Liam Twomey
Question:78 Dr. Twomey asked the Tánaiste and Minister for Health and Children if legislation will be introduced to protect whistle-blowers in the health services; and if she will make a statement on the matter. [35723/05]
Priority Questions.
Proposed Legislation.
Statutory provisions exist in respect of governance in the health services which deal, inter alia, with the issue of confidential information. Section 35 of the Health Act 2004 obliges the Health Service Executive to draw up a code of governance which will include guiding principles applicable to the executive as a public body. Earlier this year my Department issued a framework document for corporate and financial governance for the HSE and requested the executive to draw up a code of governance in line with the framework. Under the section dealing with codes of conduct and quality customer services, the framework document specifically highlights that the Government approved in 2001 a code for the governance of State bodies under which such bodies need to set out objectives for maintaining proper standards of integrity and disclosure of confidential information. Under the 2004 Act, the HSE is obliged in its annual report to indicate its arrangements for implementing and maintaining adherence to the code. The executive is working on drafting its code and I understand that it intends to submit it to me for approval in the near future.
In addition, professionals within the health services are governed by their own codes of conduct. The Medical Council has a guide to ethical conduct and behaviour which deals with matters of confidentiality and consent including circumstances where there are exceptions to the rules on confidentiality and where doctors should report on the behaviour or competence of other doctors. An Bord Altranais has a code of professional conduct for nurses and midwives which provides that any circumstances which could place patients or clients in jeopardy or militate against safe standards of practice should be made known to the appropriate persons or authorities. Under the Health and Social Care Professionals Bill provision is being made for the registration boards for each of the professions to give guidance concerning ethical conduct and support to those registered with the boards concerning the practice of their profession. These codes of conduct and ethics will be enforceable by the health and social care professionals council.
In addition section 25 of the Health Act 2004 provides that members of the board of the Health Service Executive, members of any committees of the board, employees of the executive or any person engaged by the executive as an adviser shall maintain proper standards of integrity, conduct and concern for the public interest. To ensure the implementation of such standards, the executive is obliged to draw up a code of conduct for employees not covered by standards applied by the Ethics in Public Office Act 2001 and advisers and their employees. The code must indicate the standards of integrity and conduct to be maintained by them in performing their functions. Such a code should more than adequately cover the rights and obligations of employees, advisers, consultants etc.
Given the range of provisions which I have just outlined governing the issue of confidential information, it is not my intention to introduce such legislation such as that referred to by the Deputy. However, I will review this position when I have seen the formal code of governance and code of conduct which will be adopted by the HSE shortly.
Would the Tánaiste not admit that codes of conduct and the guidelines she has outlined have failed patients? Let us consider two major ongoing events. The consultant medical oncologist in Cork University Hospital, Dr. Seamus O'Reilly, wrote to the Tánaiste outlining his serious concerns about the treatment of cancer patients at that hospital. Does she agree that if he had published that letter in the local newspaper, he would have been brought before the hospital's management and reprimanded for discussing such issues in a public forum? Under the codes of practice mentioned by the Tánaiste, he would not have been protected from highlighting concerns about the care of patients for which he is responsible.
In two weeks the report into the activities of Dr. Neary will be published. We will need legislation to protect patients from what was carried out by Dr. Neary in Our Lady of Lourdes Hospital in Drogheda. The same codes of conduct mentioned by the Tánaiste and the same guidelines issued by the Medical Council were in place when many of these events occurred. The people who want to protect patients in the system need the protection of the Oireachtas through legislation. Does the Tánaiste agree people trying to protect patients should have that protection? Codes of conduct have failed and anything else proposed by the Tánaiste will not give the type of people about whom we are talking, whistleblowers, the protection whistleblower legislation or any legislation properly passed through the Oireachtas would give them.
I have been in the House many years, but I have never known of a case where medical staff, whether doctors or other professionals, were shy about voicing their concerns in any forum. Dr. O'Reilly, the man to whom Deputy Twomey referred, worked in Waterford and then moved to Cork. His post was advertised, but I did not get anybody suitable for it and a locum was appointed in the meantime. I do not believe legislation has prevented him or anybody else from voicing their concerns, including in a public forum.
