Commencement Matters

Human Rights Investigations

I welcome the Minister of State, Deputy McEntee.

I would like to share my time with my colleague, Senator Norris.

Is that agreed? Agreed.

There are only the two of us here.

The Senators are hardly going to disagree with each other at this stage.

We agree with each other.

Senator Murnane O'Connor will remain silent.

I will keep my remarks brief. I want to highlight a massacre that occurred in Iran in 1988, when tens of thousands of people were summarily and extrajudicially executed because of their political or religious beliefs. Approximately 30,000 people, including women and children, were murdered under the fatwa or leadership of the supreme leader of the time.

The vast majority of the victims were members and supporters of the main Iranian opposition party, the People's Mujahedin of Iran, PMOI, and their family members. Death commissions in more than 70 towns and cities approved all the death sentences.

On 9 August of this year an audio tape was published for the first time, made by Khomeini’s former deputy supreme leader, confirming that the massacres took place and had been ordered at the highest level within the political and religious regime of the country.

What happened in 1988 was catastrophic. That summer, when the European championships in soccer were taking place, people were being herded into towns to be murdered and buried in mass graves. The people responsible for those atrocities remain to this very day at the highest level of political and administrative office in Iran.

Amnesty International has continually raised this issue but there is a requirement for international recognition within every state, including Ireland, to condemn the brutal massacre in 1988 as a crime against humanity. The Government should call on the High Commissioner of Human Rights, the United Nations Human Rights Council and the Security Council to order an investigation into the massacre that took place at the time.

There was a period of mass executions in 1988 following the Iran-Iraq war when things were tense. It is really chilling to read the language with over 70 death commissions established. Moreover, some of the people principally involved in this are still involved at senior government level, including Mostafa Pourmohammadi who is the current-----

As the Senator well knows we cannot have the names. We cannot be accusing people of anything.

-----Minister for Justice in Hassan Rouhani’s cabinet. Mr. Rafsanjani was also involved. I raised these kind of issues two decades ago with Rafsanjani when I met him in Tehran and he was not very amenable. A total of 30,000 people were killed. Amnesty International has issued a report. It has been condemned by resolution of the Canadian House of Commons. There is a signed statement from the Members of the Commons and the Lords. Congress in America has passed a resolution. This needs to be recognised as an international war crime. It has been reinforced by the emergence of a tape made by Ayatollah Hussein Ali Montazeri who was the No. 2, a successor to Khomeini. With great courage he protested at the time and as a result he was sidelined and subjected to house imprisonment. If someone as authoritative as the No. 2 in the regime is objecting, we know there is clearly something there. There is evidence of mass graves. Children as young as 13 were routinely hung from cranes, six at a time, in Evin Prison. It is a catastrophically shocking situation and a reproach to all decent people.

I have put down, with Senator Ó Domhnaill, a resolution which is No. 12 on the Order Paper, instancing the Amnesty International report, talking about the audio file and requesting the Government to recognise and condemn this massacre as a crime against humanity and to ask the United Nations Human Rights Commissioner, the Human Rights Council, the General Assembly and the Security Council to order an investigation and to bring the perpetrators to justice. As people in this country who have consistently upheld human rights in the international arena, it is very important that we condemn this and describe it appropriately as it is, a crime against humanity. A total of 30,000 people and I emphasise, six at a time, 13-year-old children hung from cranes. One thing that really struck me was a photograph of two beautiful, handsome 18-year-old men condemned for being gay and hung on that basis from cranes in Tehran. It is a most disgusting regime.

I am sure both Senators would prefer if the Minister was here, but I am addressing this matter on his behalf. I will try to do it justice.

As we all know, the decade following the Iranian revolution in 1979 was a turbulent and violent period, characterised by both external threats and the severe and intolerant stance of the new Iranian leadership. Throughout this period, many members of the former regime or opponents of the new one were summarily executed. A number of external perceived threats may help explain, but do not excuse, some of these events. These included above all the invasion of Iran by Iraq in 1980 and the long and bloody war that lasted until 1988.

These executions of opponents culminated in the killing of large numbers of prisoners in a period of months beginning in July 1988. Estimates of the numbers killed start at a figure of 4,500 disappeared prisoners, named by Amnesty International, to as high as 30,000, claimed by the People’s Mujahedin of Iran, PMOI. Whatever the true figure, which is unfortunately likely to be in the upper part of this range, both the numbers and the summary nature of the proceedings justify the term "massacre".

