Is the Taoiseach aware that there are nearly 600 whole-time staff members in the Department of Health and Children at a cost of €30 million a year? This is breast cancer awareness month. Breast cancer services at Ennis Hospital have been closed. The service in Galway has been reduced to three days a week. The closure of several hospital treatment units has been announced where little activity was taking place. There is no argument about that. The frenzy of closures is now spreading to places such as Drogheda, Sligo, Mayo General, Wexford and Kilkenny.

I have two simple questions. First, will the Taoiseach or the Minister for Health and Children give an assurance on the floor of this House that no service will be withdrawn from the five centres I mentioned until the centres of excellence are built, staffed and financed, and are in operation and in a position to supply a better service and quality of care for patients than we have now, and until it is proved that what the Government is now doing in closing down centres wholesale in a frenzy will not result in women in particular having to wait long periods for assessment, treatment and aftercare?

Second, the HSE is the Government's creature and implements Government policy. Can I take it that the policy of the Government is to treat all cancers in the same manner and that there will be no distinction between those receiving potentially curative care and those receiving palliative care? Yesterday, I listened to a senior executive of the HSE imply that there will be a distinction and that persons who are to receive potentially curative care will be treated in one place while those receiving palliative care will be treated elsewhere. Will the Taoiseach confirm that the Government's policy is to make no such distinction? Thousands of ward sisters all over the country who do a wonderful job with either category give of their best. I do not want to hear the HSE executives, the creatures of this Government, applying a determination that will split types of services for people afflicted with cancer.

In reply to the Deputy's first question, I have given the facts in regard to the resources that have been allocated and the policies of the Department of Health and Children. Far from cutting back on breast cancer services, we have approved 111 additional posts, recruitment for which is under way. On the capital side, two new clinical units, seven additional mobile units and state-of-the-art digital equipment have been provided.

What about the embargo?

The construction of the two static sites in Cork and Galway, approval for which was given a year ago, is under way and they will be completed this autumn. On the overall question, clinical decisions on cancers are made by consultants. I cannot say what clinical decisions will be made in any particular hospital.

They are made by the HSE.

The HSE administration cannot do that either. The clinical and medical directors make such decisions. The HSE recently announced the appointment of Professor Tom Keane as the interim director of the national cancer control programme. His function is to lead and manage the establishment of a national cancer control programme. The delivery of cancer services on a programmatic basis will serve to ensure that we get equity of access to services and equality of patient outcomes. I accept that is important irrespective of geography. Investment in cancer control will be based on the reform programme now being implemented by the HSE. I know Deputy Kenny supports that reform programme, as I do. The implementation of the national cancer control strategy is a priority of Government. It is the policy of the Government. The reorganisation of cancer services is at the heart of the delivery of the strategy. It is imperative that the decisions of the HSE in regard to the designation of the four managed cancer control networks and the eight centres are implemented without delay. That is our policy.

I have noticed that every little effect on the service around the country under the HSE budget of €14 billion, which caters for 120,000 people, is being faxed to me, as it is to the Deputy and to every Member. This concerns a 1% control on the HSE's annual budget, based on its national strategy, and represents a small amount of the overall resources.

It hurts the poor.

It affects 25% of patients.

I have read four or five such notes today.

There were no cutbacks before the election.

It is not a cutback when a body goes over its budget of €14 billion. The HSE has a service delivery budget.

Is the HSE working?

I am not involved in individual cases but, at times, people look around to find the emotive angle rather than any other. We are talking about the HSE being 1% over budget. With the small amount of resources involved, for a short period in the year, everybody should do their best to ensure sensitive services, of which cancer is just one, are not affected.

What about the removal of home help for the elderly?