As the Deputy is aware, the report of the sub-group of the National Cancer Forum, Development of Services for Symptomatic Breast Disease, the O'Higgins report, was published in March 2000 and contains recommendations for the establishment of a network of specialist breast units throughout the country, and the appropriate infrastructure, personnel and equipment which is needed for such specialist units. The report also makes recommendations regarding the siting of such units in each health board area. The report recommends that women with breast cancer are best served by a team of specialists working together and that women experience better outcomes if their cancer is managed in centres developed along the lines of the sub-group report. The modern management of breast cancer entails triple assessment, which involves the surgeon, pathologist and radiologist being in the clinic together. The report recommends that specialist breast units should be based on a population of 250,000 to 300,000 from which it is expected that there will be a minimum of 100 new primary breast cancers per annum.
Since the publication of the O'Higgins report, there have been extensive consultations between my Department and the health boards in relation to the best way forward for the development of symptomatic breast disease services in their functional areas. Financial approval to the boards' proposals has been given on condition that they operate to agreed protocols and standards of care in accordance with national guidelines and quality assurance arrangements to ensure compliance with best international practice and to achieve optimum outcomes.
A total of €5.2 million was allocated between health boards in 2001 specifically for the development of symptomatic breast disease services. An additional sum of €23.55 million was allocated in 2002 for the ongoing development of cancer services, including symptomatic breast disease services and during 2001 and 2002, financial approval has issued for nine consultant posts for symptomatic breast disease services across a number of health boards.