Tuesday, 13 May 2008
Cuirim fáilte roimh an Aire Stáit, an Teachta Barry Andrews. Tá súil agam go n-éireoidh go maith leis sa phost úr atá aige. Ní bheidh mé i bhfad, siocair go bhfuil agóid á reachtáil ag cumann Gaelach Shinn Féin anocht mar gheall ar cheist an tumoideachais taobh amuigh de na Gaeltachtaí. Tá sé ag tosnú i gceann cúpla nóiméad.
Is é an fáth go bhfuil mé ag tabhairt an ábhar seo os comhair an Seanad inniu ná go bhfuil eolas le fáil againn ón Roinn Oideachais agus Eolaíochta, nó ón Roinn Sláinte agus Leanaí. An seasann an tAire, an Teachta Harney, leis an méid atá ráite aici cheana fhéin ó thaobh seirbhísí radaiteiripe de — go háirithe an méid atá sa straitéis ailse a fhoilsíodh anuraidh? There is a need for clarity regarding the position of the Minister for Health and Children as to whether it remains the same that, in order to provide a safe and efficient radiation oncology service to a given region, a critical mass of population of 500,000 must be in place. That was reiterated by the Health Service Executive's cancer control strategy of last year.
I raise this issue because my party colleague, Deputy Caoimhghín Ó Caoláin, posed a parliamentary question but the Minister refused to answer it, which is becoming commonplace. The questions are always referred to the HSE. The Deputy's question was a simple one. Is this still the Minister's position? I raise this Adjournment matter because for many years the people of Donegal campaigned long and hard for radiation oncology services. We have been told time and again that it would be unsafe to provide those services in Letterkenny General Hospital for the population of Donegal, which is around 150,000, because international best practice says half a million people would be needed. It would take four linear accelerators to treat those patients in a safe environment. The key word is "safe".
People will accept that we need to have services provided in a safe environment but in recent weeks the former Minister of State at the Department of Health and Children, Deputy Pat The Cope Gallagher, turned the sod on the private, for-profit Wyndale Clinic in Letterkenny, not far from the general hospital. Mr. Pat Harvey is leading that consortium and he was a senior member of the HSE. He was CEO of the North Western Health Board until recent years and was formerly general manager of Letterkenny General Hospital. He contends that international best practice will allow him develop and deliver radiation services for the people of Donegal, with no need for a catchment area of 500,000 people. He will do this in a safe environment with two linear accelerators. He and his private investors will seek to enter service level agreements and the former Minister of State at the Department of Health and Children indicated this when speaking on Highland radio.
Has the Department of Health and Children changed its tune? Will we amend the national cancer control strategy or has the Minister changed her tune? Is it now safe for private or public cancer radiation services to be delivered to a population under 500,000, using two linear accelerators rather than four? This is a question that is in the minds of those in communities I represent, as was evidenced when 15,000 people took to the streets of Letterkenny in 2006 demanding the provision of adequate public cancer services for the north west.
Has the attitude of the Minister changed? I do not support what is said in the cancer control strategy — there are major questions relating to cancer services for Sligo and other regions. However, I am focusing my argument on whether the Minister, the Department and the Government agree that their stated position remains the same. Or is it now safe to buy services that are under the level deemed acceptable by the Department and in the cancer control strategy from a private clinic?
I thank Senator Doherty and the Cathaoirleach for their kind remarks. I will be taking this Adjournment matter on behalf of my colleague the Minister for Health and Children, Deputy Mary Harney. I welcome the opportunity to set out the current position to Senator Doherty regarding the provision of radiation oncology services.
The Health Service Executive established a national cancer control programme in 2007 to implement the recommendations in the national strategy for cancer control, which was agreed by Government in June 2006. The programme involves the designation of four managed cancer control networks and eight cancer centres as recommended in the national strategy. Each of the designated centres will serve a population of approximately 500,000.
The Department is working closely with the HSE in implementing the national plan for radiation oncology, which was agreed by the Government in July 2005. The plan, which forms part of the national cancer control programme, consists of four large centres in Cork, Galway and Dublin — at St. James's Hospital and Beaumont Hospital — and two integrated satellite centres at Limerick Regional Hospital and Waterford Regional Hospital.
The report on the development of radiation oncology services agrees, in principle, with the existing international recommendation that a population of greater than 650,000 should, where possible, be the minimum population necessary to support a radiation oncology unit. This population, of itself, is not sufficient without adherence to additional quality and safety guidelines. For example, the majority of radiation oncology treatment facilities should be located within the context of a designated cancer centre.
The overarching objective of the national plan for radiation oncology is to deliver high quality, fully integrated, multi-modal cancer care nationally. The Minister's intention is for radiation oncology services for public patients to be provided solely within the national model, once established. In the interim, however, the Minister has asked the HSE to give consideration to opportunities for availing of radiation oncology capacity which exist in the private sector, conditional on adherence to quality assurance standards.
Developments to date in the radiation oncology plan include the procurement of additional capacity, two linear accelerators, for St. Luke's Hospital, Rathgar. The first linear accelerator was commissioned in February 2008 and the second was commissioned in March 2008. Two replacement linear accelerators will be commissioned later this year. It has been agreed that the phase 1 facilities at St. James's Hospital and Beaumont Hospital will be increased from four linear accelerators to eight, four at each site. The HSE has confirmed that 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 that these needs continue to be met.
Cancer patients in the north west requiring radiation oncology treatment are referred to either St. Luke's Hospital, Dublin, or University College Hospital, Galway. In addition, since 2006 a service level agreement has been in place for the referral of radiation oncology patients from Donegal to Belfast City Hospital.
The Minister met Minister Michael McGimpsey, MLA, of the Department of Health, Social Services and Public Safety in Northern Ireland on 28 November 2007. The potential for further cross-Border collaboration on cancer care and, specifically, the provision of a satellite centre for radiation oncology in the north west, linked to Belfast City Hospital, was discussed. The Minister welcomed Minister McGimpsey's announcement last month of the provision of a satellite centre, linked to Belfast City Hospital, to be located in Altnagelvin. It will provide the additional radiotherapy capacity needed to meet an anticipated increase in cancer in Northern Ireland and recognises the potential for cross-Border co-operation in the development of this resource. Officials from the Department and the Department of Health Social Services and Public Safety will hold further discussions in this regard.
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 that I outlined here today will ensure that a comprehensive service is available to all patients with cancer.
I thank the Minister of State for that clarification and I welcome the developments that have taken place regarding a North-South approach to radiation oncology in the north west. The timeframe of 2015 is not acceptable and we must accelerate it if possible.
The Minister of State said there is agreement "in principle, with the existing international recommendation that a population of greater than 650,000 should, where possible, be the minimum population necessary to support a radiation oncology unit". He went on to say that the HSE has been asked "to give consideration to opportunities for availing of radiation oncology capacity which exist in the private sector". If it is not safe to provide this within the public sector for a population of less than 650,000, how can it be safe to provide it in the private sector for a population of less than 650,000? I understand the Minister of State does not cover this brief but should the HSE and the Department buy services that may not be safe and that would not be built in the public sector? I ask the Minister of State to take these comments to the Minister for Health and Children, Deputy Mary Harney.