Dáil Éireann debate -
Thursday, 7 Oct 1999

Vol. 508 No. 5

Written Answers. - National Breast Screening Programme.

Róisín Shortall

Question:

92 Ms Shortall asked the Minister for Health and Children the position with regard to the national breast screening programme; if he has satisfied himself with the delivery of the service; the average waiting times for screening; and if he will make a statement on the matter. [19415/99]

Minister for Health and Children (Mr. Cowen)

At present, 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. There are 19 diagnostic mammographic units available in Ireland for symptomatic breast cancer patients. Of the 19 units, 14 are available outside of Dublin, with at least one unit in each health board area. 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.

The Deputy will be aware that, in March 1997, my predecessor gave the go-ahead for the introduction of phase one of the national breast screening programme for the target population of women aged 50-64, in the Eastern, North-Eastern and Midland Health Board areas. There will be two central units located at St. Vincent's hospital and the Mater hospital, where the screening, assessment and treatment of women will be carried out using a multi-disciplinary approach. In addition, the use of mobile units by BreastCheck, the national breast screening board, will ensure that the screening service is accessible to all women in the target age group in these areas. It is expected that the programme will commence in October 1999. My intention is to provide a top quality service which meets best international standards. I am satisfied that the careful planning and deliberation by the national breast screening committee over the past two years in relation to all aspects of the programme will ensure that we can offer a service which is underpinned by standards of excellence and one which will ultimately pay dividends in terms of reductions in mortality among women in the target population.

A key element in meeting this target date is the provision of appropriate physical facilities. The refurbishment work is in hand and the contractors are currently on site at both the Eccles unit at the Mater Misericordiae hospital and the Merrion unit at St. Vincent's hospital. The planning for the development of the permanent site at the Merrion unit is also ongoing. It is hoped that the necessary works for both units will be completed to facilitate the commencement of the screening programme in October 1999. Another key determinant in meeting the target start up date for the national breast screening programme is the recruitment of the relevant consultant and support staff. The key consultant staff have now been appointed and the recruitment process for support staff is well advanced. The Department is satisfied that all relevant staff will be in place to accommodate an autumn start-up date for the programme.

My Department is very conscious of the importance of early access to symptomatic mammography services and of the provision of an equivalent standard of excellence in both symptomatic and screening mammography services. For this reason, I have requested the national cancer forum to undertake a review of symptomatic breast cancer services at national level prior to the commencement of phase one of the national breast screening programme and to report back to my Department as soon as possible in the matter.

In tandem with this, my Department recently raised the issue of mammography referral practices with the health boards. The Department's key concern is to ensure that all women, irrespective of age or where they live have timely access to symptomatic services. A critical factor in this regard is referral by GPs to local diagnostic mammography services in the first instance. This should result in a reduction in average waiting times at all mammographic units, thereby improving access for women and at the same time ensur ing that expertise levels are maintained and developed in diagnostic units around the country.

The diagnostic mammography units and average waiting times for appointments in each unit are listed on the following table:

Location of Mammography Units	Waiting Times
Adelaide and Meath Hospitals, incorporating the National Children's Hospital, Tallaght	Routine referrals – 7 months Symptomatic GP and Consultant referrals – 7 to 10 days
Beaumont Hospital	2 weeks
Mater Hospital	Routine appointment 7 monthsConsultant referral – 1 week
St. James's Hospital	Breast Clinic – on demandUrgent referrals – 1 to 2 weeksRoutine referrals – 3 to 4 weeks
St. Vincent's Hospital	Consultant referral for symptomatic patients – 3 to 4 weeksSymptomatic GP referral – 8 weeks
Ennis General Hospital	Urgent referrals – seen immediatelyNon urgent referrals – 3 to 4 week wait
Letterkenny General Hospital	Waiting time 3 to 4 weeks
Limerick Regional Hospital	Breast clinic – urgent referrals seen on the day
Mayo General Hospital	Consultant referral – 5 weeks
Nenagh General Hospital	Clinical referral – 2 weeksScreening referral – 8 weeks
Our Lady of Lourdes Hospital, Drogheda	Breast Clinic Referrals – as soon as possibleGP routine referral – 16 weeks
Our Lady's Hospital, Navan	Urgent referrals – as soon as possibleReferral from Breast Clinic – 3 weeks
Portiuncula Hospital	Machine currently not in use
Portlaoise General Hospital	No waiting list
Sligo General Hospital	3 to 4 weeks
South Infirmary-Victoria Hospital, Cork	Routine GP referrals – 4 monthsRoutine Consultant Referrals – 2 to 3 days
Tralee General Hospital	No waiting list
University College Hospital, Galway	Routine Clinical referrals – 5.5 weeksUrgent Clinical referrals – seen immediately
Waterford Regional Hospital	Waiting time – 4 weeks