I welcome the Minister of State at the Department of Health and Children, Deputy Moffat, to the House.
Adjournment Matters. - Cancer Screening Programme.
Thank you for the opportunity to speak on my third attempt. I am anxious to hear the Minister of State on the issue of the provision of a mammography service in Clare. We discussed it here before. It was provided in 1985 when fundraising was done by the local community. A machine was put into the hospital and a highly qualified radiologist, Dr. Joe Hogan, came from England and undertook the management of it in Ennis general hospital. It has been extremely successful but three or four weeks ago the machine broke down.
Last October the Minister assured a deputation from the hospital and the Oireachtas Members from Clare that the mammography service would continue in the county. He also undertook to instruct the health board to allow the hospital to purchase a new unit if that were necessary. The machine broke down but the instruction did not come through until noise was made within the local media. A letter then emanated from somewhere within the Minister's office to the office of the Minister for Arts, Heritage, Gaeltacht and the Islands, Deputy de Valera, and it arrived on the table of the health board on the morning of the meeting. What does the Minister of State have to say on that?
We appreciate that a cancer strategy report has been done and that a sub-committee has been set up to examine the specifics in relation to the provision of breast cancer detection care. We require in Ennis general hospital the continuation of the provision of the detection service in the form of the mammography unit. It is imperative that the unit is purchased and I understand the anaesthetist has examined the machines available and has indicated to the administrative officers what he requires. A report in last week's Clare Champion stated that the question of the extension of Breast Check services to the board area would be taken up with Breast Check in the context of its future planning as the letter stated. We have not got a copy of this letter. Could the Minister provide a copy?
We must recognise that the proposals to provide mobile breast check units is desirable and commendable but it is important also that the existing structures should remain. It is a traumatic experience for a woman to undergo this check, especially if there is an extensive waiting period. Once a woman is advised by her doctor to have a check it should be available to her within 24 hours.
Ennis general hospital has a fine record in the provision of the service. It is opportune now for the Minister not just to look at its retention but to examine the future of Ennis general hospital. Ennis is the largest growing town in Ireland. In the national development plan it is envisaged to be the fourth major centre of development. There should therefore be a responsibility on the Department of Health and Children to upgrade and improve the type of health care and service being provided in the area. The existing facilities need to be examined to ascertain whether they are adequate or whether the health board and the Minister should be looking towards a green field site for the development of a high tech new hospital. This is a vitally important issue.
The provision of a detection service for mammography is also vitally important and is an inherent part of the services currently provided. It must be improved and expanded. Will the Minister assure us that that will be done? It is not satisfactory to be provided with a machine for three years and then decisions are made that it be removed. Mobile units are commendable but not satisfactory on their own. They are fine for random checks but a woman whose GP finds a lump needs the services of a local hospital unit. A three week wait to attend a regional hospital is not satisfactory. It must be dealt with in a sensitive fashion.
The situation in Limerick is also unsatisfactory. Examinations on women take place in St. John's but they have to travel to the regional hospital for the actual X-ray. They are being pushed from A to B and women from Clare, who have had to use that service have had to put up with it. In Clare they would get the service within 24 hours.
The Minister must review the current procedure that exists in Limerick in relation to movement between the two hospitals. Patient care there is unsatisfactory. Will the Minister give an assurance that this machine will be a permanent fixture in Ennis General Hospital? It must be an integral part of the health service in County Clare in the future. Will the Minister and the Department of Health and Children give Ennis a state-of-the-art hospital to cater for a hugely expanding population? Now is the time for forward planning. The Department of Health and Children is competent to do that. The importance of the local general hospital must be augmented and it must be developed in the future. All our population will then have easy access to top class health care.
I thank the Senator for raising this matter on the Adjournment of the House and for giving me this opportunity on behalf of my colleague, the Minister for Health and Children, Deputy Martin, to set out the current position in relation to the development of breast cancer services in the Mid-Western Health Board area.
As the Senator will be aware, there have been substantial developments in the care and treatment of patients with cancer throughout the country over recent years, since the launch in November 1996 of the national cancer strategy. The principal objectives of the strategy are to take all measures possible to reduce rates of illness and death from cancer and to ensure that those who develop the disease receive the most effective treatment and care. Underlying these objectives is the need for a high quality, patient-focused service.
To achieve the objectives set out in the cancer strategy, £60 million of targeted development funding has been allocated between 1997 and 2001 to develop a range of cancer services throughout the country. Some of the more significant features of the developments to date are the provision and development of consultant appointments in the areas of medical oncology, haematology, palliative care and histopathology and the introduction of the national breast and cervical screening programmes.
It is intended to continue to build on these significant developments. In this regard, at the request of the previous Minister for Health and Children, the National Cancer Forum, which was established and appointed by his predecessor, Deputy Noonan, to advise on appropriate developments and structures in the area of cancer, set up a specialist expert group to examine the symptomatic breast cancer services throughout the country. The overriding objective underlying this review was to develop our breast cancer treatment services to an optimal level to ensure the highest possible quality of care and the best opportunity for long-term survival for breast cancer patients. A sub-group of the National Cancer Forum undertook a detailed review of the symptomatic breast cancer services, and their recommendations are contained in a report entitled Development of Services for Symptomatic Breast Disease. The Minister has accepted the broad thrust of the recommendations of this report.
I would like to clarify for the House that the provision of hospital services in this region is the statutory responsibility of the Mid-Western Health Board in the first instance. In relation to services in the Mid-Western Health Board area, the board formally adopted a report on the development of symptomatic breast disease services for the region on 8 December 2000. Detailed proposals on the implementation of the report have not yet been submitted by the board. With regard to mammography services, the board recently brought to the attention of the Department of Health and Children that the present mammography equipment in Ennis General Hospital required to be replaced if services were to be maintained at the hospital. The board has been informed that the Department has no objection to this. The board has also been informed that the provision of specific funding for the development of symptomatic breast disease treatment services in Limerick will be considered for priority attention in the context of the Estimates for 2002.
The Minister of Health and Children is confident that the implementation of the recommendations of the report on the development of services for symptomatic breast disease will result in an enhancement of the services currently being provided.
May I ask the Minister one question? Will he assure the House that the mammography service will remain in Ennis for the foreseeable future?
The Department of Health and Children has no objection to the development of the mammography service in Ennis. I cannot comment further, I cannot look into the crystal ball.