Cancer Care Services.

Senator Jerry Buttimer

Ar an gcéad dul síos, cuirim fáilte roimh an Aire Stáit. I thank the Chair for allowing me to raise this important matter. I refer to the transfer of the breast cancer treatment unit from South Infirmary-Victoria University Hospital to Cork University Hospital. The Minister of State, Deputy Moloney, is aware that South Infirmary-Victoria University Hospital is an absolute centre of excellence. The impending loss of the cancer treatment unit from the hospital is unacceptable, especially in so far as it will affect women with breast cancer. It would be a mistake to transfer the breast cancer unit from South Infirmary-Victoria University Hospital to Cork University Hospital.

It is proposed to amend the national cancer strategy to allow hospitals in Dublin to maintain their existing cancer services. The hospitals in question will work together to deliver the best possible patient-centred care. I suggest forcibly that Cork should receive the same type of provision. Cork should be no different from Dublin. We are supposed to be building synergies, creating centres of excellence and putting patients first. It has been decided to proceed with two centres of excellence in Dublin, at the Mater Hospital and St. Vincent's Hospital. The hospitals will operate as a single combined centre, sharing their resources and experience, in the interests of delivering the best possible breast cancer care service to women. The same approach should apply to cancer services in Cork, without exception.

We all remember the great announcements which were made by the Minister, Deputy Harney. She promulgated from the four corners of Ireland that BreastCheck was in Cork. We all welcomed the investment that was made in BreastCheck in Cork. Money was invested in facilities to create a centre of excellence. I invite the Minister of State, Deputy Moloney, to visit South Infirmary-Victoria University Hospital, if he has not already been there. The staff of the hospital are wonderful. It is clear from the hospital's detection rates that they provide excellent care. Some 210 cancers are detected at the hospital every year. That figure is growing every year. The corresponding number for Cork University Hospital is 141.

What is Professor Keane doing? It is convenient to blame the HSE, the Minister and the Minister of State. What is the cancer strategy supposed to achieve? We have already established the excellent centre I have mentioned. It makes no sense to proceed in this manner at a time of fiscal rectitude. Why are we telling the people of Cork that we will close one centre and transfer it lock, stock and barrel to Cork University Hospital? The hospital is already at straining point and, in my opinion, having lived in that area all my life, can no longer cope.

In this economic climate it makes no sense to waste valuable resources to make this transition. In Cork we have established a renowned centre of excellence. To close it is regressive and makes no sense economically, socially or medically. If we transfer it, what will happen to the BreastCheck unit we have established? Will it be lost? Will it move to Cork University Hospital? What are we saying to the women of Cork and the dedicated staff?

I hope in the Minister's reply we have an open-door policy. Despite what the HSE said and the reports in the media, I do not believe the management and staff of the South Infirmary Victoria University Hospital have bought into this. Newspaper reports and other information I have suggest they have not. At his 11th hour we could have a combined strategy in Cork, like we have in Dublin. It works well in Dublin and will work well in Cork. We have a centre of excellence there that requires to be maintained.

Minister of State at the Department of Health and Children (Deputy John Moloney)

I apologise on behalf of the Minister for Health and Children, who is in the Dáil for the Private Members' debate. I welcome the opportunity to set out the position on the restructuring of cancer services, with particular reference to the issues the Senator raised on breast cancer services in the South Infirmary-Victoria University Hospital, Cork. I might also take the opportunity to deal with some of the issues raised regarding the cancer strategy.

In September 2007 the Government endorsed the establishment by the Health Service Executive, HSE, of a national cancer control programme, NCCP, to manage, organise and deliver cancer services. The objective of the programme is to improve survival rates for patients diagnosed with cancer. This involves significant realignment of services to move from the present fragmented system of care to one which is consistent with the best international standards. The HSE has designated four managed cancer control networks, aligned with the four HSE administrative regions, and the eight cancer centres selected nationally. The designated cancer centre in the southern hospitals network is Cork University Hospital.

The implementation of the national quality assurance standards for symptomatic breast disease will ensure that every woman who develops breast cancer has an equal opportunity to be managed in a centre which is capable of delivering the best possible results. To comply with the standards, the HSE has already directed 17 hospitals, including Mercy University Hospital in Cork, to cease breast cancer services. Further staged reductions in the number of hospitals providing symptomatic breast disease services will occur over the coming months in line with the transfer of services to the eight designated cancer centres nationally. In June 2007 there were 33 hospitals providing breast cancer services. By the end of this year just ten hospitals will provide breast cancer services and before the end of 2009 breast cancer services will be delivered in only the eight designated hospitals plus an outreach service in Letterkenny.

In the southern region this will involve the transfer of diagnostic and surgical symptomatic breast care services from Kerry General Hospital and South Infirmary-Victoria University Hospital to Cork University Hospital. Arrangements have been finalised for the transfer of services from Kerry General Hospital and outpatient clinic appointments are being made for Kerry patients at Cork University Hospital. The relocation of the South Infirmary symptomatic breast service to Cork University Hospital will create a critical mass of specialists of all oncology disciplines on a single geographic site.

The national cancer control programme believes the best interests of the women of Cork and of the southern region will be served by this consolidation and is confident that the consolidated service will meet the national standards for symptomatic breast care as approved by the Health Information and Quality Authority, HIQA. A high-level planning group has been established to facilitate engagement and working arrangements between South Infirmary-Victoria University Hospital, Mercy University Hospital, Cork University Hospital, Southern Hospitals Group and the national cancer control programme. The terms of reference of the high level planning group were agreed at the first meeting of the group which was held earlier today. The scope of work and key elements of the work programme were also discussed.

A parallel programme of work on identification of services suitable for reconfiguration and relocation is being carried out by the hospitals concerned under the office of the network manager, HSE south. A senior manager has been seconded to the office of the hospital network manager to work on this. These are complex and challenging programmes. Work on the development of these programmes is expected to further advance in the coming weeks and progress will be reported to key stakeholders.

The roll-out of BreastCheck, the national breast screening programme, will also significantly reduce the number of symptomatic breast cancer presentations. The Minister for Health and Children officially opened the new clinical static screening unit for the southern region last December and more than 4,000 women from the Cork area have been already screened.

The Government is committed to providing symptomatic breast disease services in eight centres nationally. Roll-out of the national breast screening programme and a quality assured symptomatic breast disease service will ensure that women will have the best chance for early detection and treatment of breast cancer. The developments I outlined will ensure a comprehensive service is available to all patients with breast cancer in the southern region.

Senator Jerry Buttimer

I thank the Minister of State for his reply. Have we completely ruled out the Dublin model of the combined centre? What will happen with the BreastCheck located on the South Infirmary-Victoria Hospital campus? Has that been clarified? Will that move across to CUH?

Seanad Éireann debate - Wednesday, 22 Oct 2008