Health (Miscellaneous Provisions) Bill 2010: Committee and Remaining Stages

Sections 1 to 5, inclusive, agreed to.
NEW SECTION

Amendments Nos. 1 and 2 are related and may be discussed together, by agreement. Is that agreed? Agreed.

I move amendment No. 1:

In page 4, before section 6, to insert the following new section:

"6.—From the commencement of this Act any review of services, including those of any land and buildings, at Saint Luke's Hospital, must be laid before the Dáil and the Oireachtas Joint Committee on Health and Children by the Minister for approval.".

We had a long discussion on Second Stage. The key points to emerge from that debate focused on centres of excellence and specialist centres, people's experience of them and also their experience of St. Luke's Hospital. It was agreed on all sides of the House that the experience of St. Luke's Hospital had been very positive. The hospital was described as a gem and an oasis. Various adjectives were used to describe what was for almost everyone a quality experience. There was a concern that this ethos would be lost. The key point to emerge time and again centred on how one could ensure the standards of excellence and care and the ethos developed in the hospital could be continued.

I raised this issue during our last discussion in the House. My colleague, Deputy James Reilly, tabled an amendment proposing that any changes to be made from the commencement of the Bill, or any review of services, including of lands and buildings, at St. Luke's Hospital should be laid before the Dáil and the Joint Committee on Health and Children for approval. The Minister for Health and Children, Deputy Mary Harney, had said in previous discussions in the Dáil and at the committee that she agreed with this proposal. I asked that she come back to the House today to inform us whether there had been a change of opinion or whether she still intended to do this. The value of the amendment would be that we could have a detailed discussion at the Joint Committee on Health and Children about any change of use proposed at the point where it was envisaged this would happen. It is envisaged that this happen in 2014.

This debate has particular relevance. While I did not hear the discussion, I understand the question of centres of excellence was discussed on "Today with Pat Kenny" today, arising in particular from a letter from Mrs. Kay Coburn. It is a very sad story. Mrs. Coburn's sister died from ovarian cancer and she wrote a four-page letter about what her sister had experienced in one of our centres of excellence. This is the very point I was making last week when I suggested we were removing a well proven centre of excellence. There is a page on Facebook which over 2,000 people have signed to support the continuation of the service in the hospital. There have also been numerous e-mails sent to public representatives. One cannot but be moved by their quality and how people speak about their experience of St. Luke's Hospital.

What Mrs. Coburn writes can only be described as disgraceful. If we are talking about moving patients from a proven to an unproven centre of excellence in terms of the quality of the experience, we have a real problem. My plea to the Minister on the last occasion was that if we were intent on removing the service, we should offer an equivalent service elsewhere. That is what all of the people who have contacted us are so concerned about, namely, that such a service will not be available, although it has been for so long in St. Luke's Hospital. What we are trying to restore with the amendment is control for the Minister in front of her colleagues at the Joint Committee on Health and Children and in the Dáil before further radical changes are made.

I want to return to the centres of excellence supposedly available. Mrs. Coburn's sister was not admitted directly to an oncology ward; in fact, she never reached such a ward. She was on a trolley in the accident and emergency department for 25 hours where she was subjected to various indignities and unacceptable treatment, including a delay in being seen. Mrs. Coburn refers to her sister being on a trolley which was most uncomfortable, narrow and restrictive when she was not well enough to sit in a chair. She goes into further detail in her letter. It is the saddest story one could ever read. She asks why, if we have dedicated oncology wards, there are patients who have been diagnosed with cancer in wards all over the hospital in which, potentially, they are exposed to infections which in their compromised state could have a serious or fatal outcome. It is a reasonable question to ask, if we say we are providing specialist centres and at the same time doing away with a specialist centre that was providing high quality care. How can we describe these as specialist units if half of the patients who should be in them are in medical, surgical and geriatric wards around the hospital?

Mrs. Coburn asks where is HIQA in all of this. She thought her sister was entering a centre of excellence, but she did not receive excellent treatment. Mrs. Coburn asks why patients who are suffering from cancer have to be readmitted time and again via an accident and emergency department process when the name of the doctor who will be dealing with them is known. Unfortunately, her beautiful sister died on 23 June "at home in the loving care of her family, and I had the privilege of nursing her." The letter continues: "I have never written to a TD, Minister or anyone else before but I am going to bombard everyone because of what I witnessed and what my sister endured over the past 48 hours and indeed may have to endure again". That is her experience of a centre of excellence in 2010.

This adds weight to the point that so many of those who have contacted us about St. Luke's Hospital have made. We have a centre which provides excellent care. I absolutely support the provision of high quality and specialist care. However, it is reasonable to ask what standard of care will be provided in the specialist centres of St. James's and Beaumont hospitals when services are transferred from St. Luke's Hospital.

I speak to amendment No. 2 in the name of the Labour Party that the HSE "may not dispose of any land (including buildings) vested in it by this section and must continue to use the land (including buildings) vested in it by this section for medical purposes related to the treatment of cancer in public patients in a manner and form determined by the Executive with the consent of the Minister". Like other Senators on all sides of the House, I have received communications from many people who have themselves, following a diagnosis of cancer, received treatment at this centre of excellence in Rathgar or a family member or close acquaintance. There are so many clichés about St. Luke's Hospital and its surroundings being such a unique gem in the provision of such excellent care.

As someone who has worked in a hospital setting, I know that when people are disagnosed with cancer, it is very difficult for them if the other patients in the ward have not received the same diagnosis. Their psychological, medical and treatment needs are different and often they are very sick. Having a centre dedicated to the treatment of such patients allows staff to become expert in providing treatment. Many people took great comfort from the staff and, in particular, the surroundings. Time and again people were delighted with such surroundings in a centre of excellence, if that was possible when diagnosed with cancer. Each e-mail we received was different and detailed either a personal story or that of a close family member. The nub of the matter is that the HSE is always seen in a negative way but we have an opportunity to keep something truly wonderful.

There are not many places about which we can say that. I know everybody works very hard in the HSE and some people on the front line suffer extraordinary difficulties at the moment with the moratorium on staff recruitment. It is having a serious impact on the delivery of some services. There has also been a major impact on the way doctors can be employed, and just last week there was a difficulty because there was talk of closing one of the main accident and emergency units in Cork because of a lack of doctors.

These are serious issues but the system in St. Luke's is working very well. We will press our amendment and I hope we will get an opportunity for reasoned debate before the amendment is accepted. We are not looking for the world and the Government's action will not save money; it will only put people at a disadvantage and make people who are already having a very difficult time in their lives unhappy. Those people with family members who have already passed on having been treated in St. Luke's will take great solace and comfort if we can retain this facility and keep it for what is good. We cannot say that about many places in the country.

I am very interested to see time is being made available this week for a debate on cystic fibrosis, and there is a need for a specialist centre that has not yet materialised. St. Luke's is a centre of excellence taking in the same old clichés on what is a centre of excellence. Such a centre is where people feel they get all their needs met in a holistic way. This unit and hospital provides for people and I ask that the House accept the amendment.

I strongly support this two amendments, which are very important. If the amendments are not agreed I will call for a vote, and if such is granted I will vote against the entire Bill. I will do so because there is something profoundly undemocratic about what would happen today without these amendments. I say this for a number of reasons. There is a clear wish on the part of patients that this service be retained. Those campaigning for St. Luke's are very rational, reasonable and moderate in their demands. The principal demand I have come across is the idea that people should listen to patients, and as a result of the patient's views, St. Luke's should at least be retained as a satellite hospital.

