Bernard Allen
Question:368 Mr. Allen asked the Minister for Health and Children the plans, if any, he has to extend the national breast screening programme to cover the entire country; and details of this programme undertaken to date. [21548/99]
Written Answers. - Cancer Screening Programme.
The Deputy will be aware that in March 1997, my predecessor 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.
There are two central units located at St. Vincent's Hospital and at 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. 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.
The decision to proceed on a phased basis 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. I am very 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. It is for this reason that the Irish national breast screening programme must be driven by international quality assurance standards and best practice.
Specifically the phasing will take account of the following critical success factors, the achievement of acceptable compliance levels among the target population, the ongoing evaluation of the programme from a quality assurance perspective and the availability of the necessary clinical expertise to conduct the programme.
In March 1999, I announced the start up date of the programme as October 1999 and I am pleased to say that this target date has been met. The planning and design of both centres is almost complete and I understand that consent letters will be issued to women shortly on a batch basis. The essential staff to commence the high quality programme have now been recruited. State of the art equipment and an information technology system have also been purchased. Decisions in relation to subsequent phases of the programme will be guided by the experience gained from putting phase I of the programme in place. The steering committee has recommended that phase II of the programme should follow phase I as soon as is practicable.
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 I of the national breast screening programme and to report back to the 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 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 ensuring that expertise levels are maintained and developed in diagnostic units around the country.