-operation include accident and emergency services, road traffic accident mobilisation and planning for major emergencies, co-operation on the purchase of high technology medical equipment and cancer research. Health promotion is an area of active co-operation involving research projects and joint conferences.

Cross-Border co-operation in the provision of health care services will help strengthen opportunities for people to access quality health care services, especially where people have better geographical access to services on the other side of the Border. Cross-Border health care services that operate on a patient voluntary basis can be budget neutral between the co-operating jurisdictions. That matter should be examined further. Working together to expand the range of co-operation in the health care area will strength the sense of partnership for the mutual benefit of all.

The HSE proposal for eight specialist cancer care centres means that there will be no cancer care north of a line from Dublin to Galway. That is appalling. The front page editorial in last week's Sligo Champion asked: "Did nobody look at the map and ask what's wrong with that picture?" The proposed removal of cancer care services from the midlands and Border counties runs totally counter to all the Government's talk of regional development, seeing the region as having an important and interdependent cross-Border dimension. The proposal is further evidence of the Government abandoning the entire midland and Border counties area and the reinforcement of the growing east-west divide.

The Minister for Health and Children spoke in the Dáil of her recent meeting with Northern Ireland's Minister for Health, Social Services and Public Safety, Mr. McGimpsey. She confirmed that she had a good discussion on co-operation in cancer care between Altnagelvin and Donegal. I welcome this proposed co-operation and I can see many advantages in cross-Border co-operation in health care. I call on the Minister for Health and Children to take up the issue of cross-Border co-operation in health care with Mr. McGimpsey, to explore fully the possibilities of extending co-operation to include the provision of the full range of cancer care services covering all midland and Border counties. In particular, she should fully explore the provision of specialist cancer care services from Sligo Hospital to patients from County Fermanagh. This possibility has not been previously analysed. Following such a review, the case for continuing specialist cancer care services in Sligo Hospital will be fully justified.

Pending the outcome of such a review, I ask the Minister to direct the HSE — and especially Professor Keane who has now taken up his appointment — to defer any further planning for the transfer of cancer care services from Sligo Hospital to Galway. There is outrage in the county over this proposal. As a Deputy representing a Border area, I recognise the opportunities for County Fermanagh, which should be considered for inclusion in the scheme. Its population base contributes to the demographic case for a specialist centre in Sligo. I call on the Minister to defer the instruction given to Sligo Hospital to transfer the oncology facility to Galway. I am appealing to the Minister of State to impress upon the Minister, Deputy Harney, the need to take immediate action on this important issue.

Photo of Brendan SmithBrendan Smith (Cavan-Monaghan, Fianna Fail)
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I am taking this matter on behalf of my colleague, the Minister for Health and Children. I welcome the opportunity to set out the current position regarding the restructuring of cancer services, with particular reference to Sligo General Hospital. Professor Tom Keane took up his position on Monday as national cancer control director to lead and manage the establishment of the national cancer control programme and I wish him every success in the implementation of the programme. The key objective of the programme is to ensure equity of access to services and equality of patient mortality and survival irrespective of geography. This will involve significant realignment of cancer services to move from the present fragmented system of care to one consistent with international best practice in cancer control. The decisions of the HSE on four managed cancer control networks and eight cancer centres will be implemented on a managed and phased basis.

The HSE has designated University College Hospital Galway, UCHG, and Limerick Regional Hospital as the two cancer centres in the managed cancer control network for the HSE western region, which includes Sligo. The national quality assurance standards for symptomatic breast disease services provide that each specialist unit should manage a minimum number of 150 new breast cancer cases per annum. Sligo General Hospital had 65 such cases in 2005. Many locations will feel they are losing out but we must be clear about the need for this change. People in the west and south have a poorer survival rate for common cancers, including breast cancer, than the remainder of the country. The designation of cancer centres aims to ensure patients receive the highest quality care, while at the same time allowing local access to services, where appropriate.

Sligo General Hospital has a dedicated inpatient oncology unit, comprising 15 beds, and a dedicated day services unit comprising eight beds. Where diagnosis and treatment planning is directed and managed by multidisciplinary teams based at the cancer centres, then much of the treatment, other than surgery, can be delivered in local hospitals such as Sligo. Cancer day care units will continue to have an important role in delivering services to patients close to home. The HSE is putting in place a structured programme of quality assurance, support and information services to underpin the reorganisation of services to ensure cancer patients will receive quality services as close to home as possible.

Patients from Sligo needing radiotherapy continue to be referred to the radiation oncology department at UCHG for treatment. The HSE has informed the Department that, in 2006, UCHG treated almost 1,000 radiation oncology patients, 107 of whom were from counties Sligo and Leitrim. The Minister met Minister Michael McGimpsey of the Department of Health, Social Services and Public Safety, Northern Ireland, on 5 October last. The potential for further cross-Border co-operation and collaboration on cancer care, and specifically provision of a satellite centre for radiation oncology in the north west, linked to Belfast City Hospital, was discussed. Consideration of a satellite centre in the north west will have regard to populations in Border counties such as Donegal, Derry and parts of Fermanagh and Tyrone. It was agreed both Departments would progress this issue through the joint North-South feasibility study on the potential for future co-operation.

The Government is committed to making the full range of cancer services available and accessible to cancer patients throughout Ireland in accordance with best international standards. The developments I outlined will ensure a comprehensive service is available to all patients with cancer in the western and midland regions, including County Sligo.