I know St. James's Hospital to be excellent as I was a patient there for a while because of medical silliness. An investigative operation went wrong and I was given the benefit of septicemia. I cannot speak highly enough of the care I received and it is a teaching hospital of Trinity College, where I used to work. I have the highest regard for it and the staff working there.

I wonder how appropriate it is to concentrate all the work done historically in St. Luke's — it has a very special place in the hearts and minds of people not just in Dublin but around the country — in St. James's Hospital. A new building will be required, which will be fairly tall. People will no doubt have the kind of comfortable accommodation I eventually received in St. James's Hospital but that is not the same as what one would get in St. Luke's.

If one is considering an holistic approach to medicine, it is interesting to note what so many people have commented on to me. In St. Luke's, extended families could stay in the facility or visit easily. The patients could enjoy the health-giving surroundings and wonderful gardens. This may sound sentimental but it is not because the state of mind of a cancer patient is extremely important.

There is also the risk of cross-infection. Senator Prendergast raised — as I had intended — the question of cystic fibrosis and the moving accounts given by several people in the newspapers recently, particularly Ms Orla Tinsley, on the issue. For five years, Ms Tinsley has been promised the development of a special 24-bed unit but at the moment people like her must endure being placed in a ward with other decent patients — she does not criticise such people — but some of them are in a pretty feeble state, incontinent or with wandering minds. They have different diseases and Ms Tinsley and others have described their experiences as like being forced to sleep in a public lavatory, and there is a serious risk of cross-infection.

All of us have been touched in some measure by cancer and we all know that after chemotherapy or radiation therapy, a significant impact is the reduction in the effectiveness of the immune system, leaving people open to infection. That can be extremely dangerous. Will the Minister of State respect the views of the patients? Will he understand and respect the fact that the patients, their families and supporters have raised €26 million? To a certain extent, the ownership of the hospital, at least morally, is vested in them.

Is it the intention to dispose of the land, as this has been happening all over the place and people are being forced from nursing homes on ridiculous and specious arguments about health and safety concerns that involve nothing more than a lick of paint? Such action occurs so land and planned facilities can be sold to realise money for the central Exchequer. My concern is that this will ultimately be a fund-raising exercise so will the Minister of State address what will happen to the money that may be raised from the possible sale of the hospital and its grounds?

In addition to the €26 million raised, a petition was handed in at Leinster House last Wednesday containing 150,000 signatures, which is a massive vote by the ordinary people, whose representatives we are, against this unqualified move and in favour of, at the very least, the two amendments put before us. The first amendment is in the name of Senator Frances Fitzgerald and the Fine Gael Party. It deals with the modest requirement that any review of services and alteration in the use of land and buildings should be laid before the Oireachtas. That is accountability, and this Government has quite rightly preached to us about openness, transparency and accountability.

The second amendment is in the names of Labour Party Members. It deletes part of the Bill and includes instead a proscription preventing the Minister disposing of any land or buildings except in a manner informed and determined by the executive, with the consent of the Minister, which must contain medical services related to the treatment of cancer. I have no difficulty in strongly supporting these amendments.

I will, with regret, be forced to call for a vote if these are not accepted and have to vote against the Bill. I do not like doing so because I like to vote in favour of positive and progressive measures in health and treatment sectors. I do not see this Bill as such without the amendments put down by my colleagues.

I commend Professor Hollywood and the staff at St. Luke's, and I also commend Fine Gael and the Labour Party for tabling worthwhile amendments. However, as politicians, we are afraid that people who have cancer will not be cared for properly and, as a result, we are also afraid to suggest that there should not be such firm adherence to the policy relating to centres of excellence. What constitutes a centre of excellence? I wholeheartedly agree with Senator Norris's assertion that it is a place where a person is provided with holistic treatment and care. People can only recover if they are not exposed to infection and are treated in a relaxed atmosphere where they can be loved and cared for in a compassionate manner. That has not been my experience of the new centres of excellence. This is a matter about which I feel strongly.

Senator Fitzgerald read into the record a very emotive piece about a lady who is dying from cancer and who was left to wait on a trolley. I assure the Minister of State that a patient would not be treated in that way at St. Luke's Hospital. That is the bottom line. St. Luke's Hospital should remain in place as a satellite facility of St. James's Hospital. The Minister of State has made the point very well that there is a need for intensive care services to support St. Luke's. That is fine, once it remains in place as a satellite facility of St. James's Hospital. St. Luke's should remain in place, in the leafy suburb of Rathgar, as a public facility for people who are ill and who need care.

Members of my family and some of my friends were treated at St. Luke's Hospital. I cannot say enough good things about the place. My constituents have been discussing this matter with me and sending me e-mails. They stated that it would be terrible if the service on offer at the hospital were to disappear.

Senator Norris also stated that €26 million has been collected through fund-raising efforts. It has come to my attention that St. Luke's Hospital was donated to the State. How, therefore, do we have a right to sell it off to pay for the bailout of Anglo Irish Bank and for the various mistakes that have been made?

I suggest that for once there should be all-party consensus in the House. In that context, I am aware that some colleagues on the Government side of the House share my view that St. Luke's should be retained in its present form in order that its staff can care, in a compassionate manner, for people who are sick.

I support both amendments which were tabled by the Labour Party and Fine Gael and which clearly address the major problem with the Bill. We are of the view that amendment No. 2 is critical and we will not be supporting the Bill if it is not accepted.

Amendment No. 2 provides, as Deputy Ruairí Quinn stated in the Dáil, that St. Luke's should be retained as a centre of excellence and should not be sold. It is a simple but critical amendment. We are aware that St. Luke's is more than just a local institution in what Senator McFadden referred to as a leafy suburb. As the Senator stated, some of her constituents have travelled to St. Luke's for treatment. People travel from all over the country to be treated there.

St. Luke's is recognised as a national centre of excellence, which is evidenced by the many thousands of people who have argued for its retention. The Minister of State will be aware that a petition containing more than 150,000 signatures has been handed in and approximately 5,000 people have signed up to the Facebook page. We have all received e-mails and messages from people in all walks of life in which they related the most heart-rending stories. Senator Fitzgerald, quite rightly, read some very tragic human stories into the record. While their stories may indeed be tragic, the people to whom I refer have been assisted by the calm atmosphere that obtains at St. Luke's and the excellent treatment they have received there. There are people in the Visitors Gallery — many of them with direct personal experience of this matter — who have been arguing for the retention of St. Luke's.

In excess of 71,000 treatments were delivered at St. Luke's in 2009 and large numbers of patients were provided with care. Those who support the hospital are formidable fund-raisers and I understand a new extension costing €15 million was opened there in the past 18 months. I am very familiar with the hospital, having visited friends there. I have always been impressed by the high levels of care and treatment patients receive there. This is a centre worth retaining.

My party's spokesperson on health in the Dáil, Deputy Jan O'Sullivan, made a very strong case to the effect that we are not arguing for St. Luke's as some sort of stand-alone centre. Rather, we are arguing that it should be linked to one of the designated centres for the Dublin area. This is because we support the centres of excellence policy that is at the core of the health strategy relating to cancer care. However, we understand that there are facilities such as St. Luke's which have a unique character and which have been doing work to assist the recovery of cancer patients for many generations. We are of the view that these facilities can be incorporated into the centres of excellence strategy in a way that will allow them to continue the work they have been doing. We are not necessarily suggesting that surgery be available at the hospital. We propose that the hospital be attached to one of the designated centres of excellence.

