Dáil debates

Thursday, 3 October 2019

Saincheisteanna Tráthúla - Topical Issue Debate

Cancer Services Funding

3:55 pm

Photo of Niamh SmythNiamh Smyth (Cavan-Monaghan, Fianna Fail)
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I thank the Minister of State, Deputy Byrne, for attending. I rise to speak to her about the important and critical work of the Cuan cancer social support and wellness group in Cavan town. The service first opened its doors in the small town of Cootehill in 2012 and expanded to Cavan town in 2018 where it worked with Cavan County Council on the provision of a venue. Cuan provides support and nurturing for male and female cancer patients, in particular those who have come through their treatment. It is a community cancer support. This year, Cuan received a small but welcome grant from the Irish Cancer Society to assist with the provision of its service. Cuan is unique in the way it delivers its service. There are many good groups which provide comfort and services to cancer patients as they undergo treatment but Cuan's role is to provide services to patients and their families once their treatment has concluded. Cuan even provides services to families. It is about counselling and alternative therapies, including yoga, or even just a cup of tea and a chat with someone who has been through a similar experience. The ladies I have met who were among the founders of Cuan have all been through a journey of cancer treatment. The small grant towards the funding of its counselling service which Cuan receives from the Irish Cancer Society in no way meets the full cost of that service. Cuan offers a range of services free of charge and relies on fundraising and the generosity of the public. It feels that there is no transparent, equal or fair funding mechanism for support centres nationally, including Cuan.

In November 2018, Cuan joined with other services nationally and wrote to the Minister for Health, Deputy Harris, about fair and equitable funding for cancer support services. In the same month, the Minister responded to advise that centres were funded through the HSE, section 39 of the Health Acts and lottery grants. In reality, HSE areas differ nationally in what they offer. Some services are funded while others are not and the level of funding varies considerably. All centres were advised to apply to their HSE area but when Cuan applied under section 39 it was, unfortunately, unsuccessful. In July 2019, the survivors' needs assessment was launched. The assessment demonstrated the ongoing psycho-social needs of cancer patients and survivors. At this time, community cancer support services were urged to apply for funding from the national cancer control programme. Centres were asked to calculate the amount requested on the basis of services being provided by full-time equitable posts.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I attend on behalf of the Minister, Deputy Harris, and I thank Deputy Smyth for raising the matter. The Department of Health and the HSE's national cancer control programme have achieved significant improvements in the quality of cancer services over recent years. We have moved to system of care that consolidates cancer treatment in large centres with multidisciplinary decision-making and care, leading to better outcomes for patients. Cancer care in Ireland is provided across a continuum of primary care, acute hospitals and social services. In line with best practice, cancer surgery is centred in eight designated centres. There is clear evidence that patients who undergo cancer surgery in hospitals with a high patient volumes from doctors who see a high volume of cases have better outcomes. As such, cancer patients from Cavan have access to the services at the designated cancer centre at Beaumont Hospital and other centres as appropriate. Radiation oncology is also provided at Beaumont. At the same time, care is delivered to patients as close to their homes as possible. Therefore, medical oncology, mainly chemotherapy treatment, is delivered in 26 hospitals under the direction of the designated cancer centre. Cavan Hospital is one such hospital providing quality medical oncology care in the region. An aseptic compounding unit is also located at Cavan Hospital, enabling chemotherapy drugs to be made up on site. Cancer screening through the BreastCheck, CervicalCheck and BowelScreen programmes is also available to eligible people on a national basis.

The national cancer strategy 2017 to 2026 sets out a roadmap for the continuing development of cancer services over ten years. The strategy places a significant emphasis on cancer prevention, early diagnosis, access to quality treatment and maximising patients' quality of life. The need for the organisation of voluntary sector pyscho-social support is recognised. In response, the Irish Cancer Society has developed a programme of activities aimed supporting good practice and governance in cancer centres throughout Ireland. The programme aims to increase the collective strength of cancer support and provides valuable training to volunteers, managers and board members of affiliated support groups. I understand the Cuan cancer social support and wellness group in Cavan is affiliated to this programme. The national cancer strategy places a renewed focus on interaction with the voluntary sector. Recommendation 43 of the strategy targets increased collaboration with voluntary organisations to develop programmes which emphasise the physical, psychological and social factors that affect health and well-being. Funding to ensure the continued implementation of the recommendations of the strategy and the development of cancer services programmes is being sought in the Estimates process for 2020. Section 39 of the Health Act 2004 makes provision for the HSE to provide assistance to bodies that provide services similar or aligned to services that the HSE may provide. Voluntary cancer support centres may be eligible to apply for such and can also apply for lottery funding through the HSE. The Department of Health will continue to work with the HSE's national cancer control programme and voluntary organisations to address the needs of cancer patients in a holistic manner.

