Mary Harney (Dublin Mid West, Progressive Democrats)

It is true that there has been cervical cancer screening in other jurisdictions for some considerable time, including the United Kingdom and Canada, where it was introduced in the 1960s. I acknowledge that we are way behind in many areas. However, we have in place a co-ordinated programme for the roll-out of both BreastCheck and a cervical cancer screening programme on a sustainable basis. The vaccine has not been rolled out in either the United Kingdom or Canada. Everybody is examining the most effective way of rolling it out. It would not be appropriate to simply provide for it on the medical card. Any immunisation programme would have to be targeted at the whole population to be effective. Some countries have decided what course they will take — I understand the Canadians are considering a programme aimed at nine year old children while others are considering beginning with 11 year old children. We have asked the national expert group, which advises on immunisation programmes, first, whether we should do it and, second, how we should do it. The most effective way to do it would be on a whole-population basis among the age group to be targeted, probably utilising the schools.

To take as an example BreastCheck, a national screening programme, of the women contacted, 70% come forward for screening and 30% do not. The most effective way to implement screening programmes is to seek the most appropriate way to reach the whole population. If we decide to introduce a vaccine for nine, ten or 11 year old girls, we should do this through a school programme.

The cervical screening programme will begin later this year and the screening group has been put in place. In addition to a roll-out of the screening programme, we must also deal with cytology facilities, which, as the Deputy knows, are inadequate. Due to these inadequacies, a number of smears had to be sent abroad recently so that results were expedited and not delayed. The HSE is currently working with hospitals to improve cytology facilities so smear tests give accurate results. As a general practitioner, the Deputy will know there have been hundreds of thousands of opportunistic smears. The results have been questionable and in one case it was necessary to close down a screening clinic given the dubious results.

Huge action is being taken. As I said, later this year we will have both the screening programme and, I hope, a decision with regard to the vaccine.

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