I welcome the Minister of State at the Department of Health and Children, Deputy Moffatt, to the House. I know he is aware of this matter because he is a frequent visitor to Letterkenny.
A report was carried out for the Department of Health and Children on the development of treatment for systematic breast diseases by the National Cancer Forum, which has been charged with modernising cancer treatment. I agree with some of the issues raised. Alarming statistics were quoted in the report, such as the fact that 700 women die annually from breast cancer. It also highlighted the necessity for proper surgeons to attend patients so they had a greater chance of surviving for a longer period after the cancer had been diagnosed. The more experience a person gets, the better equipped he or she is in the field. According to the report, those who attend surgeons on a full-time basis are better looked after.
The Minister for Health and Children, Deputy Martin, has appointed a new group to consider the implementation of the recommendations. While I agree with some of its recommendations, I do not agree with others. It highlighted the fact that women have to travel long distances to treatment centres and that this was a big issue and that all women should be entitled to a quality transport service to bring them to the clinics more quickly than is the case in some areas. It also recommended that the 20 hospitals providing treatment should be reduced to 13 and that the best expertise should be concentrated in a number of hospitals which would improve the treatment and prognosis of women with cancer. It also referred to providing specialist units with a full team of breast surgeons, radiologists and pathologists.
The report states that the location of the centres of excellence should be decided on the basis of population. It also recommends that there should be up to 300,000 people in the catchment area where this service is provided and that the centre should treat up to 100 cases per annum. I do not accept that. Certain parts of the country have been forgotten in terms of roads and other issues. Peripheral rural areas are entitled to this service.
The reason I raise this issue this evening is that the report recommends the closure of the service at Letterkenny General Hospital on the basis of the distance some people must travel. It recommends that a formal link should be established with Altnagelvin Hospital in Derry. At the same time it recommends that Sligo General Hospital should service patients in surrounding counties, including south Donegal, Cavan, Leitrim and parts of Mayo. However, it seems to have forgotten that Sligo General Hospital does not have a proper service because it was later into the field than Letterkenny General Hospital. The north-west is unique in terms of its geographic position. That is why I raised this issue.
A great service is provided in Letterkenny General Hospital. There are difficulties in terms of waiting lists but it has been developed into a fine hospital with a good team of surgeons, doctors and nurses. The north-west has a population of 210,000. Breast cancer services were established in the Letterkenny service centre in 1993. The report states it does not have a large volume of patients. However, it fails to state how many people have attended the services and have had the comfort of knowing there was nothing positive in their tests. It homes in on the number treated for breast cancer surgery. More than 1,000 patients are examined annually in Letterkenny General Hospital and 50 are treated as a result of positive tests. That is 50% of the recommendation. It should consider the fact that Donegal is thinly populated in some areas and that people have long distances to travel.
Letterkenny General Hospital has provided an efficient service. Many people who have attended there and the population in general have great confidence in the service. If a lot of the cases where there is a suspicion had to go to Derry, particularly those from the Glencolumbkille, Killybegs and Kilcar areas, many of the women may shy away from going, whereas at the moment, they are happy to go to Letterkenny. Letterkenny provides surgery and chemotherapy and when stronger chemotherapy is needed, the patients can go to Dublin.
The service has been provided by the urological surgeon, Mr. Moran, on a very professional basis and patients are treated with sensitivity, particularly the women involved. What is needed in Letterkenny is not a closure of the service but a top class service. I am asking the Minister of State and the Minister, Deputy Martin, to provide a full-time breast cancer surgeon, a radiologist and a pathologist to Letterkenny. Much of the equipment is already in place and there would not need to be a huge investment in that regard. Many women, who have been treated in Letterkenny, have contacted me over the last weeks since the issue became public and they are very annoyed that the service is being taken away, particularly those who may need the service in the future.
The report refers to the long distances people must travel. It may be a short distance for the people in the Inishowen area to travel to Derry and it may be convenient for those in the Ballyshannon and Bundoran area to travel to Sligo but what about the people in the west of Donegal from Glencolumbkille to the Downings and Milford? They are entitled to the same service as everyone else. The fact the area is not heavily populated like the cities should not prevent it from having that service.
Anyone who travels on the road network in Donegal will know how long it will take to upgrade them. The distance to Letterkenny from places like Dungloe, Gweedore and Falcarragh is maybe three quarters of an hour, but it is a bit longer from Glencolumbkille. I believe Letterkenny should remain open on that basis alone. The North Western Health Board has been complimented by the Department for many years for the efficient service. Indeed, funding at the end of the year is provided on the basis of efficiency and both those hospitals in the north western region continually receive additional funding.
Mr. Moran, the urologist in Letterkenny, described the report as ambiguous at best and probably disingenuous. It is his belief that the service should remain in Letterkenny. The service in Letterkenny has a multidimensional approach comparable to that anywhere else in the country. Official statistics from the public health department of the heath board show that mortality rates for breast cancer in the north west region are lower than those in the rest of the country. This should prove that the service has been operating efficiently in Letterkenny.
The group which carried out the report visited Letterkenny and acknowledged that it had a quality service, yet when it recently became public, it compared Letterkenny with many of the other smaller hospitals in the country. There is no need to move the breast cancer service from Letterkenny. Indeed, Mr. Moran has stated that Letterkenny should show Derry how to run a proper service.
Letterkenny has as good a service as any elsewhere in the country. We would like it to be improved and to be appointed as one of the centres of excellence. I am totally against using statistics of population as a basis for making decisions. Letterkenny and Donegal have proved on many occasions that they will always come up with private funding, as was the case with the CAT scan through the Friends of Letterkenny Hospital. The Donegal hospice unit building has just commenced.
We have always played second fiddle to Sligo in many things, including orthodontic treatment for school children, hip operations and other operations, in that Sligo has had the service first, In this case, we had the breast cancer service first and we want to retain that service. There is deep concern in Donegal and we want the service to continue there.
The hospice building has commenced. Nearly £1.5 million has been provided – nearly £1 million by the local community in Donegal through different fund raising activities. At present there is a shortfall of £650,000 and we are looking for funding from the Minister of State's Department from the lottery. We lost out last year but the building has now started. The Minister, Deputy McDaid, one of the Minister of State's colleagues, is the chairman of the Donegal hospice and has done great work over the years. I hope some of the shortfall can be made up from lottery funding.
