by Enid O'Dowd
Also, the Minister’s amendment relates to general health services while ours relates specifically to cancer. I am not satisfied with the Minister’s amendment despite the fact that on Committee Stage she seemed to take on board what we were saying.
The Minister of State, Deputy Moloney, might be able to offer a more holistic response on this issue. My experience of debating with the Minister for Health and Children on these issues is that for her it is about winning the debate, not about the health issue. I am trying to get agreement on the unique contribution of St. Luke’s Hospital and how to preserve that into the future without in any way interfering with the cancer control strategy.
There is no reason there could not be a centre in the hospital that does not offer surgery or diagnosis but that offers the sort of unique atmosphere in which follow-up treatment can be continued, such as specialist supervision under the auspices of the cancer control programme. That is what I envisage for all patients who will need these services, as well as for those families who are currently involved in treatment and want to ensure we maintain what we have.
We can develop strategies that look great on paper, and which deserve our support, but there are elements that are unique and different that can contribute something extra, which is what St. Luke’s Hospital does through its ethos. I do not see any reason why that cannot be incorporated within the strategy.
I ask the Minister to keep an open mind on this and to listen to the arguments of the Opposition and the voices of the public we are responding to on this issue.
Deputy Lucinda Creighton (FG): I welcome the opportunity to speak on this and I acknowledge the work done by Deputies O’Sullivan, Reilly and, in particular, my constituency colleague, Deputy Quinn in pursuing this issue and offering a reasonable solution to the challenges facing us in this legislation.
I am pleased the Minister is here. I accept and understand this is a busy period from a legislative point of view but it is regrettable that legislation is being rammed through. Two weeks ago, there was a week where there no votes, no legislation of any substance and a week where the Government was completely unaccountable, wasting the time of Opposition Deputies, when legislation such as this could have been taken and we could have dealt with it in depth.
I do not want to give a Second Stage speech but I have profound concerns about the HSE. It is a failed entity and the transfer of the assets, resources and board of St. Luke’s Hospital to it is a fundamental error. St. Luke’s Hospital has worked for decades, since the early 1950s, but it will be broken if it is subsumed into the monster that is the HSE.
As an Opposition Deputy who has only been here for three years, it is depressing to see Opposition Members putting forward constructive amendments to improve legislation, as we did on Committee Stage last week, only to see Deputies from the Government side coming into the committee to vote against them without having even listened to the debate. That is precisely what happened last week and I presume it will happen again today. I regret that.There are two substantive amendments. The first was tabled by the Labour Party last week - and I support it completely - to secure the land and buildings of St. Luke’s Hospital for public health care use, particularly cancer treatment. Deputy Reilly has also proposed an amendment that I understood from the Minister’s comments on Committee Stage she would be willing to accept, that in the event the Labour Party amendment is not acceptable, the Minister would put in place a safeguard that would oblige the Minister to appear before the Dáil and the committee to detail any future changes to St. Luke’s Hospital. It now appears neither of these propositions is acceptable to the Government for some reason.
I reiterate to the Minister that Deputy Reilly, during his contribution on Committee Stage, said that he would table an amendment on Report Stage to have any review of services or new plans for St. Luke’s Hospital brought before the committee by the Minister.
This would allow Members to have their say and to act on the basis of full information. In response to that, the Minister for Health and Children replied that she was happy to agree to Deputy Reilly’s suggestion. The Opposition Members present took that in good faith; unfortunately, it is not observed or being put forward in a substantive way in the amendment proposed by the Minister. As pointed out by Deputy Jan O’Sullivan, it is essentially an enabling provision which states that subject to the approval of the Minister the spirit of the proposal can be overridden. This is very unfortunate.
I accept that the Minister speaks in good faith when she states that she wishes to see the lands of St. Luke’s preserved and used long into the future for the public health service. Most of us on the Opposition benches would like to see them committed to cancer care services. Unfortunately, the Minister’s word will not be binding. Her word will not be enough if and when there is a change of government, and who knows who will be the future Minister for Health and Children. Unless it is written and woven into the legislation there will be no safeguard for St. Luke’s Hospital. I concur with the point made by Deputy Quinn that St. Luke’s Hospital will be given away and will no longer have the protection of legislation if the Bill is carried by the House today, even with the amendment proposed by the Minister. That would be unfortunate.
It is fair to state that while St. Luke’s Hospital is located in my constituency, it provides a national service and has done so for many years. It would be a sad day for the health service, cancer care and the tens of thousands of people who have benefited from the service through the years if either the Labour Party amendment or the Fine Gael amendment is rejected in the Chamber today. I appeal to the Minister to think carefully and to consider accepting one or other of the amendments proposed by the Opposition in good faith. It would stand to the Minister in the spirit of co-operation and trying to secure the best possible outcome for the hospital and its patients.
