Vol. 645 No. 2
1 Deputy James Reilly asked the Minister for Health and Children the date investigations (details supplied) into a number of cancer diagnostic scandals will conclude; the reason for the delay in publication of these reports particularly the Dr. Ann O’Doherty report promised by the end of November 2007; and if she will make a statement on the matter. [2924/08]
The investigation by the Health Information and Quality Authority into the care provided by the HSE to the named individual commenced in June 2007. In December 2007, information came to the attention of HIQA that led it to decide that further work was needed. I have been informed by HIQA that it expects this report to be published before the end of February 2008.
The HSE has advised my Department that a report on the reviews of mammography services and ultrasounds in Portlaoise will be published when the necessary legal requirements have been completed. The legal process is ongoing. Due process and natural justice must apply in respect of this report and any report where the findings in that report may affect the professional reputation of any individual. The report on the review of circumstances which gave rise to the placing of a radiologist on administrative leave in Portlaoise is complete and is with the chief executive officer of the Health Service Executive.
The report I requested from the HSE board into the events following the HSE decision to initiate a clinical review of breast cancer services at Portlaoise, being carried out by Mr. John Fitzgerald, is currently being finalised.
The review team carrying out the review of breast services in Barrington's Hospital and medical centre expects to finalise the draft report in the next few weeks. Following the completion of the necessary legal requirements, the report will be submitted to me and to Barrington's Hospital.
The investigation by the Health Information and Quality Authority into pathology services at University College Hospital Galway was commenced in September 2007. I am informed that significant progress has been made in this investigation. While it is difficult to predict precisely at this stage when the work will be completed, it is hoped that the investigation will be concluded by the end of March 2008 and the report will be published as soon as possible thereafter.
The pathology review in Cork University Hospital is currently being finalised. It will then be submitted to the director of the national hospitals office.
The greatest health scandal to have hit this country in the last 25 years has been the manner in which women were treated by the breast cancer service in Portlaoise. The Minister was informed of this in 2005 and her response was appalling; she passed the buck and nothing was done with the consequence that 11 women were misdiagnosed and hundreds of women had to go through the worry and mental anguish of waiting while the results of repeat tests had to be checked. I refer to the appalling manner in which files were left stacked up in boxed lots in the corner——
The Deputy should ask a question.
The question is coming.
Soon, please.
I think it is important to set the tone.
They remained until the cohort was reached and until it was decided by the HSE — the Minister's invention which she created by legislation and whose ethos has evolved under her — that it was then the time to deal with these people. It seemed to be a case of "It is all right, Mrs. Reilly, you might have a breast lump and in fact, you might have cancer, but we will deal with you when we are good and ready. When we feel we have enough people to warrant taking action, we will take action". This is the lowest point which the health service has reached for a long time.
The Minister promised this House on 7 November 2007 that the Ann O'Doherty report would be available by the end of November, yet we are now at the end of January 2008 and we are being promised the report again. The reason given for the non-production of this report is that natural justice must be allowed for and we all agree this should be so. However, the specific reason I was given was that an individual is not in the country having returned to South Africa and must be given sight of the report before a conclusion can be reached. Is the Minister telling the House and the people of Ireland that if this person does not return to Ireland for two years, we will not have a report for two years? This is not the case because it is absolute, errant nonsense. Fax machines and e-mail mean that people can be contacted within 24 hours anywhere in the world. A person's response can be received and his or her rights can be preserved.
Will the Minister ensure that this and the other reports come to hand by the end of next month? Can she make a commitment that can be kept this time, rather than all the false promises given on this and so many other matters which will be referred to in later questions?
I have one other supplementary question. I ask the Minister to ensure the independence of the Portlaoise second investigation on how the matter was handled and whose terms of reference are broad. She has asked for the good services of Mr. Fitzgerald but has asked him to report to and work with three members of the board of the HSE. This does not inspire confidence in the people who were so badly let down by the very same HSE which the Minister is now asking to investigate itself. On behalf of the people of Ireland and the women who have suffered so badly at the hands of the State's health service, I ask her to assure them that Mr. Fitzgerald can act in an independent fashion, select his own team to help him complete his report and report directly to her so that she can report to the House.
