Paddy Burke (Fine Gael)

I move:

"That Seanad Éireann, noting:

the announcement of a National Cancer Strategy;

the proposal to develop eight centres of excellence at various locations around the country;

the intention to provide every patient with the best medical care and clinical attention;

the absence of a Centre of Excellence north of a line from Dublin to Galway and conscious specifically of the geographical challenge and population distribution of the West/North West region; and

the proposed closures at University College Hospital Galway, where the Centre of Excellence is to be located, for the month of August this year due to severe budgetary constraints;

calls on the Government to:

proceed immediately with the provision of Centres of Excellence, based on an adequate and ring-fenced budget;

proceed immediately with the provision of a satellite unit at Letterkenny General Hospital and under the responsibility of the Galway Centre of Excellence;

retain existing safe, high quality cancer services as at Mayo General Hospital and Sligo General Hospital as satellite units under the responsibility of the Galway Centre of Excellence;

ensure that all Centres of Excellence and satellite units are the subject of an annual HIQA audit; and

continue to work closely with the authorities in Northern Ireland on the development of cancer services.".

I welcome the Minister back to the House. She is a great attender here for debates on motions on health matters. I am delighted she is here to take this important motion.

I thank the Labour Party for joining Fine Gael in tabling this motion. It is a very important motion dealing with the provision of cancer services, particularly in the west and north west. The motion will afford the Minister and the Government an opportunity to reverse the decisions that she has taken, or at least to put them on hold, until the centre in Galway, in our case, is fully operational.

This motion is the same as that which was debated in the Dáil some weeks ago. I am delighted that something positive has emerged from tabling it. The Government amendment to the motion is different from that to the motion on this matter in the Dáil. I welcome some aspects of the Government amendment, particularly where it is stated that "seasonal arrangements for summer months at University College Hospital Galway do not impact on key specialties, including cancer specialties". I would like the Minister to explain that aspect because the word is out that cancer services and operational services will close in University College Hospital Galway during the summer months, particularly for the month of August. I am delighted this provision is included in the amendment and welcome the intent of it, but I would still like the Minister to explain it.

The Minister needs to clarify a number of issues regarding statements she made concerning cancer services in the west and north west in the context of the number of hospital procedures carried out. What figures did she use to support her statement that women had a better chance of survival if the treatments were carried out on the east coast versus the west coast? She made that statement some weeks ago. Can she explain the differences between the figures she gave for breast cancer procedures carried out at Mayo General Hospital and Sligo General Hospital and those given by the surgeons and those hospitals? I would like the Minister to explain the discrepancy in those sets of figures.

The Minister is doing a disservice to Mr. Barry in the case of Castlebar and Mr. O'Hanrahan in the case of Sligo because they know the number of procedures they carried out. She has cast aspersions on them by saying they have not carried out the number of procedures that they have carried out and by saying that there is a better chance of survival if treatments are carried out on the east coast rather than on the west coast and in the south. Those two issues in question are dear to the hearts of those surgeons and I hope the Minister will take this opportunity to clarify them.

The Minister also said that the people were voting with their feet and were leaving Castlebar, other parts of Mayo, Sligo and the north west and going elsewhere to have their procedures carried out. I do not find this is the case on the ground. Thousands of people marched on this issue in Sligo and 7,000 people marched in Castlebar. The women who had procedures carried out in the centres in Castlebar and in Mayo led the campaign. Those seven brave women know what has happened in their cases. They have the highest respect for Mr. Barry and his multidisciplinary team in the case of Castlebar and Mr. O'Hanrahan and his multidisciplinary team in the case of Sligo. I do know of any cases, particularly in Castlebar and elsewhere in Mayo, where people are not going to the centres in Castlebar or Galway. The Minister said people were voting with their feet already and going elsewhere to obtain breast cancer services or have procedures carried out, but I do not find that to be the case.

I do not know from where the Minister got the figures to support her claim that people have a better chance of survival if treatments are carried out on the east coast than if they are carried out on the west coast. The centres in Castlebar and Sligo are only in operation since 2000. The first five-year survival rates are coming on stream. The survival rates in the centres in Castlebar and Sligo are more than 88%, which compares favourably with any centre in the world. That is why I hope the Minister will use this opportunity to apologise to those surgeons and to clarify the position. That would be welcome.

There is also the matter of funding. I acknowledge that the Government amendment refers to arrangements during the summer months. There is chaos in Galway. There are procedures that need to be carried out other than breast cancer services.

For parathyroidectomy there is a waiting list of almost 40 patients for Galway. That hospital can carry out only three operations per week. In effect, there is a waiting period of more than six months in Galway for this procedure. This is a life threatening disease for which procedures have to be carried out urgently for the patients involved but due to pressure on theatres these procedures are not being carried out. We now have a situation where people from Mayo, Sligo, south Donegal, Leitrim and north Roscommon will descend on University College Hospital Galway after September when Mr. Barry and his team move to Galway. This is unprecedented. Can one imagine Mr. Barry and his multi-disciplinary team leaving Castlebar and travelling one and a half hours to and from Galway one day per week when he could look after patients in Castlebar because he will meet only patients from Mayo in Galway? It is a Mayo clinic within University College Hospital Galway.

I am not sure whether there will be a Sligo, Roscommon, or south Donegal clinic in University College Hospital Galway. Two beds are available for the Mayo clinic within the Galway hospital which has ten beds. These beds are operating at full capacity. That a top class surgeon and his team will travel one and a half hours each way, one day per week, to Galway from Castlebar to meet patients from Mayo when he and his team could meet them in Castlebar every week is ridiculous. Some 30 to 50 people will travel from Mayo to Galway when they could be seen in Castlebar. That makes no sense.

I wish to draw the Minister's attention to an article in the Irish Medical Times of 28 May 2008 on the Beacon centre which reads:

A new breast cancer surgery service will open in six weeks' time at Dublin's Beacon Hospital. . .

The breast surgery service will augment a "comprehensive cancer care services" which has been operating at Beacon for the last year . . .

Delivery of an outreach service is envisaged under the Government's cancer plan. University of Pittsburgh Medical Centre (UPMC), which manages Beacon, runs a cancer facility in Pittsburgh, which is outpatient-oriented and operates in conjunction with 43 satellite centres. Service Level Agreements for cancer were reached for UPMC's joint venture Whitfield Clinic in Waterford in February last year and for the Beacon Hospital in January 2008. The beds in Beacon's oncology day unit can be turned around more than once daily. . .

In Western Pennsylvania, 90 per cent of patients get cancer care close to their homes, through a network of 23 centres. Ninety five per cent of our patients can get care at locations less than 20 minutes from where they live.

That is all we are asking for in Castlebar and Sligo. We are seeking an outreach and a satellite of University College Hospital Galway. We understand that and we are fully in agreement with the centre of excellence in Galway.

The Minister has an opportunity to at least delay the removal of services from Castlebar until Galway proves itself. She has said in the past that these centres will provide a better service to patients than at present. The people of Mayo, Sligo and the north west will not get a better service in Galway at present than they get in Castlebar or Sligo.

I ask the Minister to examine this issue closely and delay the removal of services to Galway. I hope she will avail of the opportunity to clarify the issues I have raised in regard to the number of procedures and the shadow she has cast over the work of some of the finest surgeons in the country.