Fergus O'Dowd (Louth, Fine Gael)
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I thank Deputy Dan Neville for allowing me to go ahead of him as I have an urgent appointment elsewhere.

The north east hospital situation is in crisis, including Our Lady of Lourdes Hospital. Serious concerns raised by cancer X-rays have recently been brought to light. There is no clarity and no objectivity and we do not know what is going on. The HSE is releasing information bit by bit. These concerns are serious and have been evident for some time. The HSE has not appointed radiographers, which it ought to have done, as recommended by the former health board. There has been a deficit of full-time professional staff to read X-rays and a lack of commitment by the HSE to the entire north east, particularly Drogheda and its hospital.

I am deeply saddened by the news I heard tonight that the new north-eastern hospital will not be located in Drogheda but in County Meath, at Navan. Drogheda will have a population of 90,000 people in the near future, it has rail links, motorway links, it is beside the airport and is at the centre of the growth of population. The people of Drogheda and those in the surrounding county, as well as in east Meath, will absolutely resist the removal of the centre of excellence at Our Lady of Lourdes Hospital. That hospital has been run down by the HSE.

Professor Carney, the leading professional cancer consultant in the north east for over 17 years, resigned last October because he was not consulted about changes being made to breast cancer services vis-À-vis staff at the hospital. He recently withdrew his resignation, which the HSE did not accept. I wish to quote directly from and place on the record of the House his letter of 7 March 2008, when he wrote to the chief executive of Our Lady of Lourdes Hospital. Professor Carney is a national figure dealing with oncology and cancer. He is an absolute professional who is totally dedicated to the north east and has been for 17 years. In his letter he states that he withdrew his resignation because:

I now realise, for a variety of reasons, that it has not been possible to make the arrangements that would allow a smooth transition of care, particularly of patients currently undergoing active chemotherapy treatment, for newly diagnosed patients, or indeed for patients receiving chemotherapy for recurrent cancer. Moreover, arrangements are not in place for the follow up and support of patients who have attended our clinic for a number of years and who, for one reason or another, have become dependent upon us.

All of the above has led to considerable stress and uncertainty for patients, their family and for the oncology staff in Our Lady of Lourdes Hospital in Drogheda.

The HSE is an absolute disgrace. It is running down the hospital and allowing a situation to pertain whereby the patients of the most eminent professor in oncology and cancer care in this country will not, in his medical opinion, be properly looked after. Professor Carney is not being allowed to continue to treat those patients until the transition, as he points out in his letter, is in place. It is unacceptable and is an appalling, shameful situation for which the Government is totally responsible.

It is a sign of how bad things are that, having gone through the Celtic tiger era, the Government is now destroying a fantastic hospital in Drogheda, which employs more than 1,500 people. Those people will not now be able to work in the place where they live but, more importantly, the cancer care to which patients are entitled, and which Professor Carney wants to provide, will not be provided. He is not satisfied that adequate and proper arrangements are in place for their medical care. This is the worst story that could ever be visited upon cancer patients in the north east, many of whom are breast cancer sufferers. They have been abandoned by the HSE and by the Government. I ask the Minister of State to respond to this issue.

Máire Hoctor (Tipperary North, Fianna Fail)
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I am taking this Adjournment debate on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. I welcome the opportunity to set out the current position to Deputy O'Dowd regarding cancer services, with particular reference to the north east region.

The HSE issued a statement on Monday, 31 March concerning radiology services in Our Lady of Lourdes Hospital, Drogheda, and Our Lady's Hospital, Navan, which have emerged in the media in recent days. The HSE has informed the Department that it is HSE policy, learned from recent events in relation to diagnostic services in the Midland Regional Hospital, Portlaoise, to ensure that if there are concerns regarding any aspects of patient care which are found to be valid, the patients and their families will be the first to be informed and supported. This requirement takes precedence over all other considerations and, on that basis, the HSE will not be making further comment on the details of the review until these arrangements have been finalised.

Regarding the small number of cases referenced in the HSE statement, arrangements are in train to ensure the necessary initial contacts and briefing, initiated via the relevant general practitioners, are in place. It is expected that this very important phase will shortly be completed. In tandem with this, the HSE is assessing the appropriate next steps to be taken. This will take into account the input of external experts who have been consulted by the HSE and the advice from whom has only very recently been received.

The HSE has advised that it will make a full statement on the matter, including providing details of next steps, very shortly after the contacts referred to above are completed. In making its statement, the HSE will be in a position at that stage to provide additional background information. The HSE is very anxious to provide such additional information as it can appropriately make available to inform the public and allay fears. However, it is entirely appropriate that the small group of those most affected are communicated with directly in the first instance.

As the House is aware, Professor Tom Keane has been appointed to lead and manage the establishment of the HSE national cancer control programme. Professor Keane has ambitious plans and has already made significant progress in implementation of the programme. The key objective of the national cancer control programme is to ensure equity of access to services and equality of outcome, irrespective of geography. This will involve significant realignment of cancer services to move from the present fragmented system of care to one which is consistent with international best practice in cancer control.

The HSE has designated Beaumont Hospital and the Mater hospital as the two cancer centres in the managed cancer control network for the HSE Dublin and north-east region, which includes Our Lady of Lourdes Hospital. 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, such as Our Lady of Lourdes. In this context, chemotherapy and support services will continue to be delivered locally. Cancer day-care units, including at Our Lady of Lourdes Hospital, will continue to have an important role in delivering services to patients as close to home as possible.

An absolute priority is to retain the key cancer clinicians in the networks even in circumstances where their own hospitals may no longer be involved in cancer control. Professor Keane has advised that meetings and discussions are under way with the eight designated centres and with the non-designated hospitals currently providing cancer services to manage the transition. These discussions have focused on identifying the capacity issues for the eight designated centres so that a detailed transitional plan can be put in place to facilitate the progressive, gradual and carefully managed transfer of services over the course of the next two years.

The HSE has informed the Department that early in 2007 a strategic decision was made to develop links for both breast services and oncology services with Beaumont Hospital, which has a major academic link with the Royal College of Surgeons in Ireland. Professor Carney tendered his resignation as a medical oncologist last October, as and from the 31 March 2008. The HSE has informed the Department that Professor Carney's resignation from Our Lady's Hospital was received with much regret by both management and staff within the hospital. His expertise, experience and commitment to patients and staff have been very much appreciated.

Following the receipt of Professor Carney's letter of resignation, management at Our Lady of Lourdes has been working with colleagues in Beaumont Hospital to put in place alternative arrangements for the transition of care of patients to a consultant medical oncologist from Beaumont Hospital. A series of meetings took place and a plan has now been put in place which will allow both new and review patients to be seen by this consultant and his team in Our Lady of Lourdes Hospital from 31 March 2008.

From 1 July there will be a registrar in place on site specifically focused on oncology. While the HSE is continuing with the three sessions per week by the consultant oncologist, previously provided by Professor Carney and now provided by a consultant from Beaumont, it is working to develop a full-time oncology post for Our Lady of Lourdes Hospital, which would be linked with Beaumont Hospital. The HSE has confirmed that there will be no interruption in the continuity of care that patients are receiving in the provision of oncology services at Our Lady of Lourdes Hospital, Drogheda.

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 outlined here today will ensure that a comprehensive service is available to all patients with cancer in the eastern region.