Photo of Niamh SmythNiamh Smyth (Cavan-Monaghan, Fianna Fail)
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While the Minister of State touched on Cuan, my specific request is for the Department of Health to provide the group with the funding it needs to run its service. It costs at least €30,000 to do that. Those involved are volunteers and they do not have anything close to that money. They depend completely on the generosity of the public and the fundraising events they run. Some of the volunteers are cancer survivors themselves and they cannot continue in this way. To provide some specific detail, Cuan had 69 new clients in 2018. After it launched its new venue in September 2019, that went up to 121 clients. The numbers attending for complementary therapies went from 24 to 139 in September 2019. The numbers have jumped in the counselling service too. These are significant increases four and five times above the previous level within 12 months. The bottom line is funding.

I have testimonies from service users. They are emotive and real and it is important to hear them. One person says a cancer diagnosis is devastating and life-changing. He says that living with cancer is very difficult. While the initial care is fantastic, he points out that survivors continue to need support as they can feel isolated as check-ups are stretched further apart. According to his testimony, this is where the Cuan cancer support care has been a lifeline to this man and his wife. It offers a free and confidential service, even if it is just for a chat. It offers free therapies, which are very beneficial for cancer patients and family members. This man says he is a grateful survivor and Cuan member. I have numerous testimonies in the same terms which make the same passionate plea for support and funding for the Cuan cancer support service. As the Minister of State said, most centres like Cuan are run on a voluntary basis. None of the volunteers is complaining about that. The complaint centres on the need for transparency and equality.

They need to know they have a future and that there will be consistency so they can plan, safe in the knowledge that they are going to have funding.

4:05 pm

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I thank the Deputy again. What she said about the importance of community support for people who are recovering, or have recovered, from cancer struck home. There is a centre somewhat like that in my parish to which people can go after being diagnosed with cancer, during the cancer programme and when they come out the other end. It is important for a number of reasons. The Deputy mentioned a cup of tea, which is important, and interactions between people who have had cancer and those who are in the process of treatment or who are coming out the other end can be helpful.

I do not know why funding was not given to this particular service from the National Lottery and I am not sure the Minister will know either. However, I will inform the Minister and see if anything can be done. I cannot give a commitment on that but I understand the need for the service. There is such a service on the South Circular Road, near where I live. I attend their coffee mornings and I know that the need for people to sit down and talk to each other is obvious. People can get support from each other and that is what community services are all about.

I do not have an answer for the Deputy on why funding was not given to the group but I will certainly pursue the matter for her. I will ask the Minister to come back to the Deputy if I do not do so myself.

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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The Minister of State's commitment is appreciated. The next matter is in the name of Deputy Maureen O'Sullivan.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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The relevant Minister is on his way but is not here yet. I can deal with the matter.

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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Is Deputy Maureen O'Sullivan happy with that, or does she want to wait for the Minister?

Photo of Maureen O'SullivanMaureen O'Sullivan (Dublin Central, Independent)
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I will wait, if the Minister is coming.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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He is coming but I do not know how long he will be.

Photo of Maureen O'SullivanMaureen O'Sullivan (Dublin Central, Independent)
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Does Deputy Ferris want to go ahead of me?

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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Is the Minister of State also going to deal with the issue around greyhounds?

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I can do so.

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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As an alternative, we could suspend proceedings for ten minutes.

Photo of Martin FerrisMartin Ferris (Kerry, Sinn Fein)
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If the Minister of State is happy to take my matter, I will go ahead.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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That is fine. The Minister said he would be here but he has not arrived yet.