John Minihan (Progressive Democrats)

I am glad to have a few moments to discuss the inherently troubling issue of cancer and cancer care. The National Cancer Registry reports that in 2001, the most recent year for which data is available, there were 22,473 cases of cancer in this country. Cancer is the second highest cause of death in Ireland. Approximately 30% of people now alive will eventually suffer from cancer. Over the years it will strike about three out of four families. Those facts will trouble us all. We in this House must ensure that the issues surrounding cancer and cancer care are expanded upon and considered in a wider health policy context. This morning's statements are an example of how that process can work, and I welcome the opportunity to speak on the issue.

The prevalence of cancer exercises the minds of health care professionals across the globe. In our statements today we must not forget that, as the NCR points out, cancer is not one disease but a group of more than 100 diseases characterised by the uncontrolled growth and spread of abnormal cells. Different types of cancer have different causes. They have different rates of occurrence, and there are different chances of survival.

This is a composite problem. The Government must do its part in dealing with the prevalence and impact of cancer on people and families in this country. We cannot question the Government's commitment to making the fullest possible range of services available to deal with cancer and cancer-related care. The Government has also made a clear commitment to making those services accessible to cancer patients throughout Ireland in accordance with best international practice. That is how it should be, and it is to be commended. Meeting that commitment means having real determination. In agreeing that a major programme is required rapidly to develop clinical radiation oncology treatment services to modern standards, the Government has demonstrated its intention and determination.

In this specific policy area, like so many in health care, the Government correctly relies upon the relevant experts to advise it on how to proceed. That not only ensures that policy decisions are informed by the best and most up-to-date medical knowledge, but also removes the political and parochial from high-level decision-making, another thing that must not be forgotten, especially where radiotherapy services are concerned. For example, regarding radiotherapy, the national radiation oncology co-ordinating group, NROCG, provides advice to the Government and following that process, the HSE has responsibility for the management and delivery of the related health and personal social services.

Expertise is required, welcomed, received, considered and acted upon. Let us take the report on the development of radiation oncology services in Ireland, for example, which was prepared by a multidisciplinary group of experts. It has received approval — something that may already have been mentioned — from such international bodies as the US National Cancer Institute and the American Cancer Society. What is more important to patients is that significant progress is being made in implementing the report's recommendations. While international acclaim for the report is welcome, it is the pursuit of best international standards for cancer patients throughout the country that is of immediate and paramount concern. I am reassured that the Government is determined to achieve those standards. I also share the view that, although the immediate priority has been the provision of significantly enhanced cancer care services in the major conurbations of Dublin, Cork and Galway, the question of networked satellite locations is also addressed.

At this point, I turn to that specific topic, the location of cancer care services. The Tánaiste and Minister for Health and Children has made it clear that there is a significant responsibility on our health services to ensure that patients, particularly cancer patients, are adequately supported clinically and, where necessary, with proper transport arrangements.

Patient transport is a hot topic and was referred to throughout this debate, but any measure that can minimise the stress and discomfort of cancer patients, their families and carers must be considered.

In the first instance, patients must not be referred unnecessarily to Dublin for treatment. Second, the Health Service Executive must put in place appropriate transport arrangements for patients requiring radiotherapy. The Tánaiste has correctly placed the delivery of appropriate and effective cancer care at regional level at the centre of oncology service policy. One could be left with the impression from some statements that the Department has not pursued the question of transport arrangements with the HSE but that is not the case. The Department has raised the matter with the HSE. The HSE has been asked to ensure appropriate transport arrangements are in place. That must be done on a national basis and be available to all appropriate patients who require to travel long distances to obtain radiotherapy.

I am aware of the importance of regional services provision to patients, their families and carers. In Cork, as in many areas, much progress has been made and since the implementation of the national cancer strategy in 1997, approximately €80 million in accumulative additional funding has been made available to the southern region and an additional 11 consultants and support staff have been appointed across that region. I am delighted approval has been secured to proceed to the next phase of the development of the €47 million oncology, cardiac and renal centre, which will include a dedicated 30 bed oncology ward and is planned to commence construction in mid-2006.

