Seán Power (Kildare South, Fianna Fail)

I very much welcome the opportunity to contribute to this debate on the national cancer control strategy and wish to acknowledge the significant work of the National Cancer Forum which developed this strategy following a detailed consultation process with stakeholders in cancer, including major voluntary groups such as the Irish Cancer Society, ARC Cancer Support Centre and Reach to Recovery. I thank Members for their contributions.

It is fitting that the House should allocate time to discuss cancer because not only is it a major element in health and social policy but also because it has major implications for so many people. Many contributors today have shared their experiences of the difficulties created by cancer for their families. Cancer has a major impact on society, in economic and health terms and, most important, on those diagnosed with cancer and their immediate family and friends. The statistics are stark: one in four people will die of the disease and 20,000 people annually will suffer from it. The number of cancer cases will double over the next 15 years. There are around 120,000 survivors of cancer, reflecting the improving diagnosis and more successful treatments for cancers generally. Thankfully there will be greater numbers of survivors as survival rates improve for many cancers.

Some of the facts that emerged during the preparation of the strategy are worrying, such as the variation of survival rates and the poor rates of survival for common cancers when compared with other EU countries. This can be attributed to the fragmentation of cancer services where too many hospitals are involved in cancer treatment. That cannot continue if we are to deal with cancer realistically, instead of trying to provide a service in every small area.

The House has already been advised of the substantial increases in investment which have resulted in increased medical, nursing and support staffing. This investment has delivered real improvements in care. An evaluation of the 1996 national cancer strategy, including a broadly-based consultation process, was commissioned by the Department of Health and Children. The key achievement of the 1996 strategy most commonly commented on by those consulted was that it provided a framework for the development and funding of cancer services in Ireland. In fact, the National Cancer Forum has concluded that "there has been a transformation in the range and capacity of cancer services since 1996".

Palliative care is a component of integrated cancer care that is of particular interest to me. Since October 2001, almost €17 million has been invested in palliative care services and funding of €9 million was provided by the Government for specialist palliative care in the budget for 2006. A further €4 million will be allocated in 2007 to develop the service, giving the full year cost of €13 million. The funding provides for the following: 24 extended care beds in Our Lady's Hospice, Harold's Cross; €1.9 million to open six palliative care beds at Blackrock Hospice; ten new palliative care beds in Milford Hospice; a €1 million increase in funding for St. Francis Hospice, Raheny; €2 million for the development of palliative home care and community-based initiatives throughout the country; and the development of palliative care services in the midland, western and south-eastern areas.

Questions have been asked about future investment in cancer control. This Government has invested heavily in cancer services and the House can be assured that we intend to invest substantially in cancer control in the coming years. As a first step, the Tánaiste has asked the Health Service Executive to conduct a needs assessment for cancer services with a particular emphasis on the need for reorganisation and reform; the need to maximise the efficient use of resources; the need for the development of cancer service capacity at national and network levels; and the need for appropriate linkages with the national roll out of BreastCheck, the cervical screening programme and the national plan for radiation oncology services.

The executive has already commenced work on this exercise, which will take several months to complete given the importance and breadth of the work involved. Investment will be made based on demonstrable return on investment, an equitable distribution of resources and priority setting that maximises ambulatory care.

There are major challenges in the way we deliver and organise cancer control. These include the need to expand capacity, the need to ensure equity in access and delivery of care. Outcomes are variable and poor in some cases where efficiency is poor and we have fragmented services. The future investment and delivery of care must build on the positive achievements while at the same time addressing the deficiencies I have outlined. This will require significant leadership at medical, executive and community levels.

Senator Henry spoke about leadership but we are all guilty when it comes to the provision of services of trying to ensure our own area is looked after and that centres are as close as possible to our constituencies. That is simply not possible with cancer services. Expertise is needed and it cannot exist in every county. Politicians on all sides should look beyond the next election when dealing with this and should not give false hope to constituents. All parties have been guilty of doing that.