Dáil Éireann debate -
Tuesday, 11 Feb 2003

Vol. 561 No. 1

Priority Questions. - Cancer Screening Programme.

Liz McManus

Question:

97 Ms McManus asked the Minister for Health and Children the number of health board areas in the country where the BreastCheck screening service is available; the number where it is not available; the proportions of the population to whom it is available; when it is intended to extend it to the whole country, especially having regard to the findings contained in the report of the Women's Health Council of 11 September 2002; and if he will make a statement on the matter. [3517/03]

Mr. Martin:

As the Deputy is aware, BreastCheck, the national breast screening programme, commenced in March 2000 with phase 1 covering the Eastern Regional Health Authority, Midland Health Board and North Eastern Health Board areas. Screening is being offered free of charge to all women in those areas in the target age group of 50 to 64 years of age. The target population consists of approximately 136,000 women and represents about 50% of the national target population. To end November 2002, 106,585 women had been called for screening and 79,906 women have been screened, representing an uptake of 75%. Yesterday, I announced the extension of BreastCheck to a further three counties and I am committed to its extension nationally.

As a result of yesterday's extension, approximately 19,000 women in the 50 to 64 age bracket in counties Wexford, Kilkenny and Carlow will be invited for screening. Approximately 9,500 per annum will be invited once the programme is fully operational in these counties and it is expected that approximately 60 additional cancers will be diagnosed and treated annually. With regard to the further expansion, the board of BreastCheck has submitted a business plan to my Department which requires a further investment totalling €26 million, including €13 million in capital costs. Two static units are proposed in host hospitals, one in Cork and the other in Galway, at which breast surgery would be performed for women in the south, west, mid-west and north-west following diagnosis.

A number of key issues have been raised by health boards and health professionals in relation to the national roll-out of BreastCheck which need to be addressed in advance of further expansion. I will be meeting BreastCheck shortly to discuss these issues. The objective is to prepare an effective and cohesive model which is in the best interests of the women concerned and which builds on the quality standards of BreastCheck and the symptomatic services.

Ms McManus:

Will the Minister admit that this was to be a nationwide programme of breast cancer screening and that the original date for its completion was 1999? The date was put back to 2002 and has now been further delayed for an unknown period of time. Is the Minister aware that €26 million, which he said would be the cost of the full scheme, represents half the cost of a Government jet? The Minister has cut the country down the middle to create a whole new form of apartheid in which a woman fortunate enough to live in the east of the country can access breast cancer screening which can save her life, but if she lives in the west or the south she will not be able access a life saving programme. Experts are clear that screening reduces the breast cancer death rate by 25%. This is insupportable. The matter does not involve a huge amount of money, but it involves bad planning by the Minister's Department and it is a question of life and death.

Mr. Martin:

The Deputy is engaged in political polemicizing. When I took office this scheme was well advanced for 50% of the population. Phase 1 was always identified as such in accordance with the original decision taken in the lead-up to the establishment of the breast cancer screening programme to introduce it in two stages. Phase 1 was to inform phase 2 in terms of best practice, evaluation, quality assurance and standards.

Ms McManus:

That is not an excuse for delay and prevarication.

Mr. Martin:

I did not interrupt the Deputy.

An Leas-Cheann Comhairle:

Order, please. Allow the Minister to continue.

Mr. Martin:

The establishment of a service like this requires the recruitment of specialist personnel which accords with the way the programme was planned and rolled out. We have had a very successful implementation of phase one and have received a business plan from the BreastCheck board. Since 2001, we have spent an additional €30 million cumulatively on symptomatic breast cancer services for women who present with symptoms. That was not in the country prior to 2001. We are building those services up over time. When BreastCheck was first conceived the symptomatic centres had not even been announced or decided upon as a policy. We are committed to the expansion of BreastCheck, it is not something we are saying we will not do. The key point now is that as we develop centres of excellence in Limerick, Cork, the south-east and the west, there needs to be some engagement with the professionals as regards a cohesive approach between both strands. That is the issue that has to be sorted out.

Ms McManus:

Does the Minister not accept it is time he stopped leading people on? Commitments were made to this nation-wide programme; everybody recognises it is excellent and that there is no need for it to be adapted in any significant way. The only problem is that so many women cannot access the service. That is the difficulty. When does the Minister intend to publish the report on radiotherapy treatment centres? It is of crucial interest, particularly to people in the south-east who were misled in terms of their understanding about the needs being met by the Government. Maybe the Minister will now state what the situation is in relation to that report and what it means for people who are living far away from the proposed centres.

Mr. Martin:

I do not want to be adversarial but I will not take any lectures from Deputy McManus. The only Government, prior to the current Administration, that did anything about providing decent breast cancer services was the last Government.

Ms McManus:

It did not do enough.

Mr. Martin:

The last Government provided significant, increased investment. No other Government prior to that did anything in terms of allocating resources or building up breast cancer centres of excellence across the country. We have far more consultants employed in our services today.

Ms McManus:

It was set out for the Minister.

Mr. Martin:

For God's sake, can the House at least acknowledge that some improvements, genuine investment and progress have been made in specific services?

Ms O. Mitchell:

The Minister is getting ratty.

Mr. Martin:

We should do that.

Ms McManus:

Who established the cancer strategy?

Mr. Martin:

Equally, I would acknowledge that we have more work and investment to put into breast cancer treatment. There is no question about that. However, many women did not even have access to centres of excellence for symptomatic breast disease, never mind the opportunity of the screening programmes.

Ms McManus:

They still do not, despite all the prosperity.

An Leas-Cheann Comhairle:

We must move on to the other questions. That concludes Priority Questions.

Mr. Martin:

I will publish the report from the expert committee when I get it, but I have not yet received it.

Ms McManus:

We will read about it in the papers.

Mr. Martin:

It is with the committee.

An Leas-Cheann Comhairle:

That concludes Priority Questions. We now come to other questions and once again I must remind the House that supplementary questions and answers are limited to one minute each.