I wish to express my support also for the efforts to give effect to the establishment of a ten bed medical oncology unit in Cork University Hospital, which is a tertiary referral centre for radiation oncology services. The people of the southern region and I were delighted additional ongoing revenue funding of €3 million was allocated in 2004 to cater for this expansion. A further boost for the region was delivered when the third linear accelerator commenced treatments in March 2005 and the fourth commenced treatments in October. A total of 29 additional staff have been recruited for that service. The expansion of the services under the national plan announced by the Tánaiste last July will increase the number of linear accelerators from four to seven and greatly improve access to radiotherapy treatment for cancer patients throughout the Cork and southern regions. I commend the Tánaiste, the Department and the HSE for that progress.

Another area of cancer care services that has been of some prominence recently is the treatment or, more accurately, the detection of breast cancer. The House will be aware of — I am sure Members will join me in welcoming — the fact that planning is under way for the development of the necessary infrastructure for the national roll out of the BreastCheck programme. I understand BreastCheck has advertised for key lead consultant radiologists and radiographers for the programme, and the recruitment of other key clinical posts will commence in early 2006. A design team has been appointed for the construction of two static clinical units, one at the South Infirmary-Victoria Hospital in Cork and the other at University College Hospital, Galway. While planning approval remains to be secured, I share the expectation that the design process, including the preparation of tender documentation, will be completed in early 2006 and that we will meet the target of roll out in 2007. That target is justified.

Yesterday's budget further illustrated that the Government is determined to target public spending effectively. The investment I have outlined will ensure that screening and follow-up treatment is available to approximately 72,000 women throughout the southern region, including approximately 34,000 women in Cork alone. The investment in CUH has provided tremendous results and I share the concerns often expressed in the media and elsewhere that we must get value for money. Return on investment in health services is often characterised as a type of black hole for funding but the most recent health funding for CUH has provided, in the first ten months of this year alone, over 16,000 radiotherapy treatments. In additional, over 3,300 day inpatient haematology cases and over 4,000 day and inpatient oncology cases have been treated.

It is not only a question of return in terms of quantity. The highest quality of cancer care is provided in CUH. That is illustrated by the fact that CUH was named as Ireland's first and only designated centre in integrated oncology and palliative care earlier this year. Furthermore, CUH is one of only eight centres in Europe chosen to receive this designation from the European Society for Medical Oncology for the excellence of its supportive treatment for cancer patients. The delivery of quality health care requires the good work and dedication of many people, from the Tánaiste, the Ministers of State, the HSE and, at the front line, the staff of hospitals.

I wish to record my admiration and support for the work undertaken and carried out by the superb staff of CUH. The HSE southern area is, to its credit, currently developing a regional group comprising all acute hospitals in the area to ensure the service is delivered in a unified manner. I hope the new network structure will give acute hospitals the opportunity to work together to provide the best possible cancer services for the communities they serve. To that end, I am encouraged to learn that meetings have been scheduled between the HSE and the director of cancer services in the southern area to discuss the further development of cancer services. I am also encouraged by the discussions currently taking place on options for roll out of the cervical screening programme nationally, as mentioned earlier by the Minister of State, Deputy Tim O'Malley.

I welcome the statements this morning, in particular from the Minister of State, and the measures taken by the Tánaiste regarding oncology services. I urge Members of the House to express their support for the steps that have been taken. Cancer is a terrible occurrence for sufferers, their families, friends and carers. It is a complex medical area, and one that poses challenges for practitioners worldwide. The Government has recognised the complexities and has sought, received and acted on expert advice. The national radiation oncology co-ordinating group and the HSE are to be commended and supported in this work.

I have referred to the issue of the location of services and the transport of patients, and hope that the progress sought is delivered as soon as possible. Patients must not be unnecessarily referred to Dublin for treatment, and the HSE must make available appropriate transport arrangements for patients requiring radiotherapy.

I have dedicated a good portion of my contribution to oncology services in Cork and the southern region for good and specific reasons in light of recent media reports. Cork is a clear illustration of the targeted investment practice employed by the Government. It shows how consultation provision can be expanded. It demonstrates how significant progress is being made in providing new staff, new wards and new beds. It highlights the way important oncology services such as BreastCheck are being developed and delivered. It shows that remarkable return on investment in health, in terms of quantity and quality, can be achieved and is evidence of the powerful work taken on and delivered by health personnel in the region. I welcome this debate and encourage the Government to stay on its course and continue its impressive and important work in developing oncology services across the country.