Frances Fitzgerald (Fine Gael)

I welcome the Minister to the House. This legislation, which changes the governance of St. Luke's Hospital, has evoked a strong reaction from the thousands of individuals and their families who have used the services in St. Luke's. That is clearly because of the quality of service those families and individuals have received in St. Luke's. It has led to incredible fund-raising of €26 million, the establishment of institutes and foundations to support cancer research, and an organisation called Friends of St. Luke's Hospital. All that has happened in the past 55 years while the hospital, in the absence of quality cancer care in other areas of the country, fulfilled a vital role.

Since its formal opening in 1954, hundreds of thousands of patients and their families have been through the doors of St. Luke's and experienced quality care. They have not just received medical care. They have received medical and psychological support and, at the most stressful of times, they have had a very good experience in the hospital. That is the reason we have had so many people reacting to the news in the Minister's Bill.

I will read one of the e-mails I got about St. Luke's; I am sure the Minister has received many also. It states:

1. Over 180,000 people have petitioned Dail Eireann to retain St Luke's and all its services.

2. History shows that decisions taken without due care and rationale have enormous consequence; [the person gives some examples].

3. Visit the Facebook 'Save St Luke's Cancer Hospital'.

I looked at the website and 2,215 people have signed on to the Facebook page in an effort to keep St. Luke's as a viable entity.

It is important that we take account of the holistic and healing ethos in St. Luke's and do whatever we can to bring that forward into whatever new services are being developed. There is no doubt that it is a gem of a service. The quality of people's experience in the hospital has been very good, and the quality of care has been excellent. However, the medical context is now changed. As the Minister of State outlined, we are moving to specialist centres with inter-disciplinary teams where the quality of care is the very best possible, and we hope that will continue.

I welcome the approach the Minister has taken to the lands at St. Luke's, which will be kept for health services. However, I point to the contradiction in what the Minister said on Committee Stage in the Dáil when Deputy James Reilly moved an amendment to the Bill. Will the Minister's staff in the Department re-examine that? On 30 June Deputy Reilly said he would table an amendment on Report Stage to ensure that any review of services or new plan for St. Luke's Hospital would be brought before the health committee. The Minister said in reply that he was happy to agree to Deputy Reilly's suggestion. Before Committee and Report Stages of the Bill in this House I ask the Minister to look again at that amendment which she agreed to accept but which is not met by the amendment tabled in the Dáil during the debate yesterday. I ask that it be examined and built into the Government amendment because it appeared at the time that the Minister was happy to accept that.

I welcome that there will be ongoing discussions between the board of St. Luke's Hospital and the Minister to work out the future use. It is extremely important that we learn from the ethos in St. Luke's and that in developing HSE services that ethos becomes part of what is available to patients under the HSE services which, sadly, have been lacking in quite a number of cases. I do not have the time to go into the details of those now but, unfortunately, it is easy to recall the disappointment many cancer patients experienced at the hands of our medical services in the past six months to a year. I readily acknowledge that there have been very good experiences as well but the experiences of people like Rebecca O'Malley, the late Susie Long, the women in Portlaoise and the people whose x-rays were not read in Tallaght hospital was very bad and we must work constantly to improve the services available.

I support the role of specialist centres. I never had any doubt about it, particularly in regard to breast cancer services, for example. However, we must take account of geographic considerations which are important. Undoubtedly, the outcomes are better in specialist centres and it is vital that we all acknowledge that. I want women and men to have the best possible outcomes. Those affected by cancer deserve the very best care and if we are not engaging in best international practice, that is wrong.

We cannot move people to specialist centres before the specialist centres are properly developed and have the ethos and the support services that have been available in St. Luke's. Many of our general hospitals, for example, were not ready for the designation they got as a specialist centre. We have seen that in Galway and in other hospitals. I note that at the same time we are debating this legislation about moving radiation oncology to Beaumont and St. James's hospitals, 52 beds have been closed in Beaumont Hospital in the same number of weeks. A question arises, therefore, about the timeframe around the development of radiation oncology. Perhaps in her reply, the Minister of State, Deputy Áine Brady, could outline that. She commented on it in her speech. However, I note that the original plan for the development of those specialist centres had a different timeframe and it appears it is being pushed back, probably to 2015. We have stated that the radiation oncology services would move in 2014, but I understand that has already been extended to 2015. Is it likely that the services will continue for a longer period in St. Luke's than is currently envisaged in the Minister of State's speech today? For example, we had been told that there would be two new radiotherapy centres, at St. James's and Beaumont, at the end of 2010 under phase one of the national plan for radiation oncology. They all were supposed to be rolled out by 2011, but that timeframe seems to be in serious question. In principle moving people to specialist services is excellent and in principle outcomes are better, but in practice, if we are unable to develop the services and make them available because of cutbacks and if the support services are not in place, then obviously, it should not happen and the timeframes may well need to be revisited. I have no difficulty in supporting the principle of the Bill.

I also welcome the title St. Luke's Oncology Network. It is important that the title has been kept. It is a positive statement and a positive acknowledgement of the work done in St. Luke's. I hope every effort will be made to support the work of the two research institutes and foundations in their ongoing attempts to get more money for cancer services and to continue the fund-raising work.

I hope the volunteers who are terribly disappointed and the professional staff from St. Luke's will be able to make the transition envisaged positively, and no doubt they will do it in a professional way. I hope their disappointment at the changes being made today will not hamper their ongoing work or will not make them feel disillusioned about the support they have given to cancer services, and, I hope, will continue to give because we need the efforts of all the volunteers in this area. I have been involved for several years with the breast cancer voluntary organisation Europa Donna and I am familiar with the work it has done to support individuals who have breast cancer. Really, a family can never have enough support if a member is going through cancer. The medics and the professionals will never be enough. It always will be about the support that one gets from family and one's wider network and from the volunteers who do such fantastic work with all of these illnesses and offer such brilliant support services. I hope the thousands of people who have given so much to St. Luke's will be able to continue to work for the benefit of cancer patients throughout the country. That is extremely important.

I suppose one of the major criticisms of the HSE has been the lack of the kind of ethos we have seen in St. Luke's. It is a significant challenge for us to turn the HSE, as the overarching supervisor of the health services, into the kind of body able to deliver the quality service that was available in St. Luke's.

I support the Bill. Will the Minister look at the amendment Deputy Reilly tabled? I acknowledge that to some degree the Minister has met his request that the lands would be maintained for health and allied services, and I welcome that. I congratulate and pay tribute to the enormous amount of work that all of those associated with St. Luke's have done over the many years that it has been providing such a tremendous service to Irish people who have had cancer. I hope their work will continue, albeit, perhaps, in a new place but also on the grounds of St. Luke's where the services will take a slightly different format than we have been used to.