Marcella Corcoran Kennedy (Offaly, Fine Gael) | Oireachtas source

I thank the Senator for raising this very important issue and giving me the opportunity to update the House on it.

In 2007, in recognition of the particular and unique geographical circumstances applying to County Donegal, the Department set out a very clear policy direction, approved by the Government, that Letterkenny breast cancer service should operate as a satellite centre of University Hospital Galway. Specifically, on a sole exception basis, the Government agreed that University Hospital Galway should be permitted to enter into outreach service delivery in Letterkenny as an additional activity. This exception was subject to a number of conditions, including case volumes meeting the minimum criteria and all other quality assurance standards being satisfied on the same basis as for care being provided in Galway.

The Saolta hospital group has always expressed a strong commitment to continuing the Letterkenny service as a fully integrated part of the symptomatic breast disease service in Galway, including through a joint multi-disciplinary team approach. The Letterkenny service has been run by a single consultant who also undertakes general surgery at the hospital. Support is provided by Galway-based Saolta consultants who travel to conduct clinics in the Letterkenny service to meet needs arising.

Recently, with surgical vacancies arising in the hospital and patient referrals increasing slightly, the Letterkenny service has been under some pressure to meet key performance indicators. While a particular focus has been maintained on urgent referrals, challenges are arising in addressing non-urgent breast cancer referrals in a timely way. Steps taken to address this included using locum consultants to undertake clinics, increased clinics undertaken by Galway-based consultants and the referral of some women, with their agreement, to University Hospital Galway. In mid-2016 a locum surgeon was in post in Letterkenny for a period and this had a significant impact on waiting lists. With his departure, further measures are required to address the issue.

In the short term steps are being taken to appoint a full-time locum consultant breast surgeon as soon as possible and Galway-based Saolta consultants will increase their level of support for the Letterkenny service. Meanwhile, the requirements of the Letterkenny breast cancer service in the medium term are being assessed. This is being done in the light of the clear evidence that patients who are operated on by surgeons who carry out higher volumes of surgery achieve better outcomes. Efforts have been made to recruit GP support for the Letterkenny service and will be renewed. The appointment of an advanced nurse practitioner is also being pursued. The possibility of further co-operation with health services in Northern Ireland will be explored in the future, building on the level of co-operation achieved in the case of the North West Cancer Centre at Altnagelvin Area Hospital. The centre was opened in November last year and is providing access to radiotherapy services for people from both jurisdictions in the north west.

I emphasise that the Minister, Deputy Simon Harris, is very committed to providing high quality, safe health care for patients in Letterkenny University Hospital. A significant number of capital projects have been carried out, or are planned, including a medical academy, a blood science laboratory, expansion of the recovery unit and renovations to provide accommodation for a pharmacy, a respiratory laboratory and a cardiac investigations facility. The Minister is committed to the continued provision of high quality, timely services for patients attending breast cancer services in Letterkenny University Hospital.