Thursday, 27 September 2007
Seanad Eireann Debate
Senator Pearse Doherty: I propose to share my time with Senator Ó Domhnaill. Cuirim fáilte roimh an Aire Stáit go dtí an Teach. While I welcome the Minister of State, I am disappointed that the Minister for Health and Children is not present to deal with this question which seeks to determine her intentions regarding meeting her Northern counterpart, Mr. Michael McGimpsey, to discuss progress on the development of a satellite radiotherapy centre in the north west. I hope her absence from the Chamber is not an indication of her lack of support for such a centre.
In July 2005, the Minister of Health and Children, Deputy Harney, announced the Government’s approval for a network of radiation oncology services in the Twenty-six Counties to be in place by 2011. According to recent reports, that the deadline has been moved to 2014 or 2015. As part of that announcement, the Minister also stated that the issue of a satellite centre in the north west would continue to be progressed as a joint initiative involving bilateral discussions at departmental and political levels. Two years later, cancer care in this country is still largely focused on Dublin, to the detriment of the health of those living in areas such as remote parts of Donegal and the north west.
Sinn Féin and others have consistently highlighted the need for the establishment of a satellite cancer care service in the north west, given that the disparity in access to cancer care service provision is most acutely felt by people in that region. This issue should be at the top of the agenda in terms of North-South co-operation. Very ill patients from the north west are being forced to undergo repeated and prolonged journeys to the only existing units in Belfast, Dublin, Cork and Galway. It is shameful and an absolute disgrace. It is intolerable that cancer patients are subject to long journeys and lengthy absences from home when the hospitals at Letterkenny or Altnagelvin could house a satellite radiation oncology unit to meet their holistic needs. The practical and political logic of all-Ireland co-operation on this, and many other issues, is undeniable.
Will the Government commit to progressing and developing the north-west satellite cancer centre as a matter of urgency? Cancer patients do not have the time to wait for political agendas which delay this process. This is about saving lives and making life considerably more comfortable for those cancer patients who must travel for hours every day to receive treatment. It is imperative that this unit offers all patients equal access to treatment, according to need. With the construction of such a unit, cancer patients will be treated near their homes, families and friends.
For too long the people of Donegal have been neglected by the political establishment. Enough is enough. People from the north-west region are being treated as second-class citizens owing to their geographic location. This can no longer be tolerated. A dedicated satellite radiotherapy unit in the north west is what the cancer patients of the region need. Sinn Féin repeats its call for those patients in Derry, Donegal, Fermanagh, Tyrone, Sligo and Leitrim to have the same rights as those in the rest of Ireland.
I welcome the decision announced yesterday that Letterkenny will be linked with the Sligo specialist cancer care unit. However, we must also recognise that two other parts of the puzzle are missing. The first is screening for breast, cervical and prostate cancers, and the second is radiation. A radiation oncology unit can be developed in the north west.
The Northern Ireland Assembly reconvened in May. The Government made a commitment two years ago that such a unit would be developed but there has been no discussion of the matter on a North-South basis. The people of Donegal demand action on this issue. I urge the Minister for Health and Children to meet her Northern counterpart, Mr. Michael McGimpsey, as a matter of urgency and put this issue on the agenda. My party’s correspondence with Ministers in the Assembly in the Six Counties indicates that Mr. McGimpsey is open to discussing this issue and wants to place radiation oncology on top of the North-South agenda. I ask the Irish Government to give similar priority to this issue.
Senator Brian Ó Domhnaill: I thank Senator Doherty for sharing time with me, which gives me an opportunity to consolidate my position and support much of what the Senator has just said. In the general context, I welcome yesterday’s announcement of the development of eight new specialist centres under the national cancer control programme. We must all welcome such a development which will benefit cancer patients enormously. The issue of the centre in the north west is identified in this programme through the Letterkenny-Belfast linkage. I support Senator Doherty’s assertion that we should foster links with the new Administration in Northern Ireland and that a meeting between the Minister for Health and Children, Deputy Harney, and Minister McGimpsey should take place as soon as possible. Such a meeting should attempt to identify a co-ordinated, strategic approach to cancer services, whether that be through linking Letterkenny with Derry or with Belfast. My personal preference would be for a Derry-Letterkenny approach.
While I do not want to score a political point here, it is worth noting that when the centralisation of services took place in Northern Ireland in 2001 and 2002, it was a Minister from Senator Doherty’s party who was responsible for the centralising of services in Belfast. I support much of what Senator Doherty has said. We must take a holistic approach to the issue in the north west. It is important that the same level of service is available in the north west as in the rest of the country.
Deputy Máire Hoctor: I congratulate Donegal Senators Doherty and Ó Domhnaill on their recent election. I convey the apologies of the Minister for Health and Children, Deputy Harney, who could not be in the House this afternoon to deal with this matter. I welcome the opportunity to address the issues raised by the Senators regarding radiotherapy services for cancer patients in the north west.
Some time ago, the Minister agreed with the then Minister for Health for Northern Ireland, Mr. Sean Woodward MP, that the radiation oncology centre at Belfast City Hospital would provide treatment to patients from Donegal. A project board was established under the aegis of Co-operation and Working Together to deliver on the ministerial commitment. It includes representatives from Belfast City Hospital, Altnagelvin, Letterkenny, the Health Service Executive and both Departments. A service level agreement is now in place for the referral of radiation oncology patients from Donegal to Belfast City Hospital.
