That Dáil Éireann:
– the poor budget given to cancer care since 1997;
– the failure to extend the preventative cancer programmes to all our citizens;
– the inability of all our citizens to access radiotherapy services equally;
– the total lack of a proper oncology service; and
– the total lack of a proper cancer support service;
– that cancer care apartheid exists in Ireland;
– that Irish citizens are dying unnecessarily because of the lack of proper cancer services as evidenced by the statistics;
– that the Government is negligent in failing to provide an adequate budget for cancer care for a disease that affects one in three and kills one in four of us; and
– that the Government is negligent in refusing to allow staff recruitment commence for the Galway radiotherapy unit with the result that it will be 2006 before the unit treats patients;
– notes that leaks from the imminent and long overdue radiotherapy report proposes even more centralisation of services with no local radiotherapy units proposed to be opened except Galway;
– further notes that local units at Waterford and Limerick would save more lives and cost less;
– demands that a proper budget be provided for cancer care by Government;
– further demands that cancer preventative services be available to all our citizens;
– further demands that equality of access to radiotherapy services be assured for all our citizens;
– further demands that proper oncology and support services be developed; and
– calls for an end to cancer care apartheid in Ireland.
I am glad to move this motion. I wish to share time with Deputies Connolly, James Breen, Finian McGrath, Gormley and Ó Caoláin. This motion was on last Wednesday's Order Paper, but it got nowhere because the Government did not take it up. Thanks to the co-operation of my Independent colleagues, this motion has been moved on behalf of the Technical Group and has the support of all Opposition Members.
I wish to know what the Government's policy on cancer care funding is. Where is the priority to fund proper prevention and care regarding a disease which affects one in three people and kills one in four? We are still reading about the Taoiseach and the national stadium and we have heard the Taoiseach say he wants world-class sports facilities. Why can we not have world-class cancer care facilities with European standards? Cancer care is certainly not a Government priority and it is no wonder we are lagging behind in the statistics on death rates from the disease.
The Government gave sporting organisations €161 million in 2002 while only €23.5 million was provided for the development of cancer services. I do not begrudge sporting organisations but I begrudge the small amount given to cancer care development. We need proper funding to make up the deficit between what is possible and what is there at the moment. The figures are shocking. The latest statistics from the 1999 national cancer registry show that 20,000 people, or one in three of the population, is being diagnosed with cancer which means that every hour two more families will receive the terrible news that a member has cancer.
As early as 2015, the incidence of many cancers will double. The numbers being diagnosed with breast cancer will increase by 43% over the next 12 years which is a shocking figure. Are we prepared to tolerate this doubling in the numbers in light of current resources? There is concern given the high rates of morbidity and mortality in our national cancer registry compared to the EU average. There are also variations in those rates within the country. According to the recently published national cancer registry, there has been no reduction in the death rate from cancer, in the large numbers of people receiving no cancer specific treatment or in the large numbers of elderly people who receive no treatment at all. The large numbers of patients who live in areas not facilitated by radiotherapy services are less likely to receive treatment, while the likelihood of receiving scientifically-based treatment is a lottery which depends on where one lives. That is unacceptable.
I was always told that prevention was better than cure which is why I threatened to march on the Oireachtas in regard to BreastCheck. Within 48 hours of marching, a commitment to extend BreastCheck was given by the Minister for Health and Children, but we are still waiting for the Minister for Finance to confirm the €6 million necessary for the capital roll-out this year. The decision to roll-out BreastCheck in one part of the country rather than another meant that 195 women died unnecessarily in the south and west. A wealth of international evidence was available which proved that mortality rates from breast cancer could be cut by 20% to 30% through a breast check programme. It is wrong for the Department of Finance effectively to control the health service and I call on the Minister for Finance, Deputy McCreevy, and the Taoiseach to confirm the availability of the €6 million needed for the capital roll-out of BreastCheck this year. It is unacceptable and a recipe for further cutbacks for the health boards to be expected to take the money from their existing budgets.
A national programme for the prevention of cancer of the cervix was promised in 1999, but we are still waiting for it to extend beyond a single health board area. Given that in England the death rate from this cancer is being cut by 7% every year, it is a national disgrace that we do not have a country-wide screening programme. Cervical screening is a simple test. Even in the cases of those who have it done or can pay for the service, a waiting period of 28 weeks applies which constitutes another cancer lottery. It costs lives.
