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Dáil Éireann debate -
Wednesday, 12 Feb 1986

Vol. 363 No. 11

Adjournment Debate. - Cork Hospital Radiotherapy Unit.

Deputy Ned O'Keeffe has sought and been given permission to raise on the Adjournment of the House the failure of the Minister for Health to provide funds for a building to house the radiotherapy unit at Cork Regional Hospital.

First, I want to thank you, Sir, for making time available to me and also to apologise if I inconvenienced you in any way over the last few days when I was looking for this permission and you found it difficult to get to me to allow me to speak on such a very important subject. With your permission, I have agreed to divide my time with my colleague from Cork, Deputy Denis Lyons, and our spokesman on Health who is a medical doctor and very much aware of the problem identified with the subject I am speaking about, Deputy Mac Carthy.

Cork Regional Hospital is one of the most modern in western Europe. It has been in operation since 1978 and in that time it has given the city and county of Cork an excellent service, with first class nursing staff and medical profession all doing their best for the care, well-being and health of the people in the area. It is a 500-600 bed hospital.

A hospital today, no matter how modern it is from the structural point of view, is of very little use if it has not got modern equipment, and that is one of the problems that the hospital service in this country faces today. No matter what type of equipment we have, it has an age span of only five to six years after which it is out of date and requires updating or further equipment, even if it is only the motor car we drive that takes us to our work. I want to speak about the radiotherapy unit at the hospital. People have gone out of their way to give large subscriptions voluntarily for the purchase of this much needed equipment, and the problem has arisen because there is no building or facility to house or take care of that new equipment. As well as that, one or two staff are required. My information is that the Minister for Health has not given the necessary permission. Also some small amount of funding is required and that has not come forward.

I understand further, that this whole problem started about 1982 and has continued up to now with no action being taken. An amount of £300,000 is lying in the bank or somewhere. I understand that it has been subscribed voluntarily. Going over some old ground, I say that it should be free of VAT. Anything done voluntarily in the care of people's health should have the incentive of being VAT free.

About 1,200 new patients suffering from cancer are admitted to that hospital each year over and above people who were there previously who may have to come back for further treatment. Six to eight of those patients have to be flown to London to get specialist treatment which could be available here if this equipment was installed or erected in the hospital. Those patients cost £8,000-£10,000. Therefore, it is costing about £80,000 per annum to take that number of patients to a London specialist hospital for the type of treatment we are looking for. We are all aware that cancer is a dreaded disease which needs urgent treatment. We cannot neglect it. We must have our priorities right. Cancer hits many a family and very few families are exempt from the experience of a member suffering from that ailment. I do not want to be alarmist because I understand the anguish people feel when a member of their family is looking for that type of treatment with often only a short period left before that person goes to meet his God.

The source of the funding has dried up recently. Many more pounds could be added to what is already there if the Minister would provide some incentive. The people who subscribed the moneys and the voluntary committee gave of their best but they have become annoyed and soured and they have failed to continue. All they have kept going is an ad hoc committee to monitor the situation. Now the existing unit is out of action for repairs even though it is old. It has been there since 1968. It is the old treatment unit that was in St. Finbar's Hospital and was brought to the regional hospital when that was built in 1968. This is 1986, so we realise the age of the treatment unit which needs repair and updating. It is now out of action and 40 or more patients this week will not get treatment which they may need urgently. That puts those patients back another week.

The primary objective of any Government or Opposition must be to save life and to reduce suffering and pain substantially. We have the power to do that in this House by making this contribution to the Cork Regional Hospital which is servicing one of the largest areas in the country outside Dublin. For that reason I am making a personal appeal on behalf of my constituents and the people of Cork county and city. I ask the Minister to come to our aid and give us the modern equipment that is necessary for the health care in that area.

I thank my colleague for affording me the opportunity to contribute to this Adjournment debate which I sought yesterday by the three means available to me, Private Notice Question, on the Order of Business and Adjournment Debate. Regrettable thought it is, the collapse and dismantling of the cobalt unit in the regional hospital in the past week has probably encouraged the Ceann Comhairle to acknowledge, by allowing this question on the Adjournment, the urgency of the matter not alone of that cobalt unit but of asking the Minister, as he has been asked over the years, to provide a building for more modern equipment, the money for which has been collected voluntarily to the amount of £300,000.

I would like to relate, blow by blow, this sorry saga of this whole affair and relate the stubbornness of the Department and the Minister on this matter in the regional hospital. The cobalt unit that I have spoken of was transferred in 1979 from St. Finbarr's to the regional hospital and in the same year an equipping meeting — what a lovely term — was arranged between the Department officials and the Southern Health Board. In May 1980 a request was made to the Southern Health Board to seek from the Department the necessary simulator that was required in the fight against this dread disease of cancer. That request in turn was made by the Southern Health Board to the Department. In July 1980 St. Luke's Hospital requested and were granted in principle modern equipment. They raised £100,000 for this equipment by voluntary subscriptions, and I put a conservative estimate that £50,000 of that came from the Munster area.

