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Dáil Éireann debate -
Wednesday, 3 Jul 1991

Vol. 410 No. 3

Adjournment Debate. - Bone Marrow Transplant Operations.

I thank the Minister of State for taking the time to be with us here tonight. I wish to deal with a very specific matter which, indeed, will not take five minutes as such but is of extreme importance. It relates to the long waiting list for bone marrow transplant operations, which, as the Minister and the House will know, can save the lives of people with certain kinds of cancer.

One six month old County Galway baby has been waiting for more than four months for this operation, which may not be carried out until late in the autumn or even later in the year. The irony of the case is that there is a donor available, which, the Minister will agree, is a very important aspect, and there is no reason why the operation should not have taken place. To complicate matters, the family concerned lost a four year old child with a similar complaint a few years ago.

Bone marrow transplant operations have virtually come to a halt in this country. In 1990 a total of 19 such operations was completed, but to date this year's total is only three operations. The unit handling these most delicate operations is based in Our Lady's Hospital for Sick Children in Crumlin. It contains some of the most modern facilities in the world. However, due to Government financial cutbacks last year, most of the 25 specially trained nurses and other specialist staff were dispersed into other areas of the health services. When the Department of Health decided to grant financial funding to the unit earlier this year the hospital authorities had to recruit and train another 25 staff. The lack of planning and the lack of a short to medium-term strategy, which prevents the continuity of the service, is nothing short of deplorable. The result of this mismanagement by the Department of Health is causing great anxiety and stress to parents of many children who require such operations. It is particularly galling for parents to know that the technology and medical expertise is available in Ireland but that because of Government mismanagement and lack of recognition of the problem the unit has been virtually closed from 1991.

It is understood that a bone marrow transplant operation in Ireland costs between £20,000 and £25,000, whilst a similar operation could cost £50,000 in the United Kingdom and a staggering $100,000 in the United States.

The Minister for Health must take the blame for the problem. I cannot imagine how an even half thought out plan could go so wrong, that a unit carrying out such important work could literally be closed. I know that it will be said that the unit is still open, but I put it very clearly on the record of the House that because of the initial cutbacks a very difficult problem has arisen. It is important for me to point that out. It is very important to have specialised, well-trained staff for such very sophisticated operations. Bone marrow transplant operations are extremely important and we are very lucky in this country to have people with training and expertise that matches the best in the world.

I speak now on behalf of the parents of a child from County Galway, but I am fully aware that there are many other people around the country with the same anxiety. What I say tonight is that our priorities must be standing on their ear.

My colleague, Deputy Higgins mentioned funding from the national lottery. I would go further. One can argue the toss one way or another about the Taoiseach's office and other projects. However, when a child in County Galway whom I personally know and whose parents whom I know very well are under great stress and pressure because time is of the essence, is in such great need, it is difficult for politicians like me to say we have our priorities right if golf clubs and other such amenities can attract lottery funds while a unit of that nature is virtually closed down because the funds are not available. In the name of the Almighty, where are our priorities?

The Minister for Health talks about planning strategies for the future and delivering good service and so on. Surely at this late stage — and it is very late because a full year has been lost — something can be done for this very important hospital unit so that my constituent and many others will get the sort of treatment that will save their lives or at least prolong them.

I wish to thank the Deputy for giving me this opportunity to clarify the position regarding bone marrow transplant operations for children at Our Lady's Hospital for Sick Children, Crumlin. The hospital provides an excellent national service in paediatric oncology generally which has been developed on an ongoing basis over the past number of years. The achievements of this unit have been very successful and compare favourably with international standards in the field of paediatric oncology. One very successful form of treatment for certain types of cancers is bone marrow transplantation and a successful programme for transplantation is presently in place at Our Lady's Hospital, Crumlin.

I understand from the hospital that two bone marrow transplants have been carried out this year to date, which is a slight decrease on the number of transplants carried out over the same period last year. The reason the number is down is a lack of nursing staff with specialised nursing expertise who are required to nurse these patients.

In response to this specific difficulty my Department have approved an additional six staff nurses. These nurses have now taken up appointment at the hospital together with a clinical teacher who is assigned to the oncology unit for the training of staff in all aspects of oncology and bone marrow transplantation. The Deputy will appreciate that oncology is a particularly stressful discipline for staff and a high level of training and expertise is necessary for staff in order to prevent burnout.

The hospital provides a first-class multi-disciplinary team approach to oncology patients and their families. This team includes the consultant, nursing staff, social worker, clincial psychologist, psychiatrist and dental surgeon. The team is very sympathetic towards the medical, social and emotional needs of the patient and family and in this regard provides a 24-hour service where the parents of patients may receive advice on any matters which are of concern to the family.

I am glad to inform the Deputy that a modern, purpose-built unit at Crumlin Hospital is due to open in the very near future. The building of this unit is now completed and is presently being equipped. This 15-bed new unit will replace existing accommodation. The unit includes purpose-designed facilities for parents of children. A great deal of diligent and sustained effort has been applied in order to raise funds for this very worthwhile project and my Department are making a significant contribution of £300,000 towards the overall cost.

The difficulties referred to by the Deputy have not arisen in this area because of cutbacks in the Department of Health, nor has the unit been closed for 1991. The allocation of the additional staff, resources and capital expenditure for this hospital will allow them to continue to expand the excellent services to which the Deputy has referred.

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