We must distinguish between those that may, from time to time, express concerns on behalf of patients and those that may have their own perspective on matters. I have not yet received the Neary report, but from what I know of the situation issues will arise with regard to clinical governance. The reality is that nobody at clinical governance level has statutory backing to take action. That is a very different issue. Neither the professional ethics of the Medical Council nor others give protection in this situation. Neither does the board of the hospital give protection. Every hospital has a chairman of its medical board or council, but that person does not have adequate protection in law. I think legislative issues will arise in that regard. Also, contract issues will arise with regard to time that can be assigned on a full-time basis to these important issues.
It is only somebody at the Deputy's peer level who could intervene in the interests of patients. It is not reasonable to expect people who are not medical personnel to be able to take action when they feel something is inappropriate in a hospital. The Neary report will, I hope, provide a basis for legislation in this area.
Illegal Drug Dealing in Hospitals.
Liz McManus
Question:79 Ms McManus asked the Tánaiste and Minister for Health and Children the extent of the problem of drug dealing in hospitals; the name of the hospitals affected; the measures being taken to deal with same; the co-operation being sought from the Garda; the treatment programmes being provided to deal this problem; and if she will make a statement on the matter. [35536/05]
I am advised by the Health Services Executive that, unfortunately, all hospitals in large urban areas, like most public buildings, face potential risks of drug dealing on their premises. Hospitals work closely with gardaí to minimise such activity and there are protocols in place to alert the Garda where concerns arise.
I understand the Deputy's question relates to media reports about widespread drug dealing within St. James's Hospital. St. James's Hospital refutes allegations of systematic drug dealing within the hospital. In the past, the hospital sought the advice of the Garda Síochána when a problem was identified, and having taken its advice on board, crime prevention measures have been implemented. The hospital is active in utilising CCTV and ultra violet lighting along with other recognised security measures in combating any form of drug abuse. Liaison is maintained between the hospital and the Garda on a 24-hour basis.
My colleague, the Minister for Justice, Equality and Law Reform has advised me that a Garda inspector from Kilmainham Garda Station acts as a designated liaison officer to St. James's Hospital and that regular meetings are held between gardaí and the hospital authorities. This ongoing liaison is part of the implementation of the crime prevention initiative, Hospital Watch, which is due to be officially launched in St. James's Hospital in December. Hospital Watch schemes are already in place in Tallaght, Blanchardstown, Beaumont and the Mater hospitals to ensure that hospitals and their surroundings are safe places for patients and visitors.
Garda authorities further advise that while a number of complaints have been received of low level drug dealing taking place in the grounds of St. James's Hospital and in the vicinity of the adjacent Luas station, local gardaí are unaware of reports of open drug dealing within the wards, waiting areas or in the hospital corridors.
All reports of crime related activity in the area are vigorously investigated and dealt with in the appropriate manner.
Additional material not given on the floor of the House.
As the Deputy is aware the delivery of drug treatment programmes is the responsibility of the Health Services Executive. I am informed by it that the range and availability of treatment services has expanded considerably in recent years.
Services provided directly by the health boards include outreach services, education services, treatment services which include assessment, stabilisation, harm reduction measures, care planning, methadone maintenance, and counselling and detoxification within specialist clinics, residential settings and community settings. In addition, services are provided by a range of voluntary and community sector organisations which are funded and co-ordinated by the HSE. The cumulative increase in additional annual funding provided to the HSE to address the problem of drug misuse since 1997 amounts to approximately €57 million.
There are currently 66 drug treatment locations in the HSE areas compared with 12 in 1996. General practitioners and pharmacists also provide treatment services. At the end of September 2005 there were 7,619 people receiving methadone treatment compared with 1,861 at the end of December 1996.
