Other Questions.

Cancer Screening Programme.

Michael D. Higgins


6 Mr. M. Higgins asked the Minister for Health and Children the position on the roll-out of BreastCheck nationwide, per centre; the latest cost estimates of each centre; if she expects the roll-out will be on time and within 2007; and if she will make a statement on the matter. [12065/07]

I am committed to ensuring the BreastCheck service is rolled out to the remaining regions as quickly as possible. I have allocated additional revenue funding of €8 million for this year to meet the additional costs involved and I have approved an additional 69 posts for the roll-out. BreastCheck appointed the clinical directors for the south and west last November and has recently appointed three consultant radiologists, two consultant surgeons and two consultant histopathologists, all of whom have a special interest in breast disease. The recruitment of radiographers and other staff is under way.

I have also made available an additional €26.7 million in capital funding for the construction of two new clinical units and the provision of five additional mobile units and state-of-the-art digital equipment. The static units at the South Infirmary-Victoria University Hospital, Cork and University College Hospital, Galway are on schedule for hand-over in September, followed by a three-week commissioning period and will be operational in October.

Screening in individual counties will be dictated by BreastCheck's management and operational considerations. In advance of the commissioning of the static unit in the south, BreastCheck is making every effort to achieve earlier roll-out through the use of a mobile unit. Early deployment of a mobile unit in advance of the completion of the regional screening unit gives rise to particular and unique operational and recruitment challenges for BreastCheck in the south. At present, these challenges have not been overcome and as a result it is not possible to indicate when an early mobile unit will be deployed. BreastCheck will continue to make every effort to achieve early deployment in the south.

As regards the west, about which Deputy Michael D. Higgins asked, the roll-out is to commence in April.

I thank the Minister for her reply although it greatly concerns me. Women in the west, south and north west had understood that universal screening would be available by the end of 2007.

That was my understanding.

Previously, such women were given a commitment to the effect that the roll-out would be completed in 2004. However, the Minister's reply indicates that light at the end of the tunnel will not even be seen this year. This is disturbing and concerns me because breast cancer screening saves lives. Improvements have been discerned in Northern Ireland where such screening is available to all who need it.

Regrettably however, Members are also aware that the cancer plan is in something of a shambles and that services such as radiotherapy that should be in place are in a quagmire. They have been removed from the public private partnership process that was supposed to be the method for providing cancer services and are now in a different system. The present scenario is a sorry affair. Is the Minister stating that Members can no longer expect the complete roll-out of BreastCheck in 2007 and that gaps will continue thereafter?

The cancer plan is not in a shambles and the radiotherapy plan has not been removed from the public private partnership process. The construction stage will be carried out in the traditional manner and the linear accelerator element will be carried out through the public private partnership. This is because the money has been allocated in the capital plan, which was done for reasons of speed to meet the timeframe of 2011.

As for the roll-out, the buildings will be handed over in September and commissioned three weeks later, which suggests a date in late September or October. I am uncertain when in September the hand-over will take place. That has always been the date and I have never given another. However, to advance screening, approval was given for mobile units. A mobile unit will begin work in the west in April. A staffing issue has arisen with regard to the mobile unit in the south. It is more difficult to obtain key staff for mobile units because they are farther away from base and it is still a challenge. Recently, I had a meeting with BreastCheck on this matter. If memory serves me correctly, once the roll-out begins in a region, which will be April in this case, it takes approximately two years to roll it out to the entire population of the region. This was the timeframe in Dublin and other areas for full roll-out.

What the Minister stated is amazing. The Minister acknowledges that due to fact the Government has not really put its back behind this, the first women screened under BreastCheck on the east coast will possibly have their third screening before the programme is implemented in the west of Ireland. This is truly dramatic when we see the cancer report published during the week which shows BreastCheck identifies breast cancer at an earlier stage, the disease is less advanced, the trauma is reduced and the possibility of survival is dramatically improved because of it. These opportunities will be missed in the west.

The Deputy understands that with regard to screening programmes it is not a case that one presses a button and suddenly everyone is covered. It is an issue I discussed——

It does not take seven years either.

I wish it could be done a lot quicker and no one is exerting more pressure than me to expedite this.

Somebody took his or her foot off the pedal.

Sometimes the recruitment of key staff takes longer than expected. Above all else, it must be done on a quality assured basis and the multidisciplinary approach works extraordinarily well. I discussed population screening programmes with other countries. I know of no country which was able to do it quickly. I do not state it took seven years. I cannot state that and put my hand on my heart. It takes quite some time from when the policy is approved to the time the population covered by the screening is contacted and screened and receiving follow-up attention.

In her initial response, the Minister indicated the numbers of appointments and those being recruited. I presume the process has moved forward. Will the Minister clarify the extent of recruitment as against the identified need? The Minister gave figures on radiologists and others who were pinpointed and who, I presume, signed the dotted line to take up various areas of responsibility. Will the Minister state how short of the expected requirement in terms of staffing cover will the roll-out be as the year progresses? What deficiencies exist?

Will we find a situation like that of the previous question on the situation in Cork University Maternity Hospital whereby in the immediate run-in to the expected official opening we will find deficiencies in staffing numbers? Will the Minister comment on the remarks made last evening in the associate House in this institution by a Senator from the west of Ireland who is anything but satisfied at the roll-out in the west and expressed grave concerns with regard to whether BreastCheck availability in Galway will be up and running by October or November? The Minister indicated the clinical screening unit will be in situ at University College Hospital, Galway and will be the identified area for the west. How soon after that will the mobile units physically get about their work?

The mobile unit will start its work in April in the west. The stationary unit will be handed over in September and it will take three weeks to commission it.

The static unit.

I apologise, I said "stationary". It has been a long day.

It is the same in the south where the static unit will be available in September and commissioned three weeks later. An issue is raised with regard to the mobile unit for the south with regard to recruiting manager radiographers. The process is aggressively under way by BreastCheck but it has not yet succeeded. I had a meeting with BreastCheck during the past month and it faces challenges in the south with regard to this matter. The consultant staffing complement was recruited and is not an issue.

Is that the full complement?

Yes, I believe so.

Legislative Programme.

Bernard Allen


7 Mr. Allen asked the Minister for Health and Children her plans to break up the VHI; and if she will make a statement on the matter. [12019/07]

I have not made any decision to break up the VHI. The Government's legislative programme provides for legislation to be brought forward to amend the existing Voluntary Health Insurance Acts. The Parliamentary Counsel is drafting the related Bill and this is to be published before the summer recess. The main provisions of the Bill include giving the VHI commercial freedom on products and pricing and obliging the board to attain the level of reserves necessary to achieve authorisation

I recently received reports from the Competition Authority and the Health Insurance Authority on increasing competition in the private health insurance market. The two reports addressed the VHI's status. I am in the process of studying the recommendations made in the two reports, including those relating to the VHI. I am also awaiting a report from the market review group which is expected at the end of this month. When I have had the opportunity to examine all of the recommendations I intend to bring forward proposals to Government. Those recommendations will also inform the legislation.