Senator Kenneally and I are jointly sponsoring this motion on the Adjournment and I would like to share time equally with him.
Adjournment Debate. - Radiotherapy Services.
That is agreed.
The need for radiotherapy services for Waterford and for the south-east in general has been discussed for some time. The citizens of the south-east are anxious to have such services provided. The south-east is the second largest region in the country, with a population of about 450,000. Of these, some 3,000 are diagnosed with cancer each year with approximately 600 requiring radiotherapy.
There are various reports about consolidating special services within the health service as part of the drive towards increased cost-effectiveness. While I subscribe to that plan, a special case can be made where cancer treatment is concerned. When someone is diagnosed with cancer, it is traumatic both for them and for their family. The medical profession agrees that a positive outlook is an important part of the treatment process.
In that regard, it is a wrench for families when patients have to go to Dublin or Cork – many people from the south-east travel to the latter for treatment – and stay away from their families for perhaps a week, although the treatment lasts only ten minutes daily and is spread over five or six weeks. At a time of crisis, the support of the family is fundamental to the patients but, in this instance, there is a serious imposition on families.
Some people resort to travelling daily. However, the treatment takes a toll on the physical energies of the patient, which is unsatisfactory. On compassionate grounds, there is a strong case to be made for treating patients within their areas. Given the importance and density of the population in the south-east, and that the Government strategy is focusing on Dublin and Cork – with Galway to be included – it seems that to complete that jigsaw the south-east, and Waterford in particular, would be a good location for these services.
I am aware that there are capital and operational costs involved, but, equally, there is a cost involved when people from the south-east have to travel and stay away from home. The latter is borne by the health services at present. To that extent, there would be some return on investment in the service. The primary reason, however, is care of the patients at a time of serious illness, during which they can have the support of their families.
I thank Senator Walsh for sharing time. Our both speaking on this issue shows that there is some solidarity in the south-east region because this is perhaps the most important issue with which people – not only those in Waterford but the entire population of the south-east – are concerned. It is not often that people in the south-east come together to put forward a view on an issue on which they are at one. However, this is such an issue. I will not list all the reasons that we need this service. Senator Walsh has mentioned some and they are all well known. The Minister for Health and Children is aware of them because they have been brought to his attention on numerous occasions.
There have been suggestions that the report of the committee chaired by Professor Hollywood is with the Minister but that he has not yet brought it to Cabinet. There have been some leaks and while we cannot testify to their veracity, they tend to be accurate. One of the suggestions is that when the south-east reaches a certain critical mass, a radiotherapy unit should be located there. A decision was made in 1998 to establish such a unit in Galway. The best estimate indicates that this unit will be in operation by 2005. Many people do not realise that there is a long lead-in period to establish units of this sort.
I do not know when the report suggests that the south-east will reach critical mass – whether it be 2010 or 2012 – but there is no point in waiting until that time and then deciding that the region has reached the required critical mass to establish in a radiotherapy unit, which would take a further seven years. That is nonsense. We have to decide to work back seven years from 2010, 2012 or whenever the population will be there to sustain it, designate it as a lead-in period and move towards establishing a unit in the south-east. I have made that point to the Minister on numerous occasions and I hope that he will take it on board.
I appreciate that the Minister is trying to achieve best practice for all patients and is intent on putting in place a system that will give all patients proper cancer treatment, which even he acknowledges they are not receiving at present. However, there are some matters – one of which involves access – that are out of his control. The biggest difficulty is that patients from the south-east are obliged to travel to Dublin, they are thrown around in ambulances on their journey, they have no place to stay in the city when they arrive and they are obliged to return home. Even if accommodation was provided, it might be suitable only for someone who is more settled in life who perhaps does not have any responsibilities at home and can stay away for a few weeks.
Cancer can attack anybody, at any age, and, unfortunately, many young mothers are being diagnosed with the disease. They cannot stay away from home for five or six weeks, they have to go home every evening to look after their children and so on.
It is vital that these services are put in place close to the people whom they are supposed to serve. That is why there is an unanswerable case in terms of providing such a unit in the south-east.
I thank Senators Jim Walsh and Kenneally for raising this matter and outlining what I know is heartfelt by both of them – the provision of radiotherapy services for cancer patients in the Waterford region. I take the opportunity to set out the current position on the provision of radiotherapy services nationally.
As the Senators are aware, an expert review group on radiotherapy services was established to examine their appropriate future development. The group comprises, as one would expect, a multidisciplinary team of experts. It has conducted a national assessment of needs for radiotherapy services.
The group will address the following key issues, which have been referred to by the Senators: access to radiotherapy services; information, finance and organisational components, and the need to provide a high quality, evidence based service. I appreciate that both Senators have indicated that the evidence is available. The group will also address the need to take account of current and new developments in health technology, the requirements of the system in human resources, international norms regarding service provision, planning and staffing, and the organisational development of the services in structures and processes which must be in place, as one would expect, in a radiotherapy facility.
All health boards, including the South-Eastern Health Board, have been afforded the opportunity to meet and make submissions to the group. The provision of additional radiotherapy services will be considered in the context of its report. Senator Kenneally has asked exactly where it is. On completion, it was submitted to the Minister on 24 April 2003. On receipt, the Department immediately made arrangements to print it, a process subject to public tendering requirements which have to be followed, as they have been.
Given the significance attached to it by me, the Minister and the Department and its implications for the development of radiation oncology services nationally, it is necessary to submit the report to the Government. The Minister advised the Dáil of his intentions in that regard on 7 May 2003. It is also necessary that there be consultation at interdepartmental level, including with the Department of Finance, before consideration by the Government. It is anticipated that the report will be considered by it shortly.
I understand the Minister met a delegation from Waterford City Council this morning and outlined the key principles which informed the group's deliberations and the priorities for the development of radiotherapy services. He accepts that the significant under-capacity in radiotherapy services represents a major challenge for the health service.
With regard to cancer services generally, there has been considerable investment in the development of oncology and haematology services and symptomatic breast disease services in the South-Eastern Health Board area. Since the implementation of the national cancer strategy in 1997 and following representations, including some from the Senators, an additional cumulative sum of approximately €30 million has been allocated to the South-Eastern Health Board for the development of cancer services. This level of investment has enabled the approval of ten additional consultant posts in the health board in key areas such as medical oncology, surgery, radiology and haematology. This level of investment in the south-eastern region has delivered real benefits to cancer patients and their families. When the report is ready, I will be happy to work with the two Senators to see what additional services can be put in place.