That was more like a speech rather than a question.
The Deputy used three and a half minutes of the seven minutes allowed.
The Deputy well knows that when Mr. Naughten wrote to my office his letter was acted upon immediately by the clinical director, Dr. Hollywood and Mr. Naughten was satisfied with the response he received.
He certainly was not satisfied with any response. There is no doubt about it.
That is a fact.
It is the case that nine women were misdiagnosed. Unfortunately, errors of this kind that happened in the past went unreviewed, unnoticed. We are not unique in Ireland in recalling patients. I refer to an article in a French newspaper which states that last week, 7,000 cancer patients were recalled for review and the Deputy is aware of this. It is not unusual.
There were no files left standing.
Ann O'Doherty's report was completed in November and as the Deputies sitting beside Deputy Reilly will know, as they are both lawyers, when a report is completed, if it casts any doubt on the professional reputation of any person, such a person must be given an opportunity within a reasonable time period as suggested by legal advice, to respond. This is the process which is under way.
We do not want this report to be injuncted. This House sought to inquire into a different incident a number of years ago but it ended up in the courts and the inquiry could not proceed. We must ensure that the process is followed even though it is extremely frustrating but the law must be observed.
Why did the Minister not say that at the end of November?
We have the report. The HSE had the report by the end of November but it was not in a position to publish the report because of the contents of the report until it went through what I will term the process of natural justice. I will give the Deputy this assurance that as soon as that process is completed, the report will be published.
The Barrington's Hospital report will be published immediately when I receive it. I will ensure the Attorney General gives me advice but I will not be holding back that report.
We want to learn from all these mistakes with a view to ensuring that it minimises the chance of it happening again.
Mr. John Fitzgerald is a man of great integrity. He has complete independence in the carrying out of this report. Any resources he requires will be made available. However, the board of the HSE does not meet every week. When I asked the board to carry out a review, it appointed a sub-committee to take charge of the review and this is normal practice. The sub-committee is neither to write the report nor to vet the report nor to approve a draft of the report but rather simply to deal with some of the logistics associated with his investigation.
2 Deputy Jan O’Sullivan asked the Minister for Health and Children her views on whether the national emergency which she acknowledged due to the number of patients on trolleys in 2006 has re-emerged in winter 2007 in view of statistics and of concerns expressed by the Irish Association of Emergency Medicine; the action that will be taken to address this problem; and if she will make a statement on the matter. [2782/08]
Improving the delivery of accident and emergency services continues to be a top priority for the Government and the Health Service Executive.
There have been considerable improvements made over the last two years in the delivery of services in accident and emergency departments. The number of patients awaiting admission to a hospital bed from accident and emergency departments reduced by 50% between December 2005 and December 2007, from an average of 155 to 78 a day. However, there was an increase in the numbers in recent weeks which the HSE attributes to a number of factors, including increased levels of virulent norovirus, winter vomiting bug; increased levels of influenza and chronic obstructive pulmonary disease; and an increase in the number of delayed discharges, particularly in the Dublin area. These are patients who remain in hospital although they have finished the acute phase of their treatment.
The HSE is working intensively with the hospital system to bring about further sustainable improvements. One of the key issues being addressed is the system of discharge planning. A major focus is being placed on ensuring that all patients have an expected date of discharge within 24 hours of admission; the expected date of discharge is actively managed on a daily basis against the treatment plan and any changes are communicated to the patient; patients can be discharged in a more proactive manner at weekends; there is an increased emphasis on nurse-led discharges; and ward rounds are scheduled in a way which facilitates a more timely review of treatment plans.
The HSE is also working closely with a number of hospitals reporting significant numbers of patients awaiting admission. This includes a specific focus on the establishment of clinical decision units and short stay units to accelerate the throughput of patients who present at accident and emergency departments. Additional measures are also being put in place to deal with the issue of delayed discharges.
In light of the successful conclusion of talks regarding the new contracts for consultants, I hope that progress will be made in advancing the recruitment of additional consultants under the 100 Plus initiative previously announced by the HSE. The initiative is designed to reward hospitals which are operating in line with established performance targets. The additional consultants are to be employed in specialties which can alleviate the problems which manifest in accident and emergency departments.
