Brendan Ryan (Labour)

If they do, it should be prohibited. Places with large numbers of people and public access should not have retail outlets which sell cigarettes. They should not be sold within a 100 yard radius of such places. Putting up every obstacle possible is the most effective action that can be taken.

Regarding diagnosis, I fully accept the need for a limited number of centres of excellence and the overwhelming medical evidence to that effect. The consequence of accepting that is to ensure people geographically remote from those centres can get to them comfortably, easily and without undue financial burden, even if this means using air ambulances. It is no excuse to state it is expensive. If the best way is to have a centre in one city, which involves a 100 or 150 mile round trip for people, we must ensure it is no more difficult for them, apart from the extra bit of time, than for someone living next door to that centre. That is a fundamental element of a proper treatment scheme.

If we are to optimise results through the development of centres of excellences, we must ensure the experience of patients is not related to whether they are geographically near to or far from those centres. An ambulance which does a "Wanderly Wagon" trip and takes five hours to complete a 60 mile journey is not a solution, nor is a minibus. People must be provided with an efficient and comfortable means of travelling.

Without being pessimistic, part of a cancer strategy is to ensure the availability of both hospital and home-based palliative care of a high standard throughout the country. Will the Minister of State ensure that happens? According to the lobby groups on behalf of hospices that is not available as services are provided unevenly and in patches. It should not be the case that the quality of palliative care one receives depends on where one lives.