The majority of those killed were members of, or associated with, the PMOI, although other opposition groups were also included. During the 1980s, the PMOI conducted a campaign of bombings and assassinations against the Iranian Government, which killed many senior regime figures. It supported the Iraqi regime of Saddam Hussein in its war against Iran and, in July 1988, it launched a military invasion of Iran from its base in Iraq. It is likely that this invasion was the trigger for the massacre, although there were also some signs that it may have been planned already.

The victims were persons already being held, in most cases convicted or accused of being supporters of the PMOI or other movements, rather than any violent acts. They were executed on the basis of vaguely-defined continuing sympathy with the opposition and there is a clear sense of the regime taking the opportunity of a general threat to rid itself of all of its opponents within reach. There are many parallels with similar reprehensible events in European history. This episode was known at the time, although many details only emerged later and much is yet unknown. It was brutal and unjustified and the Government, of course, wholly condemns it.

The additional information circulating recently on these events, which many Members of the Oireachtas will have received, has been disseminated by the PMOI itself, or its political wing, the National Council of Resistance of Iran, NCRI. Unfortunately, the Government has no means of authenticating the reported audio tape from the period which has now emerged, but it does not alter or conflict with what was already known. In dealing with Iran today, 28 years later, Ireland and our EU partners do not hesitate to express our strong concerns about human rights issues in Iran, including the jailing of opponents and the use of the death penalty.

The additional information circulating recently on these events, which many members of the Oireachtas will have received, has been disseminated by the PMOI themselves or their political wing the National Council of Resistance of Iran, the NCRI. Unfortunately, the Government has no means of authenticating the reported audio tape from the period which has now emerged, but it does not alter or conflict with what was already known. In dealing with Iran today, 28 years later, Ireland and our EU partners do not hesitate to express our strong concerns about human rights issues in Iran, including the jailing of opponents and the use of the death penalty.

These remain serious problems, but are far removed from the ghastly events of 1988. We must recognise progress where it has been made. In that respect, it is also considered by most western states that there has been some relaxation of internal controls in Iran in recent years and that the current Iranian Government and leadership are the most hopeful for many years, even though it is our view that they have still to really deliver on their welcome expressions of intent on human rights. In doing so, we seek to persuade and pressure Iran into continuing to move in the right direction. This approach of dialogue and persuasion is the essence of our approach to foreign policy, however frustrating it sometimes can be. The PMOI and the NCRI seek instead to assert that the Iranian regime should be confronted and overthrown, not reasoned with. This is an approach we cannot follow.

Ireland strongly supports the principle of accountability for violations of human rights. We would have no objection in principle to any appropriate international mechanism considering historical events regarding allegations of systematic violation of human rights in any country, including Iran. Our own focus as a Government and our limited resources, however, must be concentrated on seeking to improve human rights in Iran today. This month, for instance, we have co-sponsored a resolution on human rights in Iran at the General Assembly of the United Nations. We will continue to do all we can in this regard.

I thank the Minister of State for the response from the Department. At least there is an acknowledgement that these atrocities happened. However, I would like to see the Department of Foreign Affairs and Trade, and the Irish Government take a stronger stand against what happened back in 1988 and acknowledge that these atrocities continue to take place today, as Senator Norris has indicated. Hundreds of people have been hanged this year alone. Many young people in their teenage years are rotting in Iranian jails, waiting until they turn 18 so they can be executed. Any democracy, such as those in the EU or the USA, that deals with the Iranian regime at present for economic and political reasons should not continue to do so without taking human rights violations into account. That is what is required. I very much welcome the co-sponsoring of the motion at the UN, but more is required.

I know this is not a matter for the Department of the Minister of State, Deputy McEntee, but I appeal to her to bring it to the attention of the Minister, Deputy Flanagan. He will have the support of Members of this House. This is an atrocity and a crime against humanity. Pregnant women and young children are being executed as we speak and what happened 30 years ago will not wash that away. I am sure Senator Norris will have more to say as well.

I will be very brief.

I am granting poetic licence here-----

I appreciate the Leas-Chathaoirleach's poetic nature.

