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Ó Caoláin - Delay in Statements points to inability of Government to deal efficiently with vital issues of healthcare

21 January, 2004


Speaking during Statements on Radiation Oncology Services, Sinn Féin leader in the Dáil and spokesperson on Health, Caoimhghin Ó Caoláin TD criticised the delay it took for statements to be heard on Radiation Servcies since the Ministers report was published on October 9 last year. The TD for Cavan/Monaghan said the delay did "not instil confidence in the ability of this Government or of the political system in general to deal efficiently with vital issues that affect our people."

Deputy Ó Caoláin went on to say:

"While the report examined different models, including more decentralised and diversified services, it went for the centralised option, in line with the Hanly Report and with the whole thrust of current Government health delivery policy. I accept that there are many considerations specific to radiation oncology delivery and, of course, such services cannot be provided in every hospital. But the recommended configuration leaves out huge swathes of the country with seriously ill cancer patients having to travel long distances for essential and often painful and distressing treatment. The Cancer Care Alliance, whose work I commend, has identified this massive shortcoming in the Report and has called for radiotherapy provision in other centres in addition to Dublin, Cork and Galway. I support that call. I regret that the report does not recommend radiation oncology units in the North Eastern, South Eastern and North Western regions. It acknowledges the aspiration in my own region, the North East, for such a unit. But it is more than an aspiration. It is a vital need." ENDS

Full statement follows...

Statement on Radiation Oncology Services 21 January 2003 Caoimhghin Ó Caoláin TD

There is an air of unreality about a report published on 9 October 2003 being addressed by way of Dáil statements on 21 January 2004. It does not instil confidence in the ability of this Government or of the political system in general to deal efficiently with vital issues that affect our people.

I am already on record as welcoming the recommended improvements in radiation oncology services in this Report of the Expert Group chaired by Professor Donal Hollywood. The Report followed the National Cancer Registry's report 'Cancer in Ireland 1994 ? 2002' which provided a comprehensive and very disturbing account of the extent of cancer in this country. Cancer is a fact of life and death, a

reality we are failing to deal with effectively and humanely as a society. One statistic alone tells the tale, a quarter of all deaths in Ireland are caused by cancer. It is all the more disturbing therefore that the Hollywood report found in this country what it describes as "a profound deficit in radiation oncology services" - a profound deficit in access to a treatment that 50 to 60% of cancer patients require. That is a very damning finding, a cause for successive governments to hang their heads in shame. But our focus must now be on how to put it right and how best to deliver this life-saving treatment to our people. They expect and deserve no less.

The Report says that a major investment programme is required to rapidly develop treatment services to acceptable modern standards. When he published the report the Minister for Health and Children said the Government accepted the recommendations and was commencing implementation. The recommendations are comprehensive and complex and we in the Opposition in this House have the difficult task of holding the Government to account on the implementation of each and every recommendation. I hope all Members on both sides of the House will join us in doing so because this is a life and death issue.

The report provides a very detailed breakdown of radiation oncology needs now and in the future. The current status of the services and future developments in clinical practice are dealt with and there are many positive recommendations on infrastructural requirements and human resources.

That said, there is a huge problem with this Report and it is the proposed configuration of services and their restriction to three centres ? Dublin, Cork and Galway. While the report examined different models, including more decentralised and diversified services, it went for the centralised option, in line with the Hanly Report and with the whole thrust of current Government health delivery policy. I accept that there are many considerations specific to radiation oncology delivery and, of course, such services cannot be provided in every hospital. But the recommended configuration leaves out huge swathes of the country with seriously ill cancer patients having to travel long distances for essential and often painful and distressing treatment. The Cancer Care Alliance, whose work I commend, has identified this massive shortcoming in the Report and has called for radiotherapy provision in other centres in addition to Dublin, Cork and Galway. I support that call. I regret that the report does not recommend radiation oncology units in the North Eastern, South Eastern and North Western regions. It acknowledges the aspiration in my own region, the North East, for such a unit. But it is more than an aspiration. It is a vital need.

The report recommends "dedicated transport solutions" for patients in those regions who will have to travel long distances to access radiotherapy but existing ambulance services are already totally inadequate. Neither the Report nor the Minister has outlined what those transport solutions are going to be. In many parts of the country, including my own, both public transport and existing ambulance services are totally inadequate and over-stretched.

I must express disappointment that the Report did not, in my view, fulfil the second of its terms of reference which states: "On the basis of needs identified, to make recommendations on the future development of radiotherapy services, including links with radiotherapy services in Northern Ireland." As far as I can see the Report only deals with links to the Six Counties in

relation to the North Western Health Board. The issue is not approached with a truly island-wide overview, the services in the North are not seen as part of a national infrastructure as they should be, and in the analysis of my own region, the North Eastern Health Board area, there is no reference at all to links to the North. This is a huge gap in the report. It should have built on the work of the Ireland-Northern Ireland National Cancer Institute and followed the example of the Men's Health Forum in Ireland which last week published an all-Ireland report on men's health.

In conclusion I urge the Minister to implement without delay all the positive recommendations in this Report, to revisit the proposed over-centralised plan of delivery and to give our people at last the comprehensive cancer treatment service they need.

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