Many people were shocked by what they read in the newspapers about this problem. Is the Minister of State aware that illegal drug dealing in hospitals creates a serious risk, not just to patients, but to the staff of the hospital? It is his responsibility to find out the extent of the problem. It would be useful to know, for example, how many arrests have been made for illegal drug dealing in our hospitals. I asked him about the extent of the problem, but he was not able to advise me on that. Would the Minister of State agree that this shows a level of ignorance not commensurate with the problem of which we are now aware, which is clearly not being dealt with adequately?
The report of a particular accident and emergency staff member of St. James's Hospital stated that drugs changing hands in the hospital included cocaine, heroin, amphetamines and hash and that whatever anyone wanted was available in the hospital. We need to know how many arrests have been made in St. James's Hospital as a result of investigations of illegal drug dealing. Why is it that when we checked today there did not appear to be any additional security measures in place? Are there undercover gardaí in our hospitals assessing the problem or will we have the ongoing problem we have in our prisons now in our hospitals, but at much greater risk to the public? What measures does the Minister for Health and Children intend to introduce to deal with this new risk in our hospitals? We already have MRSA and hospital acquired infections. Is the Government to accept that illegal criminal activity in our hospitals will now be part and parcel of our experience of the health service?
Hospitals are no different to other public buildings in that there is always the potential for drug dealing on the premises or in the surrounding area. In this instance a report appeared in the newspaper and St. James's Hospital refuting the allegations of systematic drug dealing within the hospital. The Deputy has said that information came from a staff member. If any staff member has that information, he or she should make it available to gardaí as soon as possible. The hospital authorities have been working closely with gardaí and I mentioned the liaison between them and Kilmainham Garda station.
Illegal drug dealing is the last activity we want to see associated with hospitals. We do not want to facilitate that. Every effort will be made to stamp out any illegal drug dealing taking place. We have a number of security measures in place. We would like to get the co-operation of any staff members with particular information and any helpful information they have should be passed on to gardaí.
Hospital Accommodation.
John Gormley
Question:80 Mr. Gormley asked the Tánaiste and Minister for Health and Children the number of the 3,000 promised beds which have been delivered; the time line for the delivery of beds; and if she will make a statement on the matter. [35664/05]
The agreed programme for Government includes a commitment to expand public hospital beds in line with the health strategy commitment to increase total acute hospital bed capacity by 3,000 by 2011.
Substantial investment in additional bed capacity in acute hospitals has already taken place. In 2001, the average number of beds available for treatment of patients in public acute hospitals was 12,144. In August last, this number had risen to 13,244, an increase of 1,100. Some 2,500 acute beds in private hospitals must be added to these figures to give us the full extent of acute hospital capacity in the country, that is, nearly 16,000 beds. Part of this new capacity has been achieved by funding entirely new beds. Funding has been provided for 900, some 806 of which are in place. The remaining 94 will come on stream shortly.
A further 450 acute beds are in various stages of planning and development under the capital investment programme. The recently published Estimates include €60 million to open new acute hospital facilities some of which will provide additional bed capacity. Suggestions that all these should be inpatient beds involving an overnight stay by patients are out of touch with modern practice in hospitals around the world. In the interests of patients and of efficiency many surgical and other procedures are now done on a day basis. In July of this year, I announced an initiative that will provide up to 1,000 additional beds for public patients in public hospitals over the next five years. The HSE has been asked to develop an implementation plan and to prioritise proposals in this area. Public bed numbers are increasing substantially as a result of direct provision and the initiative I have mentioned. It is important to reform the manner in which hospital bed capacity is used. We are doing that in tandem with developments in the primary and community care sectors. Acute care, primary care and community care cannot be viewed in isolation because each impacts on the other. I am determined to ensure the pace of spending increases in the health service matches the pace of reform, in order to achieve a better service for patients.
