Amendment No. 2 is related to amendment No. 1 and both may be discussed together.
Health (Provision of Information) Bill, 1997: Committee and Final Stages.
SECTION 1.
I move amendment No. 1:
In page 3, subsection (1), line 23, after "programme," to insert "or".
Amendment No. 2 contains the meat of these amendments. It is a simple amendment. The Minister attempted to say I was somehow committing him to a screening programme for prostate cancer. That is not the intention of my amendment or my claim on Second Stage.
I am asking for this enabling legislation to contain this amendment which would allow a future Minister for Health to do what this Minister said he or she might want to do. If sometime in the future — I hope in the near future — it is decided that a screening programme is appropriate for prostate cancer, we will have included in this legislation the facility to allow health boards, the Department or any other agency to implement such a programme. I do not think that is too much to ask. It would be very appropriate to do so, given that there is a major debate in Europe at the moment on prostate cancer screening. I predict that such a screening programme will become part and parcel of our future health policy. Why not include in the enabling legislation a measure which will facilitate the provision of such a screening programme in the future? If we are to look forward in this debate and say we are treating cancer seriously, we must do that.
The Minister has admitted to some extent that the action plan for cancer is defective — although I welcome it — because it excludes many cancers. It includes breast cancer and cervical cancer but excludes many others.
Limerick East): It does not, it includes all cancers. The Senator is confusing the Bill with the plan.
The Minister said that provision is made in the action plan to accommodate the screening of breast and cervical cancer, which must be costed. There is no costing in the action plan for the screening of prostate cancer. Therefore, it does not include the opportunity for screening for prostate cancer, irrespective of what the Minister says. I accept that, but I am asking him to include it in the legislation so that in the event of a future decision to have such a screening programme the Minister will not have to amend this legislation. The Minister should take this matter on board now and include it in the legislation for the future. Effective screening for prostate cancer is now possible. It may not be 100 per cent accurate but it is possible through blood tests, ultrasounds or X-rays. While the procedures are not conclusive, the evidence is that these tests are, to a large extent, successful.
I ask the Minister to accept the amendments. I do not understand why the Attorney General or the parliamentary draftsman would have a problem with them because I was careful to use the wording of the subsection in amendment No. 2 regarding a prostate cancer screening programme. It should not be necessary for the Attorney General or the parliamentary draftsman to consider the amendments in depth. Only a quick glance is necessary because the words in section 1(1)(b) are used in the amendment. It contains nothing other than a statement that an opportunity will be provided in the future for a prostate cancer screening programme. This should be included in the Bill to facilitate such a programme authorised by the current Minister or a future Minister in this or later years.
I do not understand Senator Finneran's difficulty because the Minister is being reasonable and accommodating. When Senator Finneran told me this morning that he wanted to table amendments I immediately spoke to the Minister's office. The Minister examined the matter and accepted the principle of the amendments, which is what matters. He indicated that he wants legal certainty that the words included are foolproof and he has undertaken to introduce an amendment in the other House to incorporate Senator Finneran's concerns. I have undertaken to ensure time is available on the next sitting day of the Seanad to deal with the amended Bill. I guarantee that the Bill will not be delayed. If necessary and possible, it could be taken on the same day as the Bill concludes in the other House. However, if that is not possible, it will be taken on the next available day.
Senator Finneran is getting what he wants in a generous and ungrudging manner. He is being asked to allow the parliamentary draftsman and the Attorney General to consider the wording to ensure it is legally correct. The amended Bill will be dealt with in the Seanad within 24 or 48 hours of it being discussed in the Dáil. The Minister is being reasonable and I ask Senator Finneran to accept the solemn word and good faith of the Minister that he accepts the principle of the amendments.
I support the principle of including prostate cancer screening programmes if they are introduced. The Minister has not given a commitment in relation to such programmes but he has been generous in giving a commitment that he will introduce an amendment in the other House once the matter has been clarified by the Attorney General. The Minister said it may be possible to include "prostate screening" in line 19 after "cervical screening". It will then be necessary to include "women and men" in line 22 because women do not have prostate glands. I accept the Minister's statement. He is being generous in giving Senator Finneran what he wants. I also accept that the amended Bill will be brought back to the House very quickly. The amendments should not be pressed because we are getting what we want. I commend the Minister.
The Minister is being generous in stating that he will introduce an amendment in the other House. I hope the matter will be left there today.
The Minister has gone a long way towards solving the problem raised by Senator Finneran. Most people agree with the Senator's points and sympathise with them. However, the Bill relates to screening for diseases which affect women; this is most important. There is not the same demand for screening for prostate cancer and the evidence does not support the points made by Senator Finneran. How high is the incidence of prostate cancer? Most people who work in the health area say it is not as high as cervical and breast cancers. In addition, there is no indication of the cost, if any, of including prostate cancer screening in the Bill. The need for such screening is not as great as for cervical and breast cancer screening. The House should deal with the Bill as quickly as possible and the Minister has gone a long way towards meeting the Senator's demands.
I support the principle of the amendments but the Minister stated that he cannot include prostate cancer screening without adequate medical evidence to support its effectiveness. This is the crucial issue facing the Minister. EU studies in this area will not be concluded until 1998 but a study completed in the UK showed there is no evidence at this time to support the introduction of a prostate cancer screening programme. The Minister must be guided by these aspects in accepting the principle of the amendments. He cannot go any further.
(Limerick East): I explained my position in relation to the amendments but having listened to the Senator's views and those of Senator Henry, I wish to suggest another formulation to the legal advisers. Other screening programmes for cancer may prove effective before a decision is made in relation to prostate cancer. For example, the medical advice in 12 months may be that screening for bowel cancer could be very effective. Rather than confining it to prostate cancer, I wish to consider another formulation along the lines of “any cancer screening programmes authorised by the Minister”. I want to have this legally examined rather than confining the provision. There is much merit in the advice I have received in the House, particularly from Senator Henry.
The Minister's final point may be the solution to this matter. I do not agree that the House should be shown the disrespect of amending the legislation in the other House. That is not good for the Seanad and it would not happen in the Lower House.
It does happen there.
I was not prepared to agree to that. However, I accept the Minister's point that the Bill is too restrictive and it is necessary to consider a range of screening programmes for other forms of cancer. I accept the Minister's bona fides on this matter and that he is prepared to examine this issue with the Attorney General and other legal advisers in the context of introducing an amendment which will allow screening programmes for other forms of cancer. On that basis, I will withdraw my amendment and place my trust in the Minister.
Amendment, by leave, withdrawn.
Amendment No. 2 not moved.
Section 1 agreed to.
Section 2 agreed to.
Title agreed to.
Bill reported without amendment and received for final consideration.
Question proposed: "That the Bill do now pass."
Limerick East): I thank the Members for their co-operation and advice. We will not delay in putting the Bill through the Dáil and I hope to be back in the House before Easter.
Question put and agreed to.
Acting Chairman
When is it proposed to sit again?
At 2.30 p.m. next Wednesday.