Does the Minister really believe the reasons given that the numbers have gone up again? Is she satisfied that the state of accident and emergency services does not amount to a national emergency similar to the one she indicated a relatively short time ago? The Minister gave very encouraging information about what is being done but can she equate the reality with what she just read out? Whether one goes by the Irish Nursing Organisation figures or the Health Service Executive figures, the number of people on trolleys is high. There were up to 400 people on trolleys on one day alone. The figures from the Irish Nursing Organisation tell us there was an increase of 89% in the number of people on trolleys in December 2007 compared to December 2006.
An ambulance driver who spoke on the radio this week said he has to sit around waiting for trolleys before he can move his ambulance away from the hospital because the trolleys are occupied in the accident and emergency units. A man in Wexford General Hospital in the constituency of the Leas-Cheann Comhairle stated on the radio that he waited from Thursday to Saturday to get a bed. While we heard something reassuring from the Minister, does she believe that is the reality and what will she do to ensure that the accident and emergency crisis is addressed?
I believe what I said and I believe the matter is being addressed. A number of factors must be taken into account and I have instanced some of them. If one takes the example of one hospital in Dublin where because of the performance in the hospital in regard to accident and emergency services and other matters, the Health Service Executive employed consultants to go to that hospital. The recommendations which were produced last September, if implemented, would lead to the freeing up of 64 acute beds. The Health Service Executive had to write to that hospital only last week to remind it of the measures it was to put in place by the end of March. I hope that hospital implements these changes because, if not, the Health Service Executive has stated in its letter it will have to make alternative arrangements for those patients with private providers and use the funding that would otherwise go to the hospital.
I got a report about another hospital in this city which has a patient there since 2006 who was fit to be discharged at the end of that year. There are issues there around long-term care which the new legislation setting up the fair deal scheme will address. A number of factors in particular influence late discharges. The affordability and availability of long-term care, particularly around the greater Dublin area, is a factor. With the new legislative process in regard to those matters we will certainly make enormous progress.
There are some places in the country like the north east where the rate of admission into the acute system is twice what it is in other parts of the country. Deputy O'Sullivan's area of Limerick, for example, rarely has a problem. I do not say it does not have pressures but in fairness to the hospital in the area it never has the kind of pressures experienced in some big hospitals because that hospital adopts a very good integrated approach with community primary care in the area. It also has better discharge policies and practices than others. We can learn from hospitals like that and Waterford Regional Hospital and other good performers such as St. Luke's in Kilkenny. It is not rocket science, it is already happening in this country and we want it to happen in more places.
3 Deputy James Reilly asked the Minister for Health and Children if it is the policy of the Government to implement the recommendations of A Vision for Change; the reason funding allocated for mental health services has not been spent on those services; the reason moneys realised from the sale of property assets associated with mental hospitals here have not been reinvested in the development of capital projects envisaged in A Vision for Change; and if she will make a statement on the matter. [2925/08]
The report of the expert group on mental health policy, A Vision for Change, which was launched in January 2006, provides a framework for action to develop modern, high quality mental health services over a seven to ten-year period. The Government has accepted the report as the basis for the future development of mental health services. The Health Service Executive has primary responsibility for implementing the recommendations of A Vision for Change.
Operational responsibility for the management and delivery of health and personal social services was assigned to the Health Service Executive under the Health Act 2004 and funding for all health services has been provided as part of its vote. The Department of Health and Children has been advised by the Health Service Executive that the additional €51.2 million development funding was not used as planned because of competing expenditure pressures and the overriding obligation on the Health Service Executive to live within its approved overall allocation. As a result, some of the planned developments in mental health services have been delayed. However, some of these developments will proceed in 2008, for example, the recruitment of eight child and adolescent mental health teams and the provision of 18 beds for children and adolescents.
