Seanad Éireann debate -
Wednesday, 29 Apr 2009

Vol. 195 No. 3

Cancer Screening Programme.

Senator Brian Ó Domhnaill

I wish to raise the issue of the roll-out of BreastCheck in County Donegal. The BreastCheck service provides free mammograms to women aged from 50 to 64 on an area-by-area basis. Following an extensive recruitment campaign by the National Cancer Screening Service, additional radiographers have been identified to provide the service in County Donegal. However, a difficulty has been experienced in rolling out the service to County Donegal in respect of the embargo on employing additional people in the public service. The National Cancer Screening Service issued a press statement on Tuesday stating the plan to extend BreastCheck to counties Donegal, Clare and Leitrim is temporarily on hold while it awaits the decision on the request it made for a number of posts to be exempted from the public sector recruitment moratorium. I understand these are the final three counties seeking to get BreastCheck under the plan set down to roll it out to 13 counties. The national cancer screening service applied in the past two to three weeks for a series of derogations to allow the recruitment of radiographers and other staff, including clerical and administrative staff, to be able to provide the service and roll it out to counties Donegal, Clare and Leitrim.

What we in County Donegal are looking for is not excessive. We are looking for equality of access to BreastCheck, nothing more or less. It is an equality issue. We want to ensure the service is rolled out as planned and scheduled in 2009. I commend the work done by the national cancer screening service and its chief executive, Tony O'Brien, with whom I have been in direct contact on a number of occasions over recent days on this issue. It is important now that the Minister for Health and Children — I am delighted the Minister of State, Deputy Barry Andrews, is here from that Department — the Minister for Finance and the Government allow the National Cancer Screening Service and BreastCheck to recruit the radiographers, administrative and clerical staff. There may be scope for redeployment of staff from the Health Service Executive to the National Cancer Screening Service and I understand that is being explored. I also understand this matter is under immediate consideration.

However, I want to ensure the issue is brought to the attention of both Ministers, Deputy Harney and Deputy Brian Lenihan, and that we get the approval or derogation as quickly as possible to allow the work to roll out the service to County Donegal to go ahead. The people of the county are waiting on the service. They deserve it and are only looking for the same access available in other areas. While we have been waiting for some time for the roll out, everyone involved, including the campaigning committees in County Donegal, was satisfied that BreastCheck would be provided this year. We do not want to endanger that. I hope we can have the service provided in County Donegal on a mobile basis in the next number of months, but we need the assistance of Government for that. I hope that will be available.

Senator Pearse Doherty

While I and Senator Ó Domhnaill disagree on many issues, this debate shows there is a united front in Donegal on this issue and this is shared by Deputies across the political parties in the Dáil as well. The demand comes from the ground, from the women who want to avail of this service and from their families and loved ones. When BreastCheck began to be rolled out eight years ago — some areas have had it that long — it was presumed Donegal would be last on the list to receive it. Unfortunately, that has proved to be the case.

I am sick and tired of County Donegal always being at the bottom of the list and always being the last to get the good things and first to get the bad things. When news came through of the impact of the budget announcement on the recruitment of public sector workers and the impact this would have on the recruitment of the radiographers required for the BreastCheck programme, it caused an avalanche of anger in County Donegal. Not only was it last on the list, the process could not continue until an exemption was provided.

I understand the Minister introduced the ban on the recruitment of public sector workers for financial reasons. However, in this situation radiographers have already been identified. Earlier this month the process was completed. The National Cancer Screening Service wants to make the offers to the four people who have been identified to take up the positions in the north west. However, it cannot do so because of the budget announcement on 7 April. Tony O'Brien and his team must be commended on the work they have done. On 7 April, the day the Minister made the announcement, an application was made immediately for an exemption for Donegal and the north west. I commend them on their speedy action in that regard. However, that request has been with the Department for three weeks and one day.

This issue affects not only Donegal but also Leitrim, Clare and other parts of the north west, west, south and some areas in Dublin. We are talking about 13 radiographers in total who are required to fill the complement in the national cancer screening programme, four of whom are needed to provide the service for the first time to women in Donegal. The question must be asked what price the Minister for Finance or Minister for Health and Children put on the lives of Donegal women. What price do they put on the loss to grieving children who will lose loved ones if the service is not provided? What price do they put on the heartache and agony people must go through because they cannot get the service after they have been diagnosed with breast cancer? These people know that if they lived in a different region they would have had automatic screening not only once, but twice or three times by now.

The provision of four positions for the north west and 13 positions in total to save people's lives is not a big price for the Government to pay. It is a price we should be willing to pay. We should be willing to make the statement in the House that the issue will be resolved and the radiographers will come on stream without delay once the paperwork is done so the appointments can be made and BreastCheck rolled out.

