Dr. Jerome Coffey:

To reply to the questions that the Chairman asked about screening uptake, while the numbers for breast screening and cervical screening are close to the target, it has been identified as a real problem. Trying to persuade people who do not want to undergo a test in a freely accessible service that it might save their lives is a challenge. It is important to distinguish between colorectal screening. The target is low and it is hard to reach but that is in line with the international experience. For some reason, people are happier to go for mammograms, Papanicolaou smears or HPV testing than have a faecal immunochemical test, faecal occult blood test or scope. Despite best efforts and impressive media campaigns in this country, it is a struggle to reach the targets, but I am not sure what are the international reasons for that.

I am not directly involved in the introduction of HPV testing and, therefore, I do not know the date for the introduction of the service or how the backlog is being addressed. I will, however, have the screening service convey that information to the committee.

On radiotherapy and the access to cancer treatment services, I mentioned the investment in radiotherapy in the north west, Cork and Galway, but the service will start perhaps a couple of years before the new centre is built. It is intended to meet future needs and will have state-of-the-art technology. In Dublin, there has been significant progress over the past decade. In the mid-west and the south east, we buy from the private sector and those services, which have been in place for a period, are excellent. The machines in Limerick and Waterford are at the end of a ten-year life cycle and, therefore, the question is how best to replace them while also potentially increasing capacity in order that people will not have to wait. Work is ongoing in that regard and we will probably have visible progress on the decisions and investment.