Written Answers. - Cancer Screening Services.

Frances Fitzgerald


144 Ms Fitzgerald asked the Minister for Health and Children the progress made in developing screening for breast cancer; and if he will make a statement on the matter. [1628/99]

Jan O'Sullivan


549 Ms O'Sullivan asked the Minister for Health and Children the progress, if any, made with regard to establishing a screening programme for cervical and breast cancer in the relevant pilot health board areas; and if he will make a statement on the matter. [1455/99]

Frances Fitzgerald


567 Ms Fitzgerald asked the Minister for Health and Children the progress made in developing screening for breast cancer; and if he will make a statement on the matter. [1598/99]

I propose to take Questions Nos. 144, 549 and 567 together.

In March 1997, the then Minister announced the introduction of a major action plan to implement the proposals contained in the national cancer strategy. Included in the plan were proposals for the introduction on a phased basis of national breast and cervical cancer screening programmes.

In relation to breast screening, phase I will cover the Eastern, North-Eastern and Midland Health Board areas and will target 120,000 women in the age cohort 50 to 64, which represents approximately 50 per cent of the national target population.
Following the launch of the cancer action plan, a national steering committee, chaired by Dr. Sheelah Ryan, C.E.O., Western Health Board, was established to guide the implementation of the national programme of screening for breast cancer. Since its establishment, there have been a number of key developments. These include:
(i)The passage of the Health (Provision of Information) Act, 1997 which faciltated the development of a population register. A population register for the programme has now been compiled. It is currently being validated and fine-tuned and will be operational by the time screening commences.
(ii)A decision by the breast screening steering committee on a model of delivery for phase I of the programme in November 1997. It has been agreed that there will be two central units based at the Mater and St. Vincent's, where the screening, assessment and treatment of women will be carried out using a multi-disciplinary team approach involving the relevant clinical disciplines, including the screening radiologist. In addition, there will be two mobile units to bring the screening services to the women in the more remote/rural areas within the three health boards in phase I. Each mobile unit will be linked with one of the central units. This should ensure uniformity of standards and continuity of care.
(iii)The appointment of Dr. Jane Buttimer as project director for the programme in May 1998.
(iv)The establishment of the programme as a legal entity (as a joint board under section 11 of the Health Act, 1970) in September 1998 to facilitate the appointment of consultant and support staff as well as for budgetary control and financial accountability reasons.
(v)Preparation of quality assurance guidelines by the national QA committee, which is a sub-committee of the national steering committee. The final report has been completed and is being validated by external review.
(vi)Advertisements for dedicated consultant and support staff for the programme were placed in the national press in late 1998. The recruitment process for the consultants is now under way and interviews should be completed by the end of January 1999.
A key determinant regarding the start up date for the national breast screening programme will be the recruitment of the relevant consultant and support staff. I understand from the project director that once the relevant staff are ready to take up their apppointments we should be in a position to start the programme. It is hoped to start the breast screening programme in autumn 1999.
My Department is committed to making the necessary resources available to the breast screening programme to facilitate the commencement of screening and between 1997 and 1998 a total of £2 million was allocated on a once off basis to cover the start up costs and priority capital equipment.
In addition, funding of £1,932,750 was approved in August 1998 for capital works at the two static sites (Mater Hospital: £1,035,000 and St. Vincent's Hospital: £897,750). In 1999, revenue funding of £3,940,000 is being allocated for the programme.
Decisions in relation to subsequent phases of the programme will be guided by the experience gained from putting Phase I of the programme in place.
With regard to the establishment of the national cervical screening programme, the report of the Department of Health cervical screening committee was launched as part of the national cancer strategy in March, 1997. The report recommended the introduction of a national organised screening programme for women in the 25-60 age group at minimum intervals of five years.
The programme is being piloted in the Mid-Western Health Board to identify and resolve any difficulties which might arise. The aim of the pilot project is to develop a cervical screening programme which runs successfully in the mid-west and can then be implemented throughout the rest of the country. It is expected that following two years experience of the pilot the introduction of the national cervical screening programme will commence.
An expert advisory committee has been appointed, which will,inter alia, oversee the piloting of the programme. Staff have been recruited by the health board for the development, management and evaluation of the project. It is envisaged that screening will commence towards the end of 1999.
This timescale will however depend on a number of factors including the completion of a population register, the development of IT systems, the recruitment of consultant histopathologists to the laboratories involved in the pilot and agreement being reached with the IMO on the participation of general practitioners in the pilot.

Paul Connaughton


147 Mr. Connaughton asked the Minister for Health and Children the number of children within the Eastern Health Board area taken into care during 1998 and placed in hospital wards as social admissions; the length of time each child spent in a hospital ward; the hospitals in which each child was placed; the number of hospital bed days lost as a consequence of these placements; and the action, if any, he will take to ensure that proper care facilities are available to children taken into care and hospitals are not utilised for such social admissions. [1931/99]

Information on social admissions as supplied by the hospitals in relation to 1998 is set out as follows:



Number of bed days lost

Our Lady's Hospital, Crumlin



Childrens Hospital, Temple Street



National Maternity Hospital, Holles Street



Rotunda Hospital



National Children's Hospital, Harcourt Street and Tallaght



n/a not available

Because of the level of detail involved, the information on the length of time spent by each child in hospital will be forwarded by letter to the Deputy.

To avoid the inappropriate social admission of children to hospital the Eastern Health Board has very recently opened a ten bed short-term-emergency residential centre to care for children in crisis situations. The centre has a reserved number of beds which can be accessed during out of hours emergencies. The Garda has direct access to the new service which is reported to be operating well. In addition a number of foster families are available to provide emergency care. I will continue to monitor the situation during 1999.