During the debate in the Dáil, there was a great deal of assurance provided that the provision relating to St. Luke's will not come into effect until 2014. Perhaps the Minister of State can clarify whether that is the case. On Committee Stage in the Dáil, he appeared more sympathetic to the Labour Party's argument to the effect that a different approach should be taken. However, the current wording contained in the Bill — which was put in place on foot of an amendment the Minister of State introduced in the Dáil — is not satisfactory. It merely provides an empty assurance that there will be a stay of execution for four years. It appears that when this period has elapsed, the sale of the hospital will be carried out.

There are a number of other issues which must be addressed. I refer to the consequences to which the Bill will give rise if it is passed in its current form. If the legislation is enacted as it stands, additional pressure will be placed on St. James's Hospital. It will also lead to further delays being experienced. There are already unacceptable delays in the treatment of cancer patients, especially those in the public system. In addition, issues also arise with regard to inequity in the health service. This is a matter to which the Labour Party has always been opposed, especially in the context of more favourable treatment being given to private patients. These issues must be addressed. If they are not, adverse consequences will arise for patients at St. James's Hospital. When one considers the extraordinarily high levels of cancer among people in this country, it is obvious that there is a need to be very careful about closing any facility which is recognised as a centre of excellence and where the atmosphere and the positive treatment provided appear to be especially conducive to the recovery of cancer patients.

As Senator Fitzgerald correctly pointed out, the Second Stage debate on this Bill, which took place last week when the Chamber was not, perhaps, quite so full, was very special. There was a real air of empathy in respect of the staff, board and friends of St. Luke's. Everyone recognises the wonderful, valued care that is administered to people at St. Luke's, regardless of whether it is likely they will recover or whether their illness is terminal. One could almost have cut the air with a knife during that debate. The atmosphere which obtained in the House last week was very special.

The Minister of State at the Department of Health and Children, Deputy Áine Brady, took the Second Stage debate and, as I understood it, she indicated that St. Luke's will remain operative until 2014 or possibly 2015 and that radiotherapy services will continue to be administered there.

On Second Stage, reference was made to the terrible stories that have emerged with regard to misdiagnoses and the fact that by the time some women and men received their diagnoses, it was too late. We all know what happened in these instances. I was of the view that letters such as the one sent to me at my home by Ms Kay Coburn, which I received at the weekend, were a thing of the past. My immediate reaction was to ask how this could happen. I did not hear Ms Coburn this morning on "Today with Pat Kenny". However, I believe her story about her beautiful young sister was heart-rending.

I really do not think it is acceptable that a person in the late stages of cancer should have to go in through an accident and emergency department. I tuned into the final part of the programme, when Dr. David O'Keeffe, a consultant radiologist, was interviewed by Pat Kenny. I was grateful and glad to hear him apologise. He said there are changes afoot and it is not right that cancer patients in centres of excellence, or specialist centres as I prefer them to be called, have to come in through accident and emergency departments. There needs to be some other type of admission process, perhaps through an oncology ward with at least two or three beds for people, like Mrs. Coburn's sister, who have to be brought in but are not in-stay patients.

I do not expect the Minister of State to accept these amendments. I would like to mention a question that has been raised with me about what might happen if St. Luke's Hospital closes its doors in 2014 or 2015. I am speaking as someone who buys into the whole cancer control programme, as set up by Professor Tom Keane. I support him when he says we cannot have units here, there and everywhere. When I say that, I do not mean to undermine the great work that is done in St. Luke's Hospital. If the hospital's lands and buildings are to be sold, both Houses of the Oireachtas should ensure the moneys in question are ring-fenced so that they are not used for anything other than the treatment of cancer for public patients.

The horse has bolted.

Can I also ask about the money that has been raised by the Friends of St. Luke's Hospital? The Minister of State might not know that €26 million has been raised by the group. The funds in question are probably not with the HSE. I hope they are not, because the HSE would probably spend them on something else. I am sure the Friends of St. Luke's Hospital have their own bank account. The board of the group might be looking after the money. What will happen to the funds when the doors of St. Luke's Hospital have closed and the hospital does not exist any more?

After reading the letter to which I have referred, I believe it is a shame and an indictment of us all that someone in the late stages of cancer was treated in such a small treatment room. When the light was turned on in the room, it burned the head of the poor lady, who was in her final weeks of her suffering with cancer. I congratulate her brave sister for putting together this letter, which reads like a diary. I am sure it must have been terrible. She tried to comfort her adult nieces and nephews. Although I have not had such an experience, I do not think anyone would be very patient or polite if they had to watch a loved one, particularly their mother, dying of cancer after spending 24 hours in a room that is fit for no more than having a corn pared, or some other kind of minor surgery. I should mention that the woman who spoke on radio this morning said she had nothing against the front-line staff who did everything in their power to make her sister comfortable.

I ask the Minister of State, Deputy Andrews, to try to shine some light, for everybody's sake, on the question of whether an undertaking will be given that the moneys which accrue when St. Luke's Hospital closes in 2014 or 2015 will be ring-fenced and used solely for the treatment of cancer.

The Minister of State is welcome. This Bill presents a great deal of difficulty. On many occasions recently, I visited two relatives in hospital, one in St. James's Hospital and one in St. Luke's Hospital, on the same day. The relative in St. Luke's Hospital did not live; the relative in St. James's Hospital is alive and well. I was reminded of the contrast between the two hospitals. I am a great believer in centres of excellence. I believe the policy of developing centres of excellence is correct. However, I am not convinced of the merits of bringing patients from St. Luke's Hospital to the busy hustle and bustle of St. James's Hospital. Although patient treatment is very good at St. James's Hospital, there is a difference between the manner in which the requirements of cancer patients are met there and at St. Luke's Hospital. St. James's Hospital is a very busy hospital. I am sure the medical care provided there is excellent, but it does not have anything like the calmness and serenity of the 18 acres of St. Luke's Hospital. While I support the concept of centres of excellence, I also support the view that St. Luke's Hospital must be allowed to continue, in whatever form is required.

An old Irish seanfhocal, éist le fuaim na habhann agus gheobhaidh tú bradán, which means "listen to the sound of the river and you will catch a salmon", is a great reminder of the importance of listening. In this instance, not only should we listen to the patients in St. Luke's Hospital, but we should also listen to the experts. I appreciate that the Minister for Health and Children employed experts to examine a number of hospitals. Earlier today, I saw some of the figures they produced after they had engaged in one-off examinations of certain hospitals five years ago. It is amazing that St. Luke's Hospital did not get what would be regarded as an acceptable recognition from its patients. It runs contrary to my entire understanding of the hospital that it was ranked in a much lower position on the list than it might otherwise have been. I suggest that much has changed in the intervening five years. Much more is required if we are to meet the challenges involved in the treatment of cancer in the years ahead. I have seen figures which predict that the number of cancer patients requiring treatment of this nature will increase by 50%, from 28,000 to 42,000, between now and 2020. Those people will need the services of the 500 staff who are employed in St. Luke's Hospital at present. We cannot do without the incredible experience and expertise of the staff in question.