-----but I know Senator Norris will be brief as opposed to the six sentences he spoke earlier.

I understand the Minister of State is not responsible but she might take this back to the Minister. She said that the Government has no means of authenticating the audiotape. Montazeri's family released the tape. I would have thought that is fairly good authentication. The Minister of State said that we will express our strong concerns. I am sure the Iranian Government will faint at the prospect of our strong concerns being expressed. The Minister said that the Government has no objection, in principle, to any appropriate international mechanism considering these matters. That is pretty weak, particularly when there are still people involved in the death commissions within the current Iranian Government. That is the reason it is crucial that we act strongly and not in this watery fashion.

I will finish where I started. The execution of a large number of prisoners in Iran in 1988 was a shocking event, including the number of people killed, the apparent deliberate nature and planning of the action and a process which was a front for the unchecked abuse of state power over individuals already in custody. Notwithstanding the atmosphere of domestic terrorism and external invasion, these killings were completely unjustified and must be condemned. That remains the case 28 years later. It is doubtful if any process will bring justice for the victims. One cannot but feel sympathy - for my part, I feel more than sympathy - for those families who continue to hope that will be the case. There may be many others who must be kept silent. What we can do is continue to press for improved respect for and protection of human rights in Iran. We have consistently done so in our direct contacts with the Iranian Government, in contributions to European Union policy on Iran and at international fora such as the UN General Assembly and the UN Human Rights Council. We will continue to do that. I assure both Senators that I will bring this matter to the attention of the Minister, Deputy Flanagan, and the comments about the tape also.

I thank the Minister of State.

Respite Care Services Provision

This is my second time to address this issue in the Seanad. I thank the Minister of State for coming before the House to take it.

In 2005, Tír na nÓg opened to meet the demand for respite services in Carlow and the surrounding areas. At that time, ten children were availing of the service. Eleven years later, 42 children were using the weekend respite service - with a waiting list of over 30 children - at a premises in a private housing estate in Carlow that was funded by the Health Service Executive, HSE. In December 2015, that facility was closed. In March 2016, in order to fulfil the desperate need for a respite centre, an alternative day respite service providing respite three weekends a month was set up. Children are collected from school on Friday and brought to the Delta Centre from 3 p.m. to 8 p.m. and from 10 a.m. to 6 p.m. on Saturday and Sunday. We have no emergency or overnight respite service in Carlow or Kilkenny. That is not acceptable.

A local businessman donated a site to Tír na nÓg and a committee was set up to fund-raise in order to help with the construction of a new respite centre, which was expected to cost €350,000. When the committee meets the HSE, it cannot get a commitment on the timescale. Tír na nÓg closed in the middle of December last year. There is talk of a building either in Carlow or Bagenalstown but the HSE would not commit to anything at the committee meeting last week. That is not fair. The system is still closed and we cannot get any information. As a Senator I am aware that there is no follow-up service. I telephone the HSE and the Minister's Department but I cannot get any information.

Will a respite service open shortly in Carlow, given that a commitment was given? Last August, the Minister for Health, Deputy Simon Harris, was in Holy Angels where he met a committee from Tír na nÓg, including me. We were told we would know in September where the respite service for Carlow would be. There is confusion over whether it will be in Carlow or Bagnelstown. Is it confirmed and can the Minister of State give me further information?

I thank the Senator for raising the issue again. She is very passionate about it and she is working on it. I will read the response and we can discuss it afterwards.

Holy Angels Day Care Centre is a disability agency providing services, including a preschool service for children with disabilities, in Carlow. The facility is funded on an annual basis by the HSE under section 39 of the Health Act. It received funding of approximately €720,000 in 2015. Respite services for the parents of children in Carlow were previously provided by Tír na nÓg in Carlow. Since 2013, the services delivered by Holy Angels and Tír na nÓg came under the remit of the independent regulatory body, HIQA, regarding the standards of care being delivered. In December 2015, the Holy Angels Day Care Centre advised HIQA and the HSE of the decision of the board of management to close the centre from January 2016 after they had received notice from the landlord. On 16 December 2015, the HSE disability services manager wrote to the Holy Angels Day Care Centre requesting it to develop a plan regarding an alternative approach to respite service provision to be completed in consultation with families, notifying them of the discontinuation of the existing respite service. The families were also informed that they would be invited to meetings in January 2016 regarding respite services.

