James Bannon (Longford-Westmeath, Fine Gael)
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I wish the Minister for Health and Children, Deputy Harney, was in the House. I hope she is not still in the departure lounge.

Olivia Mitchell (Dublin South, Fine Gael)
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Shell-shocked.

James Bannon (Longford-Westmeath, Fine Gael)
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A recent international study by the OECD showed that Ireland has one of the highest breast cancer death rates in the developed world and a 6% higher rate of deaths from prostate cancer than the OECD average. This is proof positive that we are at grave risk under the current health regime. Another report by the National Cancer Registry highlights the fact that women suffering from cancer in the midlands have a 30% higher chance of dying from the disease than those living in Dublin.

What has the Minister for Health and Children and the HSE decided to do in reply to these findings? Following the closure of the cancer unit in Tullamore Hospital, the cancer care services at Longford-Westmeath General Hospital were subsequently shut down, leaving 600 women without care. This makes no sense. The midlands has continually been overlooked in terms of health provision but what we are talking about here is a life and death situation. Leaving the midlands without breast cancer units is madness and, in fact, is a gross negligence of care to cancer patients. Setting up eight centres of excellence, none of which is in the midlands, condemns hundreds of cancer patients to hours of unnecessary travel, in effect, penalising them for being ill rather than easing their burden.

With the closure of the Mullingar facilities, the midlands does not have access to the 20 centres for multidisciplinary team meetings either, which according to the HSE are being set up in all but two of the 22 hospitals that are currently providing breast care services. Those two exceptions are both in the midlands, namely, the hospitals in Mullingar and Portlaoise and the people are paying the price. This is not acceptable by any standards. Something must be done for cancer patients in the midlands. I propose that the Minister reconsider cancer care in the midlands and set up a centre of excellence in the Longford-Westmeath General Hospital to cover all of the midland counties — Longford, Westmeath, Roscommon, Cavan, Laois, Offaly and south Leitrim — as provision of cancer care centres in Dublin or Galway is an insult to the people living in these counties and accessing hospitals in these cities is unrealistic for very ill people who find travelling difficult.

The Government is yet again failing to operate any form of joined-up thinking. Bringing the cancer services under eight centres of excellence based in Dublin and other major cities is tantamount to driving services back into areas that are already looking to decentralisation to ease the stress on infrastructural and service provision, in other words clogging up the very areas that decentralisation was meant to free up. While many civil servants and other personnel are vacating the cities, the demand for hospital places fills the gaps, even to the point that hotel rooms are being taken up by those awaiting hospital procedures. We witnessed this recently. The Mater Hospital and St. Vincent's Hospital are not set up to cope with cancer patients from the midlands and again the patients will pay the price. Poor quality train and bus services from the midlands put extra pressure on those who are extremely ill and the mini-bus ambulance, for those who get a place on it, does not have the siren of a standard ambulance so cancer victims are forced to sit in traffic jams for up to three hours, adding to their distress.

The provision for taxi services for patients is not satisfactory and must be updated and extended. A young patient in my area is still waiting to be compensated for the cost of taxi services to St. James's Hospital and St. Luke's Hospital for treatment since 2003. This is a shocking way to treat cancer patients and cannot be excused by any protests of ignorance on the matter. This is a regular occurrence and until the cancer service that the people of the midlands have a right to expect is put in place, such shameful neglect of the ill and vulnerable will continue.

I support centres of excellence but I cannot understand why the Government has neglected the midlands. Parts of my constituency are over 100 km from the centres of excellence. When the Government proposed decentralisation in the budget four years ago, the objective was to move people out of the cities. It has not happened yet, but it should happen in the health sector as well as other sectors. It is important that a centre of excellence is established in the midlands to accommodate people living in the region instead of requiring seriously ill people to drive long distances for treatment. This is a good idea which should be adopted by the Government.

Brendan Smith (Cavan-Monaghan, Fianna Fail)
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I welcome the opportunity to set out the current position with the reorganisation of cancer services, with particular reference to the midland region. Recent events, particularly with regard to cancer services in the midland region, underscore the absolute need for the HSE national cancer control programme to be implemented without delay. Let us all agree that the development of quality assured cancer control services, as set out in the national strategy for cancer control, is the best way of ensuring that the risk of such events is minimised in the future.

The HSE has appointed Professor Tom Keane as national cancer control director to lead and manage the establishment of the national cancer control programme. 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 designation of centres aims to ensure that patients receive the highest quality care while at the same time ensuring local access to services, where appropriate. Patients enjoy a 20% improvement in survival if they are treated in specialist centres which provide multidisciplinary care. Where diagnosis and treatment planning is directed and managed by multidisciplinary teams based at the cancer centres, much of the treatment, other than surgery, can be delivered in local hospitals.

The HSE has designated St. James's Hospital and St. Vincent's hospital as the two cancer centres in the managed cancer control network for the HSE Dublin mid-Leinster region, which includes Laois, Offaly, Longford and Westmeath. University College Hospital Galway and Limerick Regional Hospital are the two cancer centres for the western region, which includes Leitrim and Roscommon. Patients in County Cavan will be served by the two designated cancer centres in the Dublin north-east region, Beaumont Hospital and the Mater hospital. The HSE has confirmed that services will not be transferred until appropriate capacity has been developed in the receiving centres.

Arising from the designation of eight cancer centres nationally and to comply with the national quality assurance standards for symptomatic breast disease services, the HSE announced earlier this month that within the coming weeks, breast cancer services at the Midland Regional Hospital, Mullingar, will be transferred to the Mater hospital in Dublin. It should be noted that only 19 breast cancer procedures were carried out in 2006 in the Midland Regional Hospital in Mullingar. The standards require each specialist breast cancer centre to manage a minimum number of 150 new breast cancer cases per year.

The Government is committed to making the full range of cancer services available and accessible to cancer patients throughout Ireland, including in the midland region, in accordance with best international standards.