I take the point that is made in the amendments before the House. Senator Feeney has suggested that we should provide for ring-fencing. We should all accept that the grounds of St. Luke's Hospital, like the expertise that has been built up at the hospital, must not be lost. These facilities should continue to be used for cancer care. If the hospital is not developed as the centre of excellence — I understand the centre might be required somewhere else — it should be maintained as a centre for the treatment of cancer patients. These 18 acres need to continue to serve as a valuable haven in this city for people who are suffering from cancer. We must not lose them. I have no problem with supporting entirely any amendment that proposes that this hospital should continue to be involved in cancer treatment. Just as it has achieved so much in the past, it can continue to achieve so much in the future alongside the centre of excellence at St. James's Hospital. It is time to review our thinking to ascertain whether we have made the right decision. I urge the Minister of State to accept amendments Nos. 1 and 2, which are worthy of acceptance and represent the correct direction in which to go.

Unfortunately, cancer remains one of the top three killers in this country and, given the figures Senator Quinn recounted, it appears it will remain so for some time. What is the most important thing to consider in cancer care? It is the quality of the care the patient receives, the environment and atmosphere in which that care is delivered, and whether the staff are tense or can genuinely offer care. There is also the ethos in which the care takes place and the quality of outcome.

For these reasons, I support the amendments of Fine Gael and the Labour Party and compliment Senator Fitzgerald and the Labour Party team on tabling them. This gives us a chance to think about the matter. In 1990, my father was in St. Luke's. Thank God he is still alive and very well but he was a difficult man to convince he needed treatment. He had surgery and subsequent treatment but I could not believe I was in a hospital. This man came and went whenever he wanted and spent more time at the bookie's shop than in the hospital. The staff knew how to manage him. After having major surgery he came and went as he pleased but they were able to manage him. He got exceptional care, thank God, and here I stand 20 years later, speaking of a man who is fit and well, aged 80 years of age.

In 1990 I saw St Luke's had developed into a specialist centre for cancer care long before that term was ever known in this country and I know the same from friends and relatives and thousands of e-mails we have received since. It developed through experience and throughput, namely, the very reasons we want the centres of excellence. Most important, it is because of patient feedback that we know it developed into a centre of excellence. As my colleagues, including Senator Quinn, stated, we must listen to the patient. I believe it will be time to close St. Luke's only when we receive as much positive feedback from patients regarding the new centres. They are only in transition, learning how to manage, and in many respects are lost at present.

I refer to the situation in Galway which greatly saddens me because I live there. It is my constituency and University College Hospital, Galway is my local hospital. Senator Fitzgerald read into the record and Senator Feeney referred to the letter from Kay Coburn. I am shocked and devastated to think that our designated centre in Galway is not yet a centre of excellence. It is so in name but is very much in transition and only learning how to cope. One can consider a few basic matters. I have spoken to people in the centre such as Professor Kerin who told me that dedicated beds were needed in one place. What is a centre, after all, but a dedicated place to which one can go and know it is for the care of the cancer patient? If that dedicated centre exists, why admit patients through accident and emergency departments? Why would Kay Coburn's lovely sister have to spend 25 hours in the emergency department? We do not yet have that centre.

Senator Feeney asked, rightly, why Galway does not have a centre with two, three or four beds instead of having the beds spread throughout the hospital, in geriatric and other wards where patients are at risk of cross-infection. The answer is a policy decision by the Minister for Health and Children, Deputy Harney. When responding on this matter on "Today with Pat Kenny", Dr. David O'Keeffe said it was because of the moratorium. How can there be beds in a single place when the hospital has neither the beds in the first instance nor the staff to service them?

It is only some months since I spoke in this House about the scandal concerning cancer drugs in UCHG, our centre of excellence. A sum of €12 million that had been promised for cancer drugs was not given to the hospital. Did the patients get the drugs? They did but only because the money came from 100 hip operations and elective surgeries that were cancelled and from the gynaecological ward. We are living on a shoestring in this country but there is St. Luke's Hospital, working it out and doing so for generations.

I support what other speakers have said. I ask the Minister of State to confirm that the year in question is 2014 because that would give us four years to think about how to turn St. Luke's into a satellite centre of St. James's Hospital, as others recommended. Let us not consider closing it until there are centres of excellence in practice and reality throughout the country and not only in policy. The Government's policies are not working. There is a contradiction here, with St. Luke's about to close and UCHG struggling without the necessary resources.

St. Luke's will remain open until——

I heard that and qualified what I said but my basic point is that we must look at wherever there is good practice that puts the patient first and is a success story. Let us not close such places. Let us look seriously at building St. Luke's as a satellite centre to support St. James's, as was suggested in this Chamber.

Those are my few words. I ask the Minister of State to comment on the situation in Galway as described by me and others and to explain how he will ensure UCHG, the only centre of excellence that lies above the country's mid-line, from Galway to Dublin, will become a centre of excellence in practice. Will he support Dr. David O'Keeffe and Professor Kerin to ensure they have a dedicated centre with beds into which they can admit patients directly and that they will get the €12 million worth of drugs this year?

I support both amendments. The Minister of State will be well aware that I opposed this Bill on Second Stage and called a vote on it although that vote was not able to proceed as there was no one else to act as a teller in the time allotted. I welcome the amendments, both of which are important. The first deals with the bringing of any decision before the Houses of the Oireachtas. The second, in the name of the Labour Party, is the crucial one. Ultimately, any Government or whoever has a majority could decide to do whatever it wanted with St. Luke's after 2014. We should nail that in the legislation by making it clear that St. Luke's will remain, with its land and buildings, as a treatment centre for cancer patients in the public sector.

I oppose the Bill because, fundamentally, it closes St. Luke's Hospital after 2014 but it also implements a flawed plan in regard to the provision of radiation oncology, as the previous speaker observed. This plan discriminates against people who live in regions north of the line between Galway and Dublin, such as those who live in my county, Donegal. We have passed Second Stage, the Government is hell bent on pursuing this issue and, therefore, the amendments proposed by Senator Fitzgerald and the Labour Party are worthy of being accepted by the Government. I support them wholeheartedly. If this Bill is passed, the least that can be done is to ensure the lands and buildings of St. Luke's remain in the provision of the health services after 2014. They should be used in the provision of public health services.

The Government has pursued a policy of health services privatisation and attacked public health service provision. That has been the agenda, particularly of the Minister for Health and Children. Sometimes the Government has been happy to hide behind the Minister and state it is her agenda. The reality is that the privatisation of health services is part of the agenda of Fianna Fáil, the Green Party and the former members of the Progressive Democrats.

It was signalled last year that after 2014 St. Luke's Hospital would continue to be used for the benefit of cancer patients. We heard the chairman of the hospital board, Mr. Padraic White, say as much. I ask the Minister of State to confirm if that is still the case, that after 2014 St. Luke's Hospital will continue to be used for the benefit of cancer patients?

Many have spoken about St. Luke's Hospital. Thank God, I have never been a patient there, but I have visited relatives and friends in the hospital which is rightly regarded as unique in the health service because of its fine setting on its own grounds, its peaceful and tranquil atmosphere and, above all else, its excellent staff, all of which combine to ensure there is a positive health care experience for patients suffering from very serious conditions. That is the reason none of what I have mentioned should be lost.