Tír na nÓg provided respite breaks to 42 children and their families with each client being offered a one to two night respite break every three months with the service open six nights per month. The children range from 18 months to 18 years and have a range of mild to severe disabilities. There are additional children on the waiting list. To address current respite provision requirements, as the Senator rightly said, in March 2016 an alternative respite provision was set up in partnership with the HSE and Holy Angels. This is currently being provided via Holy Angels in the Delta Centre as an interim arrangement. The service is to be reviewed in December 2016 and is committed to until February 2017. HSE estates are seeking to purchase or rent suitable accommodation for future service provision. Should the HSE find a suitable residence for respite in either County Carlow or County Kilkenny, services will be provided to families from both Carlow and Kilkenny from that location until purpose built accommodation is completed.

The long-term intention of the HSE is to develop a new purpose built respite service for County Carlow, but this must be considered in the context of overall priority requirements for capital spending within disability services. The €20 million capital funding available in 2016 has been prioritised for a number of large congregated residential centres which will not meet HIQA residential standards. The matter of providing overnight respite services to families of Carlow and Kilkenny is of key importance to the HSE. On 28 September 2016, the head of service social care, Carlow-Kilkenny, and other key personnel met with representatives from an external voluntary agency to consider a proposal to use its premises. Further meetings have since taken place with Carlow parents. A venue for respite service delivery has been agreed and is being finalised on a two-year lease. The respite tender document is currently being reviewed by the health business services, HBS, procurement department. A meeting was scheduled for 11 November 2016 with HBS procurement and disability services management to finalise the document. The tender process will be advertised in due course.

While I cannot give the Senator exact dates, I will bring it back to the relevant Minister and ask him to update her when the dates are made available.

I thank the Minister of State. There is still confusion. Holy Angels is a great school in Carlow which is awaiting its new school build, which was committed to five years ago. I will follow it up in a future Commencement matter. I am very disappointed. A venue for respite service delivery has been agreed, but where is it? Can I return to the committee and tell the members where exactly it has been agreed to provide it and the timescale? Can the Minister of State give this to me? That is the question I am asking.

Unfortunately, the Minister of State, Deputy Finian McGrath, cannot be here today and I have not received the answers and I will not say otherwise. I apologise on his behalf.

What I will do is bring the Senator's comments to the Minister's attention. A venue has been agreed. The question is whether that information is in the public domain. I will bring the where, when and how to the Minister's attention and ask him to respond to the Senator directly.

Hospital Staff Recruitment

I thank the Minister of State for her presence and I ask her to refer all that is relayed and discussed in this Commencement matter to the Minister, Deputy Harris, for response. Sarcoma Ireland first met the Minister, Deputy Harris, in the first week of July. A commitment was given at that meeting to the group that a specialist sarcoma consultant would be recruited to St. Vincent's University Hospital to look after the serious illnesses faced by those who suffer from sarcomas. In the intervening period there has been much toing and froing between the Minister's office, St. Vincent's University Hospital and the national cancer control programme. In essence, a commitment was given but it looks as if it has not been followed through. I acknowledge and welcome members of Sarcoma Ireland, who came here at last-minute notice, to the Public Gallery. I hope they will have more success through this Commencement matter in getting answers from the Department and the Minister, who has ceased communicating with them despite their numerous attempts to do so. They have not even received acknowledgements.

The following questions have been put to the Minister in writing. I now put them to the Minister of State for a response and ask her to bring them again to the Minister's attention. Why does the job description contain no mention of experience in treating sarcoma patients or a requirement to be engaged actively in research in this area? Why has a separate medical area of neuroendocrine tumours been mentioned in the job description? This is not related to sarcoma. Who is on the interview panels? There is no need to name names. The roles will suffice. Do they include an independent international expert on sarcoma who can access candidates competently? Why has the position not been advertised publicly? The position has appeared only on St. Vincent's internal human resources system and not publicly on websites frequently used by St. Vincent's as well as the HSE and other hospitals. Lastly, will St. Vincent's provide an assurance that 80% of the workload of the sarcoma specialist will be dedicated to sarcoma patients?

