Statements on Cancer Services - 20th November 2007

Statements on Cancer Services - 20th November 2007
Senator David Norris: I thank Senator Prendergast
for allowing me this time to speak. I welcome
the Minister because she is a brave woman
who went into Angola but I wonder if she regrets
that decision now. I will not engage in partisan
political attacks because I agree with those who
said recently that what is needed now is a
Tallaght strategy. Rather than party members
knocking lumps out of each other we should consider
patients’ needs.
I am glad to see that in her speech the Minister
said, “if you are worried about cancer, this is the
best assurance we can give you that the best care
will be there if you need it”. When will this happen?
The word “will” is the crucial verb in this
sentence and it means in the future. The Minister
also said, “If you live in rural Ireland or outside
a major city, you deserve the same care as a person
living right beside a major cancer hospital and
you will get it”. Again I ask the Minister, when
will this happen? Can she guarantee the Susie
Long case will never be repeated in this country?
Can she guarantee that the Portlaoise case will
never be replicated? I believe this situation has
arisen due to an ideology and that the notions of
competition, co-location and so on are ideologically
driven. I pointed out to the Minister previously
that a three page script of hers mentioned
words relating to business and these practices
around ten times while patients went unmentioned.
I know the Ministers feels strongly about
patients but they must be at the forefront of
health policy.
Regarding private hospitals, the Minister
pointed out previously that one needs a licence
to own a dog but not to run a hospital. This is
because hospitals are businesses but I do not feel
that the health service should be a business; it
should be an entitlement of the citizens of the
State. I have no medical expertise but I believe,
along with many eminent medical professionals,
that we need a universal, accessible health
service. The Minister once said we should be
closer to Boston than Berlin but I would prefer
to be close to some European models of health
service than the American model. Has the Minister
seen the film “Sicko”? It shows that the
American health system is guided by the principles
of competition and profit and while the
United States has excellence in its health service
it also has people routinely and ruthlessly
excluded from the provision of health care.
I wish to put on the record my admiration for
Professor John Crown. I have never met the man
and have no connection with him but I listened
to him with interest and I trust a lot of what he
says. The Minister may agree with some of the
problems he has identified in the health service
including inaccessibility, inefficiency, unfairness
and an uneven quality of delivery. He agrees with
the Minister that the best clinical care takes place
in large, comprehensive specialist centres. One
may look at examples such as the Memorial
Sloan-Kettering Cancer Centre and the Netherlands
Cancer Institute when considering the poor
resources we have.
We, as politicians, must take some of the blame
because many Senators do not see their constituents
as the councillors who gave them their seats
in this House but as those in the constituencies
where they may seek election to Da´ il E´ ireann and
they fight for local services. Professor Donal Hollywood
from Trinity College produced a report
in 1995 and had to have a police escort out of
Portlaoise because of people stirring things up
against him. Senator Harris was right when he
raised the issue of vested interests, however those
with vested interests are not, primarily, consultants
but managers in the health service. Managers
proliferate faster than any local service and this
matter must be addressed.
I was interested to read a piece by Professor
Maurice Nelligan.
An Cathaoirleach: The Senator’s time has
expired.
Senator David Norris: Professor Nelligan
cannot be silenced. He stated that too many
promises are made regarding sophisticated
services regardless of cost only for cutbacks to be
made when the bills must be paid. The blame for
this is then shifted elsewhere.
We need a universal health service closer to
European models and we must stop political
point-scoring on the health service. We should
adopt a Tallaght strategy, not in the interest of
private medicine and profit but in the interest of
the delivery of appropriate services to the citizens
of this country.


Senator David Norris: I have three questions
also. I support strongly the idea of centres of
excellence. I know there are political difficulties
because everybody seems to fight for their own
back yard but it is important. It would have been
better if they had got agreement in principle from
everybody before they looked at the geographic
location. That was a flaw. Also, the public must
be reassured that no more local services will be
closed until the centres of excellence are in
existence.
Senator Nicky McFadden: Hear, hear.
Senator David Norris: There is no point in
doing it the other way around.
On that basis I would like an update on the
position regarding St. Luke’s Hospital. I ask the
question because of the special benefits that
accrue to patients there, large numbers of whom
have contacted me. There are substantial grounds
in the hospital where they can have a walk, sit
down, enjoy the shrubbery and so on and many
of them, as well as some of the staff, have told
me that is vital in terms of assisting in their recovery.
I understand there are proposals to move
that to St. James’s Hospital, possibly into some
kind of tower block. Will the situations that have
been proved beneficial in the special circumstances
of St. Luke’s be replicated? Will people
have that kind of nurturing environment or will
they be stuck in some type of tower block? Is
there a timescale in that regard?
Regarding my second question, I have been
very impressed, as have many members of the
public, by the passionate advocacy of Professor
John Crown. That may not be popular with
everybody but we appear to have in this man a
national asset, somebody who has international
experience, a clear view and is a specialist in the
area of cancer. Is there any way he can be
brought on board in terms of getting to grips with
the area of cancer treatment? That would go a
long way towards making the public believe that
we were all rowing in this together. I would link
that with what I said earlier this afternoon about
a Tallaght strategy. All of us must fight in that
regard. I said it about politicians earlier and I say
it now about doctors too. I would welcome it if
he could be brought on board.
Taking up what Senator O’Toole said, my third
question is about cleaning. My compliments to
the Minister on the way she is taking these questions
and dealing with them; obviously she is
somebody who is in control of the information.
1513 Cancer Services: 20 November 2007. Statements 1514
We may not agree with every attitude, programme
and ideology but she has the facts at her
finger tips.
With regard to cancer patients, when they have
had chemotherapy, radiotherapy or whatever,
their immune systems are often weakened. They
are particularly vulnerable in terms of infection
and a lack of cleanliness. Would the Minister
agree that a business model is not necessarily the
most efficient in this regard? Many hospitals buy
hours of cleaning, which might appear good in an
accountancy statement but it is inefficient. Would
it not be a good idea to have dedicated in-house
staff to do the cleaning on the spot when
required?