Dáil Éireann díospóireacht -
Thursday, 7 Nov 2002

Vol. 556 No. 5

Adjournment Debate. - Cancer Screening Programme.

Ms Hoctor: I thank you, a Leas-Cheann Comhairle, for the opportunity to raise this important matter for the women of north Tipperary and the greater mid-west region. It is my first occasion to speak in the House and I cannot think of a more important or urgent issue to north Tipperary than the provision and speedy implementation of the national breast screening service in view of recent developments in breast screening services in the mid-west region.

I want the Minister for Health and Children to provide an updated, fast, efficient and accessible breast screening service for the mid-west region and north Tipperary. This matter arose recently due to the withdrawal of mammography services at Nenagh General Hospital. A mammogram unit was in place and operational for approximately 13 years. It was provided through the fund-raising efforts of the Friends of Nenagh General Hospital, the north Tipperary ICA and many other support groups. However, the service has been withdrawn and a void has been created. This means that women in Nenagh, Thurles, Roscrea, Templemore, Borrisokane, Lorrha and Riverstown must now access breast screening services at Limerick Regional Hospital.

Surveys have proven that north Tipperary and the mid-west region have a higher rate of cancer than most other places. That is alarming in view of the recent closure of the mammography service in Nenagh General Hospital. It is well known that early detection of breast cancer means more women will lead normal lives.

I understand the national screening programme will have mobile screening units when it is extended to the mid-west region. I anticipate that the breast screening service will be regular and accessible. I call on the Minister to introduce, without delay, the national screening programme to the mid-west region. It is vitally important that women who need the breast screening service can access it locally. The mobile breast screening unit is a welcome concept. Perhaps the Minister could explain how it will operate, how often it will be in the region and how accessible it will be to women. I urge the Minister to treat this matter urgently. A fast, effective and accessible breast screening service should be provided for the women of north Tipperary.

Minister of State at the Department of Health and Children (Mr. Callely)

I congratulate and thank Deputy Hoctor for raising this important issue on her first occasion to speak in the House. I wish her well. I am glad of the opportunity to set out the current position regarding the development of breast cancer services generally and in the Mid-Western Health Board in particular.

The national breast screening programme was established in 1998 with the aim of reducing mortality from breast cancer by 20% by screening women in the age group of 50 to 64 years of age. BreastCheck commenced screening in March 2000, with phase one of the programme covering the Eastern Regional Health Authority, the Midland Health Board and the North-Eastern Health Board areas. The decision to proceed on a phased basis is a reflection of the complexities involved in the screening process and it is essential that the programme is driven by international quality assurance criteria and best practice. The experience gained in phase one will facilitate the process of planning and organising the roll-out of the programme nationwide. To the end of August this year almost 92,000 women had been called for screening and more than 68,000 women had been screened, representing an uptake of 74%.

My commitment, and that of the Department of Health and Children, to BreastCheck is evidenced by significant funding which has been provided for the programme. This year additional funding of €1.5 million was provided to BreastCheck for the continued development of the programme, bringing the total allocation to €8.7million. In addition, I have allocated approximately €6 million for the construction of a new state-of-the-art screening unit at St. Vincent's Hospital. Work is expected to commence shortly on this development.

I am fully committed to the development of quality services to achieve best health outcomes. As regards the development of cancer services generally, this commitment can be seen in the level of funding provided. Since 1997 more than €103 million has been invested in the development of services, which is well in excess of the £25 million initially envisaged in the national cancer strategy. This investment has enabled the funding of 76 additional consultant posts in key areas and it includes approval which has been given for nine new consultant posts with a special interest in breast disease. I have invested considerably in this programme for the provision of services for symptomatic breast disease in recent years and further investment is required.

While much has been achieved in recent years in relation to the development of the health service, there is still much to be done. In recognition of the need to further develop cancer services, the national health strategy has identified the need for the preparation by the end of 2002 of a revised implementation plan for the national cancer strategy. The national cancer strategy, 2003-10, is being prepared by the National Cancer Forum. The new strategy will set out the key areas to be targeted for the development of cancer services over the next seven years. This will have regard to existing policies in the area of symptomatic breast disease and palliative care and the forthcoming recommendations of the expert group on radiotherapy services. The Department of Health and Children is in discussions with the executive of BreastCheck in relation to the expansion of the programme and, especially, the linkages with the existing symptomatic services. I am committed to the national expansion of BreastCheck at the earliest possible date.

As regards breast cancer services generally, the Mid-Western Health Board formally adopted a report on the development of symptomatic breast disease services for the region on 8 December 2000. The board has agreed to develop its symptomatic services at Limerick Regional Hospital. The breast clinic at Limerick Regional Hospital opened in October 1998. Referral to the clinic allows rapid access to a consultant surgeon, mammography and rapid processing of results. A weekly multidisciplinary meeting commenced in June 2001 and is attended by all relevant members of the team. Two breast care nurses have been appointed to Limerick Regional Hospital.

In relation to mammography services available to women in north Tipperary, I have been informed by the Mid-Western Health Board that these patients are now being referred to the centre of excellence at Limerick Regional Hospital. Any woman, irrespective of her age or residence, who has immediate concerns or symptoms should contact her general practitioner who, where appropriate, will refer her to the symptomatic service in her area.