In essence, there was an agreement on 6 July for a new oncology post with expertise in sarcoma. The advertisement is completely watered down and does not give confidence that the post is that sought and agreed by these patients and the Minister. Sarcoma patients are extremely ill people. They ask simply that they be provided with the most experienced sarcoma specialist available. They do not believe that the current position advertised will meet their needs. The recruitment process is fundamentally flawed. We implore St. Vincent's hospital to re-advertise the role together with more specific candidate requirements, that is, a stronger emphasis on sarcoma and experience and interest in the research on it and a requirement that 80% of the oncologist's time will be spent treating sarcoma patients.

Again, I thank the members of Sarcoma Ireland who have fought for months to get the services they deserve. They cannot wait for more indecision on this matter. The closing date for applications for the post is this Friday, and even at that it could be at least four months before the consultant is in situ. Will the Minister of State, Deputy McEntee, confirm this? We got the promise months ago, and now it looks as if it could be at least four months before someone is in situ given the prolonged interview and employment process. Lastly, will the Minister of State provide to me in writing the timescale involved in the interviewing, recruiting and posting as a consultant for this role and written confirmation of how this will be implemented? I would very much appreciate that.

I thank the Senator for raising this issue and I welcome members of the organisation in question to the Gallery. I respond on behalf of the Minister, Deputy Harris. The Senator has raised a number of questions which I will not be able to answer, but I have taken note of them. I will bring them directly to the Minister's attention and ask him to respond to her. I thank Senator Devine for giving me the opportunity to update the House on the matter.

As the Senator and many people know, sarcomas are rare cancers, with about 220 cases occurring annually in Ireland. Services for patients with sarcoma are currently provided in St. Vincent's University Hospital, Dublin and Cork University Hospital. Both hospitals are designated cancer centres and have an extensive range of multidisciplinary services and expert clinical advice available to them.

A national clinical lead in soft tissue sarcomas is in place to oversee services for patients. Patients have their cases presented and discussed at one of the two sarcoma multidisciplinary teams, and members of these teams have links with European specialists in sarcoma.

The treatment of sarcoma requires integrated multidisciplinary care, with the involvement of many different clinicians. St. Vincent's University Hospital has provided highly specialised and individualised treatment to sarcoma sufferers for a number of years. St. Vincent's has access to all the relevant specialties for treatment, including surgery, medical oncology, radiation oncology, radiology and pathology, and it is the largest provider of surgical procedures for soft tissue sarcomas in the country. The Health Service Executive, HSE, and the Department of Health are very much committed to providing a high-quality, responsive and sustainable service for sarcoma patients.

To support the existing range of services for patients with sarcoma, an additional permanent post of consultant medical oncologist with a specialist interest in sarcoma has been approved for St. Vincent's. The recruitment for this post, as the Senator noted, is under way. It has been advertised both online and in other media and I will ask for clarification as to whether it goes further than what has been outlined. The closing date for applications is 27 November. The job description for the position makes it clear that the post will provide a specialist service for sarcoma patients, and this will be a focus during the recruitment process.

The Department is currently working on a new national cancer strategy for the next decade. Services for rare cancers such as sarcoma have received considerable attention in the development of the strategy, which will aim to meet the needs of patients in the treatment of cancer and improving their quality of life. Other areas of focus will include prevention, the early diagnosis of cancer and the facilitation of patient input. The Minister intends to publish the new strategy in the coming months.

On behalf of the Minister, Deputy Harris, I assure the Senator that the recruitment process is ongoing and will be concluded shortly. In the meantime, high-quality services will continue to be delivered by the multidisciplinary sarcoma teams, including the team at St. Vincent's University Hospital. I cannot answer the questions on the interview panels, the independent experts and the timeframe of four months currently but I will refer them to the Minister and ask him to revert to the Senator directly.

Many of the questions I asked have not been answered, which is disappointing. For the past year or so, or perhaps a bit longer, the patients were very competently served by a previous oncologist with a specialism in sarcoma. All they are looking for is somebody with expertise, interest, knowledge and research relating to sarcoma. There was something rotten, perhaps, in the state of the health service and being "off-sited" to St. Luke's, which is not, from the Minister of State's response, a centre of excellence for sarcoma. This only allows a consultant to take blood and give results but previously there was a good record in St. Vincent's hospital of hands-on, modern and effective treatment. It is a real concern and perhaps this is related to the politics of St. Vincent's hospital. Sin scéal eile for another day.

