Mr. Tony O'Brien:

Deputy Kelleher asked about accountability for budgets. Since 20 August this year, I have assumed all the responsibilities associated with the post of chief executive officer of the HSE, which includes the responsibility as its Accounting Officer, and it is expected that will continue to be my responsibility for the financial year, 2013. In that context, I have an obligation to take all steps necessary to improve the financial position of the HSE. We set about a number of things during the summer to do that. We have talked about the negative consequences of some of those this afternoon.

The Minister made reference to the Ogden report. We have seen the health service take out €2.5 billion over recent years and lose almost 10,000 staff, yet there have been considerable improvements in activity and performance in a number of areas. The financial component of the HSE has also suffered attrition due to the antibodies that developed in the past decade to ICT projects. The HSE is without an enterprise-wide financial solution and I pay tribute to the work done by the relatively small band of financial managers in the executive, recognising as the Minister often says, that while we invest significantly in the training of medical specialists, we have not distinguished ourselves in investment in management training and so on. In response to the Ogden review to work alongside and support the internal cohort of financial managers, we have brought in additional personnel resources through procurement to beef that up in terms of a medium-term financial management turnaround process to work with our existing team of financial staff to build on the strengths they have and develop more robust systems for the future, not just in the context of the work we have to do today, but in the context of what we know from the framework and Government policy more generally are the future organisational arrangements for the health service, which create particular contexts and needs.

It is intended that when the national colorectal screening programme is fully implemented, the programme will offer free screening to men and women aged between 55 and 74 on a two-yearly cycle but as 50% of cancers within this age group are found in people aged between 60 and 69, the programme will begin with this age cohort. That has been the policy for some while. That is a population of approximately 500,000 and it is anticipated that the first round will take up to three years to complete. I was heavily involved with both BreastCheck and CervicalCheck and, typically in all screening programmes, the first round takes longer than the steady stage screening cycle. Over time, the phasing of the programme will allow development of colonoscopy capacity to cater for the full 55 to 74 age cohort but, at the moment, there is no predetermined timetable for that. The Minister has outlined the list of candidate colonoscopy centres and the process of approving those units to go live is under way, the key objective being to ensure the screening programme does not interfere with symptomatic colonoscopy services in these hospitals. The national cancer screening service, NCSS, is confident there will be adequate capacity to provide this important part of the programme and the Deputy may be aware that, under the targets commonly referred to as the special delivery unit targets, although they are HSE targets, significant improvement has been achieved in access to colonoscopy services.

I do not have the figures with me but they are in the performance report and I can supply them.

A key feature of the bowel screening programme is that where a referral for a colonoscopy occurs, which will be to one of the candidate centres, in the vast majority of cases treatment, such as the removal of polyps, can be provided during the course of that colonoscopy. The programme is already in test mode and a limited number of patients have been randomly selected so their samples can validate the processes. It is planned that the first call letters will be issued before the end of the year, which means testing will commence early next year, with regard to the response to these call letters. I spoke to those responsible for the programme recently and they are very confident the roll-out will proceed.

I will ask Ms McGuinness to speak about the position on home helps.