Mary Harney (Dublin Mid West, Progressive Democrats)
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The goals of the National Cancer Control Programme are better cancer prevention, detection, treatment and survival through a national service based on evidence and best practice. This involves significant re-alignment of cancer services to move from a fragmented system of care to one which is consistent with international best practice in cancer control.

In line with the recommendations of the 2006 Cancer Control Strategy, eight hospitals have been designated by the Health Service Executive (HSE) as cancer centres. These eight hospitals will operate within four managed cancer control networks, within which cancer diagnosis and surgery is to be located. 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. Diagnosis and treatment planning is or will be directed and managed by multi-disciplinary teams based at the cancer centres, but much of the treatment other than surgery may be delivered in local hospitals. In this context, chemotherapy and support services will continue to be delivered locally.

The reorganisation of breast cancer services, which has been the highest priority for the Cancer Programme, is almost complete with services remaining to be transferred from only three hospitals - Tallaght, Sligo and South Infirmary. The service at both Sligo and Tallaght will transfer this summer while the transfer from South Infirmary to Cork University Hospital (CUH) is expected to take place later in 2009 on completion of a €5 million refurbishment project at CUH. The NCCP has at all times stated that it only transfers services when it is satisfied that adequate resources are in place.

Priorities in 2009 in relation to other site-specific cancers include services for prostate, lung, rectal and pancreatic cancers, brain tumours and head and neck reconstructive surgery and the development of community oncology. Additional development funding of €15 million was allocated to the NCCP for all of these initiatives, along with 100 new posts.

Recent achievements include the opening of two Rapid Access Diagnostic Clinics for Prostate Cancer at St. James's Hospital, Dublin and at University Hospital Galway in June 2009, the first of eight such clinics. Rapid Access clinics are also to be established for lung cancer. A single national programme for the management of brain tumours and other central nervous system tumours is being created on two sites - Beaumont and Cork University Hospital - and funding has been allocated this year to recruit a neuro-oncology trained neurosurgeon to lead this programme. St Vincent's University Hospital will become the national centre for pancreatic cancer surgery by the end of 2009. A single centre is also to be established for reconstructive surgery for head and neck cancer while the number of hospitals performing rectal cancer surgery is to be reduced.

The NCCP has also developed a separate Community Oncology office which is working closely with the Irish College of General Practitioners to train and educate GPs in oncology and also to enhance nursing capability in oncology care within communities and primary care teams. Early diagnosis and appropriate referral is critical to improving cancer care, so the successful development of this programme is a key strategic initiative.

The implementation of all of these initiatives represents significant progress towards the goal of improving our cancer services and, ultimately, outcomes for cancer patients.

In regard to palliative care service developments, the HSE was asked to prioritise these in the context of a framework over the next five years. A Palliative Care Services Medium Term Development Framework has recently been submitted to my Department by the HSE. This document details the required actions and initiatives necessary to address the gaps in palliative care service provision, against the recommendations set out in the National Advisory Committee on Palliative Care 2001. The HSE and my Department are considering how this can be rolled out within existing resources.