Vol. 488 No. 2
18 Mrs. B. Moynihan-Cronin asked the Minister for Health and Children if he has satisfied himself that all quality requirements will be met in relation to the promised September 1998 start up date for the national breast cancer screening programme; when a project director will be appointed; and if he will make a statement on the matter. [5795/98]
The national cancer strategy includes provision for the introduction of breast cancer screening on a phased basis for women aged 50 to 64. Phase I will cover the Eastern, North Eastern and Midland Health Board areas and will target 120,000 women in the age cohort 50 to 64, which represents 50 per cent of the national target population.
The decision to proceed on a phased basis was not based on financial constraints. Instead, it is a reflection of the complexities involved in the screening process and the importance of ensuring that the Irish programme meets the necessary quality assurance criteria. Specifically, the phasing will take account of the following critical success factors: the achievement of acceptable compliance levels among the target population; ongoing evaluation of the programme from a quality assurance perspective; and availability of the necessary clinical expertise to conduct the programme.
As Minister for Health, I am very much aware of the unnecessary trauma and anguish that could be caused to women and their families as a result of mistakes in an organised screening programme. For this reason the Irish national breast screening programme must be driven by international quality assurance standards and best practice.
To this end, a national steering committee, under the chairmanship of Dr. Sheelah Ryan, chief executive officer, Western Health Board, was established in March 1997 to manage and oversee the implementation of phase I of the programme. In addition, a national quality assurance committee has been established under the chairmanship of Professor Joe Ennis, who was the director of the Eccles Street Pilot Screening Programme. The quality assurance committee, which is a sub-committee of the national steering committee, is charged with the responsibility for drawing up protocols for the programme to ensure it meets the necessary quality assurance criteria.
To start screening by I September 1998, it is critical that all the quality assurance requirements are satisfied. In this regard, I am pleased that considerable progress has been made on the development of the clinical and administrative systems and on the establishment of a national population register. It is expected that the appointment of the project director will be finalised in the near future.
In terms of identifying an appropriate model of delivery for the programme, the key concern in this regard was the need to achieve acceptable compliance levels and at the same time to meet the necessary quality assurance criteria. After careful deliberation and much discussion on the issue, the decision was made to develop two central units based at the Mater and St. Vincent's hospitals, where the screening, assessment and treatment will be carried out, using a multi-disciplinary team approach involving the key clinical disciplines, including the screening radiologist. In addition, two mobile units will bring the screening services to the women in the more remote or rural areas within the three health boards in Phase I. Each mobile unit will be linked with one of the central units. This should ensure uniformity of standards and continuity of care.
I am confident that the decisions to date in relation to phase I of the programme are very much in line with international quality assurance standards and best practice. I reiterate that my Department is committed to making the necessary capital and revenue resources available for the successful implementation of the programme.
What are the reasons for the delay in appointing a project director? Have those difficulties been overcome and when will that person take up the appointment? Is the Minister confident the programme will begin in September?
I have no reason to believe that it will not begin in September as planned. The appointment of a project director is now being finalised. Interviews were held in November and December. The successful applicant is Dr. Jane Buttimer, the deputy chief medical officer of the Department of Health. It is now a matter of deciding who the employer is — whether it is the North Eastern Health Board or an independent agency under the remit of this programme. There is a secondment issue to be sorted out. I am informed that it is being finalised at the moment.
Will the Minister give an assurance that if a lump is detected on a participant, that that person will be seen the following day? We will then avoid the situation we have now, where lumps are discovered and patients are given outpatient appointments for three weeks after that date. That situation pertains in certain areas. Best practice would ensure that patients are seen the following day.
That is a detail on which I can revert to the Deputy. I do not want to give a commitment without checking it. We aim to meet international quality standards—
It is an important detail.
It is. If the international standard is that one is screened within a week of detection, we will work on that basis. I will check the time limit.
I formally request that the priority question that was not taken be reserved for the next health question time. I do not want a written reply.
Priority Question No. 15 to be held over for the next day on which Oral Questions are addressed to the Minister for Health and Children.
(Written Answers follow Adjournment Debate).
