Ciarán Lynch (Cork South Central, Labour)
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Does the Minister of State believe the best interests of the women of Cork are served by transferring the breast unit at the South Infirmary-Victoria University Hospital to Cork University Hospital, CUH, where the treatment experience of breast disease is much less significant? Does she believe the closure of the internationally acclaimed unit in favour of a service that is yet ill-defined constitutes progress in patient care?

The services at the hospital are recognised internationally to be in accordance with best practice. Instead of dismantling the existing unit and moving it to an already over-congested campus at CUH, we should be consolidating the good practice already established. As the saying goes, "If it ain't broken, don't fix it." We have a centre of excellence. To date, every evaluation and examination of the breast care unit at the South Infirmary-Victoria University Hospital has shown it to be a leader in its field. This is particularly reflected in the fact that the current referral period for women availing of the service is no more than two or to three weeks. I am very concerned that any tampering with this excellent service will ultimately result in poorer provision, at a cost to the taxpayer that is completely avoidable at this stage.

Given the long delays in the arrival and opening of the BreastCheck service in Cork, which is located directly next door to the South Infirmary-Victoria University Hospital, the idea of transferring the cancer service unit to CUH makes no sense whatsoever. CUH campus is already becoming overdeveloped and congested, particularly in light of the Government's plans to co-locate a hospital on the campus. Any rational examination of this matter would clearly indicate that the existing cancer unit should not only remain where it is but should also be expanded. Given the economic downturn, why are we spending so much money relocating an existing service when it has proven to be working properly and effectively?

The Government is proposing to relocate a service in light of an ill-defined proposal that constitutes no progress in terms of patient care. I seriously urge the Minister of State to remove the idea from the table and consider the services currently in place with a view to improving and developing them.

Deirdre Clune (Cork South Central, Fine Gael)
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I welcome the opportunity to address this issue, which is of considerable concern to the people of Cork, particularly the women who will unfortunately have to avail of breast cancer services, their families and the specialists and experts working in the field.

The national cancer strategy proposes to establish centres of excellence, a term I dislike as I prefer to refer to specialist centres, in a number of areas nationwide, one of which will be in Cork at Cork University Hospital. That campus is also to include breast cancer care. At present, the South Infirmary-Victoria University Hospital, Cork, treats breast cancer patients. Its throughput is 210 diagnoses per year, as opposed to a figure of 140 at Cork University Hospital. A figure of 210 diagnoses is certainly above the norm and would ensure excellence. A specialist centre has been established at the South Infirmary-Victoria University Hospital. The people from counties Cork and Kerry who use this service speak highly of it. The population is entirely satisfied with the service provided. Under the national cancer strategy, however, it is proposed to transfer these services. Professor Tom Keane, who is charged with implementing the cancer care strategy, has stated that he wants all centres for breast cancer care in place by the end of 2009, some 18 months from now.

Where on the campus of Cork University Hospital will this centre be located? Where will the building be located? Where are the architectural plans, theatre space, buildings and specialist and ancillary staff required to provide such a service? I have not seen them. No planning application has been made and no provision is in place to provide the necessary physical infrastructure to deal with the estimated 210 breast cancer diagnoses per annum that occur at present and will continue to occur in addition to the existing throughput at Cork University Hospital. The Minister of State should answer this simple question. Where are these women to be accommodated on the Cork University Hospital campus? There is no sign of any facilities. While I support the concept of a specialist centre, I cannot see the requisite physical infrastructure to provide it in Cork University Hospital. However, I see excellence in specialist care at present for women who are diagnosed with breast cancer in the South Infirmary-Victoria University Hospital.

As Deputy Lynch has noted, one should not try to fix something that is not broken.

Bernard Allen (Cork North Central, Fine Gael)
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I wish to be associated with these remarks.

Máire Hoctor (Tipperary North, Fianna Fail)
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I welcome the opportunity to set out the current position to Deputies Clune and Lynch in respect of the restructuring of cancer services, with particular reference to breast cancer services in the South Infirmary-Victoria University Hospital, Cork.

The implementation of the national quality assurance standards for symptomatic breast disease will ensure that every woman in Ireland who develops breast cancer has an equal opportunity to be managed in a centre that is capable of delivering the best possible results. In order to comply with the standards, the Health Service Executive has directed 17 hospitals to cease breast cancer services. Further staged reductions in the number of hospitals providing symptomatic breast disease services will occur over the next 18 months in line with the transfer of services to the eight designated cancer centres nationally.

The HSE has identified Cork University Hospital, CUH, as one of the designated specialist cancer centres for the southern region. The plan therefore will consolidate symptomatic breast cancer services in Cork University Hospital. This involves a transfer of the South Infirmary symptomatic breast service to CUH. The CUH has identified the necessary space to house the programme.

Simon Coveney (Cork South Central, Fine Gael)
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This is madness.

Máire Hoctor (Tipperary North, Fianna Fail)
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Planning is proceeding to achieve this consolidation by early 2009.

The decision to consolidate the symptomatic breast service provided by CUH and South Infirmary for the southern region into the designated cancer centre at CUH is consistent with the national programme for the centralisation of breast cancer services in eight designated specialist centres. The relocation of the South Infirmary symptomatic breast service to CUH will create a critical mass of specialists of all oncology disciplines on a single geographic site.

Simon Coveney (Cork South Central, Fine Gael)
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They already have a critical mass. It is the busiest centre in the country.

Charlie O'Connor (Dublin South West, Fianna Fail)
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The Minister of State, without interruption.

Máire Hoctor (Tipperary North, Fianna Fail)
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It is clear from the wide-ranging, evidence-based work behind the national cancer control programme that the best interests of the women of Cork and of the southern region will be served by this consolidation. The Government is confident that the consolidated service will meet or exceed the national standards for symptomatic breast care as approved by the Health Information and Quality Authority.

Bernard Allen (Cork North Central, Fine Gael)
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This is a cutback.

Máire Hoctor (Tipperary North, Fianna Fail)
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The programme recently completed a detailed review of resource requirements to create capacity for the progressive transfer of all symptomatic breast cancer services to the eight designated cancer centres with the objective of completing 60% transfer by the end of this year and 90% by the end of 2009. Funding of €7 millionhas been allocated from the programme across the eight centres to support additional staff, including consultant, radiography, nursing and clerical posts. Funding also has been allocated for some necessary additional equipment.

The roll-out of BreastCheck, the national breast screening programme, also will reduce significantly the number of symptomatic breast cancer presentations. The Minister for Health and Children officially opened the new clinical static screening unit for the southern region last December and nearly 4,000 women from Cork have already been screened.

Bernard Allen (Cork North Central, Fine Gael)
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Where is it?

Máire Hoctor (Tipperary North, Fianna Fail)
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The Government is committed to providing symptomatic breast disease services in eight centres nationally. Roll-out of the national breast screening programme and a quality assured symptomatic breast disease service will ensure that women will have the best chance for early detection and treatment of breast cancer. The developments which I have outlined today will ensure that a comprehensive service is available to all patients with breast cancer in the southern region.