Pearse Doherty (Sinn Fein)
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Cuirim fáilte roimh an Aire go dtí an Tí. Tuigim, mar a dúirt tú leis an tSeanadóir Ó Domhnaill gur fearr leat a bheith anseo nuair a bhíonn ceist a bhaineann le do Roinn le plé. Is mór an trua é, nach bhfuil an tAire Sláinte agus Leanaí ábalta a bheith anseo leis an cheist seo a phlé, ach beidh an freagra agat. Tá súil agam gur freagra maith atá ann. Is í an cheist atá le plé ná seirbhísí ailse in Ospidéal Ginearálta Shligigh agus an gá iad a choinneáil ansin. Ní hamháin sin, ach caithfear méadú a chur leis na seirbhísí ailse atá ar fáíl sa réigiún sin, an iar thuaisceart, go háirithe, go mbeidh seirbhís radaiteiripe ar fáíl d'othair ón cheantar sin. Aréir, bhí cruinniú pacáilte i mBaile Dhún na nGall do dhaoine ar a bhfuil imní mhór faoi seo, nach bhfuil a leithéid seirbhís radaiteiripe ar fáil, agus níos tábhachtaí ná sin, mar go bhfuil an Rialtas ag tarraingt siar ar an tseirbhís atá san Ospidéal Ginearálta Shligigh, a bhí ann ó 2000 ar aghaidh, is é sin an tseirbhís ailse.

I am here to ask the Minister for Health and Children to retain cancer services at Sligo General Hospital and to further develop those services to include radiation oncology. Last night I attended a packed meeting in Donegal town where we heard the concerns of patients and families of those who went through cancer treatment in the recent past or those who have been diagnosed with cancer and are going through treatment. They are appalled at the decision by the HSE and this Government to remove the cancer services that have been in Sligo General Hospital since 2000 and to ask patients to travel to Galway for their cancer surgical and diagnostic services in the future.

The Minister will be aware that there is a clear line drawn on the map of Ireland with all the eight centres of excellence below a line drawn between Galway and Dublin. The concern I echo here today is that the people of the north west, too, are cancer sufferers, need the type of treatment available to other regions, are taxpayers in this country and have votes. I was informed at last night's meeting that they will use their votes if they are not able to achieve their goals of retaining the services in Sligo General Hospital and developing them to include radiation oncology. Deputy Ó Cuív's heart is in the west and I appeal to him to bring the appeal I echo on behalf of the patients of the north west and their families and friends to the Minister for Health and Children and ask her to look sympathetically on it. I very clearly told the Minister for Health and Children in this Chamber that she is guilty of negligence of the health concerns of the people of the north west. I repeat that again tonight because she is stripping services from these hospitals. The west and north west is one of the last regions to avail of BreastCheck and time and again we are ignored.

Last night's calls were heartfelt and it was difficult to listen to them. Some of the speakers had just come through cancer treatment in recent weeks and talked in glowing terms about the service in Sligo General Hospital and the consultants there. Within a couple of days people can be seen, find out if they have cancer and be referred for the necessary treatment. There is also concern about the fact that there is no radiation available in the north west. People are forced to travel long journeys, 400 mile round trips, leaving their families for seven or eight weeks at a time of serious difficulty for them when they need their families around them. We also know of the incidents where, unfortunately, women choose to have mastectomies instead of availing of the treatment. The demand from the north west, from Sligo, Leitrim, Mayo and south Donegal, is that these services are maintained in Sligo General Hospital, that they are expanded to include radiation oncology and that the north west has another centre of excellence that will rebalance the map which shows the eight centres all based in the southern end of this island.

Éamon Ó Cuív (Galway West, Fianna Fail)
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Tá mé anseo ar son an Aire Sláinte agus Leanaí, an Teachta Mary Harney, agus táim ag tabhairt an fhreagra ar a son. Glacaim an deis seo le leagan amach a dhéanamh ar an struchtúr agus an athstruchtúr atá á dhéanamh maidir le seirbhísi ailse go ginearálta, agus go speisialta mar bhaineann siad le Ospidéal Ginearálta Shligigh.

Titim i gcónaí ar son cearta tuaithe, ach i dtaobh ailse, níl aithne agam ar dhuine ar bith nach dtiocfadh ag taisteal dá gceapfaidís go mbeadh toradh níos fearr as. Caithfimid bheith fírinneach faoi sin. Tá a fhios agam go bhfuil daoine a rachfadh go Meiriceá dá gceapfaidís go raibh seans toradh níos fearr a fháil. Caithfimid glacadh le comhairle na saineolaithe gur fearr lárionaid mhóra i gcás dul faoi scian agus ailse a aithint.