The recently formed cancer care line aims to ensure that preventative services are put in place while demanding equity in the system. Cancer care apartheid exists in this country and its most notable example is access to radiotherapy services. Last week I received a telephone call to say that a bed was available for a patient of mine who had died four days before. That was disgraceful. Here was a man who had been told he needed treatment and expected to get it, but who died waiting for a letter to arrive, which never came. If one has money, one can have these services tomorrow. If that man had money and was insured by BUPA or the VHI, he would have received the care. People are voting with their feet and nearly half of the population are members of those insurance schemes. If one lives in Ballymun or Ballydehob, one will fall victim to the same cancer care apartheid. If one does not have money, one could die waiting for treatment as did my unfortunate patient. I am not saying he would have been cured, but he would have been helped. He was recommended for the treatment and he should have received it.
The three modalities of treatment are surgery, radiotherapy and chemotherapy, but they cannot benefit someone who lives a few hundred miles from the treatment centre. It is no wonder that our cancer statistics are as they are when people have to travel so far. It is no wonder we wallow at the bottom of the European league table when only 16% of those who require radiotherapy actually get it compared to the 50% to 60% who should get it. This is a disgraceful postcode lottery in which whether one lives or dies depends on where one lives. Government policy is deciding whether people live or die.
I was in Waterford recently to speak at a demonstration. I discussed the radiotherapy unit in Galway which should be rolled out in July but which will not treat a single patient until 2006 because the Department of Health and Children has not given the go-ahead for recruitment, a process which can take up to a year and a half to complete. According to leaks and the last edition ofThe Sunday Tribune, which speaks authoritatively on the subject, there will be no radiotherapy units in Waterford and Limerick which is a fiasco. It does not make humanitarian, medical or economic sense. Science has moved on and countries like Ireland with a dispersed population have discovered local radiotherapy which is something we should do too as it provides cheap, effective treatment. A patient would receive a scan locally, his or her information would be passed to St. Luke's and a treatment plan would passed back within hours. The patient could receive radiotherapy locally. Mothers would not have to be away from their babies for five weeks. It is a cost effective option and Deputy McCreevy should note that in the case of these day patients there would be no bed costs and no long transport costs. The system works. People spend 12 hours travelling to receive five minutes radiation and it costs them hundreds of hours to get one hour's worth of treatment. That is ridiculous and non-cost effective. The report outlined in The Sunday Tribune should be rejected as old hat. For a fraction of the cost we could have strategically-located radiotherapy units with CATscanners, radiotherapy machines and staff.
They say we need 38 machines which they wish to locate centrally. I welcome the mention of Galway, but I do not understand why a service should be centralised when that will fail to make it easier for people to access it. Access to radiotherapy will not be improved by this measure. At the moment ten machines are available to the public which treat 350 people per machine per year, or 3,500 people in total. Annually, 9,000 patients will require radiotherapy. There is a requirement for cross-Border co-operation to ensure that those in the north-east can access cancer treatment services at Derry.
I calculate that the South-Eastern Health Board spent €28.2 million in 12 years on transport and accommodation costs for radiotherapy patients. It costs this amount of money to transport people to receive this treatment, yet for half the money, the same service could be provided locally. It makes great humanitarian, medical and economic sense. There are models in Norway, Truro and the Mater private hospital. The report states that, by 2015 and possibly 2010, the population of Waterford and the south-east will be such that the service will be needed. That is for four linear accelerators, but it would be done immediately with a unit of two.
Government policy is deciding whether people live or die and this has been confirmed by the National Cancer Registry report. We do not have enough oncology beds, nurses and staff. There are eight radiation oncologists for the country compared with 12 in Belfast alone and 157 in Holland. Given that Holland's population is four times ours, that would mean we should have 40 radiation oncologists. Instead, we have eight, which is a disgrace.
It is time to end cancer care apartheid. It is time for the Government to put its money where its mouth is on cancer care and give a definite commitment to multi-annual funding for cancer care. Health apartheid should be ended and Galway given the go-ahead to begin recruiting staff.
The radiotherapy report was supposed to have been made available years ago and yet we still receive leaks about it. We can read about it inThe Sunday Tribune. It is typical that we must wait so long for a report that means so much to many people and when the lack of a proper service costs many lives. It is typical of how the Government prioritises cancer, which is terrible and shocking. The final irony is that the report supposedly recommends another report to decide where to locate the second centralised unit in Dublin. Does it make sense to you, a Cheann Comhairle? It does not make sense to me.
We need to make cancer care a central priority. How can Ireland's families have a future if we are to be affected by a lack of funding for a service that is not delivering? We need a realistic budget for cancer care so that Ireland's families have a future and that, when people contract cancer, which one in three of us will, at least they can be assured of the best possible care.