Ulick Burke (Galway East, Fine Gael)
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I thank the Ceann Comhairle for selecting this important item for discussion tonight. The decision of the Minister, Deputy Harney, and the Government to continue to introduce further cutbacks amounting to €15 million at this time clearly puts at risk many of the front line services at University Hospital Galway which will result in the future loss of 60 beds, 126 front line staff and the closure of two surgical theatres. Surely this will hamper the hospital's ability to act or develop as a centre of excellence. Having already indicated potential cuts of €9 million, any further cuts will have a devastating impact on the provision of services at the hospital.

This is the biggest hospital in the west and it is on the verge of pulling out of the cancer treatment scheme. The hospital manager has made an urgent request in this respect because of the devastating impact these proposed cuts will have on the staff's ability to deliver cancer services in accordance with Government policy. She stated that these cuts will bring the hospital to its knees. When such a statement is issued by a hospital manager and neither the Minister nor the Government has shown any concern, the situation is serious.

How on earth can University Hospital Galway be a centre of excellence when its services are to be slashed so severely? The Government's cancer strategy is in disarray and cancer patients in Galway and across the west have been betrayed by the Government and the Minister. These cutbacks will have severe human consequences and will affect the survival of cancer patients across the west.

While I recognise that public spending must be curtailed, why was €17 million spent by the HSE on spin doctors and management consultants last year? There are 12 staff in the Department, four special advisers involving an expenditure of approximately €500,000 and five press officers involving an expenditure of €241,000. The 12 staff involve an expenditure of just under €1 million. Is it true, as per the Minister's constant rhetoric, that the patient is being put first when there is such expenditure on staff in her Department? Professor Drumm has an adviser who was paid €16,000 per month last year. Surely that shows that the patient is not being put first, unlike what the Minister claims.

Is spin more important to this Fianna Fáil-led Government than the lives of the people suffering form cancer and other serious illnesses? It cost €310,000 for the HSE to produce an information leaflet last year. This would provide an additional ten nursing staff in coal face services. Many of the 126 staff who will lose their jobs at University Hospital Galway are highly skilled with a level of knowledge and expertise necessary for the delivery of a first class service. Unfortunately, they are to be let go.

More than 1,000 women with concerns about breast cancer have had to wait more than three months to be seen at one of the eight specialist centres for diagnosis and treatment of breast cancer this year. This is a breach of the HSE's standards set by the Health Information and Quality Authority.

I tabled a parliamentary question to the Minister less than a month ago asking if the HSE had made provision to recruit additional medical and nursing staff to cater for the extra workload in providing specialist cancer care at the hospital because of it becoming a designated centre of excellence. I was advised then that currently, services at University Hospital, Galway, were led by a team of surgeons with special interest in breast cancer, supported by a multidisciplinary team of health professionals, including radiologists, pathologists, nursing, laboratory and allied health professionals. These are the staff who will be hit by the introduction of these additional cutbacks of €15 million. Can the Minister, Deputy Harney, justify her demand for these cuts, if the jobs that were created only less than a month ago, as I was advised in that reply, are to be cut in this instance?

Another spin doctor, Ms Chris Kane, the regional co-ordinator of Western Hospital Group, was reported in a newspaper article as having said:

"Every hospital has to live within budget. In the case of GUH, this would mean less overtime, fewer locums and getting tough on absenteeism. We may be curtailing elective surgery, but vital front lone and emergency services will be protected. The leaked internal letter quoted in ... [the] newspapers was a discussion paper only. It was never agreed," said Ms Kane.

This comment is totally in denial of the previous statement of the hospital manager.

Will the Minister of State tell us tonight once and for all where the truth lies? Will there be a curtailment of services, particularly in cancer treatment, which is looming as a result of proposed cutbacks of €15 million?

John Moloney (Laois-Offaly, Fianna Fail)
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As the Minister, Deputy Harney, cannot be here this evening, I will reply to the Deputy's matter.

I welcome the opportunity to address the House on the issue of cancer services in Galway. Contrary to some recent claims, I can assure Deputies that the viability of University Hospital Galway as a designated cancer centre under the national cancer control programme will not be affected by the financial issues it is addressing. I am happy to inform the House of several significant improvements made to cancer services at the hospital which will help equip it for its role as a designated centre.

Under the programme, there are four managed cancer control networks and eight cancer centres. The designation of cancer centres aims to ensure that patients receive the highest quality care while allowing local access to services, where appropriate. The HSE has designated University Hospital Galway and the Mid-West Regional Hospital Limerick as the two cancer centres in the managed cancer control network for the HSE west region. In particular, University Hospital Galway is the designated cancer centre for the north west. Since Professor Tom Keane took up his post as interim director of the national cancer control programme, enormous progress has been made in reorganisation and development of cancer services and in University Hospital Galway some significant developments have been made.

Deputies will be aware that the reorganisation of breast cancer services has been the first task of the national cancer control programme. In this context the symptomatic breast cancer service at University Hospital Galway has been greatly enhanced with significant additional resources provided. Funding was provided by the national cancer control programme in 2008 for additional staff to support the expansion of this service. Once-off funding of €403,000 was provided for equipment in 2008 while in 2009 funding of €863,000 was provided for operating costs. Additional pathology equipment was funded to support the breast cancer services as well as theatre equipping at a cost of €l million. This service is now located in a purpose-built premises on the University Hospital Galway campus. There are eight examination suites in the clinical area and each has access to digital radiology and laboratory results. There is a separate radiology area with its own waiting room and changing facilities and this is equipped with a fully digital mammography suite and state-of the-art ultrasound machines. Both the clinical and radiology areas are equipped for biopsy procedures under local anaesthetic. The breast care nurse team has a custom-designed facility which includes counselling rooms with video facilities and light refreshments.

Ulick Burke (Galway East, Fine Gael)
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There is no one to work there.

John Moloney (Laois-Offaly, Fianna Fail)
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I am outlining the funding that has been allocated.

A new theatre located in the main hospital block for dedicated use by the breast service is expected to be commissioned within the next two weeks.

Ulick Burke (Galway East, Fine Gael)
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Two of them are to be closed down.

John Moloney (Laois-Offaly, Fianna Fail)
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Services are led by a team of surgeons with a special interest in breast disease supported by a multi-disciplinary team of health professionals, including radiologists, pathologists, nursing, laboratory and allied health professionals. Mammography and breast ultrasound are on site in the breast clinic to facilitate ease of access to triple assessment for patients.

UCHG also provides an outreach service to Letterkenny General Hospital so that breast diagnosis and surgery may take place there under a managed clinical network. Video-conferencing on cases allows the extension of multi-disciplinary decision making to Letterkenny General Hospital.

With the reorganisation of breast cancer services almost complete, priorities in 2009 include the development of rapid-access diagnostic clinics for both lung and prostate cancer. Outcomes in these cancers have been poor by international standards and earlier diagnosis is a key factor in improving these. With this in mind, rapid access clinics will be developed in each of the eight designated cancer centres, and UCHG is in the vanguard as one of the first two hospitals to open a clinic. This is a significant development for UCHG and for the cancer programme. The clinic provides fast-track access to early diagnosis for men whose symptoms indicate they are at higher risk. Patients can now be diagnosed more quickly - within two weeks of referral - and if prostate cancer is confirmed, the patient has immediate access to a multi-disciplinary specialist cancer consultation to determine how he should be managed.

I emphasise that the enhanced services at Galway for breast and prostate cancer, which are two of our most common cancers, are significant markers of the real and tangible progress that is being made.