I must impress on the Minister of State the need to get an immediate answer to those questions. This will shut down on Friday. We do not know the timeline but people will be invited for interview and the interviewing panel, I hope, will consist of an expert. We need to know how long the process will take. If somebody is chosen and takes the post, there may be a delay in moving from one job to another. Four months would be a long time, although it seems realistic. Again, patients would be left in limbo and left between two stools. I would appreciate an immediate response from the Minister, Deputy Harris.

I again stress that I will bring this to the Minister's attention. People were previously looked after by somebody with expertise and that is the least that anybody should or will expect in future. I will bring the issues to the Minister and ask for a direct response.

Vaccination Programme

I welcome the Minister of State to the House and thank her for dealing with this matter on the Commencement. Like the previous matter, it concerns the treatment of cancer. I ask the Minister for Health, in light of the concerns expressed by the Irish Cancer Society and others, about falling rates of take-up of the human papilloma virus, HPV, by parents of teenage girls. This is the vaccine that protects against cervical cancer.

In light of these concerns and the decreasing take-up rates, from a rate of 87% in 2014 to a projected rate of below 50% this year, how does the Minister propose to increase take-up rates to help prevent the incidence of cervical cancer in the future? Does the Minister propose to launch a public awareness campaign to inform parents of the proven safety and efficacy of the vaccination programme? What plans does he have to extend the roll-out of the HPV vaccination programme to boys?

In recent days I met representatives of the Irish Cancer Society, who have also been engaged in briefing Members of the Oireachtas generally. They are deeply concerned about reports that appear to be putting people off vaccinating their children. The HPV vaccine is now being administered in Ireland to all first-year girls in secondary school. It has been offered for free to first-year girls since 2010 under the national HPV vaccination programme. Gardasil 4 is used in the programme and this protects against strains of HPV which cause seven out of ten cases of cervical cancer. It also protects against strains which cause the majority of genital warts. It is a very important health programme.

Concerns have been raised that there is a link between this vaccine and fatigue in teenage girls, particularly chronic fatigue syndrome. Clearly, any girl who suffers from such a condition should be offered clinical care pathways and treatment but that is a separate issue. We now have clear scientific evidence which refutes or denies any link between the vaccination programme and the incidence of chronic fatigue. Indeed, in December last year the World Health Organization global advisory committee for vaccine safety reviewed the evidence on the safety of Gardasil and concluded that it continues to have an excellent safety profile. In the month before that, November 2015, the European Medicines Agency similarly reported on a review of HPV vaccines and found no evidence the vaccine was linked to chronic fatigue conditions. Despite this strong scientific evidence and the clear need for this vaccination, the rates are falling even though we know that this year in Ireland, more than 90 women will die from cervical cancer. Many of us have friends or family who have been affected by this. A total of 280 women will be diagnosed with invasive cancer and a further 6,500 will need hospital treatment to deal with pre-malignant forms of the disease to prevent later development of cervical cancer. These are the conservative estimates put forward by the Irish Cancer Society. They should be a matter of huge concern.

The society says that if vaccination rates continue to fall, 40 unvaccinated girls from the cohort that should have received the vaccine this year will die in future years if one projects the estimates into the future. It is seriously worrying. We see scare campaigns being carried out in other countries, with the result that vaccination rates have fallen. In Japan the vaccination rate is below 1%. It is clear that further falls will happen in Ireland unless there is a strong, concerted, cross-party campaign by public representatives, the Government and the HSE to ensure information is provided to the public and the scientific evidence is presented to parents, so they will see the need for the vaccination programme.

To conclude with a positive story, Australia has conducted a robust information programme and it has high levels of vaccination. It has effectively achieved the elimination of genital warts, one of the conditions which the vaccine prevents. A vaccination programme for boys in Australia is also ongoing. We can learn lessons from countries where there is good practice. However, we need a strong intervention by the Minister and public representatives before the next vaccinations take place in schools to ensure that take-up rates do not continue to fall.

I am replying on behalf of the Minister, Deputy Harris, who cannot be here today. I agree with the Senator's concern that the figures have dropped, with an uptake of 87% decreasing to below 50% this year. I thank her for the opportunity to update the House on this important matter.

