Teresa Costello (Fianna Fail)

I thank the witnesses for their statements and for being here today. I want to start on a positive note. I want to talk about accident and emergency waiting times. I will go local. In Tallaght Hospital there has been a hugely significant improvement. I know that because I have had personal experience of it. Earlier in the year, I waited 33 hours in accident and emergency and on Tuesday of this week it was seven hours from admission to being admitted to a bed. That was a huge improvement. I pass on my thanks. The improvement has to be acknowledged because it makes such a difference. I hope it continues and improves.

I want to touch on three items. The first I want to talk about is early access. My colleague, Deputy O'Sullivan, already alluded to it. I want to talk about a drug called givinostat, which is used to treat children with Duchenne muscular dystrophy, DMD, which is a progressive illness. A HTA has been requested for it. The manufacturer told me it has a scoping meeting with the NCPE on 30 September and it will submit its HTA then. On the other hand, I am being told that the NCPE is ready to accept the HTA. We have children who would qualify to get givinostat currently if it was approved and available in Ireland. The longer it goes on these children will not get that drug. Where is the delay happening in regard to it?

Our counterparts in Belgium provide early access to givinostat through its compassionate use programme and allows eligible boys to receive the drug before a national reimbursement scheme is in place. Where are we in Ireland in with this? Is it going to happen? I am dealing with families and I cannot let children deteriorate and not be eligible for a drug that is in existence. I would like to get an answer on that.

I will move on to my other two questions. There has been an increase in staff in acute care but not in primary care or community care. Progress has been reported on waiting lists but GPs and patients are still facing unacceptable delays in primary care. What is the concrete plan to fix the bottlenecks? Is the current model working or does it need to be reviewed?

I now want to go on to something I am blue in the face talking about, namely, symptomatic breast clinics and scanning. When women present to a symptomatic breast clinic after being referred by a GP, younger women are not being scanned on the day. After being examined, they are told that they will be given an appointment for a scan. Sometimes, that takes over six months. I have said publicly I will advocate for anybody who is waiting, because it is unacceptable. Thirteen years ago when I was diagnosed, I presented at the symptomatic breast clinic and I got a triple assessment that day. I was diagnosed and was having chemo within two weeks. I do not need to tell anyone here that breast cancer in younger women is extremely aggressive. The longer it is left in the body, the more time it has to establish itself. Has something changed in symptomatic breast clinics? Why are people being nearly triaged twice? They are going in to their GP, who says they need to go a symptomatic breast clinic. I would take the word of GPs when they refer people urgently.

You are physically examined and then told to go away and you will be sent an appointment. If you are healthy the scans show you do not have breast cancer but for six months you are going around with stress and fear with no peace of mind. On the other hand, if you do have breast cancer it is creeping towards a higher stage than it would have had you been scanned on that day with treatment allocated. Did something change over the years? Back in the day when I started out, I never got messages from people saying they were being sent away from a symptomatic breast clinic with the promise of a scan.