Joe McHugh (Fine Gael)
Link to this: Individually | In context

I welcome the Minister of State, Deputy Brian Lenihan, to the House. I am delighted he is present to consider this important matter with respect to the permanent appointment to Letterkenny General Hospital, first, of a consultant breast surgeon. Currently there is an interim appointment of an acting surgeon on a temporary basis. Second, there is an identified need for a consultant colorectal surgeon as there is a vacancy in that position. Third, there is a great need for a permanent consultant radiation oncologist. Currently, a surgeon from St. Luke's Hospital attends Letterkenny General Hospital one day per week.

I will expand a little on the issue of breast cancer services at Letterkenny General Hospital. In light of the O'Higgins report, there is a need to centralise services as a consequence of demographics, which is a quite natural economic assumption. At the same time, however, a county such as Donegal, with a border extending 144 miles from Ballyshannon to Malin Head, is a very extensive, peripheral and isolated county, and it is very much the desire of the people of Donegal to hold on to regionalised services. The consultants, medical and administrative staff of Letterkenny General Hospital and the people of Donegal are not looking at Letterkenny in isolation. They are looking at an east-west scenario between Altnagelvin and Letterkenny and also north-south between Letterkenny and Sligo.

A think-tank is examining many of these issues, including the retention of cancer services in Letterkenny General Hospital. The local community and the hospital staff are working to ensure that cancer services are not depleted, centralised and moved away from the region.

I am delighted to raise this issue in the presence of the Minister of State because the Donegal action for cancer services group, which recently formed in the county, has been fighting for action on a consistent basis over the past year. This lobby group must be taken seriously as it represents the entire Donegal community from Malin Head to Ballyshannon.

The cornerstone of the issue is bed capacity. There has been considerable procrastination on the part of Government and the Department of Health and Children in expediting the bed capacity at Letterkenny General Hospital. There is a magical formula of 70 extra beds, which will result in extra medical beds and an enlarged accident and emergency department. An interim solution would involve the provision of 30 to 40 extra beds, representing an increase of 10% on the existing 300 beds. Increased bed capacity in Letterkenny will justify the demands made for extra surgeons. Staff at administrative, consultant and nursing levels have lobbied for this but are becoming tired of shouting. A regional approach is needed so that County Donegal can retain services. Fears exist that the downgrading of services will impinge on the welfare and health of the people of County Donegal.

I ask the Minister of State to endeavour to ensure that the people of County Donegal do not have to endure any further downgrading or take second best in terms of cancer treatment services. I ask him to listen to the people and, as a matter of urgency, make contact with the HSE about their concerns.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
Link to this: Individually | In context

I thank Senator McHugh for raising this matter on the Adjournment of the House. I would like to take this opportunity to set out the current position with regard to cancer services in the north-west region. The Government is committed to making the full range of cancer services available and accessible to cancer patients throughout Ireland, including the north west, in line with best international standards.

In recent years, considerable investments have been made in the development of cancer services in the north west. Since 1997, there has been a cumulative additional investment of approximately €48 million for the development of appropriate treatment and care services for people with cancer. This funding has provided for the approval of an additional eight consultants in key areas of cancer care. The funding has also provided for the appointment of 22 cancer nurse specialists across the north-western area. The development of a dedicated oncology ward at Letterkenny General Hospital is expected to be completed before the end of the year. This represents a significant commitment to the development of cancer services at the hospital.

The development of services for women suffering from breast disease is a major priority in the development of cancer services. National policy on the development of symptomatic breast disease services is based on the report on the development of services for symptomatic breast disease published in 2000. The report recommends the establishment of specialist breast disease units throughout the country, with each unit providing services to a population of 250,000 to 300,000 people. The report expects that there will be a minimum of 100 new primary breast cancers per annum treated in each unit. The objective is to improve the quality of care provided to patients throughout the country.

The report states that the population of the north west supports one breast disease unit. However the report, having regard to the geographical considerations and to the fact that Letterkenny General Hospital does not have a sufficiently large volume of patients with breast cancer, proposed that linkages be established with Altnagelvin Hospital in Derry. I understand that discussions are currently taking place involving clinicians and managers at both hospitals to develop these linkages. In this context, the HSE has advised the Department that an application for a consultant general surgeon with a special interest in breast disease for Letterkenny General Hospital is currently under consideration by the National Hospitals Office. The HSE has advised the Department that any proposals or application for the appointment of a consultant general surgeon with a special interest in colorectal surgery will be given due consideration by the National Hospitals Office.

The national plan for radiation oncology services announced by the Tánaiste last July provides for an integrated network of radiation oncology services that will ensure equitable access for patients throughout the country. The network will, beginning in 2008, deliver a substantial increase in current radiation oncology capacity by providing additional capacity to the equivalent of 23 linear accelerators nationally by 2011.

Patients in the north west are currently being referred for radiation oncology treatment to the recently established radiation oncology department at University College Hospital, Galway, and St. Luke's Hospital, Dublin. A new radiation oncology centre is being provided at Beaumont Hospital on Dublin's northside as part of the national network for radiation oncology services. This centre will also cater for the needs of patients in the north west. The precise patient referral pattern will be a matter for the HSE and will be factored into the planning of the national network. The HSE has advised the Department that it will consider proposals for the delivery of radiation oncology services to patients in the Letterkenny area in the context of national policy.

The Government is also considering options to facilitate access for patients in the north west, and primarily in County Donegal, to radiation oncology services as part of North-South co-operation on cancer. The Tánaiste has already met with the Minister for Health for Northern Ireland, Shaun Woodward, MP, to discuss access for patients in the north west to radiation oncology services at Belfast City Hospital. This state-of-the-art facility is scheduled to open in March 2006. The Tánaiste will be meeting again with Mr. Woodward to further progress the Government's position on radiation oncology. Officials of the Department will also meet with officials from the Department of Health, Social Services and Public Safety, Northern Ireland.

BreastCheck, the national breast screening programme, commenced in 2000 and is available to women in the 50 to 64 age group in the eastern, north-eastern, midland and part of the south-eastern regions. Planning is under way for the national roll-out of the programme to the remaining regions. The Department of Health and Children has been working collaboratively with BreastCheck in progressing the roll-out. Detailed planning for the development of essential infrastructure has commenced in order to roll out the programme to other regions from 2007.

I have set out in broad outline the considerable investment and improvement in cancer services that have taken place in the north west in recent years. This reflects the considerable commitment of the Government to this region.

Joe McHugh (Fine Gael)
Link to this: Individually | In context

I thank the Minister of State for his response. Political capital should not be made of an issue as sensitive as this. Cancer is becoming too common among communities in County Donegal and the issue is of concern to every family.

While the Minister of State set out some new information with regard to proposals by the HSE, a change in mindset is required. Patients from Malin Head face a long journey to Letterkenny and a longer trek to St. Luke's Hospital or Galway. The people of County Donegal pay their taxes and deserve a service. I ask the Minister of State to keep this issue on the table.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
Link to this: Individually | In context

I assure Senator McHugh that this issue, which I discussed recently in a different context, is on the table. It is clear that the Tánaiste has taken a personal interest in the matter. Greater North-South co-operation on health matters is vital for the future health of the people of County Donegal because, as the Senator correctly notes, long journeys to St. Luke's or other destinations in the South will not provide a permanent solution.