In regard to the sale of property, I assume the Deputy is referring to The Lie of the Land report recently launched by the Irish Psychiatric Association. The report gives examples of proceeds of assets allegedly lost to psychiatric services over a 20 to 25-year period. A small number of assets disposed of in the past two years are identified. A Vision for Change is very clear on this issue and recommends that resources, both capital and revenue, should be retained in the mental health service. It also recommends that the full economic value of psychiatric hospital buildings and lands should be professionally assessed towards identifying appropriate future use and maximum value and benefit. The value of these assets significantly counterbalances the capital cost of the new mental health services infrastructure requirement. I have asked the Health Service Executive to provide for me a report on The Lie of the Land report, especially in so far as it relates to the disposal of assets in the past two years.
The Minister for Health and Children, Deputy Harney, has also made it clear to the Health Service Executive in the context of its service plan for 2008 that there can be no question of diverting capital or development funds to meet expenditure pressures arising in regard to core services. I will meet the Health Service Executive shortly to pursue these issues.
A Vision for Change recommended the establishment of one child and adolescent mental health team per 50,000 people. In total there should be 78 teams but only 47 teams have been established and of the 47 teams only 60% of their staffing complement is in place. That is appalling, given that there were 3,598 children on waiting lists at the end of 2007, with approximately one third waiting more than 12 months for assessment. These are our children; these are our future.
A Vision for Change also recommended that there should be 100 inpatient beds for children and adolescents and in 2006 the Minister of State's predecessor, the former Deputy, Tim O'Malley, promised 80 beds would become available by 2007. To date we have only 12 dedicated child and adolescent beds but we are to get an additional 18 beds this year. Like so many other things we will wait and see whether it will happen.
We now have a problem because of the Children Act where a young person is considered to be a child until the age of 18 years. We have no adolescent service in Swords, the fastest growing town in Ireland with a population of 40,000 and expected to reach 100,000. We have no adolescent service for young people between the ages of 16 years and 18 years. Adult psychiatrists do not feel competent to deal with them and the junior adolescent service does not have the resources to deal with them. In effect, they have no service as GPs have stopped referring them.
Does the Deputy have a question please?
The question is coming. Last week the Irish Mental Health Commission revealed that almost half of the €50 million allocated for the implementation of A Vision for Change, to which the Minister of State referred, had been spent in other areas. On "Prime Time" the Minister was not able to tell us how much of the €50 million had been spent on mental health. Can the Minister explain why moneys allocated for the implementation of A Vision for Change are not being used for this purpose, why there is no allocation of the €25 million for the implementation of A Vision for Change in the budget of 2008 and why mental health services are being stripped of their assets?
I wish to add a supplementary question on the psychiatric unit in Beaumont Hospital which was promised over 25 years ago. A unit was built, but it was used because there was overcrowding in the hospital and now there is equipment stored in it. A further application was made a couple of years ago for a psychiatric unit and now the co-located hospital, although not built entirely on it, impinges on that site and makes it unusable.
I must call the Minister.
I ask the Minister to give an undertaking, as was given on page 177, chapter 17, of his document, A Vision for Change, that the moneys released will be ring-fenced and that we will not have a situation where the money goes elsewhere and where there are, in St. Ita's in north Dublin because there is no psychiatric admission unit in Beaumont Hospital, 24 patients in a unit with one single room while 23 acutely psychotic patients must lie with 3 ft. between their beds. It is a disgrace.
The time allocated for the question is exhausted.
This is the Cinderella of the health service and it has been ignored.
Although there is not time for the Minister of State to reply, I ask him to make a brief one.
I would be delighted to respond. Obviously, we do not have enough time to go into all of the questions. On the child and adolescent services, Deputy Reilly correctly stated that there are 12 beds at present. In the past two weeks I have visited St. Vincent's in Fairview and St. Anne's in Galway and the beds in St. Anne's are ready to be opened while construction is under way in St. Vincent's in Fairview and in St. Stephen's in Cork. I can guarantee to Deputy Reilly that by the end of this year there will be 30 beds. In addition, the 20-bed brand new unit in Merlin Park in Galway has just received planning permission and the 20-unit building has gone to tender in Cork. We expect that those two 20-bed units, allowing for the normal construction delays and planning permissions etc., should be on stream by the middle to the end of 2009. I guarantee that 30 beds will be operational for child and adolescent psychiatry by the middle to the end of this year.
