Adjournment Debate. - Galway Health Project Funding.

I am grateful to the Ceann Comhairle for allowing me to raise this extremely urgent matter on the Adjournment. I am seeking to establish if the Minister for Health has received a comprehensive assessment and funding proposal for the Galway Hospice Foundation from the Western Health Board and when a decision will be made on this proposal to facilitate the opening of the hospice which has been completed and ready to receive patients since last September.

The Galway Hospice Foundation was founded in 1988 on the initiative of Dr. Pádhraic Ó Conghaile, who was supported by a large group of citizens who appreciated the urgent need for a hospice care service for advanced cancer patients in the west. Since 1990 a 24-hour a day, seven day a week medical and nursing home care service for advanced cancer patients has served the people of Galway city and county at a cumulative cost of £1.6 million. It provides palliative care management, crisis intervention and bereavement care. It also provides drugs and equipment when they are not otherwise available. The service is completely free for those who need it and no one who qualifies has been refused it to date. At present 60 per cent of patients in the region with advanced cancer are cared for in the hospice and all GPs and hospitals in the city and county avail of the service. There are approximately 40 patients on the books at any one time.

Construction work on the new Galway hospice for advanced cancer patients was completed in October 1994 at a cost of £1.9 million. All of the money spent to date on the home care service and the hospice building has been contributed voluntarily by the people of Galway. Each year 400 people in Galway die form advanced cancer. At present 60 per cent of these are cared for by the hospice foundation home care service. However, 25 per cent of advanced cancer patients need inpatient hospice care. This in-care facility is available in a modern hospice building in Renmore, Galway, which is fully furnished and fitted out with all the latest hospice care equipment but which cannot receive patients as the funding has not yet been provided by the Department of Health.

Since 1989 the Galway Hospice Foundation has sought funding for its services from the Department of Health without success. At present a comprehensive assessment of funding proposals sits on the Minister's desk. This was supplied by the Western Health Board at his request but given the lack of response to date there is considerable concern in Galway that this submission may not be successful. The Minister and the Government statutory agencies have continuously referred to equity in their aspirations but when one looks at what has happened in other areas it is clear that Galway has not been treated equitably. All other hospices are funded by the State. For example, Sr. Francis Hospice in Raheny, Dublin, which has just been completed has already been guaranteed running costs by the Department of Health while Harold's Cross Homecare Service was funded by the Department of Health after three years in service and at a time when it served fewer patients than the Galway hospice. The Department has committed an additional £500,000 to existing services for palliative care. Yet Galway has not yet been included in this allocation.

Each year £6.5 million is spent in south Dublin on hospice care, £4 million is spent in Cork and £1 million is spent in Limerick, while £1.2 million has been committed in Raheny. These are Department of Health funds, not health board funds. However, no statutory funding has been allocated to Galway to date. The Sligo Hospice Homecare Service has received £150,000 in lottery funding, Raheny Homecare Service has received more than £100,000, Harold's Cross Homecare Service has received £150,000 and a £75,000 capital grant has been allocated to the Raheny day care centre. Why are all hospice services except the Galway Hospice Foundation funded by the State?

I wish to remind the Minister that to date the Galway Hospice Foundation has paid more than £500,000 to the State in VAT, PAYE and PRSI. Yet all it received in 1990 was a £30,000 lottery grant. Having looked at what the State has done elsewhere, it is clear that the Galway Hospice Foundation has not been treated equitably. To date this foundation has raised £3.9 million in voluntary subscriptions from the citizens of Galway. There are no outstanding debts on the hospice building which is fully equipped and capable of meeting all the highest standards of modern palliative care. Every week 5,000 Galway people contribute to the cost of running the Galway hospice service. The Department of Health has expounded the need for palliative and hospice care.

Last night at a meeting in the Connemara Coast Hotel in Galway which was attended by more than 500 people the Fianna Fáil, Fine Gael, Labour and Progressive Democrats Dáil representatives committed their full support to the Galway Hospice Foundation's application to the Department for funding to enable its in-care service to commence at the earliest possible date. I hope the Minister's response will bring hope to the people of Galway that the hospice's in-care service can be made available to those who so badly need it.

I commend the Galway Hospice Foundation for the very substantial fund raising it has undertaken in support of the provision of hospice and palliative care in the Galway area. In response to its request for revenue funding to run the new unit, my Department asked the Western Health Board to carry out a full and detailed assessment of the services offered by the foundation, together with the associated running costs. This assessment has been completed and has been considered in detail by my Department. The Minister for Health will consider as sympathetically as possible an allocation of funding in 1996 towards the Galway Hospice Foundation in the context of other competing demands on the health services. This will depend on the funds available for health service developments in 1996. The situation in this regard will not be clarified until the 1996 Estimates have been agreed and published.

What about equity?

The Deputy will know the position in this regard given that he was in Government when this application was made.

The health strategy document "Shaping a Healthier Future" acknowledges the important role palliative care services play in improving the quality of life of terminally ill patients and it is our intention to promote the continued development of such services, making use where possible of existing health facilities. A policy statement on cancer care services is currently being prepared in my Department and it will include a review of the role played by hospice services in respect of cancer patients and set out recommendations for their future development. When the proposals of the review group are to hand, we will be in a position to decide on priority areas for development within the palliative care sector as a whole.

We have an empty building.

The objective of palliative care is to provide the highest possible quality of life for patients and their families.

The service seeks to provide continuing and total care for patients and their families by a multi-professional team at a time when the medical expectation is not cure and the primary aim of treatment is no longer to prolong life. The service seeks to address a combination of physical, psychological, social and spiritual needs of patients and their families, including bereavement support.

Notwithstanding the fact that the outcome of the cancer review group is awaited, significant developments have already taken place in the current year with more than £500,000 being spent in additional development funding in the area of palliative care. In the area of acute hospital services, approximately £1 million in additional revenue funding has been approved this year to improve cancer treatment services.

Not one penny has been given to Galway.

I wish the Deputy would stop interrupting me. The contribution made by voluntary groups in this area is significant. The partnership and co-operation developed between the statutory agencies and voluntary bodies working in this area are fundamental to the proper planning and structuring of the service.

Where is the equity in that reply?