Fidelma Healy Eames (Fine Gael)

I welcome the Minister for Health and Children to the House. I intend to ask her questions without in any way attacking her, as has been alluded to by Government Members.

At the opening of the Seanad term, Fine Gael put forward a Private Members' motion on the crisis in cancer care. At that time, we were aware of Rebecca O'Malley's cancer misdiagnosis and the Barringtons Hospital debacle. However, we had no notion of the crisis looming in regarding to Portlaoise Hospital and the life-changing effects of misdiagnosis for eight women with breast cancer. A further six must wait to discover whether they too have cancer.

The HSE seems to be stumbling from one crisis to another. I would dearly like to receive a response to a simple question. Will the Minister, in conjunction with Professor Drumm, put in place checks to ensure systems and departments within hospitals are accountable at every level? Such an approach may prevent future health crises, whether in cancer care, hygiene or, in the case of Oranmore health centre, through the discovery of rats? Will the Minister offer a guarantee that warning letters such as those that emanated from Barringtons Hospital and Portlaoise Hospital will be heeded and acted on in future? It is outrageous that action was not taken in response to those warnings. We will give Professor Keane time and space to oversee improvements in cancer services. However, we need to know in the meantime that the necessary checks are being put in place.

I listened with interest to Professor Drumm when he told Oireachtas Members last week that no additional bed capacity is required. In the past three years, I have not met a single surgeon, doctor or nurse who agreed with this. In Galway, the delivery of breast cancer services was described to me by the eminent surgeon there as "nitty bitty" and "all over the hospital". I was told that what is needed is more dedicated beds in order that a reliable service can be offered to women as they need it. Without beds, he said, he cannot treat patients. I accept what this surgeon tells me, but it cannot be reconciled with the view expressed by Professor Drumm.

Concerns were expressed in the media last week about the reliability of all clear results previously received by women. I received a telephone call from a woman in Galway who has been for three mammograms. The result of the first was grainy and she was asked to repeat the test within six months. She did so and received the all-clear. She subsequently suffered an accident in the home which involved an injury to her breast that led to the development of a blood clot. When this was checked it was discovered, within one and a half years of receiving the all-clear, that she had a tumour of 3.5 centimetres that was diagnosed as stage three, stage four being the most serious. This woman's question was whether the Department of Health and Children's recommendation that women should receive a mammogram every two years is safe. Will the Minister review this recommendation?

Cervical smear testing is another matter of great public concern. The Royal College of Surgeons in Ireland has the only laboratory in the State accredited to undertake smear testing but more than 1 million women require smears to be analysed each year. The cancer mortality rate in this State is in the third band out of four in the EU.

The clinical director of laboratory medicine at University College Hospital Galway, Professor Martin Cormican, at the end of October wrote to doctors in the south east advising them of the discontinuation of gynaecology cytology service in the region due to a shortage of five staff since September as a result of the Health Service Executive staff embargo and a 25% increase in its workload in this year. According to Professor Cormican, this has led to:

[T]he impossibility of providing a quality and timely service to the population of both the west and south east with the current level of staff. Unfortunately, therefore, any specimens received on or after 1 November ... will be returned unopened.

He very much regretted the inconvenience to patients and colleagues.

This responsible man had to shout "stop" when he knew he could not deliver or reliably stand over the results for women's health. The smear test gives women early information regarding cell abnormalities in the neck of the womb and cancer of the cervix. On 26 October the HSE denied there was a problem. Tom Finn, assistant director at the National Hospitals Office, stated cytology services for cervical smear testing currently provided to GPs in the south east by UCHG would continue, although we now know those tests are going to Quest Diagnostics in the US. I accept these tests are going to an accredited lab, which is very good, and I accept the Minister wants the results delivered in the four to six weeks delivery time.

Currently, 10,000 tests from the south east are going to the US, costing €200,000, which money would have kept the five staff at UCHG in a job. Surely it would be more sensible to employ these five staff and keep the work in this country. An extra 200,000 tests next year going to accredited labs in the US will cost €4 million. The problem is nothing is being done to develop our own services, meaning taxpayers' money is leaving the country. Why is the Minister not investing in our laboratories? With funding, laboratories with our own staff could become accredited. What are the Minister's plans to do this? UCHG must be supported to become an accredited laboratory in the short term, and there is a wish for it to do so. The laboratory at the Rotunda is also pursuing accreditation.

Investment must be made in our laboratories to achieve accreditation. According to the HSE, the national cancer screening programme has confirmed to the Minister that a quality-assured population-based cervical screening programme will be in place from January 2008 with the good intention of reducing cervical cancer rates. How will the Minister deliver on this and is an implementation plan in place?

I will return to the issue of rats in the Oranmore health centre as I have a very disturbing piece of information to share with the House. When I discussed the matter with HSE senior management in Galway last Friday, they were very understanding and empathised with me. I was told the management was powerless. When a HSE representative saw a related letter in yesterday's Irish Independent and heard I was going on "Drivetime", the same manager was far from full of empathy. I felt intimidated by her approach.

I have reliable sources indicating that women and parents with babies are not confident about returning to that rat-infested centre. The HSE official denied it was a rat, stating it was just a mouse that was seen. We know rats and mice do not co-exist. It is has become a serious issue because there is a witch-hunt of the nurse who spoke out. Nurses did not speak to me but I have reliable sources I will not disclose in this House. The Minister has indicated she welcomes people who give good information and she is not into blaming people for reporting. That is not what I am finding in the HSE in Galway since yesterday. I ask the Minister to address the matter. I do not want to hear that any nurse is afraid of losing employment.

I welcome the Minister to the House and thank her for being here. I am looking forward to answers to the questions.