I thank the Tánaiste for her reply. Does she agree that we face a crisis, given that 80 operations are being cancelled every day, many of them because of bed shortages, and especially as Dr. Séamus O'Reilly has stated in a letter that cancer patients are being left in pain at home because they cannot access beds? Given that the population is increasing — some 120,000 Polish people are living here — does she accept that we need to revise upwards this country's bed capacity, so it is more than 3,000? The root of the problem is that the population has increased by approximately 25% since the 1980s, but the number of beds in our hospitals has decreased by approximately 25% in that time. The Tánaiste seemed to indicate to the House that she agrees with the assessment of Professor Drumm that the number of beds in our acute hospitals is sufficient. Does that continue to be her position, despite all the evidence suggesting that the opposite is the case? Will the 94 beds which were mentioned by the Tánaiste in her reply be delivered before Christmas?
I remind the Deputy that the agreement to provide 3,000 additional public beds was reached separately to any analysis of bed capacity in the private sector. The Deputy is aware that 53% of the population has private health insurance. When we consider the issue of acute bed capacity, we need to examine this country's total bed capacity and ensure that we use all the facilities available to us as effectively and efficiently as possible. The mapping exercise that the National Hospitals Office has completed in respect of ten hospitals is being carried out with a view to ascertaining the efficiency and effectiveness of current hospital practices. It is the case throughout the world that more and more hospital activity is being done on a day case basis. The reality is that Ireland has more hospital beds pro rata than the UK. While 17% of the population of the UK is over the age of 65, just 11% of our population is over that age. We are putting more emphasis on community-based services, particularly for the elderly, which is necessary. On a certain date a couple of weeks ago — I do not have the figures for today or yesterday — up to 400 people who did not need to be in hospital were in hospitals in Dublin. They were medically fit to be discharged, but we were not in a position to put alternative arrangements in place for them. I am determined to resolve this problem over the next number of months. Such people comprise the capacity of a whole hospital, in effect. When we speak about bed numbers, we need to consider the appropriate use of existing beds. In particular, we need to put a greater emphasis on resourcing community-based and home-based services for elderly patients. The Government intends to provide such resources later this year with a view to putting such services in place next year.
Obesity Related Diseases.
Liam Twomey
Question:81 Dr. Twomey asked the Tánaiste and Minister for Health and Children her views regarding the incidence of metabolic syndrome here; and if she will make a statement on the matter. [35724/05]
The Deputy is aware that the description of metabolic syndrome is of fairly recent origin, having first been described by Dr. Gerald Reaven in 1988. The syndrome has a set of risk factors, which include abdominal obesity; a decreased ability to process glucose, or insulin resistance; dyslipidemia, or unhealthy lipid levels; and hypertension. In a recent joint statement, the American Diabetes Association and the European Association for the Study of Diabetes questioned the diagnosis of metabolic syndrome. An editorial in this week's British Medical Journal noted that the debate on the existence of the syndrome will continue. The concept of metabolic syndrome provides a useful practical way for clinicians to identify patients with multiple factors which place them at a high risk of developing type 2 diabetes and cardiovascular disease. The concept also provides a rational basis for linking the actions in public health programmes like the cardiovascular strategy with the recommendations of the task force on obesity.
International literature has estimated that the prevalence of metabolic syndrome in the adult population of developed countries is between 22% and 39%, depending on the definition used and on ethnicity. There is not much information on the incidence of the syndrome. As there is no specific ICD code for metabolic syndrome in the ninth revision — clinical modification — of the international classification of diseases, it is not possible to state how many cases of metabolic syndrome are routinely identified and treated in Ireland. The prevalence of cardiovascular disease, type 2 diabetes and obesity is well documented, however. Some 39% of adults in Ireland are overweight and 18% are obese. Approximately 5% of the population is diabetic and over 40% of all deaths result from cardiovascular disease. It is well known that risk factors for these diseases are significantly inter-related.
Additional information not given on the floor of the House.
Lifestyle modifications are the primary interventions which help to reduce metabolic risk factors and manage short-term and long-term risk. Such lifestyle interventions include weight loss to achieve a desirable weight, defined as having a body mass index of less than 25 kg/m2; increased physical activity with a goal of at least 30 minutes of moderate intensity activity on most days of the week; and healthy food habits which include reduced intake of saturated fat and cholesterol.
