Maire Devine (Sinn Fein)
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I thank the Minister of State for taking this matter. The bones of the issue are really simple. The HSE conducted interviews for the position of medical oncologist with a special interest in sarcoma at St. Vincent's University Hospital on Tuesday, 14 March 2017. Now we are informed that a successful candidate from that process is due to start in the summer of 2019. Should the sarcoma specialist commence work this summer, it will have been three years since the Minister for Health, Deputy Harris, created the post and two and half years since interviews were held.According to the HSE's policy, external recruitment candidates will be required to take up duty within three months of the receipt of a formal offer of employment. Furthermore, the HSE states it reserves the right to withdraw an offer of employment should appointees fail to meet the timeframe for taking up a position. However, St. Vincent's University Hospital stated that, as a voluntary hospital, it operates its own recruitment policy and has full discretion regarding appointments.

We talk about value for money and adherence to policies but the hospital is funded by the State, which does not often sit comfortably with the hospital, so it should follow the HSE guidelines. The hospital was not slow about following the HSE's guidelines when it came to pay cuts for healthcare staff. The hospital cannot pick and choose what it will adhere to.

My involvement started when I met a gravely ill group of sarcoma patients who had set up a support group and this is one of first issues that I lobbied on as a new Senator in 2016. We managed to secure a meeting with the Minister for Health that summer. Lo and behold who comes in behind him, whom we had not invited, only a troupe of personnel or top dogs from St. Vincent's hospital. These people tried to answer for the Minister but he was there to answer to sick patients, many of whom have died since.

I seek clarity on three issues. What is the Minister of State's stance on publicly funded hospitals applying their own recruitment policies that have damaging consequences for patients? Why was a temporary contract not offered to cover the period of more than two years since the departure of the last sarcoma specialist? What will the Minister and the Minister of State do to immediately rectify a situation whereby patients still do not have access to an oncologist specialist in sarcoma?

Jim Daly (Cork South West, Fine Gael)
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I wish to advise the Senator that she can ask questions by tabling a Commencement matter. I will reply regarding what she has asked to have addressed this. If she wants to address ancillary issues, then I ask her to please table them as part of a Commencement matter. The Minister and I do not micromanage the health system. We do not engage at the level of detail that the Senator sought when she asked about the recruitment process applied by individual hospitals throughout the country, neither would it be proper or fair to expect us to answer those kind of questions.

Maire Devine (Sinn Fein)
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It is implicit in my matter. The Minister of State should have known that these questions were-----

Tim Lombard (Fine Gael)
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The Minister of State please, without interruption. Please respect the Chair.

Jim Daly (Cork South West, Fine Gael)
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I did not interrupt the Senator so she might have the decency to allow me to continue without shouting me down.

I will reiterate for the benefit of the House the matter the Senator - "The need for the Minister for Health to provide an update on the employment starting date of a sarcoma specialist for St. Vincent's hospital". That is what I will address, if that is okay with the House.

I thank the Senator for raising this issue and for the opportunity to update the House on the matter. I am advised that the person recruited to fill a permanent post of consultant medical oncologist, with a special interest in sarcoma, at St. Vincent's University Hospital will commence on 1 September 2019.

More than 200 adults are diagnosed with some form of sarcoma every year in Ireland. For patients with a new sarcoma diagnosis, it is important that decisions on the management of cases are made through a multidisciplinary team process. Multidisciplinary teams can involve clinicians and other medical personnel, as well as health and social care professionals, based in several hospitals.

The outputs of their deliberations provide recommendations on the best approach to investigations, treatment and follow-up for the individual patient. Services for patients with sarcoma are currently provided in St. Vincent's University Hospital, Dublin, and in Cork University Hospital. Both hospitals are designated cancer centres and have an extensive range of multidisciplinary services and expert clinical advice available.

A national clinical lead in soft tissue sarcomas is in place to oversee services for patients. Patients have their cases presented and discussed at one of the two sarcoma multidisciplinary teams and members of these teams have links with European specialists in sarcoma.

This Government and the HSE are committed to providing a high quality, responsive and sustainable service for sarcoma patients. St. Vincent's hospital has access to all of the relevant specialties for treatment, including surgery, medical oncology, radiation oncology, radiology and pathology.

The National Cancer Strategy 2017-2026 sets out the plan for the development of cancer services for the next decade. Effective prevention, early diagnosis, access to quality treatment, survivorship, patient involvement and safe high quality patient-centred care are key aims of the strategy. Services for rare cancers such as sarcoma received considerable attention in the development of the strategy. The importance of improving awareness of rare cancers among both the public and healthcare practitioners is acknowledged. Furthermore, the strategy sets out the need for clear care pathways for the diagnosis and treatment of patients with rare cancers, with particular emphasis on timely treatment planning in multidisciplinary teams, sub-specialty expertise in diagnosis and treatment, and linkages to international centres of excellence for specialist advice and intervention. There is a particular focus on the co-ordination of care in an expert setting.

Maire Devine (Sinn Fein)
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I thank the Minister of State for his comments but he has chastised me by suggesting ways for me to table questions.

The Minister for Health knows the details and history behind this matter. He created this post following the tenacious efforts of the Sarcoma Action & Support Group, which comprises feeble and physically ill individuals. He knows that a vacancy has existed for three years, yet sarcoma patients still do not get the specialist care that they have been promised. I will continue ask these questions this matter and we will see if the appointment is ever made.

Jim Daly (Cork South West, Fine Gael)
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l have no further comment other than to confirm that the start date is 1 September.