John Moloney (Laois-Offaly, Fianna Fail)

I apologise on behalf of the Minister for Health and Children, who is in the Dáil for the Private Members' debate. I welcome the opportunity to set out the position on the restructuring of cancer services, with particular reference to the issues the Senator raised on breast cancer services in the South Infirmary-Victoria University Hospital, Cork. I might also take the opportunity to deal with some of the issues raised regarding the cancer strategy.

In September 2007 the Government endorsed the establishment by the Health Service Executive, HSE, of a national cancer control programme, NCCP, to manage, organise and deliver cancer services. The objective of the programme is to improve survival rates for patients diagnosed with cancer. This involves significant realignment of services to move from the present fragmented system of care to one which is consistent with the best international standards. The HSE has designated four managed cancer control networks, aligned with the four HSE administrative regions, and the eight cancer centres selected nationally. The designated cancer centre in the southern hospitals network is Cork University Hospital.

The implementation of the national quality assurance standards for symptomatic breast disease will ensure that every woman who develops breast cancer has an equal opportunity to be managed in a centre which is capable of delivering the best possible results. To comply with the standards, the HSE has already directed 17 hospitals, including Mercy University Hospital in Cork, to cease breast cancer services. Further staged reductions in the number of hospitals providing symptomatic breast disease services will occur over the coming months in line with the transfer of services to the eight designated cancer centres nationally. In June 2007 there were 33 hospitals providing breast cancer services. By the end of this year just ten hospitals will provide breast cancer services and before the end of 2009 breast cancer services will be delivered in only the eight designated hospitals plus an outreach service in Letterkenny.

In the southern region this will involve the transfer of diagnostic and surgical symptomatic breast care services from Kerry General Hospital and South Infirmary-Victoria University Hospital to Cork University Hospital. Arrangements have been finalised for the transfer of services from Kerry General Hospital and outpatient clinic appointments are being made for Kerry patients at Cork University Hospital. The relocation of the South Infirmary symptomatic breast service to Cork University Hospital will create a critical mass of specialists of all oncology disciplines on a single geographic site.

The national cancer control programme believes the best interests of the women of Cork and of the southern region will be served by this consolidation and is confident that the consolidated service will meet the national standards for symptomatic breast care as approved by the Health Information and Quality Authority, HIQA. A high-level planning group has been established to facilitate engagement and working arrangements between South Infirmary-Victoria University Hospital, Mercy University Hospital, Cork University Hospital, Southern Hospitals Group and the national cancer control programme. The terms of reference of the high level planning group were agreed at the first meeting of the group which was held earlier today. The scope of work and key elements of the work programme were also discussed.

A parallel programme of work on identification of services suitable for reconfiguration and relocation is being carried out by the hospitals concerned under the office of the network manager, HSE south. A senior manager has been seconded to the office of the hospital network manager to work on this. These are complex and challenging programmes. Work on the development of these programmes is expected to further advance in the coming weeks and progress will be reported to key stakeholders.

The roll-out of BreastCheck, the national breast screening programme, will also significantly reduce the number of symptomatic breast cancer presentations. The Minister for Health and Children officially opened the new clinical static screening unit for the southern region last December and more than 4,000 women from the Cork area have been already screened.

The Government is committed to providing symptomatic breast disease services in eight centres nationally. Roll-out of the national breast screening programme and a quality assured symptomatic breast disease service will ensure that women will have the best chance for early detection and treatment of breast cancer. The developments I outlined will ensure a comprehensive service is available to all patients with breast cancer in the southern region.