I would like to raise an important question as to why half the female population has been excluded from the breast check programme. I raise this issue as a result of a question I tabled to the Minister for Health and Children on 24 October when I asked why there was no breast screening programme at Cork University Hospital. I was told by the Minister that his Department had received no submission from Cork University Hospital which, in ways, was a very misleading statement in that on checking the facts, I learned that the Minister had announced some time previously with glossy folders and brochures, the launch of the national breast screening programme.
When I heard of a national programme, I presumed it was truly national and that all parts of the country were being covered. It is obvious from the Minister's response that women who do not live within the Eastern Health Board, the North Eastern Health Board and Midland Health Board areas and who may be in the early stages of breast cancer, will not be screened. One of the leaflets I saw produced at the launch contained the question, "How do I get a breast screening appointment?". It did not give the answer, of course, that if one lives outside the Eastern Health Board, the North Eastern Health Board or the Midland Health Board areas, one simply does not get a check or an appointment. The next obvious question that came to me was that if one cannot get an appointment, when can one expect to get one if one happens to live in Donegal, Cork, Limerick or Galway? The answer is that nobody has a clue – it could be a short or long time depending on when areas outside those already mentioned are included in phase two or phase three.
On carefully inspecting the documentation relating to the national scheme, there is no definite commitment as to when phase two or phase three will be implemented. My concern is that it took ten years to progress the commencement of the pilot scheme in Eccles Street, the phase one. Will it be another ten years until we have phase two and a further ten years before we have phase three? Irish women and Deputies are entitled to a straight answer to a straight question.
On what basis was the decision taken to carry out screening in the Midland Health Board, the North Eastern Health Board and the Eastern Health Board areas and to exclude other major urban areas such as Cork, Limerick and Galway? The women to whom I have spoken would like to know the answer. I would like to know the reasons behind this discrimination and whether decisions are made on political rather than on medical grounds.
It has been claimed by the Minister, the Department and those operating the screening programme that a 20% reduction in mortality from breast cancer can be achieved by this programme. What does this mean? It means in the crudest terms, and if the figures are correct, that women with breast cancer outside the screening areas can expect to die in one fifth greater numbers than women inside the screening areas. Until such time as screening is finally extended to all the country, the so-called national screening programme is failing approximately half the women in this country by failing to offer them not merely screening, but even a firm timetable for screening.
If the organisers of breast check truly believe they can reduce deaths from breast cancer by 20%, then why are 20% of women with breast cancer outside the limits of certain health board areas being effectively condemned to death? Who is playing God in this case? At a time of plenty, the money for a proper national programme is surely there. National programmes should mean national and should not be piecemeal and callous. I would like to get some straight answers to the questions I put. I would also like to compliment Dr. Simon Mills of the Irish Medical Times for raising this important issue in that publication.
