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Seanad Éireann díospóireacht -
Wednesday, 4 Mar 2009

Vol. 194 No. 6

Cancer Services.

Cuirim fáilte roimh an Aire Stáit. An t-ábhar atá os comhair an tSeanaid anocht ná cúram ailse do dhaoine san iar-thuaisceart a bhfuil ailse brollaigh agus ailsí eile orthu agus an gá go mbeadh seirbhís radaiteiripe ann sa cheantar. Tá gealltanas tugtha ag an Rialtas seo i gcomhar leis an bhFeidhmeannas go mbunófar an tseirbhís sin. Ba mhaith liom fosta an conradh idir ospideál Leitir Ceanainn agus ospideál Bhéal Feirste, fána bhféadfadh othair as Tír Chonaill freastal ar ospidéal i mBéal Feirste fá choinne seirbhísí ailse a fháil, a lua. Tá an conradh sin le hathnuachan roimh i bhfad.

I am raising the need for the Minister of State to outline the progress being made in the provision of a satellite radiotherapy centre for the north west. There has been a long campaign in Donegal, led by cancer patients, that brought 15,000 on to the streets and which enjoys the support of politicians from all sides. The campaign looks at the critical mass on both sides of the Border to ensure a safe service is provided for the people of the north west, be they from Derry or from Donegal. Progress has been made in the campaign, which I welcome, and the Government has entered an agreement with the Executive in the Six Counties and the Minister for Health, Social Services and Personal Safety there, Michael McGimpsey, to agree to develop a satellite radiotherapy centre in Altnagelvin Hospital. The date given for the establishment of that centre is 2014.

What progress has been made? What discussions have taken place between both Ministers and Departments? Is Professor Keane, who is in charge of the cancer strategy, central to the process? Are we sure this is not just buying the service from Altnagelvin for Donegal patients or is co-operation integral between Letterkenny General Hospital and Altnagelvin Hospital? That is the necessary arrangement; this cannot be seen as a service on one side of the Border with the other side buying it up.

As an interim measure, patients from Donegal can avail of cancer services in Belfast City Hospital under an agreement the Minister for Health and Children signed in 2006, with up to 50 patients able to access the hospital for treatment each year. The number of patients has increased steadily since the contract was entered into. The contract is up for renewal and there is a fear in Donegal that the patients might be seen as a soft target when the Government is trying to curtail spending. That would be wrong. The campaign has been fought, the argument won and the service is being bought in Belfast City Hospital as an interim measure. There is also a real fear that the satellite radiotherapy centre that is to be developed in the north west will also be put on the long finger.

I am asking about this on behalf of those who took to the streets and on behalf of cancer patients and those who have not yet been diagnosed but will need these services in the future. We want to be reassured that come 2014, people will not have to leave Gaoth Dobhair to travel five hours to Dublin and that they will be able to go to a centre in the north west where the service will be available as agreed by the two Governments, North and South.

One in three people in this country will be diagnosed with some form of cancer at some stage in their lives. There are approximately 22,000 new cases each year. Overall, the number of newly diagnosed cancers is increasing by 6% to 7% annually and unless major reversal of trends occur in the near future, the number is likely to double in the next 20 years.

It is against this background that the national cancer control programme is being implemented. Its goals are better cancer prevention, detection and survival through a national service based on evidence and best practice. Part of the programme is the implementation of the national plan for radiation oncology, originally agreed by Government in July 2005.

A key objective of the national plan for radiation oncology is that radiotherapy services should be provided as part of integrated cancer care service on single large teaching hospital sites. This does not mean that all centres providing cancer services should have radiotherapy services but it does mean that where radiotherapy is provided, it should be fully integrated with surgical and medical oncology.

The plan provides for a network of radiation oncology centres nationwide to be fully in place by 2014. The network will include four large centres for radiation oncology, two in Dublin at St. James's and Beaumont hospitals, one at Cork University Hospital and one at Galway University Hospital. There will also be two satellite radiotherapy centres at Waterford Regional Hospital and at the Mid-Western Regional Hospital in Limerick.

For patients in the north west, however, it is recognised that there are particular geographic concerns that need to be addressed. For that reason, the Government also decided in July 2005 that the best option for improving geographic access to radiation oncology services for patients in the north west was through North-South co-operation. Therefore, it was decided to facilitate access to Belfast City Hospital for patients needing radiation oncology treatment and a service level agreement has been in place with Belfast City Hospital for the provision of radiation oncology services to patients from Donegal since 2006. The Government also decided that over the medium term it would progress the consideration of a joint venture between North and South for the provision of services from a satellite centre in the north west linked to Belfast City Hospital.

In 2008, the Minister the Department of Health, Social Services and Public Safety in Northern Ireland, Michael McGimpsey, announced that a new satellite radiotherapy centre is to be established at Altnagelvin Hospital in Derry, linked to Belfast City Hospital, as part of Northern Ireland's plans for provision of radiotherapy services beyond 2015. The Minister for Health and Children has agreed to explore fully the opportunity presented for further collaboration in the delivery of these services. She has agreed in principle to make a capital contribution towards the cost of this development, together with meeting the costs of patients from the Republic availing of the service.

In planning the facility at Altnagelvin, it will be important to take full account of both the infrastructural and service implications of providing services to patients from the Republic of Ireland and discussions between the two Departments continue in this regard. The Department of Health and Children awaits a business case setting out the overall costs and timeline for the development of this facility.

About half of cancer patients will require radiotherapy at some point in their illness and the aim is to ensure best outcomes for these patients regardless of location. In this context, the Minister continues to be a strong supporter of North-South co-operation in radiotherapy services, building further on the arrangements already in place for Donegal patients between the Health Service Executive and Belfast City Hospital, and warmly welcomes the proposed radiotherapy facility at Altnagelvin.

I thank the Minister of State for his positive response. I wish to raise two points with him that I outlined in my original contribution. First, the date of 2015 is to be welcomed, but we need to ensure we meet it. I am not convinced or satisfied that we will have to buy this service again. It should be integral and jointly funded for the north west, rather than something the people of Donegal buy off Altnagelvin.

Second, the Minister of State's answer did not deal with the service level agreement for patients from Donegal to access Belfast City Hospital, which I believe is up for renewal. Is there any threat of that not being renewed, given the economic climate? I note from the Minister of State's response that the Minister wants to enhance further the arrangements already in place. I take it therefore that it is probably not under threat, but can he clarify that? I also intend to have this matter raised in the Northern Ireland Assembly directly with the Minister, Mr. McGimpsey. I would appreciate if the Minister of State could forward his replies to me concerning those questions.

The Seanad adjourned at 7.55 p.m. until 10.30 a.m. on Thursday, 5 March 2009.
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