I propose to take Questions Nos. 139 and 621 together.
Breast cancer is the most commonly diagnosed cancer in women in Ireland, but outcomes are good and improving. There is a growing body of evidence internationally that long term hospital based clinical follow up of well women with a history of breast cancer is not required and confers no additional benefit to the women.
Under the General Medical Services (GMS) contract, a general practitioner (GP) is expected to provide his/her patients who hold a medical card or GP visit card with all proper and necessary treatment of a kind generally undertaken by a GP free of charge. Under this contract, GPs already accept clinical responsibility for their patients who have been discharged from consultant care back into the community. The National Cancer Control Programme (NCCP) has developed a follow-up care plan for women who have been discharged from out patient clinics following their treatment from breast cancer. This follow-up care plan is evidence-based and follows best international practice. The plan is aimed at patients who have completed their treatment, who are well, have had no recurrence after five years and continue to have a good outcome. It is a plan for well women to enable them to remain healthy and is not an active cancer care plan.
This plan involves women receiving an annual mammogram which will be undertaken and assessed by the expert team in the designated cancer centre. Each woman will also receive a general health check up carried out by their GP and if the GP has any concerns the woman can be referred into the specialist services in the usual manner. Any woman who needs to be treated on an acute basis is cared for appropriately and timely under the management of her consultant team.