A far cry from 80.
4 Deputy James Reilly asked the Minister for Health and Children the date cervical screening will become available nationally; the reason this was not made available by the end of 2007; and if she will make a statement on the matter. [2926/08]
The national cancer screening service is planning to roll out the national cervical screening programme on a national basis around the middle of this year. Women aged 25 to 44 years will be screened every three years while women aged 45 to 60 will be screened every five years. The service will be available free of charge to eligible women everywhere in the country. Approximately 230,000 women will be screened annually, assuming an 80% take-up by eligible women.
All elements of the programme, call-recall, smear taking, laboratories, colposcopy and treatment services will be quality assured, organised and managed to deliver a single integrated national service. The service is in the process of procuring quality assured internationally accredited laboratory capacity. The laboratories will be required to meet turnaround times of ten working days. This process is due to be completed by the end of March. The programme will be based on a turnaround time of four weeks for smear testing. The service is also carrying out a baseline quality audit of existing clinical colposcopy services in the State to establish their fitness for purpose in the context of a national cervical screening programme.
Additional revenue funding of €5 million was allocated to the service in 2007 for the roll-out of the programme and an additional €15 million has been allocated in 2008. Thirty posts have been approved to facilitate integration and roll-out of the programme.
I will give a quick background. Fifty years ago in Aberdeen a pilot study was started in this area. Forty years later we undertook a pilot study, in 1999. Here we are nearly ten years later and it is still promised. With the best will in the world, the Minister told us last summer we would have it by the end of the year. She told us in the autumn that we would have it on 1 January. Then she told us later, coming up to Christmas, that we would have it some time in January. Then we were told it would be March. Now the HSE is stating it will be some time this year. Is there any real intent to achieve this in 2008?
I do not believe the Minister can do it. She has not put in place the laboratory facilities. We do not have the necessary facilities such as the accredited laboratory. She will outsource it to America or some place where we have no control of their quality and we have an issue with building into a system a factor that will make interpretation more difficult and, therefore, mistakes more likely.
This is an illness of which there is 240 new cases each year and where 74 people die each year. Had the Department put this in place it could have saved hundreds of lives. We are still here talking about it and promises are still being made. It is the one cancer of which I am aware that one can detect before it happens because changes occur in the cell which allows one to treat such cells and get rid of them so the cancer never develops.
I get the impression — I do not like to take this stance — that the Minister seems to be suffering from the disability from which the entire Government, and its leader, the Taoiseach, seems to suffer, namely, she does not seem to be able to give it straight, tell the story as it is, give us a deadline that she can meet and make a commitment that she can keep. It is all broken promises and excuses.
Furthermore, I want to know about the other part of cervical screening, namely, the vaccination. When will the national immunisation advisory board make its recommendation? I believe it is in a position to do it. I cannot understand why it has been held up because the combination of the two could rid us of this terrible scourge.
I want the Minister to give this House a firm commitment. I ask her to show us that she can do it, that she can give us a deadline that she will keep. I ask her to give us a date because this carry-on of leading people by the nose causes the public to lose faith and causes a drop in morale among the people who must provide the service.
First, I never announced it was to be introduced in 2007. What we announced for 2007 was the provision of €5 million to begin the process of recruiting staff, etc. As Deputy Reilly well knows, that must happen in advance and sometimes there can be quite a long lead-in time. Second, we will do this on a full roll-out basis. It will not be done in the way BreastCheck was done, namely, region by region. The entire population affected will be done on one national basis and that is why we will be doing so many in one year.
Third, I accept what Deputy Reilly stated about other countries. If memory serves me, Canada introduced this service in 1969. The cost of these roll-outs in countries like Canada or Scotland is a fraction of what it is here. Among the issues that affect the cost here is the fee paid to general practitioners for vaccines, which Deputy Reilly well knows is three times higher here than in other countries.
