Thank you for letting me raise this matter for the second time in seven years. I raised the matter of a population register in the Seanad over six and a half years ago in relation to the important matter of breast screening, which was being set up in the country. I pointed out that the lack of a population register made it far more difficult to set up breast screening. Breast cancer accounts for the death of one in five women who die from cancer in this country. It is a major cause of concern that premature death is caused by breast cancer.
I regret that those who have so successfully set up Breastcheck still have the problem that there is no population register. The Minister of State will be aware that at present women are called for a mammographic examination between the ages of 50 and 65 years, but because we have no population register those running the screening programme must rely on getting data from the general medical services and the private health insurance companies, such as the VHI and BUPA. This can mean that some people are called twice because they are on two lists, which is a cause of anxiety, and others may be left out.
I am sure we want this to be the most effective form of screening possible. I do not understand why in this day and age, with the proliferation of computer data, this cannot be set up. The National Cancer Register Board produces data on deaths from tumours and leukaemias. It also encounters terrible problems in the absence of a population register. Instead of a central collection of information on the causes of death, the board must employ specially trained nurses to go through the death certificates in various hospitals, collect the information and send it to the board.
This is an inefficient way of operating. We co-operate with the cancer strategy in Northern Ireland, where information can be immediately obtained from the hospital in-patient inquiry. All the statistics are collected centrally and the various deaths due to cancer and the types of cancer can be identified. Why does the inefficiency I have outlined continue here?
The best way we can reduce deaths by breast cancer is by screening because it gets not all, but almost all tumours before even the lump can be felt. While symptomatic breast clinics are very important, by the time people attend them they have some sign, usually a lump in the breast or some other symptoms. At the specialist clinics the people involved in the treatment of breast cancer – surgeons, oncologists, radiotherapists, physiotherapists – discuss each case together and try to tailor the best form of treatment for the woman concerned. This is why I am sometimes depressed to hear Senators call for the maintenance of very small units around the country. The Minister for Health and Children has said they do not give the best chance of good treatment to patients, although I accept there is no bigger vote catcher for Independent candidates than to stand for election on a ticket of saving the local hospital or clinic.
We must establish a population register. We may wish to start other screening programmes. The country has a very high rate of prostate cancer. How do we hope to tackle that without a register? The country also has one of the worst rates of death in men from anal/rectum cancer in the world. Only the two parts of former Czechoslovakia have a higher rate.
Will the Minister of State explain why we have not managed to establish this register, which could help us to screen for our commonest causes of death? It would also promote research into the various forms of cancer in the country. While genetic factors may be important, environmental factors may also be very important.
