Dáil Éireann díospóireacht -
Thursday, 16 Dec 1993

Vol. 437 No. 4

Ceisteanna — Questions. Oral Answers. - Cancer Treatment Services.

Richard Bruton

Ceist:

9 Mr. R. Bruton asked the Minister for Health if his attention has been drawn to proposals to close St. Anne's Hospital, Dublin 6, which is one of only three radiotherapy centres in the country; the impact this would have on the number of beds available for this speciality, the number of outpatient visits and the number of country clinics; and if he will make a statement on the way in which the service to patients and the conditions of the staff can be preserved if this closure goes ahead.

Edward Nealon

Ceist:

15 Mr. Nealon asked the Minister for Health if he will make a statement on the future of the cancer treatment service at St. Anne's Hospital, Ranelagh, Dublin 6.

Dinny McGinley

Ceist:

69 Mr. McGinley asked the Minister for Health if he will make a statement on the future of the cancer treatment service at St. Anne's Hospital, Ranelagh, Dublin 6.

Liz McManus

Ceist:

161 Ms McManus asked the Minister for Health if his attention has been drawn to the reports that St. Anne's Hospital, Northbrook Road, Dublin 6, might be closing; and if in view of the care being provided for cancer patients and their families at that hospital, he will make a statement on the matter.

Ivor Callely

Ceist:

162 Mr. Callely asked the Minister for Health the number of new cancer cases diagnosed on a yearly basis over the past five years; if he has satisfied himself that there are adequate services to deal with all cancer patients; the proposals, if any, he has to improve services; and if he will make a statement on the matter.

Frances Fitzgerald

Ceist:

163 Ms F. Fitzgerald asked the Minister for Health if he will give details of the strategic plan for St. Luke's Hospital, Dublin which was recently submitted by the hospital to him.

Frances Fitzgerald

Ceist:

164 Ms F. Fitzgerald asked the Minister for Health if, in view of recent press reports that the cancer service from St. Anne's Hospital, Dublin, will be transferring to St. Luke's Hospital, Dublin, he will give the impact this decision will have on the decisions taken to date with regard to the proposed disposal of land by the hospital bordering on Sunbury Gardens, Orwell Park and St. Kevin's Park, Dublin.

Seán Barrett

Ceist:

165 Mr. Barrett asked the Minister for Health if his attention has been drawn to reports that the Government intends to close both the Eye and Ear Hospital, Dublin 2, and St. Anne's Hospital, Northbrook Road, Dublin 6; and if he will give an assurance that this is not the case.

Mr. Howlin

I propose to take Questions Nos. 9, 15, 69, 161, 162, 163, 164 and 165 together.

St. Luke's and St. Anne's hospital board earlier this year adopted a strategic plan for the development of the hospital as a national centre of excellence in the treatment and care of cancer patients. The strategic plan was submitted to my Department for consideration some months ago.

The purpose of the plan is to enhance the range of services at present available and to ensure that a high quality, integrated and comprehensive range of facilities is provided to meet the present and future needs of patients and their families.

Following detailed and extensive consideration of all the issues involved, the board of St. Luke's and St. Anne's Hospital is satisfied that the needs of patients and their families can best be met by transferring personnel and acute services at present provided at St. Anne's on to the St. Luke's Hospital campus.

Having considered the strategic plan in detail, I wish to announce that I am in agreement with its main elements. I am confident that the transfer of acute services from St. Anne's to the St. Luke's Hospital campus will provide a unique opportunity to consolidate and improve the overall level of services at present available. I wish to state clearly that the strategic plan is not in any way concerned with a reduction in present services but rather a significant strengthening and expansion of services to patients. This will entail significant additional costs.

I should stress at this point that the preparation of the plan and the decision of the board has been made in full consultation and agreement with the Daughters of Charity of St. Vincent de Paul. They will be concentrating in the future on the development of hospice and palliative care at the St. Francis Hospice, Raheny and these services will complement and supplement the enhanced services for cancer patients on the St. Luke's campus. In the discussions I hope the new hospice and the new national cancer centre will be linked. Taken together, these developments will represent a significant advance in the whole area of cancer care.

I am aware that the announcement of the board's intentions has raised the concerns of certain staff, principally those working in St. Anne's Hospital, and I would like to reassure all concerned that staff interests are fundamental to this change. It is the intention that all staff will be assimilated within the change process.

In order to facilitate a speedy and smooth transition, I am immediately establishing a joint project team, comprising representatives of the hospital board and officials of my Department, to plan for and oversee the arrangements for the transfer of services which is expected to take place during the coming year.

As regards the proposed disposal of lands by the hospital board, I can confirm that this matter is being pursued by the board and is not inconsistent with the board's overall plans for the development of services.