The Government established the national task force on obesity in response to this country's obesity trends. The remit of the task force is to set out a strategic framework that identifies best practice for prevention, detection and treatment of overweight and obesity. The report of the task force, which was launched in May, makes 93 recommendations which relate to actions across six broad sectors: high-level government; education; social and community; health; food commodities, production and supply; and the physical environment. The report's main aim is to create a society that enables people to eat healthily and to be physically active. An implementation plan for the report is being developed by the Department of Health and Children's health promotion unit. Additional funding of €3 million has been made available to the HSE in the Book of Estimates to support the implementation of the report's recommendations. I would like to outline some of the key recommendations.
The report of the national obesity task force recommends that every child should be able to achieve a minimum of 30 minutes of dedicated physical activity every day, in all educational settings. As part of their school development planning, all schools should be encouraged to develop consistent policies to promote healthy eating and active living, with the necessary support from the Department of Education and Science. Such policies should address opportunities for physical activity and what is being provided in school meals. The report recommends that the Department of Arts, Sport and Tourism should co-ordinate with the Department of Education and Science the shared use of sports and physical activity facilities by schools and communities. Community skills-based programmes should be developed to provide skills such as food preparation, household budgeting and those which can promote physical activity. The health services, in their strategic planning and delivery, should advocate and lead a change in emphasis from the primacy of individual responsibility to environments which support healthy food choices and regular physical activity. An education and training programme for health professionals in the appropriate and sensitive management of overweight and obesity should be developed and implemented. Programmes should include training in developing life skills for healthy eating and active living and counselling.
The report of the task force recommends that the Departments of Enterprise, Trade and Employment and Health and Children, together with the private sector and consumer groups, should take multisectoral action on the marketing and advertising of products which contribute to weight gain, particularly those aimed at children. The Department of Agriculture and Food should review policies in partnership with other Departments to promote access to healthy food. Such policies should encompass positive discrimination in the provision of grants and funding to local industry in favour of healthy products. Guidelines for food and nutrition labelling should be reviewed to ensure labelling is accurate, consistent, user-friendly and contains information on portion sizes and nutrient content. The Department of the Environment, Heritage and Local Government should develop coherent planning policies for urban and rural housing, transport, amenity spaces and workplace settings to encourage spontaneous increases in physical activity in adults and children. The task force also recommended that the Irish Financial Services Regulatory Authority should examine the high costs of public liability and their impact on physical activity and should foster initiatives to address such costs.
A new campaign, Every Step Counts — Small Changes Make the Difference, which was developed in 2004 in response to the increase in the levels of overweight and obesity, promoted two main lifestyle areas — healthy eating and regular physical activity. The 2005 campaign, which is due to be launched later this month, will focus on promoting physical activity and the consumption of five portions of fruit and vegetables daily. The health promotion unit of the Department of Health and Children is also developing a national nutrition policy. It is envisaged that the policy will provide strategic direction on nutrition for the next five to ten years. The policy's target group is young people under the age of 18 and its priority actions are obesity and food poverty. A national consultation has taken place and the policy is due to be published early in 2006.
I am glad the Minister of State has accepted that the background conditions which cause metabolic syndrome are a greater threat to public health than smoking was at the height of its popularity. What does he consider to be the best approach to dealing with the four core elements of the syndrome, which are hypertension, high levels of cholesterol, a body mass index of more than the suggested level and diabetes? Does the Minister of State agree that prevention is better than cure? Does he accept there is a need to implement a screening programme at primary care level as the best way of dealing with this? The cardiovascular strategy that was mentioned by the Minister of State is not relevant in this regard, because most of it focusses on the Heartwatch programme, which is a form of secondary prevention. In other words, one cannot be dealt with under the programme unless one has had a heart attack or something like it. Are there are any plans to introduce primary screening in this area? The four main elements of metabolic syndrome — blood pressure, high cholesterol levels, obesity and diabetes — are going out of control, more or less, among the general population. We should introduce screening programmes in such areas, rather than waiting for problems to develop.