Deputy Caoimhghín Ó Caoláin (SF): I will preface my remarks on the amendments before us by stating that I am vehemently opposed to the passage of the Bill because it will result in the closure of St. Luke’s Hospital as we know it by 2014. That is something with which I strongly disagree. I also disagree with it because it is part of a flawed plan on the provision of radiation oncology throughout the State that will see entire communities and regions north of a line from Dublin to Galway discriminated against, including the constituency that I represent in the House, namely, Cavan Monaghan.
I support amendment No. 1 as far as it goes and I fully and enthusiastically endorse amendment No. 3. The very least that can be done, if the Bill is to be passed today, is to ensure that the lands and buildings of St. Luke’s remain in use for the provision of cancer - and I emphasise cancer - health services after 2014. I wish to stress further that this should be for public health services as the amendment tabled by Labour Party colleagues clearly states. I want to lay emphasis on this because it is a very important point.
There will be legitimate concern as to the future of the buildings at St. Luke’s and the site if it is left in the hands of the HSE with the approval of any Minister in the future as to what purpose or service it will be put. In my view, it should not only be with regard to health and personal social services as the Minister’s approach suggests. It should be particular to the continuation of the treatment of cancer patients and in the public health service.
As I have stated on many occasions, the Minister and the Government have pursued a policy of health privatisation and a tax on public provision. I fear that, whether she and it be at the helm when any future decisions are taken, once the position is provided for the HSE will present a case to a future Minister and Government seeking approval for the disposal of these lands or their employment in some other purpose. That is unacceptable.
As I stated on Second Stage, I had the sad experience of attending in St. Luke’s my brother-in-law who died - a younger man than me. While everyone does not have happy outcomes, there is no question as to the care and special location. I stated on Second Stage that I found the experience
of visiting at St. Luke’s, distressing though it is for any of us who are family members watching a loved one in such a deteriorating condition, a new hospital experience. I have an abiding memory of it, which concurs with the case put by other voices this afternoon and over a protracted period of time in support of the continuation of St. Luke’s for the particular and wonderful place it is.
Amendment No. 2 from the Minister is absolutely inadequate, as will be clear from what I already stated. It is still subject to section 6(5) of the Bill, which would allow the HSE to dispose of the St. Luke’s premises and lands with the approval of the Minister of the day.
It was signalled last year - and I asked for clarification because it has not been asked so far - that after 2014 St. Luke’s would continue to be used as a cancer care facility. I refer specifically to the remarks of the chair of the hospital board, Padraic White, who stated as such as I recall. Will the Minister or Minister of State - whoever is replying - confirm that the chair of the hospital board, Padraic White, made that commitment?
In support of amendment No. 1 and, in particular, of amendment No. 3 and in rejection of amendment No. 2, St. Luke’s is rightly regarded as a unique hospital facility in the Irish hospital and health care experience. It is worthy of special mention and a special case, even with the Minister’s ongoing intent with the roll-out of her cancer care plan. Its quiet atmosphere and peaceful surroundings all contribute greatly. I wish to pay tribute to the particular care provided by the most important resource of all that I noted during my visits last year, which is the excellent staff.
Deputy John Moloney (FF): Deputy Reilly concluded his contribution by stating he did not want to end on a negative note; I do not want to begin on a negative note. I will reply to some of the issues raised. I have been here 13 years and it is the first time I have been the direct subject of a lecture from Deputy Quinn. I watched him on several other occasions over the years. It is my turn to respond.
Deputy Ruairí Quinn (Lab): It is called democracy.
Deputy John Moloney (FF): Coming from Deputy Quinn it is a talk down. I have watched it before. The Deputy appealed to me to show courage. I wonder if courage is all about supporting the popular thing in the constituency or if it is about supporting what is laid down in the national cancer strategy. I would like to show the Deputy that having knowledge of St. Luke’s Hospital is not confined to Dublin Deputies.
Deputy Ruairí Quinn (FF): As I said.
Deputy John Moloney (FF): The Deputy did not really say it. He explained he knew about the peace and tranquility of the hospital. I know it quite well as my aunt died there some years ago. The Deputy has a habit of thinking that Fianna Fáil Deputies are lesser beings or representatives.
Deputy Jan O’Sullivan (Lab): This is not acceptable.
Deputy John Moloney (FF): Can I respond?
An Leas-Cheann Comhairle: Through the Chair.
Deputy John Moloney (FF): For a number of years I have considered the question of supporting best practice and what is best for the patient. When the former Minister for Health, Deputy Noonan, selected the hospital in the next county to me in Tullamore for the national cancer strategy, as opposed to my hospital I, along with four councillors in Laois, were the only people to support the next county. Therefore, I do not need a lecture in courage or doing the right thing.
When we debated this issue, one would imagine that all of the health professionals were opposed to the Government proposals. Yet, I read about the support for Professor Tom Keane and Professor Donal Hollywood, whom we hold up to be some of the most reputable experts in the area of cancer treatment and who support the Government’s proposals. The Friends of St. Luke’s Hospital are due to meet the Minister on 9 July. I would have thought it would have some input into what future it holds for the hospital.