Senator Norris made a point which I also made on Second Stage and was attacked for doing so by the Green Party. The point is that to a certain degree Senators are elected — we are elected by county councillors. We sometimes pass legislation that has life and death implications. If the right treatment is not provided for a patient at the right location and at the right time, it can have life and death implications. Therefore, we have to carefully scrutinise the legislation we pass and weigh up the pros and cons. It would be remiss of us, as legislators, not to listen to the patients who have passed through the system and the staff and others who have had a positive experience of the hospital, the stories of many of whom have been related in the Chamber today and previously on Second Stage. The voices of 180,000 people are very loud. The Government can bring forward any Bill it wants and as long as its members toe the party line, it can change the position in whatever way it wants. However, just because it can do something does not mean it should do so. In this case, it should listen to the 180,000 voices calling for the Bill to be rejected. At the very least, the proposed amendments, particularly amendment No. 2, should be accepted.

As one of the few who spoke on the Bill on Second Stage last week, I felt obliged to come back into the House this evening to speak in support of the two amendments before the House. We spoke last week about the haven of peace, serenity and tranquility within the walls of St. Luke's Hospital. We have all had family members who suffered from cancer, many of whom attended St. Luke's Hospital. Senator Healy Eames captured the ethos of the hospital when she spoke about the treatment her father had received 20 years ago. It is something we cannot lose. The care provided with humility cannot be lost to the health system.

We all support the concept of having centres of excellence with multidisciplinary teams. During the debate on the Bill last week I argued that until such time as centres of excellence were fully operational we needed to keep places like St. Luke's Hospital and other specialised services fully operational.

Senator Feeney mentioned that the proposed amendments could not be accepted. There are reasonable amendments that could be accepted——

——if the Minister of State had the will to do so. At least, that would provide certainty for the board, the Friends of St. Luke's Hospital and patients. It would also provide certainty that the hospital would be used for cancer treatment services for public patients for many years to come. What people who suffer from cancer want is dignity and respect; that is the least they should be able to expect. They receive them in abundance in St. Luke's Hospital. Until such time as we have fully operational centres of excellence in the places St. Luke's Hospital should remain open to provide radiation oncology services.

To be parochial, I heard last week that the linear accelerators to be put in place in my home city of Waterford would not be put in place for a few years, until 2014 or 2015. People in Waterford are reliant on the provision of a public service, with some public patients attending Whitfield Clinic. In the meantime we need to keep places like St. Luke's Hospital open, perhaps beyond 2014, until all pieces of the jigsaw have been put in place. That is all we are asking, that St. Luke's Hospital continue to provide cancer treatment services for patients beyond that date.

The urgency of this matter is indicated by the fact that I understand there were plans to start moving staff from St. Luke's Hospital in November this year, at which time there would be reduced services for an increased number of patients. The feeling expressed on this side of the House — I know there is some sympathy on the other side of the House — is echoed by many, including patients and the Friends of St. Luke's Hospital. We have a distinguished group of persons representing the patients and the Friends of St. Luke's Hospital in the Visitors Gallery. I also recognise the presence of a very distinguished member of the artistic and intellectual community who lives in what has been described as the leafy suburb of Rathgar just across the road from St. Luke's Hospital, the poet and biographer, Mr. Ulick O'Connor, the biographer of a great doctor and wit, Oliver St. John Gogarty. He has authorised me to say on his behalf that he strongly supports the retention of St. Luke's Hospital and the proposed amendments and that were he, as Oliver St. John Gogarty was, a Member of this House, he would be voting with us.

I would like to follow the example of Senator Fitzgerald because nothing makes the case more clearly than the direct personal experience of patients. I beg the indulgence of the House to read a few paragraphs from a remarkable letter I received from a patient who pays tribute to the services, in much the same way as I pay tribute also to the services provided by ARC, in Eccles Street, which provides care facilities and residential accommodation for families and people from the country who need to come to Dublin to avail of cancer treatment services. I spoke at the opening of that remarkable facility. This is a letter from somebody who is also with us in the Visitors Gallery. He says:

If you are wondering what my involvement with this wonderful hospital is, my father spent his last weeks there. And it was to my great amazement and relief that he and us his family were treated with such care and dignity, and that there was space for us to stay with him, so he was never alone in his last days. I and my family are the lucky ones. I have heard many tragic stories of people who were not lucky enough to end up in St Luke's. One of the hospitals Minister Harney's experts have designated as one of the Centres of Excellence is Beaumont Hospital. I brought my father there many times. He hated it there. He was traumatised by the crowds and the noise there.

Most interestingly, generously and appropriately she goes on to say:

I would point out that the staff were hard-working and wonderful there, apart from the young woman from accounts who handed my (fully VHI-paid up) father a bill for his treatment — this happened the first morning he sat outside his bed in the high-dependency ward after an arduous invasive operation. The anxiety he experienced because of that young woman cost his health dear. Beaumont also forgot to carry out a follow up scan on my father, which meant when his cancer was found to have returned, it was by then impossible for the surgeon to fully remove the tumour. I cite all these incidents, not because I want to knock Beaumont, or the Cancer Control Strategy, but merely to point out that no hospital is perfect — certainly none in Ireland right now, but I will say that St Luke's, while only able to provide certain kinds of cancer care, is streets ahead of both Beaumont and the Mater in terms of patient comfort as far as my father experienced it.

Some of the other points made in the letter I have already placed before the House and I do not intend to speak again. I hope the Minister of State, after these final interventions from all of us on this side and with what I know is the goodwill if not the vote of Senator Geraldine Feeney, whom I greatly respect, will find it possible to accept these amendments.

I thank all the Senators for their contributions. This Bill is obviously a matter of serious concern to them. One thing which came across strongly from the comments was the strong ethos of care. Some of the phrases used were that it is "a gem", "an oasis" and that St. Luke's has provided a wonderful service to people over the years. The challenge for the HSE is to ensure the service is replicated in St. James's and Beaumont, a challenge which will not be lightly taken. However, it will be taken by the HSE and will be done in conjunction with the Friends of St. Luke's Hospital to ensure that St. Luke's radiation network will be of the first order and will try to bring the fantastic service that is provided by its staff to the services provided by St. James's and Beaumont over the next five years.

Senator Fitzgerald said something which was repeated a number of times, namely, that we all support the national cancer control programme which carries with it consequences. Perhaps when people support the generality of it at the beginning one does not anticipate what it will mean, something we all experience from time to time. If we are serious about the cancer control programme and the recommendations made by clinicians, in other words, that we would have co-located radiotherapy services, medical, oncology and surgical services for better outcomes for patients, and buy into that, it will have uncomfortable consequences which we may not have anticipated at the time.

They are the recommendations we have had from clinicians. Far from the fear described by Senator Norris that this was some kind of accounting exercise and would save the Exchequer money, the truth is that all the staff are being transferred in a similar manner to the transfer of undertakings, therefore there is no saving. The land cannot be sold or used for any purpose other than the provision of health services and social care services, therefore there is no possibility of realising any savings through the sale of land. In addition, under the national cancer control programme 12 linear accelerators will be available for the provision of radiation oncology in the two new hospitals described in the St. Luke's radiation network which will begin in late 2010 and early 2011. There will be a 50% expansion in capacity. It is impossible to describe this as an effort to realise money or create savings for the Exchequer. It is clearly informed by clinical advice from 2003. Demographics may have changed since then but we are dealing with an expansion in capacity and retention of the existing staff.