I agree that prevention is better than cure. Lifestyle modifications, such as weight loss to achieve a desirable weight, increased physical activity among young and old people and healthy food habits including reduced intake of saturated fat and cholesterol are the primary means of intervening to manage long-term and short-term metabolic risk factors. The report of the task force on obesity, which contained over 90 recommendations, was published earlier this year. The recommendations do not all relate to the work of the Department of Health and Children, as some of them relate to other Departments and agencies. Some €3 million was allocated in the Book of Estimates last week for the implementation of the report's recommendations. The Department will present its plan for the implementation of the recommendations shortly. I am aware of the significance and importance of dealing at an early stage with the problem of obesity, which has been described by the World Health Organisation as an epidemic. The evident increase in obesity in Ireland is another example of an unfortunate problem that has accompanied this country's increased affluence. Hospitals have reported cases of teenagers developing type 2 diabetes, which is normally associated with older people.
They are doing no exercise.
That is what it is.
We need to get them on their bikes.
We are trying to create a society that encourages people to eat healthily and be physically active. The Government intends to take a number of measures to bring that about.
Is it fair to suggest that the Government has given a lukewarm reception to the proposal to introduce a screening programme in this regard? It has given a similarly lukewarm reception to the breast cancer screening programme, which is being rolled out very slowly, and an even more lukewarm reception to the cervical cancer screening programme. Does the Government have any regard at all for the proposal to screen for diseases of this nature within the health care system?
The Deputy expanded on his question to cover a number of areas. From his side of the fence, our reception to the idea of the provision of such screening programmes might appear lukewarm, but we are serious about the policies we are implementing.
Some people have been critical of the Government for not dealing with the issue of obesity in the past, but last week it put its money where its mouth is. A sum of €3 million was provided in the Estimates to roll out our fight against the problem of obesity next year, an issue on which we have been working.
We will examine the provision of the screening programme to which the Deputy referred, if we consider it would be of benefit. I am not sure it would be, and I would not like to comment on it other than to say I will have the Deputy's suggestion examined and report back to him on it.
Hospital Services.
Caoimhghín Ó Caoláin
Question:82 Caoimhghín Ó Caoláin asked the Tánaiste and Minister for Health and Children the agreement she has reached with British Health Minister in the Six Counties, Mr. Shaun Woodward, regarding the treatment of cancer patients from this jurisdiction in Belfast; if this access is confined to patients from County Donegal or if it will apply on a wider basis; and if she will make a statement on the matter. [35537/05]
I am glad of this opportunity to advise the House on the very positive outcome of my meeting last Tuesday with the Minister for Health for Northern Ireland, Mr. Shaun Woodward, MP. We agreed that the new Belfast Cancer Centre, which is to open next March, will treat patients from County Donegal. Details of the arrangements will be finalised in discussions involving the Health Service Executive, Belfast City Hospital and our respective Departments. This will involve assessment of the specific radiotherapy needs of the different cancer patients in County Donegal and the development of clinical treatment protocols, including appropriate transport arrangements, to ensure best patient care. Discussions will also be necessary on the funding arrangements involving the hospital and the HSE.
This initiative is a further and practical example of North-South co-operation on health and will be of significant benefit to patients who will be treated at what I consider to be one of the best facilities in Europe. This agreement also progresses the Government's plan on radiotherapy which I announced last July. Both the Minister, Mr. Woodward, and I are committed to developing additional co-operative initiatives for the benefit of our respective health services.
On access for cancer patients in other Border counties, we need to ensure that access by County Donegal patients to the Belfast service is working effectively and is properly grounded in effective clinical referral protocols involving the relevant clinicians both North and South. This is essential before I could realistically consider the question of additional access.
I take this opportunity to welcome the agreement the Tánaiste reached with the health authorities in Belfast. We need to see much more co-operation and integration of health services where that is feasible. I give the Tánaiste every support in that pursuit in the interests of all the people of Ireland.