We move on because time is limited. In October-November 1982 a sub-committee were formed by the Department to examine the future of radiotherapy in this country. In January 1983 the Minister opened the simulator at St. Luke's, to which I have referred, and promised them there and then a further £400,000. Meanwhile the Southern Health Board still awaited a reply. Dr. Hurley then suggested to that board that a public subscription be launched to provide money for this equipment. Out of that was born the organisation known as ACT — Aid Cancer Treatment — of which I am a patron.

In June 1983 the Minister met representatives of ACT of the regional hospital who indicated what was required, what progress had been made and what the programme was to be. In October 1984 a request was made to the Minister for £40,000 to erect a building to house the simulator for which £300,000 had by then been collected by the voluntary committee. There was still no reply from the Department or the Minister. At that stage Deputies from Cork and Kerry were enlisted for their support.

In January 1985 St. Luke's Hospital notified Dr. Hurley that no more patients from Cork would be treated there due to a long waiting list at that hospital. There was still no reply from the Minister or the Department. In February 1985 the Minister agreed to meet a deputation of the Cork Deputies on 25 March, but not before because he had then some matters to go into, the details of which he did not disclose. That meeting promised by the Minister by letter to us never took place. Nothing has happened since. St. Anne's Hospital in Dublin got a new cobalt machine in August or September of 1985. In November 1985 the Minister indicated in the Dáil that the situation at Cork Regional Hospital was, in his own words, "under review". I impress on the Minister the need for his approval for £40,000 to put up a building to contain the equipment whose cost has been subscribed to and collected by the people of Cork in particular and Munster in general for the treatment of cancer.

My colleague has indicated the cost to this country and to the Southern Health Board of sending patients to Britain where they have the most sophisticated equipment available and where this sensitive machinery is available to treat patients who cannot be treated in Cork. The money is already there for the equipment and why is there continuing delay? I appeal at this late hour tonight to the Minister to approve the cost of the building for the Southern Health Board so that the machine may be put into operation.

First, I should like to thank my colleagues, Deputy E. O'Keeffe and Deputy Lyons, for giving me an opportunity to say a few words in an appeal to the Minister to make a firm decision in relation to the provision of proper equipment in the radiotherapy unit at the Cork Regional Hospital. At the outset, let me say this is not just a parochial problem which affects Cork city alone. The radiotherapy services as provided from Cork Regional Hospital service Kerry and Cork, part of Waterford, South Tipperary and South Limerick. They deal with a catchment area of approximately one million population.

It is clearly obvious that the old cobalt plant which was used until a few days ago is outmoded from the point of view of providing proper treatment. It is at present out of service for a short time for repairs and in the interim all treatment which would relate to the use of that machine has been suspended. In June 1983 the Minister met the authorities and the experts in Cork who deal with this matter. Unfortunately, he has deemed it proper not to meet them since. The radiotherapy unit at Cork which deals with the cases which need this treatment would cost approximately £400 to £500 per annum.

As someone who has some degree of knowledge of medicine and has worked in the past in our National Cancer Hospital, St. Luke's in Dublin, and involved himself in cancerological research for a number of years, let me say that people who suffer from certain types of cancer which need radiotherapy treatment have the right to the best possible technological and scientific treatment available from a radiotherapeutic point of view. All one need do is go to the major cancer units in any part of the world and, if one wants to cross the water, see what equipment they have in Christie's in Manchester. They have simulators and accelerators of all sorts. They recognise that this is the most accepted form of treatment to give the best opportunity of a permanent cure.

I hope the Minister realises that using an ordinary cobalt machine resembles shooting with a gun and aiming blind. It is a hit or miss job. If one uses a simulator — for which type of machine money has been collected — one can fire the treatment at a particular area as from a rifle. If one wanted to go even further and provide an accelerator, it would identify the area to be treated with telescopic accuracy. Let there be no doubt that people are dying because of the inferior treatment available in Cork at present. I do not want to sound an alarmist, but it would be unfair, unjust and remiss of me to let these facts pass by. As my colleagues have said, it is a fact that voluntary groups in the area of Cork and going towards Tipperary——

——yes and Limerick and Waterford — have raised over £300,000 to purchase a simulator. It is estimated that the cost of this machine would be approximately £240,000. They have, in fact, collected in excess of the cost. However, they badly need two items which I hope the Minister will provide and which he has ignored in the past, the first of which is a building which it is estimated would cost between £40,000 and £50,000 and the second, to pick up the tab on the 23 per cent VAT on the cost of the simulator. It would be unjust that those who collected this money to save many of their friends and others in that catchment area should have to shoulder this burden. This is the job of the State and the State cannot ignore it. They must provide money for that VAT payment.

