Kathleen Lynch (Cork North Central, Labour)

I am taking this on behalf of the Minister for Health, Deputy James Reilly, and I thank the Senator for bringing it to our attention. I welcome this opportunity to address the House on the issue of cancer services at Sligo and across the system. The burden of cancer continues to increase. This year, approximately 24,000 people will be diagnosed with invasive cancer and over the coming years, the numbers diagnosed will continue to rise owing to the ageing profile of our population. This provides a major challenge for cancer control.

The National Cancer Control Strategy addresses this challenge. It envisions a cancer control system that will reduce Ireland's cancer incidence, morbidity and mortality relative to other EU countries. Prevention, early detection and treatment are all core elements of such a system, and continued progress in these areas remains a high priority for the Minister. With regard to prevention and early detection, the programme for Government includes a commitment to extend BreastCheck to include women who are aged 65 to 69 years of age. At present BreastCheck is available nationwide to women aged 50 to 64. The HSE's National Cancer Control Programme is examining how it can extend the programme to those aged 65 to 69.

With regard to treatment, considerable work was done by the National Cancer Forum, which developed the cancer strategy, on how treatment services should be organised, especially in acute hospitals. The strategy set out the rationale for the restructuring of cancer services in our hospitals and recommended that cancer centres which each serve a minimum population of 500,000 should be designated by the HSE and that Ireland required approximately eight such centres. Accordingly, in 2007 the HSE designated eight hospitals as cancer centres and established the National Cancer Control Programme to implement changes in how treatment services were organised and delivered.

A key element of this is the centralisation of diagnosis and treatment for cancer in the eight centres.

This is in line with international evidence which shows that the best outcomes for patients are achieved by specialist teams in specialist settings with access to ongoing education, training, research and peer review. Sligo General Hospital is one of a number of hospitals from which breast cancer diagnosis and surgery was transferred in line with the HSE's cancer strategy. The transfer took place in August 2009 and women in the Sligo area are now provided with breast cancer diagnosis and surgery at Galway. It is important to note that 96% of women who attend the Galway unit do not have cancer and only one visit is normally necessary. For the small number diagnosed with breast cancer, 85% will require radiotherapy as well as surgery, which would involve treatment in Galway in any event.

Chemotherapy services continue to be provided in Sligo and are linked with the necessary multidisciplinary team in Galway. The Minister is pleased to confirm that recruitment of a second medical oncologist for Sligo is in train. There is also a specialist breast nurse in Sligo and detailed clinical pathways have been worked out for Sligo patients presenting with post-operative infection or other conditions so as to minimise the need to travel to Galway. Sligo also provides a significant range of other cancer services, including surgery for non-melanoma skin cancer and colorectal cancer. It has also been selected as one of the 15 candidate colonoscopy centres for the colorectal cancer screening programme to be launched next year.

The Minister intends to keep the current arrangements for cancer treatment at Sligo under review, particularly in relation to follow-up mammography services for women. These services are currently provided from Galway. The Minister shares the Senator's concerns and will keep the matter under review.