On Senator Fitzgerald's reference to Ms Coburn who spoke on radio today and wrote to a number of Senators, on behalf of the Department of Health and Children I wish to offer our sympathies to her and her extended family. It was obviously an extremely unpleasant experience and she had the courage to share it. We all learn from these things. The hospital has apologised to her and her family for the distress which was caused to her. I wish to bring to the attention of Senators that a new oncology assessment unit will open at Galway university hospital in the middle of August. It should provide direct access for cancer patients and so will provide appropriate, timely treatment for cancer patients who are referred to it by their consultants. It is correct that there are specific protocols for cancer patients who present at accident and emergency departments. What happened to Ms Coburn's sister was not appropriate and the hospital put its hands up. The consultant Dr. David O'Keeffe referred to that this morning on radio when he explained some details of the case.

Senator Norris referred to an equivalence regarding cystic fibrosis but the truth is that there is a different danger of cross-infection for patients with cystic fibrosis because they can catch infections from each other and have to be kept in separate rooms. While cancer wards are quite acceptable, cystic fibrosis ones are not. There is no equivalence between the two.

Although it is a minor point, the phrase "centres of excellence" is a slight misnomer as they are referred to as "designated cancer centres". The phrase "centres of excellence" tends to suggest that other centres are not excellent or of the highest standard, and that is not acceptable. We want to ensure the highest standards are in place, and also that designated cancer centres can provide the highest possible level of care. Many Senators have personal experience of St. Luke's.

I am not sure if it is any consolation and I am making my comments from a personal point of view, but Crumlin children's hospital is the only paediatric oncology service in the country. Parents never hesitate to bring their children there from all corners of Ireland. It is the only place one can receive the service and one has to go the whole way through the hospital to get to the oncology unit. Everybody talks about it in the warmest possible terms.

There is always a fear of change. I do not mean to diminish, qualify or classify it as some kind of psychological frailty but this process will be carried out over five years. The Minister was clear that St. Luke's would not close before 2014 or early 2015 and that remains the case. There will be a transition period, as requested by Senator Cummins in his comments.

Some Senators were afraid that the hospital would be sold. An amendment was tabled by the Minister in the Dáil and section 6(5) now states that:

Subject tosubsection (6), the Executive shall use the land vested in it by this section for the purposes of the delivery of health and personal social services within the meaning of the Health Act 2004.

The effect of the Labour Party amendment would be to go further than that and restrict it solely to cancer services. The Minister did not want to be overly prescriptive in the use because in certain circumstances palliative care could be provided to patients other than cancer patients. It may be a suitable use for the hospital. Nothing can change without the intervention of the Minister. It cannot be used for purposes other than health and personal social services.

The Fine Gael amendment refers to bringing the issue back to a committee. It is almost like a triple lock, whereby it has to go through the executive, the Government and committee. There is no precedence for that in an operational matter for the HSE. The amendment introduced by the Minister on Second Stage in the Dáil should address the concerns which were anticipated and encapsulate the amendment tabled by Fine Gael and the Labour Party. I hope I have addressed the majority of Senators' concerns.

Senator Healy Eames was correct in regard to quality of care but the outcomes are the crucial issue. She said her father is a difficult man, which I find hard to believe.

She is clearly not like him.

I can believe it.

It is clearly inherited.

I am glad he is still hale and hearty after so many years. The Senator can send him my personal best wishes.

It is important to remember the transition will last five years until 2014 and perhaps 2015. There are considerable safeguards and reassurances. The Minister heeded the concerns raised by Deputies and Senators and it is a tribute to the staff of the hospital that they will be retained in full. We will try to transfer the ethos to the new centres, which will be informed by clinicians and ensure the best outcomes for their patients. For the reasons I have stated, I oppose the proposed amendments.

I thank the Minister of State for his response. The Minister, Deputy Harney, recently addressed the Seanad on her vision for the health service. As I told her then, I agree with her vision but have difficulties with the practicalities of its delivery. It is clear from today's discussion that we support the principle of designated centres but the timing and state of development of these services present problems. This was dramatically illustrated today in the letter from Mrs. Coburn and the comments of other speakers regarding the experiences of patients in these specialist centres. Senator Healy Eames spoke about the pressures that Galway faces at present.

The Minister of State may be correct to note there is no precedent for our amendment but it offers an important triple lock given what we hear about the designated centres and the delays in developing radiation oncology services. This House would have an opportunity to review and evaluate patients' experiences in the designated centres compared to their experience in St. Luke's. The Joint Committee on Health and Children would be able to find out what has actually happened as opposed to the theory of what should happen. The theory on designated centres is excellent but the practice lags far behind. This amendment gives a safeguard by allowing the joint committee to determine whether St. Luke's strong ethos and positive experience for patients are retained.

This is why I have proposed amendment No. 1 and the reason we will press it to a vote. I hoped the Minister would, as she originally indicated, accept it. Senator Quinn spoke about listening to patients. The testimony of these patients is striking when it is compared to what we learned about the experience in designated centres. I am disappointed the Government is not accepting the amendment because it would allow us to take the appropriate decisions on the basis of patients' experiences.

I will be pressing amendment No. 2 for the reasons so eloquently set out by all Senators who contributed. In regard to the fundraising abilities of the Friends of St. Luke's Hospital, as I noted last week, €26 million is an enormous sum. Everyone in this country must have contributed to a collection for St. Luke's at one time or another. Nobody can be unaware of the services it offers.

My party's amendment is reasoned and reasonable. I do not see how it could conflict with the provision of palliative care in St. Luke's to someone who does not have cancer. If the Minister of State agrees to accept the amendment on the basis of widening its remit to allow for palliative care for such patients, I would be perfectly happy to make the appropriate changes. I will be pressing the amendment to a vote.

I do not want to ignore the Senators' comments. Senator Prendergast is concerned about funding. The Friends of St. Luke's Hospital is a limited company and, as such, a separate legal entity. Senator Feeney also raised concern about the money it raised. The company will continue to determine how the funds it collects through voluntary contributions are distributed and it has stated that it will continue to support St. Luke's cancer network over the three hospitals. On Thursday, the Minister will meet representatives from the Friends of St. Luke's Hospital to discuss the transition. The transition until 2014 or early 2015 is a considerable window of time and every opportunity will be afforded to the Joint Committee on Health and Children to examine patients' experiences during this period.

Amendment put.
The Committee divided: Tá, 24; Níl, 28.

  • Bacik, Ivana.
  • Bradford, Paul.
  • Burke, Paddy.
  • Buttimer, Jerry.
  • Cannon, Ciaran.
  • Coghlan, Paul.
  • Cummins, Maurice.
  • Donohoe, Paschal.
  • Fitzgerald, Frances.
  • Hannigan, Dominic.
  • Healy Eames, Fidelma.
  • McCarthy, Michael.
  • McFadden, Nicky.
  • Mullen, Rónán.
  • Norris, David.
  • O’Reilly, Joe.
  • O’Toole, Joe.
  • Phelan, John Paul.
  • Prendergast, Phil.
  • Quinn, Feargal.
  • Regan, Eugene.
  • Ross, Shane.
  • Ryan, Brendan.
  • White, Alex.

