Fidelma Healy Eames (Fine Gael)

I second the motion in the name of my colleague, Senator Paddy Burke.

I welcome the Minister to the House. I take this opportunity to look at Galway and how it can serve the whole region of the north west. In that regard I will point out pluses and minuses in regard to the centre of excellence. We need an assurance that the minuses will be addressed, otherwise an adequate service cannot be delivered to the people of Galway or to the people of Sligo and Mayo. I accept it is great to have centres of excellence in health because in the area of breast cancer outcomes matter. To achieve the best outcomes, high volume and throughput count. I do not say this because the Minister has said it. It is a fact.

Galway has some excellent fundamentals in place. I will give a balanced contribution having done my research locally around the pluses and minuses. We can be proud of Galway in that, according to the national cancer control programme, more than 60% of women presenting with breast cancer do not need a mastectomy; a lobectomy will suffice. Also, more than 50% of women presenting with a mastectomy undergo immediate breast reconstruction at the same time, which is the highest rate in the country. All plaudits go to Galway.

There are aspects of Galway that appear to be ready to cope with the transition of breast cancer care from Sligo and Mayo but there are a number of aspects that are not adequate, even for Galway's hinterland. In regard to outpatient care, I am delighted with the new symptomatic outpatient unit, which opened on 16 June and which is working well. I understand there is adequate physical space there to cope with increased population. However, it is lacking in terms of staffing arising from increased patient case loads predicted from Sligo and Mayo. Extra patient caseloads from these areas will require the following staff to provide essential care: two to three outpatient nurses, one breast cancer care nurse, one radiographer, one receptionist-clerical officer and one backroom secretarial person. I did not make up those figures, they come from the unit. This staffing level will be needed to run the clinics. In addition, three consultants are needed if we are to cope adequately with the transition. In light of the staffing embargo and the ongoing cutbacks will the Minister outline her commitment to these specific staffing resources?

There is a need for dedicated beds because there is still a problem with access to beds. The care is good, the outcomes are great but the access is not good. There are no dedicated or protected beds specifically for breast cancer care in University College Hospital Galway. A centre of excellence for Galway and its hinterland, not to mention the expanded area of Mayo and Sligo, needs its own protected dedicated space, not a bed here and there.

Two new operating theatres are due to open in October 2008. We need a commitment that staffing will be provided for those theatres. These are the questions coming from the practitioners in the field in Galway.

I support my colleague, Senator Paddy Burke, on the notion of network solutions and outreach centres. Last autumn, when speaking to the main surgeon in Galway, he envisaged Galway as a centre of excellence but with network satellite centres in Sligo, Castlebar and Letterkenny to create a network solution to best serve patients' needs locally where that was possible. Like my colleague, I look forward to the Minister's response on that issue. It is critical that no centre should be closed until the new resources are provided. I seek an assurance that adequate capacity and staffing are in place before local facilities are removed, not only for the women of Galway but for those in the entire north west. That is only fair. Otherwise it will make a joke of the philosophy of centres of excellence.

I am concerned about the capacity of the laboratory in University College Hospital, Galway, to cope with cervical smear testing volumes. I am most disappointed with what has happened there. The Minister is aware that there has not been investment in the laboratories in UCHG to help it achieve accreditation. I accept, however, that it is on a list for that purpose. Last autumn, due to inadequate levels of staffing to meet the volumes of cervical smear tests in UCHG, smear samples from around the country were refused. I saw the letter myself from a professor. The laboratory needed only two extra staff to cope with the increased volume of smear tests. Instead, the Minister chose to outsource that work to private laboratories that had only 80% to 85% reliability compared with 95% in Galway. The laboratory's only failing was that the Minister did not invest to upgrade it. If the Minister is committed to Galway as a centre of excellence for breast cancer care, she should tie in other aspects of women's health in order that it can be a centre of excellence for cervical smear testing also.

My final point relates to the important area of broader transport infrastructure to support UCHG as a centre of excellence. I do not know whether the Minister is aware that traffic-wise, Galway is a bottleneck. The Galway Independent is a local newspaper that profiles an important person in Galway every week. People are asked what are the best and worst things about Galway and each week it is reported that the worst thing is the traffic. I received a significant number of representations about the need for a right-turning arrow to allow people to turn into UCHG. On several occasions I have waited in my car for up to three changes of traffic light to gain access to the hospital. One can imagine what that is like for sick patients in their cars and the inconvenience caused to families visiting patients, sometimes from a long distance away. I question whether there is joined up thinking between the Departments of Health and Children and the Environment, Heritage and Local Government to make Galway a true centre of excellence capable of serving the entire area. I look forward to the Minister's reply as it is important to people in Galway and to women across the north-west region.