Colm Burke (Fine Gael) | Oireachtas source

I thank all of the witnesses for their presentations this morning and for the work they do.

How much does BreastCheck cost per annum? It is important that we have that figure for comparison purposes now that we have litigation. I listened to Professor Hill comments, especially the worry that screening programmes may have to be closed down to reduce the level of litigation, which is clearly not the way forward. It is important to have figures on the annual cost of BreastCheck and the problems we will face. The witnesses identified that we are within international standards in terms of the number of cancers missed. The service is comprehensive and everything is done by all the staff to get the most accurate results possible. When cancers are missed, if everyone opts for litigation we will end up paying out more in compensation than the entire cost of the service.

I had an interesting conversation with a consultant from Ireland who recently attended a conference in the United States at which the level of compensation paid out in Ireland for medical negligence was outlined. The attendees were surprised that Ireland appears to pay out much more in compensation than is paid out in the United States. On the one hand, we want open disclosure. On the other hand, we want to provide a comprehensive screening system. If money is taken away from the latter to pay the costs of litigation, there will be a problem. How have other countries dealt with this issue? A mediation process was mentioned. Do other countries provide a mediation service? If so, does it work?

We heard that 145,000 people avail of the BreastCheck service each year. That is a significant number. On the basis of a an interval cancer rate of two per 1,000 people, approximately 290 cases will be identified each year. That is a small number, although a missed cancer diagnosis is a big issue for the person concerned. How can we deal with this complex and difficult issue, particularly in terms of what has occurred in the past four weeks? As a practising solicitor with a legal background, I share Professor Hill's concern about the level of litigation that will arise as a result of what has happened over the past four weeks. Litigation will not serve the best interests of the medical service or those who practise medicine on whom it also has a traumatic effect. That message has not been conveyed to the general public but we must ensure it is heard. I ask the witnesses to elaborate on the issue of mediation.