Joe McHugh (Fine Gael)
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I have been approached by relatives of cancer patients in Letterkenny and relatives of people who have since passed away. The oncology unit in Letterkenny General Hospital is second to none. There is a dedicated, professional team in place there under the stewardship of Dr. Karen Duffy and Mr. Chris Lyons. However, there is a problem with regard to the fast-tracking of cancer patients for emergency services. For example, a patient with breathing difficulties as a result of lung cancer would have to go through casualty, queuing along with other patients there.

As a qualified pharmacist, the Minister of State will be aware that on a Saturday night every type of patient can appear in hospital, as a result of car accidents, drink-induced injuries and even minor domestic injuries. I am calling for a separate channelling system for cancer patients who constitute a very vulnerable group. They are most susceptible to infection, including the winter vomiting bug. They and their relatives believe it is not appropriate for them to have to sit in casualty for up to three or four hours. It is not humane and is not in line with best practice for the treatment of cancer patients.

The kernel of the problem, which was acknowledged by staff at the oncology unit in Letterkenny yesterday, is bed capacity. That is a problem throughout the country, not just in Letterkenny. Nationally, bed capacity is operating at approximately 105%. Ideally it should be at 90% with a 10% bed space available for emergency cases, whether cancer patients or others.

This is a sensitive area as the Minister of State knows due to his medical expertise, which is much greater than mine. I wish to convey the sentiments and feelings of the people who have been affected by this situation. Their relatives have spent time waiting in casualty, sometimes for up to four or five hours, although they are only awaiting consultancy services for breathing difficulties or minor bowel surgery.

Time is precious enough for cancer patients. I have received repeated representations from a daughter who had to sit with her father for five hours in casualty two weeks before he passed away. That is not good enough and I know the Minister of State also does not believe it to be good enough. Bed capacity is the problem so I am seeking some form of intervention to allow cancer patients to be treated as a separate group. Hopefully, in the short to medium term they will not have to wait in casualty for emergency services.

Tim O'Malley (Limerick East, Progressive Democrats)
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I thank Senator McHugh for having raised this matter on the Adjournment. I welcome the opportunity to address the issues raised about the delivery of cancer services at Letterkenny General Hospital. Currently, patients under active cancer treatment at the hospital are encouraged in the first instance to contact the oncology day case unit. During normal working hours from Monday to Friday, these patients can be seen and dealt with in the oncology unit. Outside of normal working hours and at weekends, it is necessary for those patients who develop complications to access the hospital services by going directly through the emergency department.

I can assure the House that oncology patients who attend at Letterkenny General Hospital receive appropriate care and follow-up treatment. Patients suffering from cancer sometimes develop non-cancer related problems. The safest and most appropriate place to deal with these non-cancer related problems is the emergency department at the hospital where dedicated teams are available on a 24-hour basis to diagnose and treat these conditions.

Last year, approval was given to the North Western Health Board to proceed with the planning of an extension to the accident and emergency Department at Letterkenny hospital. A design team has considered a number of options for this development and a proposal has been made to the Department, which is currently being considered. In addition, a new 11-bed oncology in-patient unit at the hospital is at design stage. This will ensure that cancer patients who have treatment-related complications will be able to access a dedicated unit on a 24-hour basis at the hospital. It is expected that construction of this ward will commence shortly.

Substantial developments have taken place in recent years in the development of a comprehensive cancer policy. I am pleased to have the opportunity to outline these developments and, in particular, the extensive investment programme which the Government has undertaken under the national cancer strategy.

Oncology services at Letterkenny General Hospital have undergone significant developments in recent years with the appointment of both a consultant oncologist and a consultant haematologist together with support staff. These appointments have greatly enhanced the services available to cancer patients at the hospital. The establishment of the new inpatient ward will further enhance services there.

Since 1997 additional cumulative funding of €38 million has been made available to the North Western Health Board to support the development of cancer treatment and cancer care services. This investment has resulted in the appointment of an additional eight consultant posts in specialities such as medical oncology, histopathology, haematology and surgery and the appointment of an additional 15 cancer care nurse specialists across the region. These investments have resulted in significant improvements for oncology patients. The North Western Health Board is also preparing an improved plan for the organisation of symptomatic breast disease services in the region.

The key goal of the national cancer strategy 1996 was to achieve a 15% decrease in mortality from cancer in the under-65 year age group in the ten year period from 1994. The independent evaluation of the strategy carried out by Deloitte, demonstrated that this figure was achieved in 2001, three years ahead of target.

The total additional cumulative investment in cancer services nationally has been approximately €550 million since 1997. This investment has enabled the funding of 104 additional consultant posts, together with support staff in key areas such as medical oncology, radiology, palliative care, histopathology and haematology throughout the country. An additional 245 clinical nurse specialists have also been appointed in the cancer services area. The benefit of this investment is reflected in the significant increase in activity that has occurred.

Improving cancer care is a major priority of the Government and health service providers have broadly recognised the significant changes that have taken place in recent years in improving cancer care. Between the periods 1994 to 1997 and 1998 to 2000 overall relative survival from cancer increased from 48% to 50% in women and from 38% to 44% for men. For women, there were improvements in survival for the four commonest cancers: breast, lung, colorectal and lymphoma. For men, survival improved for almost all cancers, notably for cancer of the prostate and stomach as well as for lymphoma and leukaemia.

I again confirm the Government's commitment to the development of cancer services in the north-west region. All of the developments outlined earlier will bring substantial benefits to people living in the north west. The Government will continue to work with the management of health services in the region to ensure that the best service possible is available to all those suffering from cancer.