Níl

  • Boyle, Dan.
  • Brady, Martin.
  • Butler, Larry.
  • Carroll, James.
  • Carty, John.
  • Cassidy, Donie.
  • Corrigan, Maria.
  • Daly, Mark.
  • Dearey, Mark.
  • Ellis, John.
  • Feeney, Geraldine.
  • Glynn, Camillus.
  • Hanafin, John.
  • Keaveney, Cecilia.
  • Leyden, Terry.
  • MacSharry, Marc.
  • McDonald, Lisa.
  • Mooney, Paschal.
  • Ó Brolcháin, Niall.
  • Ó Domhnaill, Brian.
  • Ó Murchú, Labhrás.
  • O'Donovan, Denis.
  • O'Malley, Fiona.
  • O'Sullivan, Ned.
  • Ormonde, Ann.
  • Walsh, Jim.
  • White, Mary M.
  • Wilson, Diarmuid.
Tellers: Tá, Senators Maurice Cummins and Fidelma Healy Eames; Níl, Senators Niall ÓBrolcháin and Diarmuid Wilson.
Amendment declared lost.
SECTION 6

I move amendment No. 2:

In page 4, subsection (6), lines 33 to 35, to delete all words from and including "may" in line 33 down to and including "section" in line 35 and substitute the following:

"may not dispose of any land (including buildings) vested in it by this section and must continue to use the land (including buildings) vested in it by this section for medical purposes related to the treatment of cancer in public patients in a manner and form determined by the Executive with the consent of the Minister".

Question put: "That the words proposed to be deleted stand."
The Committee divided: Tá, 28; Níl, 24.

  • Boyle, Dan.
  • Brady, Martin.
  • Butler, Larry.
  • Carroll, James.
  • Carty, John.
  • Cassidy, Donie.
  • Corrigan, Maria.
  • Daly, Mark.
  • Dearey, Mark.
  • Ellis, John.
  • Feeney, Geraldine.
  • Glynn, Camillus.
  • Hanafin, John.
  • Keaveney, Cecilia.
  • Leyden, Terry.
  • MacSharry, Marc.
  • McDonald, Lisa.
  • Mooney, Paschal.
  • Ó Brolcháin, Niall.
  • Ó Domhnaill, Brian.
  • Ó Murchú, Labhrás.
  • O'Donovan, Denis.
  • O'Malley, Fiona.
  • O'Sullivan, Ned.
  • Ormonde, Ann.
  • Walsh, Jim.
  • White, Mary M.
  • Wilson, Diarmuid.

Níl

  • Bacik, Ivana.
  • Bradford, Paul.
  • Burke, Paddy.
  • Buttimer, Jerry.
  • Cannon, Ciaran.
  • Coghlan, Paul.
  • Cummins, Maurice.
  • Donohoe, Paschal.
  • Fitzgerald, Frances.
  • Hannigan, Dominic.
  • Healy Eames, Fidelma.
  • McCarthy, Michael.
  • McFadden, Nicky.
  • Mullen, Rónán.
  • Norris, David.
  • O’Reilly, Joe.
  • O’Toole, Joe.
  • Phelan, John Paul.
  • Prendergast, Phil.
  • Quinn, Feargal.
  • Regan, Eugene.
  • Ross, Shane.
  • Ryan, Brendan.
  • White, Alex.
Tellers: Tá, Senators Niall Ó Brolcháin and Diarmuid Wilson; Níl, Senators Ivana Bacik and Phil Prendergast.
Question declared carried.
Amendment declared lost.
Question proposed: "That section 6 stand part of the Bill."

I regret that the Minister of State did not accept the amendment. Our amendment would have ensured there was further opportunity to analyse the state of the cancer services by 2014. It would have been a very good safeguard. I welcome today's announcement on Galway. However, it comes on the back of hearing of the absolutely appalling experiences that Mrs. Coburn and her sister had there. Obviously, as the Minister of State did, I take this opportunity to extend my sympathies to her on the sad loss of her sister. I am very saddened that her sister had such an appalling experience in the final weeks of her life. This is a case about which we have heard; how many more are there? This is the case that we have heard about, but how many more are there? The quality of the patient experience and the actual outcomes that are occurring in hospitals need to be reviewed regularly in this House. We need monitoring and evaluation of what is happening. It is one thing to have the theory, but it is quite another to examine what is happening in practice. We have heard from Susie Long, Rebecca O'Malley, the women in Portlaoise and right across the country that the patient experience is very disturbing at the moment for many people in many areas, in spite of the good work done and the dedication of staff. After ten years of the Celtic tiger, during which €15 billion was put into the health service per annum, surely we should be getting better outcomes. We should have the basic cancer services and the experience of patients should be better than what we have been hearing about today.

I regret that the amendments tabled by Fine Gael and the Labour Party have not been accepted by the Minister of State. The Minister for Health and Children indicated strongly to Deputy Reilly that she had no problem with the amendment when he tabled it on Report Stage in the Dáil.

There are many aspects to this Bill and to the approach to cancer services which I certainly support, but we have to take into account the quality of the patient experience in St. Luke's Hospital. We have to take note of what is happening in the specialist centres as we speak. I am very disappointed that the amendments have not been accepted because I felt they would provide an opportunity to build in a quality review of the situation when the Minister wants to make those changes. That kind of accountability to the health committee and to the Dáil and Seanad is important.

The Minister of State, Deputy Andrews, stated that it was unprecedented to have this type of triple lock. These are unprecedented times for patients. There are major challenges. Senator Quinn spoke about the increasing number of patients who will be in need of treatment and the need for more resources and staff in the area of cancer treatment.

I regret that our amendment was not accepted. It would have provided a real opportunity to look at the reality of the situation at the appropriate time and if necessary, to change the decision. We must listen to what patients have to say and to examine the experience of patients in designated centres, and action must be taken according to the information provided to the health committee and to the Houses. Our amendment and the Labour Party amendmentwould have allowed for reflection, for quality information and for a potential review of the decision.

We all support the cancer control programme. When we get down to the small print, it is important to read it and to support it. We understand that we cannot have the St. Luke's service operating independently of the other specialist centres. The Minister of State outlined that to us the other day. Before Professor Tom Keane came here to implement the cancer control programme, Ireland was one of the worst countries in Europe for cancer care and administration of cancer services.

My understanding from the committee meeting was that the Minister for Health and Children gave a firm commitment that the lands would not be sold. She went on to state that St. Luke's Hospital would be used for public health purposes. She could not indicate at this point for what exactly it may be used, but she envisaged a combination of palliative care and long-term care services. I stand corrected on that and maybe the Minister of State might confirm it. That is the best possible way to go forward today.

I welcome what the consultant Dr. David O'Keeffe had to say this morning. I did not hear him, but I ask that oncology beds be ring-fenced in Galway. People suffering from cancer would no longer have to access treatment through accident and emergency departments. They would be known in the specialist centre and they would now come through this oncology assessment unit which will have a number of beds available. I welcome this, but it is difficult to support the eight specialist units while demanding this or that be retained. That is not the way to do things, because it dilutes the services.

Following the implementation of the cancer control programme, we will see an end to the discrepancies in the system that we knew were there before it was introduced. I hope we will no longer be reading letters like that penned by Mrs. Kate Coburn about her sister. I sympathise with Mrs. Coburn on the death of her sister.

I am very disappointed that our amendment was not accepted. I sometimes wonder if I am hearing the same things as Senators on the other side of the House. I cannot see any difficulty whatsoever with this amendment. It would bring a degree of comfort to the people who have received an excellent service. I have a family member who received treatment in St. Luke's Hospital and she also had treatment in St. James's Hospital for two separate cancers, and I have to say that St. Luke's was the most wonderful place to visit.