As I have said publicly previously in Donegal, I have no doubt that every politician in this House and the Dáil agrees that BreastCheck must be rolled out nationally. I do not believe that anyone introduced the moratorium with the thought that BreastCheck would not be available to the women in Donegal. This is a glitch in the system we need to address. We need to address it now. I hope the Minister of State will be able to give that commitment. It will be disappointing if he has not got that commitment in his response. We will continue to aim for the commitment to be given to the women of Donegal and their families that the issue will be resolved within the 2009 timeframe.

Deputy Barry Andrews

I thank Senators Ó Domhnaill and Doherty for raising this important issue which I am taking on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. I am pleased to have the opportunity to clarify the situation with regard to the roll-out of BreastCheck. The National Breast Screening Board was established in 1998 as a specialist agency with the sole remit of providing Ireland's first quality assured, population-based breast screening programme, BreastCheck, for women aged 50 to 64. Governance of BreastCheck was transferred to the board of the National Cancer Screening Service on its establishment in January 2007.

BreastCheck provides free mammograms to women aged 50 to 64, sequentially and area by area every two years. It began offering free breast screening to women in this category in the then Eastern Regional Health Authority, North Eastern and Midland Health Board areas in February 2000 and was extended to Wexford, Kilkenny and Carlow between 2004 and 2006. In December 2007, construction of two new static units — the BreastCheck western unit in Galway and the BreastCheck southern unit in Cork — was completed. Screening began from both units in counties Cork and Galway in December 2007. These two static units, together with eight mobile digital units, will provide screening to more than 144,000 eligible women aged 50 to 64 in the south and west. Since December 2007, the BreastCheck service has been extended to nine of the 12 counties in the south and west, namely, Cork, Galway, Kerry, Limerick, Mayo, Roscommon, Sligo, Tipperary and Waterford. The completion of the national roll-out to the three remaining counties will proceed in 2009.

The Government decided to introduce a recruitment moratorium across the public service with effect from 27 March 2009 to the end of 2010. However, certain posts in the health sector may be filled, including medical consultants. The focus on these grades is in line with existing Government policy on the prioritisation of certain development areas for which significant funding has already been provided.

I am very pleased to confirm that BreastCheck will be extended as planned to Donegal, Clare and Leitrim, with indicative dates of June to reach County Clare, September to reach Donegal and October to reach Leitrim. At the same time, it is vital to stress that any woman, irrespective of her age or area of residence, who has immediate concerns or symptoms should not wait for an invitation to screening from BreastCheck but should contact her general practitioner who, where appropriate, will refer her to the symptomatic services in her area.

Within the past three weeks, the National Cancer Screening Service applied for a series of derogations to allow the recruitment of radiographers to extend the BreastCheck service to counties Donegal, Leitrim and Clare. This is in accordance with procedures put in place under the recruitment moratorium. The screening service was permitted to proceed with interviews for radiographers last week while the application to recruit for those posts was under consideration. I am pleased to confirm that recruitment of radiographers in those counties can proceed immediately. In the wider context, the scope for redeployment of staff from the HSE to the NCSS and within the NCSS itself will continue to be explored with the HSE. In the first instance, however, we will proceed with the recruitment of radiographers as originally planned.

It is important to acknowledge the excellent results of BreastCheck to date. In 2008, BreastCheck screened more than 90,000 women around the country. From the commencement of screening in 2000 until 31 March 2009, BreastCheck provided almost 500,000 screening appointments for more than 236,000 women and 3,075 cancers were detected. The continued roll-out of BreastCheck is a priority and Department of Health and Children officials have been working closely with the screening service on the matter. I am pleased that the roll-out of BreastCheck can now proceed on schedule in counties Donegal, Clare and Leitrim.

Senator Brian Ó Domhnaill

I will be brief as I have no question. I thank the Minister of State and I am delighted with his response. Senator Doherty and I raised this matter as a united front and we have received an answer. The people in County Donegal will be happy with a definitive date of September for the rolling out of the service. I thank the Minister of State for addressing the House on this issue.

Senator Pearse Doherty

I also thank and commend the Minister of State and his Department on this answer, which will be greeted with joy in Donegal, given the real concern. I am delighted with the response because we did not know the date, albeit an indicative one, for the roll-out to Donegal. That BreastCheck will reach Donegal in September, Leitrim in October and Clare in June is to be welcomed. I am glad that work is progressing.

The Seanad adjourned at 9.15 p.m. until 10.30 a.m. on Thursday, 30 April 2009.