The Minister may say that two people would be needed to operate this machine and that is so. We are not talking about big money when one sees how money is squandered in many areas, but one cannot quantify in terms of cost the saving of a life and that it what we are talking about here. There has been blatant discrimination against Cork. The Minister and his Government have involved themselves in politics of the Pale which we have seen practised in every area over the last three years. It certainly should not be operative within the area of health care. The Minister may or may not be moved in the reshuffle tomorrow but he will long be remembered as the person who did his utmost to close down our health services. He has stood like an immovable arrogant tank in the way of progress in the health services. Even at this late stage I hope he will accede to our request to provide the type of treatment that is necessary for poor unfortunate people who are suffering from cancer. They deserve the best treatment that can be provided by the State.

Cork Regional Hospital has at present a radiotherapy unit which is equipped with a cobalt machine. Last year this unit provided radiotherapy treatment for about 500 in-patients and about 5,000 out-patient attendances. To get the facts across on health is very difficult but I should like to make the point that last year only ten patients had to be referred to Dublin for more intensive radiotherapy treatment.

On Monday, 10 February the existing equipment was decommissioned to enable repairs to be carried out to the treatment couch. The decommissioning was planned, patients were told in advance and any necessary alteration in their treatment schedule was made. It is expected that the repairs will be completed this week and that normal treatment will resume on Monday next, 17 February. Frankly, I think the head of the cancer treatment centre, the consultant radiotherapist in question, would be better employed doing his work in the hospital rather than frightening the patients, and the public, in order to obtain a piece of equipment which I accept would be very valuable to Cork but which is not on the current priority list of the Southern Health Board.

It is our priority.

That is a disgraceful statement from the Minister.

I did not interrupt any Deputy and I should be allowed continue. The consultant radiotherapist would be far better employed doing his work than writing voluminous allegations to the local papers about me. A health board run that hospital and there is a hospital programme manager in charge of the hospital. There are administrators running it.

Are the radiotherapists?

A staff of 19 are involved in running that particular department. I deal with the priorities notified to me by the Southern Health Board. The first priority notified to me in 1984-85 was the urgent need for essential equipment to enable the cardiac unit in that hospital get up and running.

With due respect to Deputy McCarthy. I will go down in history as the Minister for Health who introduced the open heart cardiac service in the Cork Regional Hospital. I provided, from the resources available in the Department of Health, a sum of £423,000 to the hospital to enable it to commence cardiac surgery. I am proud to be able to say that I was the first Cork Minister for Health to do that. To date there have been 19 open heart surgery procedures carried out in the hospital.

That is a red herring. The Minister is forgetting about cancer patients. Do they count?

The Minister almost bungled the appointment of the specialist.

I have a copy of the Minister's letter sent in 1983.

The revenue cost of that service in the current year will be almost £750,000.

(Interruptions.)

Deputy O'Keeffe and his colleagues were allowed make their contributions without interruption and they should allow the Minister to make his.

The Minister is trying to mislead the House.

The Minister is trying to drag a red herring across the trail.

If the Deputies ceased their ignorant interruptions I would be able to complete my comments.

Yes master.

The whip is out again.

I do not profess to be a consultant radiotherapist but I do know that the Southern Health Board have told us that their first priority in relation to the service is to replace the existing cobalt source and the treatment couch. That alone will cost £200,000 in the current year. Before there is any question of a simulator being put into that unit the cobalt source and the couch must be replaced. The cost must be funded before any further development can be considered. The £50,000 referred to by the Deputies for a building required for a simulator has not been listed by the Southern Health Board, or the hospital authorities, as a priority in terms of capital expenditure for the hospital. The £200,000 will be required in the relatively near future for the essential segment of the cobalt unit and that is our first priority.

If the Deputies opposite are so concerned about this, and if Dr. Hurley is so concerned, I suggest to them that they should meet, under the aegis of the Southern Health Board, the Aid Cancer Treatment Group, a voluntary organisation, who have collected £300,000. That money could be used to purchase the essential cobalt source and a replacement treatment couch. Without them there is not much point in going down the road.

And leave Cork with an inferior treatment unit?

I resent and deplore the hysteria which has been created in relation to these services.

The truth is bitter.

I must point out that only ten people had to be referred to Dublin for more intensive radiotherapy treatment.

(Interruptions.)

The Minister should be allowed make his contribution without interruptions.

The public should not be unduly upset by statements emanating for entirely different purposes, in order to create exceptional jumping of the queue. If Dr. Hurley has a problem he should go to his hospital administrator or the CEO of the health board because they are the people who have sent the priorities to me in terms of the expenditure for capital purposes.

The doctor has gone to those people and they have written to the Department.

The Minister got expert advice from Dr. Hurley.

The Minister has misled the House and accused Dr. Hurley in the wrong under the privilege of the House.

Deputies opposite should resist the temptation——

An Adjournment Debate should not be carried on in this fashion.

This is a very sensitive issue. It is not sensational as the Minister is trying to make out.

Deputies opposite should resist the temptation which is now endemic here to make cheap political capital out of cancer treatment.

Nonsense.

The Dail adjourned at 11.p.m. until 10.30 a.m. on Thursday, 13 February 1986.

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