Mary Harney (Dublin Mid West, Progressive Democrats)

I thank Deputy Twomey and Fine Gael for tabling this motion. Unfortunately, I was unable to attend last night's debate owing to a private, personal commitment. I thank Deputy Twomey for not criticising this.

I have very strong opinions on this subject. One does not have to be a female to empathise with the need to provide breast screening nationwide. One would like to think that, when a programme is rolled out, it can be rolled out nationally, but unfortunately matters are not that simple. There is no doubt that my predecessor in the Department of Health and Children, Deputy Martin, made significant progress in the area of cancer care. For instance, an additional €132 million was invested in cancer care in the southern area over the past seven years while the amount was €178 million in the west, north west and mid-west. That sounds like an enormous amount of money, and it is, but it does not solve all the problems of cancer care.

Population screening programmes, where appropriate, must be embraced in the Irish health care system. Cervical screening has been introduced in the mid-west but has not been expanded beyond there. In the time since its introduction, 78,000 women have been screened. Of Irish cancer deaths, approximately 2% are due to cervical cancer. There is a role for the general practitioner in this area and it is on the agenda for the upcoming negotiations on the contract, particularly where GMS patients are concerned. It is the most effective way to proceed, from a patient satisfaction point of view and from a cost perspective. We must empower and involve the general practitioner more in health preventative programmes.

As the Deputies have said, breast screening is available in the east and the midlands but not yet in the areas of future expansion, Galway and Cork, which would cover the rest of the country. It will be in place by 2007. The funding required is approximately €21 million and will be part of the capital programme I will announce shortly. We will not work as we previously did, when we separated capital provision from the revenue implications and had many buildings lying idle for years beyond understanding. When we press the button for the capital facility, we must ensure we have factored in the revenue implications of that. That is why there will be no announcement until the whole capital programme for the year is announced in a couple of weeks. That will ensure consistency and integration between capital requirements and revenue implications.

It is no secret that the roll-out of BreastCheck to Cork and Galway will be in that programme. As the Deputies are aware, we must appoint a design team, put the facilities in place and recruit the staff at the same time to ensure there is no gap between the provision of the building, with the bricks and mortar and machinery, and the personnel. At the end of the day, while facilities are required, the most important element in cancer care is the expertise of the oncologists, radiologists and others who form part of a multidisciplinary team.

Those worst affected are in the 50 to 64 age group. I sympathise with those who say we should go beyond and below those ages, particularly where there is a family history of cancer. Deputy Twomey is a doctor, but many people will ask someone to describe their family history and they will tell them in turn what might or might not happen to them. There are significant factors, of which breast cancer is one. We have achieved an 80% survival rate from the previous rate of 72% five years ago. That is significant progress.

I remain committed to rolling out this programme nationwide. I do not like to hear the advertisements either. They are excellent but when they say "only available" at the end, it reinforces the view that there are different systems for people in different counties. However, every population screening programme I have examined was rolled out on a phased basis for obvious reasons.

On cancer care in particular, we must ensure that safety is paramount in how and where something happens and that people do not undergo surgery when it may be unnecessary. We all know that early diagnosis reduces dramatically the radical nature of the treatment that might follow, whether it is surgical, medical oncology or radiation, and the chances of surviving and being cured are much higher. I thank Deputy Twomey and Fine Gael for tabling the motion and I remain committed to ensuring this happens as speedily as possible.

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