Donie Cassidy (Fianna Fail)
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I wish to share my time with Senator Nicky McFadden.

Pat Moylan (Fianna Fail)
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Is that agreed? Agreed.

Donie Cassidy (Fianna Fail)
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I am raising this matter to draw attention to the need for the Minister for Health and Children to clarify the exact position on cancer care services at the Midland Regional Hospital, Mullingar. We have all heard the serious announcements of the Health Service Executive over recent days. Some 660 women have attended the hospital to have various tests but unfortunately 26 required further medical care. What is the timeframe of the HSE for implementing the changes to services at the hospital? Excellent care was given to all women in the hospital down through the years by Dr. McGill and his staff.

In the HSE statement we are told that the delivery of cancer services on a programmatic basis will serve to ensure equity of access to services and equality of patient outcome, irrespective of geography. The decision of the HSE in respect of the designation of four managed cancer control networks and eight cancer centres will be implemented on a managed and phased basis. The statement concludes by saying that the HSE plans to have completed about 80% to 90% of the transition of services to the cancer centres by the end of 2009. I want to hear the Minister of State say in plain English that those women attending the hospital under the care of Dr. McGill will continue to have their care attended to. Must all new patients go to the Mater Hospital in the future?

The Midland Regional Hospital in Mullingar is the only hospital on the road from Dublin to Sligo, a distance in excess of 100 miles. It has a staff of almost 700 and 220 beds, increasing to 270 beds with stage 1 of phase 2B early in the new year. It is a serious hospital that provides magnificent services. Like the Cathaoirleach, who was chairman of the health board, I was a former member of the Midland Health Board for more than 18 years and we know the dedicated staff who work in the Midland Regional Hospital. There is nothing more important to us than the completion of stage 2 of phase 2B. I understand that all the various designs have been agreed, the Department of Health and Children and the hospital have recommended that the project proceeds and that value for money considerations have been assessed and completed.

It has been a serious disappointment to everyone in the midlands, particularly women in the midlands counties of Westmeath and Longford, because we serve Longford and Westmeath on a two-county basis. It is an extremely important health facility for the area. Looking forward, those of us in Longford and Westmeath must press on the Minister of State the importance of allowing the cancer care unit to continue until all the facilities and access in the Mater Hospital are in place and stage 2 of phase 2B is given the go ahead as soon as the builder vacates the site at the end of the year. Today was a watershed in Mullingar because I understand that the first nurses entered the first phase 2B, stage 1 of the great work taking place there.

I will give the last minute of my time to Senator McFadden who wishes to join with me in this regard this evening.

Nicky McFadden (Fine Gael)
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I am very grateful to Senator Cassidy for his generous allocation of time. My concern is that the centre of excellence in the Mater Hospital has not been set up. Last Friday, the Minister took it upon herself with one fell swoop to cease the delivery of services at the Midland Regional Hospital in Mullingar.

As Senator Cassidy said, Dr. McGill provided an excellent service and I cannot see why this service cannot continue. It could be an outreach centre where women can undergo mammograms which would be read by the preferred option of a pathologist, surgeon and radiologist in Dublin. I believe this should happen and that women should not be discommoded and forced to travel over 100 miles to Dublin. A very good friend of mine found herself in this situation and had to leave Athlone at 5 a.m. to travel for chemotherapy. I cannot see why this service could not be delivered on a local outreach basis.

I am concerned because the centre of excellence has not been established in the Mater Hospital and no transport arrangements have been made for the women in question to travel to that hospital. I received an e-mail from the Health Service Executive which said that people without cars could avail of transport if they had a medical card or they could see the community welfare officer. That is an insult to these women, who are suffering and vulnerable, and I ask the Minister of State to look again at the situation until the proper transport services are put in place and the centre of excellence has been established in the Mater Hospital. I thank the Cathaoirleach for his indulgence.

Pat Gallagher (Donegal South West, Fianna Fail)
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I thank Senator Cassidy for raising this issue on the Adjournment and for his contribution. I also thank Senator McFadden for her contribution. I apologise on behalf of the Minister for Health and Children who is unable to be with us this evening.

However, I welcome the opportunity to set out the current position in respect of the reorganisation of cancer services nationally, with particular reference to the Midland Regional Hospital at Mullingar. Arising from the designation of eight cancer centres nationally and to comply with the national quality assurance standards for symptomatic breast disease, the Health Service Executive announced last week that within the coming weeks, breast cancer services at the Midland Regional Hospital, Mullingar will be transferred to the Mater Hospital in Dublin. GPs will be fully informed about the new arrangements and will be in a position to refer new patients appropriately.

A total of 26 breast cancer procedures were carried out at the Midland Regional Hospital at Mullingar in 2005. The HSE has advised the Department that the hospital currently has two consultant radiologists with specialist training in breast disease who work closely together to ensure high quality imaging services. The radiologists work with the consultant surgeon who also has a specialist interest in breast care.

The HSE has advised that the consultant surgeon is due to retire very shortly and it would have been deemed inappropriate to recruit a new surgeon with the planned implementation of the national cancer control programme and the transfer of services to the eight designated cancer centres. The HSE has also confirmed that although no new breast cancer patients will be seen at the hospital, appointments for mammograms already arranged will be honoured and returning patients to the consultant surgeon will continue to be seen until their treatment is completed.

The HSE has advised that the patient services officer in the Mater Hospital and hospital management at the Midland Regional Hospital are in discussions concerning the planning of an orderly transfer of patients from that hospital to the Mater Hospital, including transport arrangements, where required. I take the point raised about transport and will highlight this with the Minister and the HSE. Both sides are in discussions and will also refer to transport arrangements. The HSE has assured women who have been receiving care in the Midland Regional Hospital that they should have no concerns regarding this service and has emphasised that this transfer is part of the move to the eight designated specialist breast centres.

The decisions of the HSE in respect of the four managed cancer control networks and eight cancer centres will be implemented on a managed and phased basis. The HSE has designated St. James's Hospital and St. Vincent's Hospital as the two cancer centres in the managed cancer control network for the HSE Dublin mid-Leinster region, which includes the Midland Regional Hospital at Mullingar.

As the House is aware, the HSE has appointed Professor Tom Keane as national cancer control director to lead and manage the establishment of the national cancer control programme. He is due to take up his post next week. The HSE plans to have completed 50% of the transition of services to cancer centres by the end of 2008 and 80% to 90% by the end of 2009. The HSE has confirmed that services will not be transferred until appropriate capacity has been developed in the receiving centres.

The Government is committed to making the full range of cancer services available and accessible to cancer patients throughout Ireland in accordance with best international standards. The developments outlined will ensure a comprehensive quality assured service is available to all patients with cancer nationally, including in the midlands region.

Donie Cassidy (Fianna Fail)
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Confirmation by the Health Service Executive that services will not be transferred until appropriate capacity has been developed in the receiving centre at the Mater Hospital is the assurance I sought.

Nicky McFadden (Fine Gael)
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If the services have been stopped where do women go?