Nicky McFadden (Fine Gael)

I welcome the Minister to the House and thank her for taking the time to be here.

I fully support centres of excellence and I particularly support my colleagues, Senators Burke and Healy Eames in calling for the retention of existing high quality services at Mayo General Hospital and Sligo General Hospital, as satellite units. I urge the Minister to ensure the centre of excellence at Galway is able to cope with the increased volume of patients. In that context, I question the notion of closing the University College Hospital in Galway for a month. How in God's name can one close a centre of excellence for a month? I ask the Minister to clarify the situation in that regard.

There have been many fatal cutbacks in the health service. Wards have been closed, operations have been cancelled and there have been enormous increases in the number of patients on trolleys. Senator O'Toole mentioned Ms Nuala O'Faolain but there are many people like Ms O'Faolain. We should never forget the story that was documented on RTE, although I cannot mention the lady's name, about the length of time she had to wait to undergo a colonoscopy — seven months. We should also not forget the people to whom Senator Prendergast referred who were misdiagnosed in Portlaoise. I hope we never see this in our health service again. It is worth noting that the situation in Portlaoise arose less than a year ago.

I reiterate that I support centres of excellence. The Minister was present during my first debate in the House. I was accused of being parochial and colloquial when I protested at the closure of services in the Midland Regional Hospital in Mullingar but I make no apology for the concern I had for my constituents and the people of the midlands generally. At the same time, I agree with the need for centres of excellence. Unfortunately, however, people are not being cared for in the way they should be. People from the midlands region must travel to St. James's Hospital in Dublin and some who are attending Portiuncula Hospital are now being told they must attend the University College Hospital in Galway, the site of the proposed centre of excellence.

I repeat that centres of excellence are the way forward because there must be a sufficient volume of cases to guarantee better outcomes. There must be accessibility and staff. How can one deliver the service that is needed if there is an embargo on staff?

I spoke in the first debate about people travelling from the midlands to Dublin, having to get the train at ungodly hours and having to get off it to be sick. This situation has not changed. There are people in Ireland who have no cars and no means of transport. During the initial debate, I asked the Minister to put a dedicated medical transport system in place. There should be joined-up thinking between the HSE, the Department of Health and Children, which we should not forget, and the Department of Transport and a central fund should be ring-fenced for comfortable transport for victims of cancer.

It has been rumoured, and the Acting Chairman will have an input into this, that there will be a transfer of services from Roscommon County Hospital and that people will be helicoptered to a centre of excellence. I am not sure whether this centre will be Galway. Can the Minister clarify that because rumours are rife?

The Minister told me that Athlone is very well-serviced bearing in mind that we have no hospital. However, 40% of the people of Athlone, the population of which is about 25,000, attend Portiuncula Hospital. There is no longer a mammography service at Portiuncula Hospital which means that 40% of the patients from the Athlone area who have cancer or a query or need even a routine mammogram must go to Galway to which they are being transferred from Portiuncula Hospital. This is a significant number of people.

I commend the oncology service at Portiuncula Hospital and hope that it will not be removed. There is an excellent chemotherapy treatment at the hospital in conjunction with an advanced nurse practitioner. I applaud the staff who provide a 24-hour treatment facility. It is way beyond the call of duty. Due to the staff embargo, staff at this hospital are under serious strain and provide great relief to cancer services in the midlands and Galway area.

In respect of cytology, my colleague, Senator Fidelma Healy Eames, referred to the fact that laboratories are unable to cope with the volumes. To me, a centre of excellence is a place where one can get a diagnosis, prognosis, surgery and palliative care under the one roof. Is that correct? In respect of cytology and people who want to get the results of smear tests, this, to me, is diagnosis and should be provided under the one roof. As a centre of excellence, the laboratory should be able to deal with smear tests. Smear tests are no longer being reported or dealt with in Portiuncula Hospital but are being sent to Antrim at huge cost. I believe that funding must be provided in University College Hospital Galway as the centre for excellence for smear tests and the reporting of such tests.

I fully support the motion, particularly the position taken by my Mayo and Galway colleagues because I am concerned about the volume, access and egress to University College Hospital Galway where there is no car parking. This very basic issue needs to be addressed to deal with cancer services and a centre of excellence.