As the House is aware, Professor Tom Keane has been appointed to lead and manage the establishment of the HSE national cancer control programme. Professor Keane has ambitious plans and has already made significant progress in implementation of the programme. The key objective of the national cancer control programme is to ensure equity of access to services and equality of outcome irrespective of geography. This will involve significant re-alignment of cancer services to move from the present fragmented system of care to one which is consistent with international best practice in cancer control. The decisions of the HSE on four managed cancer control networks and eight cancer centres will be implemented on a managed and phased basis. The HSE plans to have completed 50% of the transition of services to the cancer centres by the end of 2008 and 80% to 90% by the end of 2009.

The HSE has designated University College Hospital Galway and Limerick Regional Hospital as the two cancer centres in the managed cancer control network for the HSE western region, which includes Sligo. The designation of cancer centres aims to ensure that patients receive the highest quality care while at the same time allowing local access to services, where appropriate. Where diagnosis and treatment planning is directed and managed bymultidisciplinary teams based at the cancer centres, much of the treatment, other than surgery, can be delivered in local hospitals, such as Sligo. In this context, chemotherapy and support services will continue to be delivered locally. Sligo General Hospital has a dedicated in-patient oncology unit, comprising 15 beds, and a dedicated day services unit, comprising eight beds. Cancer day care units will continue to have an important role in delivering services to patients as close to home as possible.

The Department of Health and Children and the HSE have been working closely to expedite the delivery of the national plan for radiation oncology, which was approved by Government in July 2005. The plan consists of four large centres in Dublin — at St. James's and Beaumont hospitals — Cork and Galway and two integrated satellite centres at Limerick and Waterford regional hospitals. Patients from Sligo needing radiotherapy continue to be referred to the radiation oncology department at University College Hospital Galway for treatment.

The HSE has confirmed it will have in place radiation oncology capacity to meet the needs of the population by 2010. After 2010 the HSE will continue to increase capacity to ensure these needs continue to be met. The Minister for Health and Children is fully confident this will be achieved through a combination of direct Exchequer provision, PPP and, where appropriate, the use of the private sector.

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 I outlined here will ensure a comprehensive service is available to all patients with cancer in the western region including in Sligo.

Pearse Doherty (Sinn Fein)
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I expected such an answer from the Minister and the Department and it is disappointing for me and, more importantly, for those who have to avail of the services now and in the future. I note Deputy Ó Cuív's comments at the beginning of his response, which were not scripted by the Department, saying patients are willing to travel for the best care, and I concur with that. People will travel to the end of the earth to save their loved ones if that is where services are. According to the Government's figures and the O'Higgins report the numbers are there in the north west to provide radiotherapy centres safely. Later this month the Minister of State at the Department of Health and Children will turn the sod for a private hospital that will provide radiation services in Donegal. How can the Government say that in the public sector it would be unsafe to have such a service in the north west but in the private sector it will be safe? I appreciate that Deputy Ó Cuív is not in the Department but I ask him to take those concerns back to the Minister for Health and Children.

Éamon Ó Cuív (Galway West, Fianna Fail)
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Tá an méid a bhfuil ráite ag an tSeanadóir i dtaobh an seirbhís radaiteiripe nótáilte agus bí cinnte go luafar é leis an tAire. Mar a dúirt mé, tá sé ráite go soiléir go gcaithfidh na lárionaid oiread áirithe othair a bheith acu ó thaobh cúrsaí fáithmheasta agus dul faoi scian. Má thugann sé toradh níos fearr go mbeidh lárionad mór seachas lárionaid bheaga mar a bhí, creidim go m'bhfearr le daoine dul chuig an lárionad mór, mar tugann sin seans níos fearr ina dhiaidh. Sin bunús na straitéise, go mór mór ó thaobh obráidí. Níl aithne agam ar éinne nach dtiocfadh píosa níos faide dá gceapfaidís go mbeadh seans níos fearr acu. Is é an tuairim idirnáisiúnta ná go gcaithfimid lárionad de shaghas áirithe a bheith againn le go mbeidh an comhthéacs criticiúl leis na seirbhísí a chur ar fáil.