Frances Fitzgerald (Fine Gael)

I move amendment No. 1:

In page 4, before section 6, to insert the following new section:

"6.—From the commencement of this Act any review of services, including those of any land and buildings, at Saint Luke's Hospital, must be laid before the Dáil and the Oireachtas Joint Committee on Health and Children by the Minister for approval.".

We had a long discussion on Second Stage. The key points to emerge from that debate focused on centres of excellence and specialist centres, people's experience of them and also their experience of St. Luke's Hospital. It was agreed on all sides of the House that the experience of St. Luke's Hospital had been very positive. The hospital was described as a gem and an oasis. Various adjectives were used to describe what was for almost everyone a quality experience. There was a concern that this ethos would be lost. The key point to emerged time and again centred how one could ensure the standards of excellence and care and the ethos developed in the hospital could be continued.

I raised this issue during our last discussion in the House. My colleague, Deputy James Reilly, tabled an amendment proposing that any changes to be made from the commencement of the Bill, or any review of services, including of lands and buildings, at St. Luke's hospital should be laid before the Dáil and the Joint Committee on Health and Children for approval. The Minister for Health and Children, Deputy Mary Harney, had said in previous discussions in the Dáil and at the committee that she agreed with this proposal. I asked that she come back to the House today to inform us whether there had been a change of opinion or whether she still intended to do this. The value of the amendment would be that we could have a detailed discussion at the Joint Committee on Health and Children about any change of use proposed at the point where it was envisaged this would happen. It is envisaged that this happen in 2014.

This debate has particular relevance. While I did not hear the discussion, I understand the question of centres of excellence was discussed on "The Pat Kenny Show" today, arising in particular from a letter from Mrs. Kay Coburn. It is a very sad story. Mrs. Coburn's sister died from ovarian cancer and she wrote a four-page letter about what her sister had experienced in one of our centres of excellence. This is the very point I was making last week when I suggested we were removing a well proven centre of excellence. There is a page on Facebook which over 2,000 people have signed to support the continuation of the service in the hospital. There have also been numerous e-mails sent to public representatives. One cannot but be moved by their quality and how people speak about their experience of St. Luke's Hospital.

What Mrs. Coburn writes can only be described as disgraceful. If we are talking about moving patients from a proven to an unproven centre of excellence in terms of the quality of the experience, we have a real problem. My plea to the Minister on the last occasion was that if we were intent on removing the service, we should offer an equivalent service elsewhere. That is what all of the people who have contacted us are so concerned about, namely, that such a service will not be available, although it has been for so long in St. Luke's Hospital. What we are trying to restore with the amendment is control for the Minister in front of her colleagues at the Joint Committee on Health and Children and in the Dáil before further radical changes are made.

I want to return to the centres of excellence supposedly available. Mrs. Coburn's sister was not admitted directly to an oncology ward; in fact, she never reached such a ward. She was on a trolley in the accident and emergency department for 25 hours where she was subjected to various indignities and unacceptable treatment, including a delay in being seen. Mrs. Coburn refers to her sister being on a trolley which was most uncomfortable, narrow and restrictive when she was not well enough to sit in a chair. She goes into further detail in her letter. It is the saddest story one could ever read. She asks why, if we have dedicated oncology wards, there are patients who have been diagnosed with cancer in wards all over the hospital in which, potentially, they are exposed them to infections which in their compromised state could have a serious or fatal outcome. It is a reasonable question to ask, if we say we are providing specialist centres and at the same time doing away with a specialist centre that was providing high quality care. How can we describe these as units specialist units if half of the patients that should be in them are in medical, surgical and geriatric wards around the hospital?

Mrs. Coburn asks where is HIQA in all of this. She thought her sister was entering a centre of excellence, but she did not receive excellent treatment. Mrs. Coburn asks why patients who are suffering from cancer have to be readmitted time and again via an accident and emergency department process when the name of the doctor who will be dealing with them is known. Unfortunately, her beautiful sister died on 23 June "at home in the loving care of her family, and I had the privilege of nursing her." The letter continues: "I have never written to a TD, Minister or anyone else before but I am going to bombard everyone because of what I witnessed and what my sister endured over the past 48 hours and indeed may have to endure again". That is her experience of a centre of excellence in 2010.

This adds weight to the point that so many of those who have contacted us about St. Luke's Hospital have made. We have a centre which provides excellent care. I absolutely support the provision of high quality and specialist care. However, it is reasonable to ask what standard of care will be provided in the specialist centres of St. James's and Beaumont hospitals when services are transferred from St. Luke's Hospital.