Jimmy Deenihan (Kerry North, Fine Gael)
Link to this: Individually | In context

The HSE south relocated the initial diagnostic and surgical symptomatic breast care services from Kerry General Hospital to Cork University Hospital, CUH, in October 2008. At the time, Professor Tom Keane made a commitment that follow up mammography screening for those patients who had undergone surgery at CUH would be carried out at Kerry General Hospital, KGH, and that the necessary facilities, including the provision of a new digital mammography machine to be purchased following the decommissioning of the existing machine, would be put in place for that purpose. This occurred in March 2009.

Women who had undergone surgery at CUH and who were then obliged to travel to Cork for follow up care began to contact me with regard to the promised digital mammography unit in Tralee. In response to their concerns, I wrote to both the hospital network manager of the HSE south and the general manager of KGH seeking an update on the replacement of the mammography machine. On 28 May 2009, the General Manager of KGH indicated that a digital mammography unit would be installed in the following few weeks and that the service would then recommence. On 3 June 2009, in a response from the hospital network manager of the HSE south, I was informed that:

[F]ollowing decommissioning of the existing digital mammography machine at KGH, a new digital mammography machine has been purchased at a cost of €340,000 by the NCCP and technical plans are being finalized for its installation and commissioning at KGH. This work will take approximately three weeks to complete. Mammography radiography staff from CUH will attend at KGH on a weekly basis, as required, and a digital link will also be installed which will enable scans to be reported by Consultant Radiologists at CUH. Mammography radiography staff from Cork University Hospital, CUH, were to attend at Kerry General Hospital, KGH, on a weekly basis, as required, and a digital link would also be installed which would enable scans to be reported by consultant radiologists at CUH. This, however, has not happened.

This week in The Kerryman, Marisa Reidy wrote:

Four months after the HSE announced it was making space within the radiology room at Kerry General Hospital for a long-promised mammography machine, it has emerged the executive is still no closer to installing the cancer-screening unit. The news comes almost eight months after the HSE wrote to The Kerryman confirming that a new digital mammography machine would be installed and commissioned in KGH within "three to four weeks" — and almost a year and a half since it first promised such facilities would be made available to the women of Kerry.

Despite assurances from the HSE last October that the machine would be operational once additional space had been created within the radiology room, KGH is still no closer to having the machine installed. Following another query from The Kerryman this week as to the status of the long-awaited machine, it emerged that the required space has still not been created, as a contractor assesses what the HSE terms this "specialist programme of works."

A HSE letter sent to The Kerryman this week, advises, "that a contractor has now been secured to carry out the installation works required for this project which will comprise creation of additional space within the radiology department to accommodate the size of the new unit. As this is a relatively specialist programme of works, the selected contractor is currently liaising with technical services at Kerry General Hospital to comprehensively scope and confirm the programme of works required," the letter concluded.

The HSE would not be drawn on an exact date for installation, but moved to assure the public that once installed, mammography radiography staff from CUH will attend at KGH on a weekly basis, as required, and a digital link will also be installed which will enable scans to be reported by consultant radiologists at CUH.

This matter has gone on for far too long. There were major protests in Kerry against the removal of this unit to CUH. Eventually, the people of Kerry accepted it on condition that after-care services would be provided immediately at KGH. This has not occurred despite these commitments. It is most unfair on the large number of Kerry women who must go to Cork for surgery and, in the future, for screening, which is a simple 20 minute procedure.

John Moloney (Laois-Offaly, Fianna Fail)
Link to this: Individually | In context

I am replying to this Adjournment matter on behalf of the Minister for Health and Children, Deputy Harney, who cannot attend the Chamber this evening due to a prearranged appointment.

The national cancer control strategy was clear that to achieve better cancer prevention, detection and survival, there should be eight specialist cancer centres, each serving a population of approximately 500,000. In the HSE southern region, CUH and Waterford Regional Hospital have been designated as the cancer centres.

The first priority for the HSE's national cancer control programme, NCCP, has been the transfer of breast cancer diagnostic and surgical services to the eight centres. As part of this process, these services were relocated from KGH to CUH in October 2008. On 1 December last, the remaining services in the region were amalgamated into the new regional cancer centre at CUH. These included the South Infirmary symptomatic breast service, the Mercy University Hospital pathology service and BreastCheck surgery.

The breast care unit at the Regional Cancer Centre South is now the largest in the country. It is expected it will see more than 10,000 patients annually and diagnose approximately 520 symptomatic patients with breast cancer. The HSE's most recent performance report shows that the service is 100% compliant with waiting time targets for new patient referrals, which set out that 95% of urgent referrals should be seen within two weeks.

The Government provided €5.75 million to develop the centre at CUH. This development includes diagnostic clinics and treatment facilities incorporating mammography imaging services, ultrasound, pathology-laboratory services, patient waiting areas and support services. Additional consultants, nurses, radiographers, medical scientists and administrative staff were appointed to the new centre.

Women in the Kerry area who are referred to the CUH symptomatic breast service travel to Cork for their initial assessment. For the majority, they will not have a diagnosis of breast cancer and will require no further follow up treatment in Cork. Where a woman has a diagnosis of breast cancer which requires surgery, the operation will also take place in Cork. For women who may need financial assistance with the cost of travel to the breast service at Cork, as at the other centres, the NCCP provides funding through the Travel2Care scheme, administered by the Irish Cancer Society. In the case of women who require chemotherapy, this can and is being delivered in Kerry in accordance with protocols set out by the multidisciplinary team based in Cork. The breast care nurse based in Kerry links with the multidisciplinary team meetings at CUH on a weekly basis.

Follow-up mammography for patients of the CUH symptomatic service who have undergone surgery will also be carried out at KGH once the necessary facilities and resources are put in place for this purpose. Following decommissioning of the existing mammography machine at KGH, a new digital mammography machine has been purchased at a cost of €340,000 by the NCCP. Technical plans for its installation have been developed and a contractor has been secured to carry out the installation works required, specifically the creation of additional space within the radiology department to accommodate the new mammography unit. This will include a digital link and integration with the systems at CUH.

As this is a relatively specialist programme of works, the selected contractor is currently liaising with technical services at KGH to scope and confirm the programme of works required comprehensively. Until the follow-up mammography service is in place in Kerry, women in the region will continue to have follow-up mammography provided at CUH.

The new mammography service at KGH is specifically for the provision of follow-up mammography for patients of the CUH symptomatic service. Screening mammography is carried out only by BreastCheck, the national breast screening programme. BreastCheck began screening in County Kerry in April 2009 from a mobile digital screening unit using digital mammography. Screening in the county will continue until first-round screening has been offered to the approximately 13,000 women aged between 50 and 64 in Kerry. However, any woman, irrespective of age, who has immediate concerns or symptoms should contact her GP who, where appropriate, will refer her to the symptomatic services.

The completion of the transfer of breast cancer diagnostic and surgical services to the eight cancer centres is a major milestone. It enables us to be confident that the service being provided is in accordance with international best practice. This is crucially important in ensuring women diagnosed with breast cancer have the best possible chance for positive outcomes.