That brings me to the vaccine. HIQA is undertaking a technology assessment of the vaccine and that will be completed shortly. The vaccine is obviously preventative for the future and I hope that we will introduce it. I believe we will, but I must await the technology assessment, which is now part of the law in this country, where we undertake a pharmo-economic assessment of new drugs and technology assessment so that we introduce products or treatments that are effective in an Irish context. The CEO of HIQA informed me at my meeting with her in the past two weeks that the assessment to which I refer will be ready in the next couple of weeks.
Will the Minister just answer the question? Will she give us a deadline that she will keep and a commitment to which she will stick?
I will not speak of deadlines. The middle of the year is what I have been told. I do not announce dates unless I can meet them. Deputy Reilly attended the launch of this year's Estimates on budget day when we were going through the moneys allocated to health. He was there and he was welcome. I stated on that occasion that it would not be January, February or March because until we knew the budget allocation was available the national screening service was not in a position to enter into contracts with anybody, either the providers of laboratory services or general practitioners. This will be a general practitioner-led service, as Deputy Reilly knows, and that is why it will be so accessible on a countrywide basis.
5 Deputy Alan Shatter asked the Minister for Health and Children the new services she proposes to put in place to provide for adults and children suffering from cystic fibrosis; and if she will launch a public and ongoing advertising campaign to encourage the public to carry organ donor cards to facilitate the greater availability of organs for heart and lung transplant operations. [2890/08]
The improvement of services to persons with cystic fibrosis has been a priority of mine. The negative experience recounted by some patients is a matter of concern to me.
In 2006 and 2007, additional revenue funding of €6.78 million was provided to the Health Service Executive. Some 44 additional staff, covering both adult and paediatric services, have been appointed across a number of hospitals, throughout the country and necessary funding is available to facilitate the recruitment of a further 37 staff nationally.
The HSE was asked to place a particular focus on the development of services at the national adult tertiary referral centre at St. Vincent's Hospital. A number of capital projects have recently been completed at the hospital and have helped to improve facilities. These include a new ambulatory care centre, the refurbishment of St. Camillus ward and a new accident and emergency department, which includes single room accommodation. However, I accept that these developments do not address the immediate needs of patients.
The HSE is currently fast-tracking the redevelopment of a ward which is adjacent to the main cystic fibrosis treatment area. The project is to commence within the next few weeks and will provide six single rooms. On completion, additional work will begin to provide a further eight single rooms. This will result in a total of 14 single rooms for cystic fibrosis patients by the end of the summer.
In the longer term, a new ward block is to be built, which will include 120 replacement beds in single en suite accommodation, including accommodation for cystic fibrosis patients. Planning permission has been obtained, financial provision has been included in the HSE capital plan and the contract is to be awarded this year. It will be a condition of the contract that the design build period is to be not more than 24 months from the date of contract award.
Beaumont Hospital operates as a regional centre in providing services to adults with cystic fibrosis. In 2008, a special allocation of €2.5 million capital funding was provided to enable Beaumont Hospital to provide outpatient facilities for cystic fibrosis patients.
I am keen to support and promote initiatives designed to increase the level of organ donation in this country. I have supported the annual organ donor awareness campaign, organised by the Irish Donor Network and administered by the Irish Kidney Association. I also want to ensure that the organ procurement and retrieval rate is maximised at hospitals around the country. A national audit of potential organ donors commenced last September in 35 acute hospitals with intensive care units. The audit will seek to identify any obstacles to donation and any measures which may be required to increase the level of donation and retrieval of organs at individual hospitals.
Would the Minister accept that the manner in which we have treated cystic fibrosis patients and their parents and families is a national disgrace and scandal? Is she aware there are over 1,100 patients with cystic fibrosis in this country at the moment, the highest proportion of patients per head of population of any other country? Is she aware that a person born in Ireland with cystic fibrosis has an average life expectancy that is ten years less than a patient in similar circumstances suffering from cystic fibrosis in the United Kingdom or in Northern Ireland and does she regard that as acceptable?
Does the Minister acknowledge that, as is the position in adult hospitals, many of the cystic fibrosis units, including those relating to paediatrics and the clinic in Crumlin hospital, do not have ring-fenced, dedicated inpatient wards with single en suite rooms to prevent cross-infection? Will she acknowledge there is a need to urgently establish such facilities in tandem with providing them for adult patients who suffer from cystic fibrosis?
