Ciarán Cannon (Progressive Democrats)

I welcome the Minister's appointment of Professor Keane to the post of interim director of the national cancer control programme. Professor Keane brings with him a wealth of experience from working in cancer control in British Columbia, which has a similar population to Ireland,of slightly more than 4 million. As a result of Professor Keane's work, that province now has a model that is the subject of worldwide envy.

Ireland's new cancer care programme differs markedly from the previous approach as it will control all identifiable cancer-related HSE expenditure and will manage all of the country's cancer control assets. In practice, this means the cancer control assets of hospitals and institutions will come under the control of the national cancer control director, who will have the authority to direct the discontinuation of any service that does not meet the required standards. It is highly appropriate that Professor Keane, with his expertise and experience in the Canadian system, would assume this interim position in Ireland, which is a country he knows and a health system with which is he familiar.

I firmly believe his appointment is a watershed in Ireland for cancer care. This is a time when we can make the practical decisions that are needed to break through to higher standards in our health services nationwide. I also believe that a major factor in Professor Keane's decision to take on this role is the presence of Deputy Mary Harney as Minister for Health and Children. Her unflinching commitment to securing the best possible outcomes for all patients surely must have instilled great confidence in Professor Keane that any sweeping changes he might suggest would be supported by a Minister who has a long track record of courageous reform.

It is time for all Members, on both the Government and Opposition benches, to take a responsible attitude to the difficult decisions that lie ahead. The decision is not about hospitals, institutions or budgets but is about the best patient care. All those involved in health care have an ethical obligation to make decisions in the best interests of patients before local, institutional, political or professional interests. I believe this is the moment when Ireland can demonstrate that it is capable of re-organising cancer surgery according to patients' best interests. There are those from some political quarters who seem to think that the introduction of centres of excellence and the consequent scaling-down of smaller hospitals offers them a wonderful soapbox opportunity from which to pontificate shamelessly on a supposed downgrading of health services in their locality.