In relation to the incidence of cancer, as cancer is not a notifiable disease, it is not possible to say how many new cases of the disease have been diagnosed on a yearly basis over the past five years. However, the recently established National Cancer Registry Board, which I opened in Cork, will be commencing full national cancer registration on 1 January 1994 and this will allow detailed information to be assembled on the incidence and prevalence of cancer.

Finally, in relation to the question concerning the future of the Royal Victoria Eye and Ear Hospital, I can confirm that there are no proposals before me for the closure of the hospital.

Mr. R. Bruton

Will the Minister deal with some of the specific points raised in the question? Will he indicate how the service can be strengthened if 64 beds are to be closed and if a question mark will be placed beside country clinics, held in counties such as Wexford — the Minister's home county — and Mayo, and in St. Anne's Hospital where there is an out-patients clinic? Will matching funds be made available in 1994 to provide these facilities at the St. Luke's centre? While the Minister says that the staff will be protected can he assure the House that this applies equally to temporary and other staff who do not have contracts under which they have statutory protection?

Mr. Howlin

I am determined to ensure that the facilities for cancer patients will be strengthened. There is no question of closing 62 beds and not replacing them on the new campus. The purpose is to transfer the beds and to strengthen and enhance services for cancer patients, not simply to close a hospital. It is the view of the joint board of the hospitals that because technology is constantly changing and being improved and because of the expense involved in acquiring the latest hi-tech facilities it makes sense to have one national state of the art centre. I hope to work towards this. There will be no diminution in the number of beds available in the new centre as opposed to the number of beds available in the two centres at present. The outreach services will be subsumed into the new centre. In relation to staff matters, I do not want to pre-empt the negotiations but I am determined that all staff will be treated fairly which is consistent with the equality of care they have provided to generations of Irish people.

Mr. R. Bruton

At the risk of repeating myself I find it difficult to understand how the loss of 62 beds, according to the Minister, tallies with his statement that it is the intention to provide as many beds as possible. Specifically, will the Minister refer to the country clinics which have been a very valuable feature of the service provided by St. Anne's? Will these clinics continue to be provided and staffed on the same basis as heretofore?

Mr. Howlin

At the risk of repeating myself I have no intention of closing any beds that will not be replaced on the new campus.

Mr. R. Bruton

But the Minister has not said that he will spend money to provide a 64 bed unit anywhere.

Mr. Howlin

In my initial response I said specifically that this proposal will entail significant capital costs. I am establishing a project team to quantify these capital costs but I am prepared to pay them because the recommendation made to me was that services for cancer patients could be enhanced on a single campus.

An Ceann Comhairle

I observe that a number of Deputies have tabled questions on this subject, albeit many for written reply. I observe some of them in the House and I would be glad to facilitate them if they wish to intervene.

Ms F. Fitzgerald

Does this decision mean that St. Luke's will not be selling land, rather that they will be retaining it for the developments which the Minister has outlined? This raises the question of whether other hospitals should retain land for developments which may be provided in the future. We have to think long term, rather than short term given that it was the intention to dispose of some of this land. Does the Minister know at this stage what will happen the St. Anne's Hospital premises? Is that matter being considered in the negotiations?

Mr. Howlin

St. Anne's Hospital is actually owned by the Daughters of Charity and on lease to the joint board. It is not a matter for me to dispose of it. It is private property owned by the order, as is the land connected to it. I certainly will be anxious to ensure that sufficient land exists on the St. Luke's site to provide the new enhanced facilities that I require.

Mr. Flanagan

In thanking the Minister for his somewhat comprehensive reply, could I ask him to give an assurance that his plan will be put into effect in 1994 and that the axe will not be hanging over the future of St. Anne's for very long? I do not think the Minister addressed the question posed by Deputy Fitzgerald. It seems somewhat foolish to allow the sale of land from a complex that the Minister states will be a national centre of excellence. Surely it is important in the interests of long term development to keep the campus of St. Luke's in one unit and not allow the sale of land.

Finally, would the Minister agree that it is important to remember the need of cancer patients to have a choice about where they might go for treatment and that that choice will be greatly reduced following the closure of St. Anne's?

Mr. Howlin

I think most people who suffer from life threatening or debilitating diseases such as cancer would feel better served and would prefer to know they are going to a national centre of excellence than to have a range of choices. We have one national neurological centre for neuro-surgery. We have a national liver transplant centre, because that makes sense. We have one national cardiac centre, although there is a developing cardiac unit in Cork. The scale of treatment and the cost and technologies of it do not always make choice an essential component in care of the highest quality.

On the question of land, I am establishing immediately a project team to overview this project and the matter of sufficient land will of course have high priority on their agenda.