I can certainly acknowledge that the facilities we have in place are not what they should be. However, I equally acknowledge, as have many of the families and the organisation, that the services have greatly improved, particularly with regard to the employment of clinical expertise. I accept that in this and many other areas the need for single rooms is a priority. That is the reason the new paediatric hospital for the country will be all single rooms.
The measures being taken at St. Vincent's Hospital, which will be completed by the end of the summer, are only temporary. It was the hospital's wish that the cystic fibrosis facilities would be part of the 120-bed facility to be built there. For many reasons, the hospital did not believe it was appropriate to build a cystic fibrosis unit separate from the 120-bed facility. That is the reason a modular-type facility will be put in place and ready by the end of the summer.
We have a long way to go. The Deputy is correct that we have 1,100 cystic fibrosis patients, 45% of whom are children and 55% are adults. The life expectancy has greatly improved here, as acknowledged by Professor McElvaney.
It is still substantially less than in the UK or Northern Ireland.
It is somewhat less, not substantially. I accept that and I accept the incidence of cystic fibrosis is higher here. The Deputy is probably aware there are many reasons for that. The issue is a priority. In each of the last three years, since I became Minister for Health and Children, we have put specific ring-fenced funding into the area of cystic fibrosis. In the service plan approval I gave to the HSE before Christmas for 2008, I made special reference to the need to strengthen the facilities for cystic fibrosis patients.
Is the Minister aware that since 1983 all newborn babies in Northern Ireland have been screened at birth for cystic fibrosis? Is she aware this not only allows an early diagnosis, but allows at an early stage for appropriate treatment to be commenced? Is she aware the average age in Ireland for discovering whether a child has cystic fibrosis is two years? There is also a gender gap as girls are diagnosed later than boys. Will the Minister acknowledge there is an urgent need to introduce a neonatal screening programme?
In the context of the Minister saying the issue is a priority, can she explain how it is that while her Department was asked to commence such a programme in 2003 and it was promised in 2005, it has not yet been introduced? How is it that the HSE is now intimating that it may or may not introduce such a programme in 2008? Will the Minister indicate whether a neonatal screening programme will be commenced in 2008?
To return to St. Vincent's Hospital, will the Minister acknowledge that the number of rooms that will be provided by the short-term initiative now being taken are grossly inadequate to meet the need in this area? Will she explain why the suggestion of a prefabricated unit on an emergency basis with a far greater number of rooms has been turned down? Will she acknowledge she has now told the House something different about the proposed facility? It was announced recently that within two years the construction in St. Vincent's would be completed and the single rooms necessary would be available. Today she has told the House that sometime later this year contracts will be signed. It will take 24 months for the construction to take place. Presumably, the new unit will then have to be commissioned. Will the Minister confirm we are probably four years away from the new extra badly needed facilities being available and will she admit this is unacceptable?
The Deputy must have misunderstood me. I said the contract would be awarded this year and a condition of it would be that the facility would have to be completed within 24 months.
That will be three years.
No, it will not. The contract will be awarded in 2008 and the facility will be completed in 2010. Nobody has said any different.
How early in 2008 will it be awarded?
It will be the latter half of this year and it will be completed by the latter half of 2010. That is what we have always said. It is what Professor Drumm said when speaking on the issue a few weeks ago.
That is still three years away.
The Deputy may not be aware, but when capital projects are approved, Revenue funding is provided in tandem with that approval. Therefore, there will not be a big gap between the completion and commissioning of the facility.
The 14 single rooms provided at St. Vincent's will be a significant improvement and will operate via direct access rather than through the accident and emergency unit. We must also provide greater community-based services. Just last week, I met a young girl who is a cystic fibrosis patient. She indicated to me that her counterparts in other countries can receive many of the services at community level for which she must go to hospital. Professor Drumm, who treated cystic fibrosis patients in Canada, has strong views in that regard.
The HSE has announced it intends to put a screening programme in place later this year. The Deputy may have seen that announcement in the health supplement of The Irish Times about two weeks ago.
Why has it taken so long? Can it be in place this year?
I hope so.
