James Bannon (Longford-Westmeath, Fine Gael)
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I thank the Ceann Comhairle for affording me time to raise this important matter, namely, the need for the Minister for Health and Children to provide an urgent update on her plans for a realistic transport service for cancer patients in rural areas who are not being adequately provided for in terms of travelling to Dublin or other centres of excellence for treatment, despite the Minister's assurance that such provision would be made. These patients are falling between health clinics and the HSE and failing to get funding or compensation for such expenses, not to mention the exhaustion caused by inadequate transport provision.

I am sure the Minister of State will agree that nothing illustrates a point better than example. I have had recent correspondence from the Society of St. Vincent de Paul outlining an appalling situation regarding an extremely ill lady who has to travel to the Mater Hospital weekly and sometimes twice weekly.

Travel difficulties have forced this lady to miss urgent hospital appointments because of exhaustion, ill-health and lack of funding. Her travel costs are €89 per day and she has no idea how the frequently required journeys will be financed or how she will be able to withstand the long hours spent travelling.

On one occasion this constituent managed to get an ambulance bus from the Mater which took from noon until she arrived in Longford at 7 p.m. and then had to take a taxi to her home, arriving at 9.10 p.m. This would be a gruelling journey for an able-bodied person but it was a nightmare for an extremely ill cancer victim.

Although the woman had an important appointment at the hospital the next morning, she was unable to undertake such an arduous journey again due to the toll on her health. For anyone in the whole of their health to undertake such stressful travelling on a regular basis would be daunting but for a person already weakened by a debilitating illness, it is totally untenable and a shameful indictment of the Minister's lack of concern for individual patients who are falling victim to cost-cutting measures which have seen essential services centralised without adequate transport measures being put in place.

This patient has fallen between the local health clinic and the HSE with regard to funding. The end result of the system of passing the buck which extends across all Departments, is that she feels abandoned by the health services and has no idea from one visit to the next how she is going to be able to afford to get to the hospital. Because of travel expenses this lady has allowed her rent, her electricity bill and other pressing accounts go into arrears. She is the real casualty of the cutbacks with which the Minister and her colleagues have rewarded those who put them back into Government.

This is not a stealth tax or a rise in the cost of luxury cars. This is a matter of life and death and no Government has the right to jeopardise people's health or impose unduly harsh and inhumane measures on them when they pursue treatment. This is the situation for a large number of patients in the midlands.

The bottom line is that people in the midlands are not getting the service they deserve. Expecting extremely ill people to undertake marathon journeys to access treatment is scandalous. We could point the finger and say that the Government simply does not care, because it does not.

We heard this morning that the HSE is to introduce new health service cutbacks to the tune of €300 million in the weeks ahead. These are cutbacks which the Minister will be forced to admit are needed to cover the financial mismanagement of her Department for which she has the nerve to expect the chronically ill to bear the brunt of and to forego essential treatment and services. It is not an exaggeration to say that very soon this Government will expect the seriously ill to cycle to so-called centres of excellence because there will be no money for ambulance buses or taxis as it will all have been used up by scandalous waste on one fiasco after another.

I ask the Minister of State to outline how long more this lady and others can be expected to endure such hardships. It is bad enough to be a victim of cancer and to have to undertake treatment. However, to endure constant worry about transport and the added stress of financial difficulties in doing so, is unbearable for many patients in the midlands. Even Dickens could not have envisaged such misery. I ask the Minister of State to take action and provide a good and reliable transport service for victims of cancer in the midlands. I have spoken to several officials in the HSE and they say the transport system for patients in the midlands is nothing short of a disgrace and a shambles. It is up to the Minister to ensure that proper transport services are put in place for people from the midlands. The way this Government has behaved towards cancer victims in the midlands over the last number of years is a shame and a disgrace.

Máire Hoctor (Tipperary North, Fianna Fail)
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I am taking the Adjournment on behalf of my colleague, Deputy Mary Harney, Minister for Health and Children. I welcome the opportunity to address the issues raised by the Deputy and to set out the current position regarding the national cancer control programme and the provision of transport services for cancer patients.

Professor Tom Keane took up his post as national cancer control director on 19 November last. The decisions of the Health Service Executive to designate four managed cancer control networks and eight cancer centres will be implemented on a managed and phased basis.

The designation of cancer centres aims to ensure that patients receive the highest quality care while at the same time allowing local access to services where appropriate. 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.

A detailed transitional plan is being put in place to facilitate the progressive, gradual and carefully managed transfer of services over the next two years or so. The HSE plans to complete 50% of the transition of services to cancer centres by the end of this year and 80% to 90% by the end of 2009. The HSE is putting in place a structured programme of quality assurance, support and information services to underpin the re-organisation of services to ensure that cancer patients will receive quality services as close to home as possible.

Professor Keane and the HSE have emphasised the importance of mobilising existing resources and redirecting them to achieve the national cancer control programme objectives. Arrangements are in hand to enable Professor Keane to take control of all new cancer developments and, progressively, all existing cancer services and related funding and staffing. Additional funding of €35 million has been allocated for cancer control in 2008, representing a 71% increase over the equivalent funding for last year which was €20.5 million. This includes funding of €15 million for the 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.

The HSE currently provides transport for cancer patients in a range of circumstances. In many cases this is managed locally at the hospital or at community level. The HSE has advised that it makes every effort to assist patients who require transport and patients are encouraged to make direct contact with the treating hospital to determine suitable arrangements. Where difficulties are brought to the notice of any staff member, options are explored and the most suitable arrangements put in place for patients.

Following completion of the current HSE review on transport services, the national cancer control programme expects to be in a position to administer current expenditure on cancer transport. The programme has also allocated €750,000 to the Irish Cancer Society which will administer a grants programme based on agreed criteria to enable patients to be transported to designated cancer centres for necessary treatment. This will be in addition to the existing hardship-related programme which the Irish Cancer Society administers.

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 which I have outlined to the House will ensure that comprehensive quality-assured treatment and support services are available to all cancer patients nationally.