Tony Gregory
Ceist:321 Mr. Gregory asked the Minister for Health and Children if he will review the position where women who have medical cards are not entitled to free smear tests and other cancer check-ups. [9605/99]
Written Answers. - Cancer Screening Services.
The general medical services scheme provides a wide-ranging treatment and curative service for medical card holders. Accordingly, screening services per se, including cervical smear testing, are not currently provided by GPs under the scheme for medical card holders. However, it is important to emphasise that cervical smear testing and all such other measures, as are found to be necessary, in the context of an individual patient's medical examination and clinical needs are available under the GMS scheme.
The report of the Department of Health cervical screening committee recommended the setting up of a national cervical screening programme for women in the 25 – 60 age group at five year intervals. In line with that recommendation, the programme is being piloted in the Mid- Western Health Board area to identify and resolve any difficulties which may arise. Work is currently in progress and it is hoped to call women for screening early next year. Cervical screening will be provided free of charge to women involved in the pilot scheme and to all women on the introduction of the national screening programme.
Tony Gregory
Ceist:322 Mr. Gregory asked the Minister for Health and Children if he will consider the provision of a mobile screening service for disadvantaged areas, for example, large urban estates with no local health centre, such as, Cherry Orchard, Dublin 10. [9606/99]
The Eastern Health Board is concerned about the stigmatisation caused by delivering a mobile health service in disadvantaged areas. The board has health centres in most areas and is committed to the provision of modern and appropriate health centres throughout its area of responsibility. A new health centre was opened in Cherry Orchard last year so that Cherry Orchard/Gallanstown area is adequately catered for.
The board has concerns about opportunistic screening as against programmes of targeted screening, such as breast screening. My Department is funding a national breast screening campaign which will target at risk age groups. This campaign will be conducted on a mobile basis and cognisance will have to be taken of such matters as suitable and adequate parking, a three phase electricity supply and security.
The Eastern Health Board does provide a mobile health service to the travelling community. The board had intended to make a second mobile unit available but following discussions with the traveller association it became clear that this was not the preferred way forward. The association has requested strong education programmes to encourage travellers to attend local health centres. In this context the board is committed to promoting a traveller friendly culture in its health centres.
The Eastern Health Board's focus is on health promotion to increase clients' knowledge of personal health and social gain. This focus is particularly pertinent to disadvantaged areas. The board targets disadvantaged areas and provides additional staff as appropriate. The board provides cervical screening in such areas through the public health nursing service.
Tony Gregory
Ceist:323 Mr. Gregory asked the Minister for Health and Children if he will consider the public advertising of available screening services. [9607/99]
When a new screening service is being launched one of the considerations is the best way to inform the target population.
A major success factor for the national breast cancer screening programme is the achievement of a high compliance rate in the target population. I am conscious that every effort needs to be made to encourage women to participate in the programme.
The national breast screening programme is developing its promotional and advertising strategy with the assistance of the communication officers of the three health board areas to be included in phase I of the programme, i.e. Eastern, Midland and Northern Eastern Health Board areas.
The promotion of the programme requires that the publicity and education should be directed at:
–the women in the target age group;
–the public as a whole;
–health professionals, women's groups and voluntary organisations which might have an opportunity to inform and influence women.
It is proposed to target these groups using the following mechanisms. Communication with the national and local media by way of the issue of general press statements on the progress, on the implementation of the service, as well as pro vision of interviews and articles on different aspects of breast disorders. Direct communication with women in the target age group. In this context, the issue of the consent and invitation letters is a key promotional opportunity. It is also intended to use every opportunity to distribute relevant information about the programme to the target group so that women can make informed decisions about participation in the programme. Regarding communication with the primary care team, it is acknowledged that the primary care team has a major contribution to make to the promotion of the programme and in this regard, it is planned to provide an information pack to the GPs well in advance of the programme. It is also proposed to notify practices in each target area about the programme in order to improve compliance among the target population and the assistance of the ICGP is being sought on how best to communicate with all practices. Regarding communication with women's groups and voluntary bodies, every effort will be made to work in partnership with women's groups and the voluntary organisations and employers. Regarding communication through other bodies and professionals, it is proposed to work closely with bodies such as my Department's health promotion unit, the national cancer forum and regional directors of cancer, the Irish Cancer Society, the voluntary agencies and health boards in promoting the programmes.
The launch of the programmes identity "BreastCheck" on 29 March 1999 was the first step in the implementation of the promotional strategy. It received extensive coverage in the national media and in medical publications. In addition, I circulated the first report of the national breast screening committee with the chairperson's comprehensive statement to all TDs and Senators. I also understand that there has been extensive circulation of the report to professional and voluntary bodies and women's groups. It is the intention of the national breast screening programme to build a strong relationship with all those using the service and to continually draw on new ideas to improve the service.
Arrangements are currently being made for the piloting of a cervical screening programme in the Mid-Western Health Board area. Education, promotion and advertising will be undertaken and directed to women in the target age group, health professionals etc.
Screening services such as developmental check or school health services are organised by the health boards and notified to parents by health board staff or through schools.