Marc MacSharry (Fianna Fail)

There are other details from the O'Higgins report, entitled The Development of Services for Symptomatic Breast Disease, which is a report of the sub-group to the National Cancer Forum. It states: "A unit seeing 100 cases of breast cancer per year would see at least 1,000 new patients with breast symptoms annually." As it stands, medical personnel in Sligo General Hospital carry out 4,000 mammograms per year.

Under the 2006 cancer control strategy, the HSE should:

[C]onduct a needs assessment for cancer services with a particular emphasis on hospital-based cancer treatment that addresses the need for continued expansion in capacity and maximises the use of ambulatory care. Diagnosis and patient management should be planned by site-specific multidisciplinary teams.

This has not happened yet. Professor Keane is going to prioritise breast services and we are led to believe, from Professor Drumm and John O'Brien from last week, that he will have plenipotentiary status in how he will carry out the service. If that is the case, why did we announce the centres of excellence in advance?

I do not have an issue with the eight locations and it stands to reason they should exist. Should there be a ninth, with Sligo being that hospital? At a minimum, we should be cognisant that an excellent service of a multidisciplinary nature is being carried out. We cannot ignore that. That National Cancer Forum agreed and recommended the concept of centres of excellence, the theory of which everybody would buy into, myself included. It did not recommend where the centres should be or that we should close down an existing service being carried out excellently.

I am not being parochial because I am from Sligo or I want services in every corner. I beg the Minister to allow common sense to prevail and not just a series of management consultants and health professionals in one expert group deciding there should be eight centres and the north-west centre should be closed. There is specific reference to Letterkenny, 18 miles from Altnanagelvin.

Last week Professor Drumm referred to specific issues geographically and on a cross-Border basis. What is happening on the North-South Ministerial Council? It is a no-brainer for there to be an outreach centre for Galway with Altnagelvin so close. Why is it not Altnagelvin, Letterkenny, Sligo, Galway? I am not saying that services should be taken from Letterkenny, I do not want anything taken from there unnecessarily, but where is the joined up thinking in removing an excellent service from Sligo? It makes no sense.

I am delighted that Professor Keane, on the invitation of the Minister of State, Deputy Devins, will be coming to Sligo to see at first-hand the nature of the excellent service there, with its multi-disciplinary approach. I will be interested to see the level of outcomes there. We must be logical in our approach to this. Everyone supports centres of excellence and applauds the determination and conviction in pursuit of them but we must not begin by winding down a centre of excellence in breast care in all but name. It is ridiculous in the extreme and the reaction of some HSE personnel when such points are made is a disgrace.

I know the Minister will show leadership in holding the HSE to account on behalf of the people, particularly those of the north-west. All of the locations are acceptable but we must re-examine the north-west region and be true to the people there. Various reports over the years have highlighted that Sligo should be a centre of excellence and in practice it is. We must acknowledge that and applaud the work being done there by consultants and others, people the HSE is anxious to relocate and has asked to do so.

A question Senator Healy-Eames will recognise is where will the 4,000 women park in University College Galway. It is all well and good to have the aspiration of centres of excellence and moving everything to Galway but it is an impossibility unless billions of euro are dedicated to it.

I ask the Minister to allow common sense to prevail, to allow Professor Keane to carry out an audit of service and outcomes in existing facilities in Sligo General Hospital and to grant him the authority to say we have got it wrong in this case. It is good to admit a mistake sometimes, such as with the driving tests, it is okay to say we have overlooked an issue, that an excellent service is being offered in Sligo and that the matter is being reconsidered.

The Minister is determined and does her business in the interests of the people. She wants to be true to the people of the north-west. I beg her to be cognisant of the points raised by me and my colleagues from the region.