Joe McHugh (Fine Gael)

I welcome the Minister of State to the House and thank the Independent group for tabling this motion. It is important to be proactive rather than reactive in the debate on health services. It becomes clear that this is a live debate when one speaks to those directly or indirectly affected by cancer. Unfortunately, whether through family, friends or the local community, Senators will all know people who have experienced the ordeal of cancer or are undergoing cancer therapy.

I seek clarification on an issue I have raised previously. I am pleased to note a slight change in the language used in respect of cancer, radiation and oncology treatment for patients from County Donegal. Cancer patients in my county have had to endure the long trek to Dublin for cancer care. Options will, however, become available in Galway. A recent announcement that it may be possible to treat cancer patients from County Donegal in Belfast was met with confusion and derision. I intend no disrespect to the Tánaiste and Minister for Health and Children or her counterpart in Northern Ireland but this response was justified shortly afterwards when Mr. Shaun Woodward MP, the Minister with responsibility for health in Northern Ireland, stated on a radio programme in County Donegal that cancer patients from County Donegal would be treated in Belfast provided beds were available. This was a legitimate point and it was clearly based on demographic factors.

It is planned to establish four major radiation oncology units in the South, two in Dublin, one in Galway and one in Cork, as well as two outreach satellite centres, one in Limerick and one in Waterford. Six major centres will, therefore, cater for a population of 3.5 million. Viewed from a geographical perspective, service provision will follow an arc stretching from Galway in the west, south to Limerick, Cork and Waterford and north into Dublin. These units will cater for those living in the region extending from north County Louth southwards around the coast as far as south County Sligo. The people of the midlands will also have access to these services. When one subtracts from the population of the Twenty-six Counties the population of counties Donegal and Leitrim and north county Sligo — approximately 400,000 — one finds that the proposed plan will cater for 3.1 million people. The population of Northern Ireland, on the other hand, is more than 1.5 million. The reason Mr. Shaun Woodward MP made his remarks is that the new Belfast radiation oncology unit will cater for 1.5 million people and they will be given priority in terms of access to services. In contrast, we are establishing six centres to cater for a population of slightly more than 3 million. One does not need to be a rocket scientist to figure out that these figures present a mathematical and numerical anomaly. The reason Mr. Woodward stated that County Donegal patients would be accommodated in Belfast provided beds were available was because he looked at the mathematics.

Not alone are people from north County Sligo, Donegal and Leitrim examining the complexities of the system, so too are the people of counties Tyrone, Fermanagh and Derry. This is the reason we must have ongoing cross-Border interaction and communication between Altnagelvin Hospital in Derry and Letterkenny General Hospital in County Donegal. While I am aware that negotiations and communications between the joint management teams at both hospitals are ongoing, we have not received much detail on progress.

In terms of service provision, the people of the north west have been overlooked and find themselves facing a dangerous anomaly. People in the North who live west of the River Bann, an area which includes much of counties Fermanagh, Tyrone and Derry, have long held that central government in London has neglected them. The proposed provision of cancer services in the South is an example of the same type of neglect being shown to the people of the north west who have long believed they have been abandoned by central government in Dublin. Cancer service provision is the proof in the pudding. Peripherality and distance have been blamed but the truth is the north-western regions have been neglected.

Why did the Scottish and Welsh want devolved government? The reason was that the centralisation of power does not work either in our democracy or in the United Kingdom. We must address the failure of central government in London and Dublin to meet the needs of the people of the north west and the forum for doing so is at joint ministerial level. We can talk about the Good Friday Agreement until the cows come home but we must start to act on it. We have cross-Border opportunities to accommodate and facilitate those whom we represent.

The geographical arc between Galway and Dublin which I described extends beyond health into such areas as transport, industry and infrastructure. We have failed to provide infrastructural investment or adequate health services to the people of the north west.

How can the radiation unit in Belfast accommodate cancer patients from County Donegal when it already covers a population of 1.5 million people? The figures do not add up. The north west was previously mentioned as a potential satellite centre and I want to know why reference was not made to that today.