Written Answers. - Cancer Screening Programme.

Róisín Shortall

Question:

60 Ms Shortall asked the Minister for Health and Children if he has satisfied himself in relation to the adequacy of the doctor to patient ratio in clinics operating the national breast screening programme; the ratio in this regard; and if he will make a statement on the matter. [19884/98]

Róisín Shortall

Question:

61 Ms Shortall asked the Minister for Health and Children the budget available to him for the national breast screening programme; the number and locations of venues at which the programme is currently in operation; and the number of women who have sought the service in the past 12 months. [19885/98]

I propose to take Questions Nos. 60 and 61 together.

In Ireland mammography is used primarily as a diagnostic tool for symptomatic or concerned women on referral from their GPs and in some cases for women at particular risk of developing the disease. Diagnostic mammography services are provided at 19 centres throughout the country, as per the following list.

Breast cancer screening involves the carrying out of mammography on a mass population basis. The aim is to lead to earlier detection and treatment of breast cancer in asymptomatic women. In Ireland, experience of breast screening to date derives from a pilot programme, known as the Eccles breast screening programme, which was established in 1989 by the Mater Foundation. The Eccles programme successfully demonstrated that a mammography screening programme is feasible in an Irish setting.

In March 1997, the then Minister announced the introduction of a major action plan to implement the proposals contained in the National Cancer Strategy. Included in the plan were proposals for the introduction on a phased basis of a national breast screening programme. 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 approximately 50 per cent of the national target population.

Following the launch of the cancer action plan, a national steering committee, chaired by Dr. Sheelah Ryan, chief executive officer, Western Health Board, was established to guide the implementation of the national programme of screening for breast cancer. Since its establishment, there have been a number of key developments. These include: (i) The passage of the Health (Provision of Information) Act, 1997, which facilitated the development of a population register. A population register for the programme has now been compiled. It is being validated and finetuned and will be operational by the time screening commences. (ii) The appointment of Dr. Jane Buttimer as project director for the programme, (iii) A decision by the breast screening steering committee on a model of delivery for Phase I of the programme. It has been agreed that there will be two central units based at the Mater and St. Vincent's, where the screening, assessment and treatment of women will be carried out using a multi-disciplinary team approach involving the relevant clinical disciplines, including the screening radiologist. There will be two mobile units to bring the screening services to the women in the more remote-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, (iv) The establishment of the programme as a legal entity to facilitate the appointment of consultant and support staff as well as for budgetary control and financial accountability reasons. The programme was recently established as a joint board under section 11 of the Health Act, 1970, (v) recent advertisements for consultant and support in the national press, (vi) Preparation of quality assurance guidelines by the National QA Committee, which is a sub-committee of the national steering committee.
In relation to staff for the national breast screening programme, I can confirm that there will be dedicated consultant and support staff appointed to specifically manage the workload involved in Phase I of the national breast screening programme, in line with best international standards. Every effort has been made to ensure that the level of staffing will be appropriate to deal with the estimated throughput levels in Phase I of the programme.
A key determinant regarding the start up date for the programme will be the recruitment of the relevant consultant and support staff, advertisements for which were recently placed in the national press. Once the relevant staff are ready to take up their appointments we should be in a position to start the programme.
I am committed to making the necessary resources available to the programme to facilitate the commencement of screening and I have approved funding to date of £2 million to cover the start up costs and minor capital equipment. I recently approved the following capital allocations: £1,035,000 towards the refurbishment of 36 Eccles Street, Mater Hospital, as a screening and assessment unit and also as headquarters of the programme; and £897,750 towards the construction of screening unit facilities at St. Vincent's Hospital.
In relation to subsequent phases of the programme, I will be guided by the experience gained from putting Phase I of the programme in place.
Diagnostic Mammography Units
Hospital

Beaumont HospitalMater HospitalSt. James's HospitalSt. Vincent's HospitalTallaght HospitalEnnis General HospitalLetterkenny General HospitalLimerick Regional HospitalMayo General HospitalNenagh General HospitalOur Lady of Lourdes Hospital, DroghedaOur Lady's Hospital, NavanPortiuncula HospitalPortlaoise General HospitalSligo General HospitalSouth Infirmary-Victoria Hospital, CorkTralee General HospitalUniversity College Hospital, GalwayWaterford Regional Hospital