I worked in the health profession and I often saw the deficiencies of the service first hand. People did not get treatment in the fullest sense, but the area in Rathgar where people were being nursed was the ideal location for them. It would not have harmed Fianna Fáil or the Green Party to have voted this in. I feel very disappointed that this has not happened.

People are so irate in this country. Some people now have to pay prescription charges, while others have suffered social welfare cuts. We have seen €22 billion given over to Anglo Irish Bank, even though it is useless, yet the Government would not accept this provision for the hospital in Rathgar. When it was indicated in the Dáil that the Minister would accept an amendment, it allowed us to focus on some of the positive aspects of this Bill. Like Senator Fitzgerald, I am positive about many aspects of it. However, our amendments were reasonable and balanced. They would provide a degree of comfort. The Minister for Health and Children has often said things in the past and denied them later.

People's fears are quite real. The Minister does not seem to be able to take on board perfectly reasonable amendments. We are not opposing for the sake of it. This is a genuine debate and the people who made the representations to all Senators across all parties had very valid points. They were genuine stories about the care and comfort that people received in St. Luke's Hospital, and I regret that this House could vote against perfectly good amendments.

I regret that the Labour Party and Fine Gael amendments have not been accepted by the Minister who made sympathetic noises in the other House, such that there was some hope there might have been a reprieve in the Bill. It is a real shame the Minister cannot accept the amendments, in particular having heard the genuine words of sympathy from the other side of the House. They would have provided some comfort.

There is a contradiction in what the Government is doing. It is rushing the Bill through with what some would describe as unseeming haste, given that it was taken in the Dáil in the middle of last week and brought straight to the Seanad. We are rushing through Committee and Remaining Stages today, yet the Government gave an assurance that St. Luke's Hospital would remain in operation until 2014, or early 2015, according to the Minister of State, Deputy Barry Andrews. It is an odd or an irrational approach to take to what has been described as a hospital with an excellent reputation and which provides an excellent standard of service and treatment for patients. All we have managed to get is a respite for the hospital, rather than any proper assurance in respect of its prolonged existence. As I said, this is just a stay of execution and is simply not good enough.

In the other House Labour Party and Fine Gael Deputies thought that there might be some further movement on the part of the Minister on Report Stage or possibly in this House. However, we have not seen any movement. Unfortunately, this leaves us in a position where we will have to vote against the Bill, given that the amendments have not been accepted. As Senator Prendergast said, they were reasonable. Ours would have allowed for the retention of St. Luke's Hospital. The Minister could have come back and tried to persuade the House otherwise. It is a reasonable amendment and it is unfortunate that it has not been accepted. It leaves us in a difficult position. We are not opposing the Bill for the sake of it because we very much support the national cancer strategy and the concept of having centres of excellence, but St. Luke's Hospital could be retained as part of a network of centres of excellence. The Government accepts that it should continue in operation for a number of years. The Bill is hasty in the extreme and not rational. We have to oppose it on that basis.

On 12 June 2009 the HSE insisted that cost cutting measures would not impact on cancer treatment services, yet the general manager of UCHG warned it that enforced cutbacks would prevent the hospital from functioning as one of the eight cancer care centres of excellence. Again, there is a contradiction. The HSE makes a point about quality of care, yet the person charged with the responsibility for delivering services states the cutbacks are impacting and preventing the hospital from becoming a centre of excellence. The necessary resources are not being provided and the enforced cutbacks are preventing the hospital from functioning to that end. That is a very serious statement from the general manager of UCHG which highlights the points we have been making on the transition, how it will be managed and its timeframe.

I extend my sympathy to the family of Mrs. Coburn. I reiterate what the Minister said that the management of the case was unacceptable and the hospital has apologised. When addressing the media this morning, the clinical director said the hospital was working to reduce delays inadmission times through the emergency department and also noted that the new oncology assessment unit to open in UCHG in mid-August would provide direct access for cancer patients and appropriate and timely treatment for patients referred to the hospital by other consultants.

On section 6 which addresses concerns about the future use of the site by explicitly requiring the consent of the Minister for any disposal of the land, on Committee Stage in the Dáil the Minister stated she would reflect on the concerns raised about the use of the St. Luke's Hospital site for the provision of public health facilities. Accordingly, she proposed an amendment which was accepted. As a result, the Bill provides that the site must be used by the HSE for health care purposes.

It is the Minister's view that amendment No. 1 tabled by Senator Fitzgerald would not be an appropriate way to address the concerns expressed or provide any guarantees about the future use of the St. Luke's Hospital site. It would lead to an unwieldy decision-making process and not provide certainty about the future use of the hospital site.

On amendment No. 2, the Minister does not consider it appropriate that the use of the site be restricted to a specific aspect of health care such as cancer care services, as proposed. The board of the hospital, in conjunction with the Friends of St. Luke's Hospital, has commissioned a report on the best use of the facility. Until the report is received and there is an opportunity to engage with the various parties involved, the Minister does not believe it would be appropriate to be prescriptive in the legislation.

Question put and declared carried.
Sections 7 to 11, inclusive, agreed to.
Question, "That section 12 stand part of the Bill," put and declared carried.
Question, "That section 13 stand part of the Bill," put and declared carried.
Sections 14 to 17, inclusive, agreed to.
Title agreed to.
Bill reported without amendment and received for final consideration.
Question put: "That the Bill do now pass."
The Seanad divided: Tá, 28; Níl, 23.

  • Boyle, Dan.
  • Brady, Martin.
  • Butler, Larry.
  • Carroll, James.
  • Carty, John.
  • Cassidy, Donie.
  • Corrigan, Maria.
  • Daly, Mark.
  • Dearey, Mark.
  • Ellis, John.
  • Feeney, Geraldine.
  • Glynn, Camillus.
  • Hanafin, John.
  • Keaveney, Cecilia.
  • Leyden, Terry.
  • MacSharry, Marc.
  • McDonald, Lisa.
  • Mooney, Paschal.
  • Ó Brolcháin, Niall.
  • Ó Domhnaill, Brian.
  • Ó Murchú, Labhrás.
  • O'Donovan, Denis.
  • O'Malley, Fiona.
  • O'Sullivan, Ned.
  • Ormonde, Ann.
  • Walsh, Jim.
  • White, Mary M.
  • Wilson, Diarmuid.

Níl

  • Bacik, Ivana.
  • Bradford, Paul.
  • Burke, Paddy.
  • Buttimer, Jerry.
  • Cannon, Ciaran.
  • Coghlan, Paul.
  • Cummins, Maurice.
  • Donohoe, Paschal.
  • Fitzgerald, Frances.
  • Hannigan, Dominic.
  • Healy Eames, Fidelma.
  • McCarthy, Michael.
  • McFadden, Nicky.
  • Mullen, Rónán.
  • Norris, David.
  • O’Reilly, Joe.
  • O’Toole, Joe.
  • Phelan, John Paul.
  • Prendergast, Phil.
  • Regan, Eugene.
  • Ross, Shane.
  • Ryan, Brendan.
  • White, Alex.
Tellers: Tá, Senators Niall Ó Brolcháin and Diarmuid Wilson; Níl, Senators Maurice Cummins and Phil Prendergast.
Question declared carried.