However, there are serious questions about the Government's proposed roll-out of radiation oncology services, specifically the focus on Dublin, Cork and Galway with possible public access to a private facility in Waterford. In the context of the agreement, what is the position of the Border counties? I listened carefully to her reply. Is the agreement reached with the Minister, Mr. Shaun Woodward, to apply only to County Donegal? When the Government's plan for radiation oncology centres was rolled out last July, it was indicated at that time that the north west was to be the focus of discussions leading to access to facilities in Belfast, and even possible access to facilities in Derry was mooted. The north west, as I understand it, includes counties Donegal, Sligo and Leitrim. Am I to understand from the Tánaiste's reply that counties Sligo and Leitrim are not covered in the agreement she reached last week?
Patients from counties Cavan and Monaghan are supposed to access radiation oncology services in Beaumont Hospital in Dublin, yet those two counties which I represent are more distant from Dublin than they are from Belfast. That is true of all of County Monaghan and the greater part of County Cavan. Why was the Belfast option not considered for those for whom the shorter distance would be welcome? Equally important, why is there no intention on the part of the Tánaiste and her Department to provide in situ radiation oncology services for the rest of this jurisdiction north of a line drawn from Dublin to Galway? Provision of services north of this line has been completely excluded from her plans, with the exception of this recently reached agreement in respect of services in Belfast.
Is the Tánaiste not aware that people throughout the rest of this island who are not being catered for again feel very much that they are viewed as being of less worth than citizens in other parts of the State? That is the case especially in the north-east region. The Tánaiste spoke of accessing services for people in County Donegal and the possibility of extending access to such services to the whole of the north west. What about access to such services for people in the north east? In terms of ballpark figures for the roll-out of radiation oncology, is the Tánaiste aware that the population in the north east is growing at an enormous rate, as has been shown time and again, more recently with the break-up of the Meath constituency to provide an additional representative seat in this House? What will the Tánaiste do to help address access to health services for people in those counties who, despite being desperately ill and in need of urgent attention, face long distances to access such services?
I thank the Deputy for his comments. A number of issues are involved. I understand that Belfast will have spare capacity for approximately 100 or so patients a year. Some 500 new cancer cases occur in County Donegal annually and approximately half of those, some 250 people, require radiotherapy. They are the furthest from either Dublin or Galway. Therefore, they were the priority in terms of seeking access for up to 100 of them to appropriate radiotherapy in what will be the best facility on this island next March with eight linear accelerators and a huge complement of staff. In Northern Ireland it was decided to have one single centre. Deputy Ó Caoláin's colleague, the Minister, Bairbre de Brún, was responsible for centralisation to get critical mass and provide a really good facility. The people in the North will have the best facility on this island when the centre there is opened in March.
In time, the centre in St. James's Hospital and our other centres, as they develop, will also be of that standard. I hope the centres in St. James's and Beaumont hospitals will be the larger centres. This provision is about being realistic and pragmatic. When the centre in Beaumont Hospital is completed, it will be much more convenient with the new road network to patients from counties Cavan, Monaghan and Louth.
Access to services for patients in County Donegal was and is the priority. However, I hope this experiment works well and I heard what the Deputy said about introducing more such initiatives. If it were not for partition, political instability and violence, health services on the island would be very different for the northern part of this island. There is no doubt about that. There are many initiatives we want to explore together. This one is a start and I hope that is the case. I hope we can do more. It may well be that further capacity could be installed in Belfast to facilitate the treatment of other patients, but for the moment access to these services is being provided for patients in County Donegal. We hope shortly to be able to pin down the political agreement that was made with the appropriate protocol in order that the treatment can begin as soon as possible.
That concludes priority questions.
If I may ask a brief supplementary——
We have extended the time allowed for this question.
I will ask a brief supplementary, if the Chair will accommodate me.
That is unfair to other Deputies who have questions tabled.
I only want to ask——
The Deputy must be brief.
Will the Tánaiste accept that we are not comparing like with like in regard to the Six Counties and any other comparable region within the jurisdiction of the Twenty-six Counties, given the reality of the infrastructure? Will the Tánaiste also——
That completes priority questions. We must proceed to Question No. 83.
As I cannot pursue any other line of questioning, I wish to say to the Tánaiste that I agree with her that partition has been more than a damned nuisance.