Brian Hayes (Dublin South West, Fine Gael)
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Question 252: To ask the Minister for Health and Children the reason she is requiring the transfer of breast cancer patients from an actual centre of excellence, albeit non-designated, at Tallaght Hospital, Dublin to other centres (details supplied); and if she will make a statement on the matter. [17742/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Under the National Cancer Control Programme (NCCP), there are four managed cancer control networks and eight cancer centres. These centres were designated by the HSE following a recommendation from the Advisory Group set up under the NCCP. 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. It is within this framework that the progressive transfer of cancer diagnostic and surgical services from Tallaght and other non-designated hospitals to the designated centres is taking place. Symptomatic breast disease services are the first to be transferred to the eight centres.

The Health Service Executive (HSE) has designated St. James's Hospital and St. Vincent's University Hospital as the two cancer centres in the Managed Cancer Control Network for the HSE Dublin Mid-Leinster region. The general catchment area for Tallaght Hospital incorporates both St Vincent's University Hospital and St James's Hospital, and the transfer of services from Tallaght will take place in a coordinated way to these two designated centres. The resources to be transferred from Tallaght and the incorporation of these resources into the specialist cancer services at the receiving hospitals will take place in accordance with patient need and choice and in line with where GPs will refer to in the future.

Only initial diagnosis and surgery are transferring from Tallaght. Medical oncology services will continue to be provided at Tallaght to serve the needs of the population in the area. The oncology day ward opened by me in June 2006 will continue to operate. It is important to emphasise that the decision to reorganise services is about achieving optimum outcomes. This is not a value judgement about the work being carried out in Tallaght or any other pre-existing centres, some of which may have had a relatively large workload but nevertheless are not among the designated centres.

Brian Hayes (Dublin South West, Fine Gael)
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Question 253: To ask the Minister for Health and Children her views on a report in the media of 24 April 2009 stating that the eight designated cancer centres would not meet standards of excellence ensuring the best care for patients until the end of 2009 (details supplied); and if she will make a statement on the matter. [17743/09]

James Reilly (Dublin North, Fine Gael)
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Question 262: To ask the Minister for Health and Children if, further to a newspaper report (details supplied), the Health Information and Quality Authority quality review of the remaining seven cancer centres has been completed; if she has received a copy of these reports; if she has been briefed on the findings of these reports; if these reports will be published; and if she will make a statement on the matter. [17983/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 253 and 262 together.

It is important to set the recent media reports referred to by the Deputies in context. The Health Information and Quality Authority (HIQA) initiated a quality review of symptomatic breast cancer services in 2008. The overall objective of the review was to assess the performance of the designated cancer centres against the National Quality Standards for Symptomatic Breast Disease Services and assist in devising an implementation plan for incremental progress to becoming specialist cancer centres by the end of 2009.

The standards have been developed to provide patients with the best possible cancer care. They include standards for functioning specialist breast centres, such as the population size they should serve, the personnel employed and the physical facilities required. They also include standards for waiting times, and standards for the involvement of multi-disciplinary teams and for various diagnostic and treatment procedures. They have been developed with leading clinicians and their implementation is being led by clinicians. It is important to emphasise that as the plan is implemented, it has been, and remains, in the best interests of patients to transfer progressively their specialist care to the eight centres from other hospital settings. This is the advice provided to me and the shared position of all involved - the HSE, its National Cancer Control Programme and its interim Director, Professor Tom Keane and HIQA.

There are a number of phases in the process of meeting the entire range of standards involved. The first was a self-assessment completed and submitted by each individual hospital in Spring, 2008. The second phase involved an independent validation by HIQA, in October 2008, of the Spring self-assessment process. In January 2009, HIQA issued individual interim reports to each of the designated centres. These were based on data from the self-assessments carried out in Spring, 2008 and were not an inspection of the status of the centres in October, 2008. The interim reports were copied to the CEO of the HSE, the Secretary General of my Department and to Professor Keane in January, 2009.

The individual hospitals have prepared implementation plans in conjunction with the NCCP, which are now being implemented and monitored by the NCCP. A further inspection and assessment by HIQA is planned for the end of 2009, and these reports will be published. In relation to Waterford Hospital, the Consultant Surgeon in the Hospital, together with Professor Keane have noted that they are confident that all of the deficiencies identified in the interim assessment have/are being addressed and they expect that the Hospital will be fully compliant with the standards when the next phase of the HIQA assessment occurs at the end of 2009. I have not received details of the un-validated self-assessments carried out by Tallaght or any of the other hospitals that are not designated cancer centres.

The interim reports on the validation assessment against the Standards will assist each designated centre in identifying gaps and on where to focus their priorities for further improvement. For a number of standards, some of the designated centres were unable to provide evidence to demonstrate that they complied with the standard. This does not necessarily mean that they were non-compliant. HIQA reported that there is an urgent need to improve the internal monitoring and performance against the Standards and that this needs to be linked to more consistent, robust and connected governance and management arrangements at local and national levels.

The interim reports provide the centres with details of the standards that are being met and of where gaps exist. Significant progress has been made by all of the designated cancer centres in addressing the gaps in systems and services. There is ongoing liaison also between the NCCP and HIQA about compliance with the standards.