Dr. Jerome Coffey:

There are a number of hugely important issues which I will try to separate out a little bit. As a parent and as an oncologist who has treated people with advanced cervical cancer and advanced head and neck cancer, they are disasters that can now be prevented. When one looks at other countries that have data because they started the vaccination system a little bit earlier, there has been a fall in the number of diagnoses. That is where the benefit lies. I agree entirely with the Deputy that the benefit did not feature in the headlines of the debate. In a democracy, it is important to have a debate. However, my sense is that much of the debate was based on belief and what people who may not have been highly health literate or scientifically literate felt was the case. Girls who had vaccinations developed symptoms but the science could not link the two. It was a complex debate. The Deputy is right that the main issue got diluted and perhaps lost. I would be happy to state that vaccination is important and it works. I worry that parents who make decisions on behalf of their children are influencing other parents not to vaccinate. We have seen a spillover from the HPV vaccination debate in other countries in Europe and in parts of the US, where people are not vaccinating against MMR. We are seeing fatalities from infectious diseases which we do not see anymore. It is horrific to feel we could have admissions to hospital and children dying because of the misplaced beliefs of the parents.

I will address the importance of the GP. Other countries have looked at this from the angle of health literacy, which we have to start doing. It is about doing awareness campaigns in the media about red-flag symptoms such as abnormal bleeding and lumps or bumps and telling people to go to their GP this week and not next month or a year from now. I have seen patients who have had a problem for a while and either they had a fear or some other reason for not presenting at an appropriate time and they go from a curable situation to an incurable one. They suffer from the symptoms of their disease simply because they chose not to present.

It comes back to the education programme. We need to get people to their GPs and to get GPs to support a secondary action, order immediate diagnostics or refer immediately so patients can be seen within a week or two at the nearest cancer centre. Health literacy should be a campaign. The National Cancer Screening Service provides BreastCheck, CervicalCheck and BowelScreen and is very good at what it does. It is a measure that is reflected in the numbers who attend for screening. Uptake is never 100% because we can make something available but we cannot make it compulsory. The challenge is in convincing people that it is in their best interests to get checked out. Most check-ups will be negative but at least it provides peace of mind for them, their families and their health care providers that they have had the appropriate tests and do not have a serious diagnosis.