The Minister for Health and Children informed the House yesterday of the appointment by the HSE of the interim national cancer control director to lead and manage the establishment of the national cancer control programme. This will have responsibility for the management and delivery of all aspects of cancer control within the HSE. The delivery of cancer services on a programmatic basis will ensure equity of access to services and equality of patient outcome, irrespective of geography. This will involve the significant realignment of cancer services, to move from the present fragmented system of care to one which is consistent with international best practice in cancer control. It is important the decision of the HSE regarding four national cancer control networks and eight cancer control centres is implemented without delay.
It is fully recognised that particular and unique geographical circumstances apply to Donegal. This is reflected in North-South co-operation in the provision of radiation oncology to patients from Donegal at Belfast City Hospital. On a sole exception basis, the managed cancer control network in the west will be permitted to enter into outreach service delivery in Letterkenny as an additional activity. This exception is subject to certain quality assurance standards, linkage to University College Hospital Galway, governance and staffing arrangements to ensure equity of services provided to patients from Donegal.
The reorganisation of cancer services is at the heart of the delivery of the national cancer control strategy and it is imperative the decisions relating to the north west are recognised as being in the best interests of patients and do not negatively impinge on the success of the programme. We have a unique opportunity to provide patients with cancer services which are on a par with international standards and improve survival by as much as 20%.
Regarding the national plan for radiation oncology, a key factor in the successful delivery of effective radiation oncology is its integration within the National Cancer Control Programme. I expect a national director of radiation oncology to be appointed without delay.
The Department of Health and Children and the HSE have been working closely on the examination of procurement options in order to expedite the delivery of the plan. The Minister met with Department officials and with the HSE yesterday. It is now clear that we will have in place radiation oncology capacity to meet the needs of the population by 2010. After 2010 we will continue to increase capacity to ensure that these needs continue to be met. We are fully confident that this will be achieved through a combination of direct Exchequer provision, public private partnership and, where appropriate, the use of the private sector. The sole objective of the national plan for radiation oncology is to meet the needs of the cancer population. There is no doubt that this will now be achieved.
The Government is committed to making the full range of cancer services available and accessible to cancer patients throughout Ireland, including the north west. I am pleased to say that the Minister will meet with her counterpart Minister in Northern Ireland, Michael McGimpsey, in the coming weeks where the potential for further cross-Border co-operation and collaboration on cancer care, and specifically radiotherapy, will be discussed.
Senator Pearse Doherty: I want to correct Senator Ó Domhnaill who, in a spirit of non co-operation, put forward an untruth. The decentralisation of cancer services in Belfast occurred under the stewardship of Ms Bairbre de Brún and is exactly what Senator Ó Domhnaill and other Senators welcomed regarding the eight centres of excellence in the Twenty-six Counties. In terms of the Assembly, it was always envisaged that there would be satellite radiation services available on a cross-Border basis. Unfortunately, owing to political circumstances, the Assembly lasted only a year and a half. That was a cheap political shot.
I will now address the question I put to the Minister of State. I welcome the fact that the Minister for Health and Children, Deputy Harney, is to meet Minister Michael McGimpsey but no commitment has been made in her answer to progress on radiation facilities in the north west. She mentions only potential cross-Border collaboration on cancer care. I am not interested in hearing that 60, rather than 50, patients from Donegal will be able to access Belfast, though it is important that this happens. A dedicated satellite radiotherapy centre is needed in the north west.
Yesterday’s announcement mentioned centres of excellence based on a population of 500,000 yet Donegal has been told repeatedly that it cannot have a radiation oncology unit because it does not have the critical mass. The north west has the critical mass and we seek a clear commitment from the Government. Such a commitment was given in the oncology plan of 2005 and in the national development plan. Deputies and Ministers have made this commitment to the people of Donegal time and again but the Minister for Health and Children, Deputy Mary Harney, will not make this commitment. Will the Minister firmly commit to a satellite radiotherapy centre for the north west?
Deputy Máire Hoctor: If Senator Doherty reads the final paragraph of the Minister’s response that I read on her behalf today he will see that she mentions she will undertake further discussions with Minister Michael McGimpsey, her counterpart in Northern Ireland, for further cross-Border co-operation and collaboration on cancer care. This specifically includes further discussions on the possibility of providing radiotherapy facilities. Senator Doherty, who comes from the north west, knows that a final outcome can only be reached through discussion. His area of the country has shown the rest of the land that discussions can lead to positive outcomes. We welcome the fact that the Minister for Health and Children is undertaking these discussions with her counterpart in Northern Ireland and she has assured us that the provision of radiotherapy facilities for Donegal and the north west will be a priority.
An Cathaoirleach: Generally in matters on the Adjournment one makes the points one wishes in one’s presentation and the Minister listens to these points which are examined by his or her Department. Normally one is allowed one brief question to the Minister following his or her reply.
I thank the Minister of State at the Department of Health and Children, Deputy Máire Hoctor, for attending on this her first time in the House and wish her well in her Ministry. I wish her well in the future and hope that this is the first of many visits to the House.
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