Breast cancer is a major contributor to the premature death of women in this country resulting in approximately 640 deaths per annum. In 1996, 278 women aged under 65 died from breast cancer. I fully appreciate the great level of trauma and stress experienced by women found to be suffering or who suspect they are suffering from this condition. The Government is committed to the enhancement of services in this area at both national and regional levels.
A key principle of the health strategy is the need to develop regional self-sufficiency in the provision of health services. This principle is reflected in the national cancer strategy which sets out a plan for reorganising cancer treatment services around supra-regional and regional cancer centres. Each region will have a high quality cancer service for treatments which can be administered locally with speedy access to appropriate specialist services in the supra-regional centres. Each centre has a regional director of cancer services who is currently overseeing the reorganisation process and preparing a regional plan for the development of services. A number of these plans have been prepared while others are being finalised. Part of the approach under these plans will be to develop appropriate services for the detection and treatment of breast cancer. In this regard, a number of breast clinics in hospitals throughout the country have already been financially assisted.
Another key objective in the national cancer strategy is the establishment of screening programmes for the earliest possible detection of breast cancer. It is hoped to commence screening in phase one of the breast cancer screening programme in September of this year. As part of my Department's national breast screening programme, the sum of £360,000 has recently been allocated to St. Vincent's Hospital against the cost of priority equipment required for phase one of the programme.
I am aware of the difficulties faced by patients attending the breast clinic at St. Vincent's Hospital. One of the principal difficulties is that there has been a significant increase in the number of patients attending the clinic, many of whom are referred from outside the St. Vincent's Hospital catchment area. For example, the number of attendances at the clinic has increased from approximately 6,200 in 1996 to nearly 7,300 in 1997. The clinic at St. Vincent's was the first of its kind in this country and, to some extent, its reputation has led to this dramatic rise in referrals. The breast clinic at St. Vincent's Hospital is not a national centre; rather it should be seen as a model for the development of breast clinics on a regional basis. The priority is to ensure that women who need to avail of the services of a breast clinic can receive a multi-disciplinary service at local level.
The hospital management and the clinic staff are doing everything possible to alleviate waiting times and to improve services. The hospital has stressed that women referred to the clinic who require urgent appointments are given appointments at the following Friday clinic. A series of measures has been put in place to reduce pressure on the clinic and further improvements are planned. The hospital is conscious of the need to curtail the number of inappropriate referrals to the clinic and it has been in contact with general practitioners as part of an ongoing education campaign.
The hospital operates a consultant led clinic every Friday. To improve the level of service provided, my Department made additional funding available to the hospital to facilitate the introduction of new nurse led clinics which are held twice weekly on Mondays and Thursdays. These additional clinics deal with return patients who would not necessarily require to be seen by a consultant. In addition, one of the consultant surgeons and the specialist breast clinic nurse are seeing patients every Wednesday. These clinics are focused on return patients who require time for discussion and counselling. The authorities at St. Vincent's have advised me that the block booking of patients on Friday has ceased and patients are now given appointment times.
Since October 1997 the hospital has carried out a review of the systems currently in place at the breast clinic and has issued recommendations for improvement of the service for clinic users. I understand many of the recommendations are in the process of being implemented and improvements to date include the computerisation of the breast clinic since 27 February of this year, which includes patients receiving appointment times, patients outside the catchment area being facilitated in relation to appointment times, new patients being seen first as many require access to diagnostic facilities on the same day, a senior administrative officer who also acts as a liaison officer being appointed to improve the patient services, the general manager responsible for clinical services receiving a weekly management report on the breast clinic and the chief executive at the hospital intending to have a follow up on the original review of the breast clinic services after six months.
The major capital upgrading programme approved in 1997 for St. Vincent's at a cost of approximately £50 million includes provision for the complete upgrading of the breast clinic. This work is progressing and construction work will commence at an early date.
