Dáil Éireann debate -
Thursday, 21 Jun 2001

Vol. 538 No. 5

Adjournment Debates. - Cancer Treatment Services.

Mr. Kenny

I thank the Leas Cheann-Comhairle for allowing me to raise this matter on the Adjournment. I raise the issue of developments at the breast cancer unit in Mayo General Hospital because it is of serious public concern in the county and in the region. It is also timely and appropriate that one should do so because the Estimates for the forthcoming budget are currently being prepared and will be discussed in greater detail over the next few weeks.

It is interesting that in the Estimates speech given by the Minister for Health and Children, Deputy Martin, to a committee on 19 June a specific paragraph is inserted on symptomatic breast disease services. It states that the National Cancer Forum at the request of the Minister's predecessor, the Minister, Deputy Cowen, produced a report on the development of services for symptomatic breast disease, the report indicated a need to reorganise and develop breast disease services in centres of excellent to ensure that every effort is made to reduce the number of women in this country who die from breast cancer every year.

We all support efforts to save lives and to provide as much safety as possible in the health area for everybody. This document that was referred to is not Government policy and was never intended to be. It is only a report. That report gave rise to serious agitation and concern in the western counties to the extent that the arguments contained in it about centralising services in locations far from rural areas could lead to further waiting lists, longer queues and a lessening of service. In the case of County Mayo the distances involved and the number of women who would be forced to travel to obtain the service demolish that argument.

The Minister for Health and Children articulated Government policy on this matter in my presence, in the presence of the Minister of State, Deputy Moffatt, who comes from my county, other public representatives and representatives of the cancer support group from Mayo who represent all women in the county and the region. He articulated Government policy when he said that the Castlebar-Mayo General Hospital breast cancer unit would develop and expand in parallel with the specialist centre in Galway. What has happened in relation to that development? What number of extra staff has been approved? What moneys are to be allocated for the forthcoming year? How much of the £2.25 million allocated by the Department of Health and Children to the Western Health Board for disease services is to be spent in the Mayo breast cancer unit in Mayo General Hospital?

It seems that the Western Health Board report is patently unclear as to a division of the £2.25 million allocated. I would like the Minister of State, Deputy Moffatt, to clarify whether a much more sizeable proposal was submitted from the Western Health Board to his Department but was severely restricted and curtailed by officials in the Department of Health and Children to the point where there has been no great development of any significance at the breast cancer unit in Mayo General Hospital, contrary to the words of the Minister and his articulation of Government policy. I would like the Minister of State to clear this up this evening.

I am concerned about this. Nurses, consultants and, most of all, the women of the western region are extremely concerned about it. I would like the Minister of State on behalf of the Minster for Health and Children and the Government to spell out clearly and to let the Dáil hear that there will be no strangulation of the service at the Mayo breast cancer unit and that there will be no diminution of it but that rather it will expand and develop as the Minister for Health and Children, on behalf of the Government, told us in public. I want to see that happen and I know the Minister of State, Deputy Moffatt, wants that also. He is in a position to influence this. I would like if he would articulate that view and confirm that position in the Dáil this evening.

Minister of State at the Department of Health and Children (Dr. Moffatt)

On behalf of my colleague, the Minister for Health and Children, Deputy Martin, I am pleased to have the opportunity afforded to me this evening by Deputy Kenny to inform the House of the current position on the development of specialist breast cancer services in the Western Health Board area. As the Deputy will be aware the provision of medical services at Mayo General Hospital is a matter for the Western Health Board in the first instance.

As the Deputy is also aware, at the request of the previous Minister for Health and Children, Minister Cowen, 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 was also 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 so doing, provide the best opportunity for long-term survival to those who are found to have breast cancer.

The Minister for Health and Children received the report of the Subgroup on the Development of Services for Symptomatic Breast Disease and established an advisory group under the chairmanship of Professor Niall O'Higgins to assist the health boards in formulating their plans for the development of services for symptomatic breast disease. This group met with Western Health Board officials and clinicians following which the board considered the development of specialist breast disease services and adopted a plan for this development. This plan was submitted to the Department of Health and Children and is being considered and the Department will revert to the Western Health Board in due course.

I would like to assure the Deputy that the development of specialist breast disease services in the Western Health Board area is being actively considered within the Department and this involves services at Mayo General Hospital, Castlebar. I can also reassure him that we will seriously consider this matter in regard to what he said about the moneys that will be given to Castlebar and the continuity of the existing service there.