I wish to share my time with Deputies Jim Higgins and Cooper-Flynn.
Adjournment Debate. - Cancer Treatment Services.
Is that agreed? Agreed.
The National Cancer Forum issued its report on symptomatic breast cancer services earlier this year and presented it to the Minister for Health and Children, Deputy Martin, and to the various health boards which have statutory responsibility for the provision of services.
The Minister has accepted the main recommendations of the report but has made no final decisions until the question of what he terms "local refinements" can be dealt with. He has already confirmed to me in the Dáil that he can overrule any section or recommendation of the report. The report recommends the phase out and closure of the breast cancer unit at Mayo general hospital, Castlebar.
The Minister appointed an advisory group to deal with the issue of the local refinements referred to, and, in respect of Mayo general hospital, this group met in Galway with medical staff and Western Health Board personnel on 12 October 2000. The meeting was quite acrimonious and its concluding recommendation was to phase out and close the Mayo breast cancer unit when the specialist unit in University College Hospital, Galway, would be provided. It was also suggested at the meeting that it would be a sufficiently good service to bus women from Mayo to UCHG for examination and treatment.
This news and the implications of the recommendation has been received with a deep sense of shock and a level of anger I have not witnessed in many years. Women from all over the county have contacted me by telephone, letter, and personally to express this anger. I have a letter from a woman who recently had a mastectomy who would not have been even examined, never mind had treatment, if she had had to travel to Galway and deal with waiting lists.
I want to say loudly and clearly that this unit should not be allowed to close under any circumstances, for a number of reasons. The consultants in Mayo general hospital, backed by a superb team, have dealt with 52 cases so far this year. Women can have a referral, surgical attention, radiology, pathology and cytology, breast care nurse, medical oncology and radiotherapy in a short time with no waiting list. The medical team would welcome any audit of the quality of its treatment and attention which will stand up to any scrutiny.
If this recommendation were carried through, all breast cancer cases from the Western Health Board area would be referred to Galway. This would inevitably lead to long waiting lists as has happened with orthopaedic, orthodontic, cataract, and cardiac cases. Breast cancer is traumatic enough and of a deeply personal and stressful nature, without having to deal with long waiting lists.
A Dublin solution will not work in a west of Ireland setting. Professor O'Higgins initially recommended only two units for Dublin but, after discussion with his colleagues, increased this to five. His recommendation for the west does not take account of capital investment to date, geography and distances involved in Mayo, or population projections. Does the Minister realise that a round trip to Galway from Geesala, Belmullet, Aughleam, Blacksod, Porturlin or Rossport is in excess of 220 miles?
The status and reputation of Mayo general hospital – a new hospital – would be seriously diminished and reduced. I will not allow this to happen and I want this unit kept open. I want to hear the Minister say that it will be kept open. I want this unit to continue its valuable work, not in competition with UCHG but in co-operation with it.
I express my appreciation to all the women's groups, the Mayo Cancer Society, the ICA, the IFA and the hundreds of men and women who have supported my call in this matter. The Taoiseach is due to visit the hospital on Friday next. He will be welcome but, as a politician, I warn him to take careful note of the extent and depth of feeling about the issue. The closure of this unit must not be allowed.
(Mayo): I thank Deputy Kenny for sharing his time with me and Deputy Cooper-Flynn. Seldom has an issue galvanised public and political opinion as much as the possible proposed closure of the Mayo breast cancer unit. This is a matter of life and death and that is how people see it.
It is deplorable that anybody could apply the economic slide rule to such an essential service. At a time when the incidence of breast cancer is rampant and on the increase, it is beyond me how anybody could parade the sacred cow of so-called rationalisation and centralisation to such an essential service. The decision to close the Mayo facility is not acceptable. It must not happen and it will not be tolerated. Apart from the medical necessity for the service, as Deputy Kenny stated, the political consequences are obvious. Mná Maigh Eo are on the march and they will not take no for an answer.
I thank my colleagues for allowing me an opportunity to contribute to this important debate. They have outlined the up to date position quite well.
It is important for a number of reasons to state at this stage that no decision has yet been taken. We want to see a standard of excellence at Mayo General Hospital. As a member of the health board, I already know, because this has been confirmed by the chief executive officer on numerous occasions, that that standard of excellence applies at Mayo General Hospital. For that reason alone, there is no reason to close the cancer unit. There are a sufficient number of procedures taking place at Mayo General Hospital to ensure that the standard of excellence is maintained and, no doubt, that will be the case in the future.
We want to achieve the best possible care for women. We all recognise that the purpose of this report was to improve those services to women all over the country. When one is living in the regions, particularly in a county like Mayo, while standards of excellence are paramount one cannot ignore geographical considerations. As Deputy Kenny outlined, the county is 120 miles in diameter. This, together with the fact that the requisite standard applies already in Mayo, makes me urge the Minister to make a quick decision to remove any element of uncertainty on the issue. I also recognise how motivated the women of Mayo and, indeed, of the Western Health Board region are to the retention of those services.
I thank Deputies Kenny, Jim Higgins and Cooper-Flynn for raising these issues.
On behalf of my colleague, the Minister for Health and Children, Deputy Martin, I am glad to have the opportunity afforded to me this evening by Deputy Kenny to inform the House of the current position regarding the specialist breast cancer units in the Western Health Board area.
As Deputy Kenny will be aware, the provision of medical services at Mayo General Hospital is a matter for the Western Health Board in the first instance. At the request of the Minister for Health and Children, the National Cancer Forum established a sub-group to examine the provision of services for women with symptomatic breast disease. The sub-group had the following terms of reference: to assess the impact on the existing diagnostic services for benign and malignant breast disease in the light of the National Breast Cancer Screening Programme, the increase in the target population, the increased awareness of the importance of breast screening and the current and evolving technologies in the area of breast screening. The sub-group asked to make recommendations to the Minister for Health and Children on the diagnostic services for symptomatic breast disease necessary to meet projected increased needs, the need to develop associated services in radiotherapy, medical oncology, counselling and other support services, the resources required to develop these services and the principles that should underlie the organisation and delivery of services for breast disease.
As part of the work of the sub-group, the regional directors of cancer services were asked for information concerning their current service and their views were sought on how the service should be developed in their region. In addition, three members of the sub-group visited each region. The consensus view regarding best practice in the management of breast disease was presented to regional representatives and their views on how this could be achieved in their region were sought.
The sub-group found that although services should be delivered as close to the patient's home as is feasible, the overriding priority should be to provide the best, safest and most effective treatment for women and, in doing so, provide the best opportunity for long-term survival to those who are found to have breast cancer.
The Minister for Health and Children has received the report of the sub-group on the development of services for symptomatic breast disease. No final decisions regarding implementation arrangements at health board level have been taken. The Minister has established an advisory group under the chairmanship of Professor Niall O'Higgins to assist the health boards in formulating its plans for the development of services for symptomatic breast disease. This group has recently met with Western Health Board officials and clinicians. Further discussions will take place with the chief executive officer and the Western Health Board, following which a definitive plan will be formulated for the treatment of breast cancer in the health board area. This, in turn, will be forwarded to the Minister for final decision and funding approval.
This is a serious and sensitive problem. We must put the patient first, hospitals second and politicians a poor third. We should not play political football with the issue. Unfortunately, this has been the case on the issue of breast cancer in many instances. It is not the way to go forward. I will do my best in the Department of Health and Children to make sure we retain the service in Castlebar.