First, I note the concerns of families who believe their daughters have experienced adverse reactions and health issues after receiving the HPV vaccine. I know girls in my constituency who have experienced a very difficult time in the last number of years. No parent should have to see their child suffer. I assure these girls and their families that they are eligible to seek medical treatment for their symptoms. As the Senator mentioned, they should be provided with a clear pathway for any treatment they require. It appears that some girls first suffered symptoms around the time that they received the HPV vaccine, but this does not mean that the vaccine caused the symptoms. Negative publicity and misinformation are certainly affecting the uptake of the vaccine. We must ensure that people understand that the vaccine is safe and can save lives.

I will first present the facts.

This vaccine protects against two high-risk types of the virus that cause 73% of all cervical cancers. It is estimated that HPV vaccination will eventually save 60 lives a year in this country. HPV vaccine safety has been monitored for more than ten years by many international bodies, including the European Medicines Agency and the World Health Organization. It has been found to be a safe and effective vaccination.

The HSE has been working with other stakeholders since early this year to counteract negative publicity and misinformation about the vaccine. The Irish Cancer Society has held two public meetings in Galway and Cork, two areas where uptake rates of the vaccine had reduced significantly. These meetings have included talks by a renowned international HPV cancer expert, Professor Margaret Stanley, as well as cervical cancer survivors and hospital consultants. The parents of first-year secondary school girls have been given revised information leaflets, consent forms and contact phone numbers for their local immunisation offices. Any queries they have concerning the vaccination can be addressed by the school immunisation team prior to vaccination day. In addition, girls who may have declined the first dose of vaccine will get an opportunity to receive this when the school immunisation team revisits the school. Information about the vaccine and its benefits has been circulated to all school principals, management bodies, the National Parents Council and general practitioners. Officials from the HSE have met representatives of the Department of Education and school management bodies.

Prior to the start of the 2016-17 school immunisation programme, there was a co-ordinated local and national media campaign involving the Irish Cancer Society, the HSE communications unit and the national cancer screening programme. This campaign stressed the importance and safety of the HPV vaccination. It is intended that the promotion of the HPV vaccine as a safe and effective vaccine will continue. The HSE plans to commence focus groups with parents in the near future. I take this opportunity to thank the dedicated people in all organisations who are working hard to improve the uptake of this important vaccine. They know how safe and effective this vaccine is, and I want to join them in encouraging all the parents of eligible girls to ensure their daughters receive this important cancer-preventing vaccine. The Department of Health has asked the HSE and HIQA to carry out a health technology assessment on the proposal to extend the HPV programme to boys. Any new recommendations in this regard will be considered.

I thank the Minister of State for her very full reply. I know that, like the Minister, Deputy Harris, she has been very strongly supportive of the Irish Cancer Society and appreciative of the need to ensure there is increased take-up of the vaccination programme. While I join the Minister of State in expressing sympathy to the girls who have experienced chronic fatigue syndrome, and indeed to the families of those girls, I emphasise that the evidence says there is no link between that syndrome and this vaccination. Previous unfounded scares about vaccination programmes have exposed children to risk of death from measles, for example. This is very worrying.

I thank the Minister of State for setting out the position in respect of the public information and awareness-raising campaign. On 20 November last, an article by Susan Mitchell in The Sunday Business Post outlined some of the issues that have arisen at public meetings in Galway and Cork and pointed out that there is a strong campaign to dissuade parents from taking up the vaccine. I think that is regrettable. It is important for public information campaigns to continue so that there is more public awareness every time a vaccination programme is proposed in schools. I think another stage of vaccination is due to begin in the spring. I hope we will see further raising of public awareness then. I will keep in touch with the Irish Cancer Society and endeavour in my own way to try to ensure this important issue for women's health is kept under review. I thank the Minister of State again for taking the time to reply to me.

I thank the Senator for raising this issue. As public representatives, we have a duty to encourage young women to take up this vaccine. As Senator Bacik said, it is possible that 40 women will die in years to come as a result of not taking the vaccine. There is an onus on those of us whose friends and family members who have been affected by cervical cancer to stress the importance of the vaccine. I outlined in my response a number of the actions that are being taken and have been taken to date. If the Senator would like further details in this regard, I can submit a request to make sure she is updated as the various events take place and as public information is disseminated.

Sitting suspended at 3.20 p.m. and resumed at 3.30 p.m.