ADJOURNMENT DEBATE ON HOSPITAL WAITING TIMES AND SERVICES

14th July 2011 Adjournment debate on Hospital Waiting Lists

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Catherine Murphy I thank the Ceann Comhairle for allowing me to raise this matter. There appears to be a serious problem at St. James’s Hospital, which is a centre of excellence for the provision of cancer care. I was contacted by three men in the past couple of weeks who have all been diagnosed with prostate cancer and all of whom require surgery. In the middle of May, one was informed that his surgery would take place in six weeks. Now his procedure has been postponed until the end of July. However, it is not definite that it will be carried at that time. Another of the men to whom I refer was due to go for surgery this week but he has been told to ring on the day before or on the morning on which the procedure is scheduled to take place. This individual has been informed that the procedure may, in fact, be postponed.

The third man by whom I was contacted is awaiting a date but has been told that he should not worry because his cancer is of a type which is slow to develop. The difficulty is that this person has been informed by some individuals that there can be a delay of months in respect of the surgery he requires. He has been told that he should not worry but how can one not worry when one has been diagnosed with cancer and when one requires surgery? That is nonsensical.

As already stated, St. James’ Hospital has been designated as a centre of excellence. Patients were diverted from St. Luke’s in order to ensure that there would be such a centre and a major argument developed in respect of that matter. If better outcomes are to be achieved, adequate resources must be provided, particularly in acute situations such as that to which I refer.

What is the point in obtaining an early diagnosis if such a diagnosis is not responded to? Everyone will remember the well-publicised controversy which arose a number of years ago in respect of cancer diagnoses. My husband was diagnosed with colon cancer some years ago, a few weeks after I was first elected to the House. He is doing very well now but one of the lessons I learned from what happened to him is that once the surgery was carried out, it was possible for him to adopt a positive mental attitude because he was not focusing on his cancer but rather on his recovery. The men to whom I refer are not being allowed to focus on their recoveries.

There is something seriously wrong when we have designated a centre of excellence and when certain surgeries cannot be carried out there. I telephoned St. James’s Hospital and spoke to a nurse in the admissions section of the relevant unit. I felt sorry for her. She informed me that she is on the front line and that every day she is obliged to postpone operations and deal with the people who are continually arriving – by ambulance and by other means – from different places throughout the country. She is completely frustrated. It is not, therefore, just a case of my being informed by the three men to whom I refer that a difficulty exists. A person who works on the front line at the hospital informed me that there is a serious problem there.

I request that the Minister talk to the people who run St. James’s Hospital in order that he might be satisfied that the service to which I refer can be provided to those who require it. This matter does not even relate to cutting costs. The longer someone must wait for surgery, the longer he or she is out of work and the longer his or her recovery will take. It is not a question of money, there is something seriously wrong with regard to the way the service in question is being delivered.

Ciarán Cannon I am taking this matter on behalf of my colleague, the Minister for Health, Deputy Reilly. I welcome the opportunity to address the House on the provision of cancer services, including surgery, at St. James’s Hospital.

The burden of cancer continues to increase. This year, approximately 24,000 people will be diagnosed with invasive cancer. Each year an average of over 2,600 men are diagnosed with prostate cancer, making it the most common cancer in Irish men other than non-melanoma skin cancer. While approximately 500 men die from the disease each year, it is encouraging to note that estimated five-year relative survival for those diagnosed with prostate cancer in Ireland is now over 89%.

The HSE‘s national cancer control programme aims to address the challenge of cancer in Ireland. The programme’s goals are better cancer prevention, detection and survival through a national service based on evidence and best practice. St. James’s Hospital is one of the eight designated cancer centres under the programme. It provides cancer diagnosis, including a rapid-access prostate clinic which is designed to enhance access to early diagnosis and multidisciplinary decision-making, surgery and medical oncology.

Radiation oncology services are now also provided on the St. James’s campus in a new unit opened in April 2011. This unit, St. Luke’s Hospital and a second new unit on the site of Beaumont Hospital form the St. Luke’s radiation oncology network. The development of this network means an overall increase of 50% in radiation oncology capacity over what had previously been available in the eastern region. The new centres reflect the latest advances, equipment and expertise available internationally.

In recent weeks St. James’s Hospital has experienced a significant number of patients awaiting discharge to community beds. This means that fewer beds have been available for emergency or elective accommodation and this had knock-on effects in respect of scheduling of elective surgery, including treatment for prostate cancer.

With regard to prostate cancer surgery at the hospital, the national cancer control programme has advised that of the 40 elective urology surgeries booked at the hospital between 1 June and 11 July this year, seven were cancelled. In one instance, the cancellation was due to the fact that the patient did not attend. One of the seven patients affected by the cancellations has already been admitted and treated, while the other six have a date for surgery within the coming three to four weeks. I am pleased to say, on behalf of the Minister, that the hospital now anticipates an improvement in access to prostate surgery as the number of delayed discharges declines.

The latest delayed discharge report already shows a reduction in the number of delayed discharges nationally. The Minister has been advised that the HSE has approved 25 patients for transfer from St. James’s Hospital under the nursing homes support scheme since early July. These transfers are now being effected, which will reduce congestion and allow elective prostate cancer surgery to proceed. It is also important to note that St. James’s Hospital has confirmed that there is no issue in respect of the resourcing of necessary surgical capacity for these patients or for other cancer patients.

The Dáil adjourned at 9.30 p.m. until 10.30 a.m. on Thursday, 14 July 2011.

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