I am not interested in where I will be in three or four years’ time; I am discussing the current health strategy as best practice. I have to take issue with comparing the KGB and the HSE. I am not sure how often Deputy Quinn attended the meetings in this House in the audiovisual room held by the HSE. It came in on many occasions but the meetings were disbanded because so few Deputies attended them. I see no connection whatsoever between the KGB and the HSE. In fact, I fully support what the HSE is doing.
The HSE was set up to try to bring unity of purpose to the delivery of health services, which is what we support. We want to see it happen and I see it happening in the national cancer strategy. Some have been selective in suggesting that I support the amendments which ignored the national cancer strategy proposals for best practice. I do not see the connection and that is why I fully support the Minister. I also support everything she has done in terms of the national cancer strategy.
On the commitments made by the Minister, no Member of this House can single out any commitments she made over the years upon which she has reneged. The issue of the sale of St. Luke’s Hospital was the Deputy’s main point. There is no intention to sell it off, a point which has been made clear by the Minister on Committee Stage and previously. It could not be sold in future without the permission of the Minister for Health, regardless of who that will be. Therefore, I do not see how it can be an issue for the Minister. To return to amendments Nos. 1 to 3, inclusive, it is important to reiterate what the Minister said on Committee Stage and subsequently. As we know, radiotherapy services will continue at St. Luke’s Hospital until 2014. The Minister stated on Second and, I understand, Committee Stages that it is her intention that the site will continue to be used for healthcare purposes in the future. I can understand the media coverage is showing some concerns about the future use of the land and buildings of St. Luke’s Hospital. There are concerns that there may be an intention to sell off the site.
In response to the amendment tabled by Deputies Reilly and O’Sullivan, the Minister reiterated on Committee Stage that it is her intention that St. Luke’s Hospital should continue to be used for healthcare purposes after 2014. It is built into the Bill and will be considered when radiotherapy services cease at the hospital. On amendment no. 1 tabled by Deputy Reilly, it is the Minister’s view that it is not an appropriate way to address the concerns that have been raised or to provide any guarantees about the future uses of the hospital. It would lead to an unwieldy decision making process that will not provide any certainty about the future of St. Luke’s Hospital.
On amendment No. 3, the Minister does not consider it appropriate that the use of the site should be restricted to a specific aspect of healthcare, such as cancer care, as is proposed. Therefore, it is not proposed to accept amendment No. 1 or amendment No. 3. I refer to Committee Stage and Second Stage in the Dáil, on which the Minister was clear that her intention was that the site should be used for any purposes other than the provision of health services. In this regard, the board of the hospital, in conjunction with the Friends of St. Luke’s hospital, has commissioned a report on the best use of the facility and until that is received and there is an opportunity to engage with the various parties involved, the Minister does not wish to be prescriptive on this Bill.
On Committee Stage the Minister stated that she would reflect on the concerns raised about the use of St. Luke’s Hospital site for public health facilities before Report Stage. Accordingly, I propose that amendment No. 2 is accepted by Deputies. The Minister believes the amendment will address the concerns the Deputies have expressed on the future use of St. Luke’s Hospital after 2014 when radiotherapy services cease.
Section 6 addresses concerns about the future use of the site by explicitly requiring the consent of the Minster for any disposal of the land. However, the Minister acknowledges the concerns which remain and proposes this amendment to bring certainty and clarity to the position. As a result of this amendment the Bill will explicitly provide that the hospital site will be used by the HSE for the purposes of providing health and personal social services in line with the Health Act 2004. I ask Deputies to support the amendment.
Deputy James
Reilly (FG): I remind the Minister what I and Deputy Creighton have already told the House her words to me when I said I would table an amendment on Report Stage to have any review of services or new plans for St. Luke’s Hospital brought before the committee by the Minister. This would allow Members to have their say and act on the basis of full information. The Minister told me she was happy to agree to my suggestion. I regret the Minister of State’s belief that my amendment would serve no purpose. It sets out its purpose clearly. There is no benefit in reiterating it if the Minister chooses not to hear it.
The Minister of State also said that he had never known the Minister to renege on her word. Unfortunately, that does not fit with reality. The cervical cancer vaccine and the cystic fibrosis unit at St. Vincent’s which we were promised would be built this year were not delivered. There was a co-located hospital policy that was to fast-track 1,100 beds into the system five years ago which it still to give us a bed, have a sod turned or a brick put in place. I understood we had agreement on this. I know the Minister agreed to it because it is on the record of the House for the Select Committee on Health and Children. I can do little other than remind her what she said. I can only appeal to her to see the benefit of what we proposed, namely, to allow the people to have their say in any future review of the services, buildings and plans for St. Luke’s Hospital.