Paul Gogarty (Dublin Mid West, Green Party)

I express my sympathy to the families concerned in Portlaoise and Cork. I note the Minister's timely and prompt apology and her commitment to ensure that every possible action will be taken to ensure that errors like this do not happen again in cancer care services. I would like to make a few suggestions in this regard. I note the Taoiseach this morning pointed out that triple assessment only takes place when a diagnosis of cancer or pre-cancer has been made. Even from a cost efficiency point of view, would it not make sense for the file, having been examined by a radiologist, to be sent to a backup group of radiologists dedicated to checking files as a matter of course? They do not need to be in the same location and it could be done on a central basis. A copy of the screening could be sent to such a national location for a mandatory double check of all diagnosis. As the Minister said it is not necessarily the machines that are at fault. In some cases it is human error. Double-checking would seem to represent good practice even if the checking is not taking place alongside the local radiologist.

I do not have a problem with the roll-out of centres of excellence. I acknowledge that for cost efficiency and to ensure standard treatment we need centres of excellence. However, for low-level cancer screening we should decentralise when possible. The most vulnerable, the elderly, low-income families and those on social welfare do not necessarily have the means to travel long distances. They have to take buses, taxis or trains and stay overnight, often at considerable expense. They suffer most from the centralisation of services that should not always be centralised.

I tabled a parliamentary question recently about the smear testing of Traveller women in my constituency. The service which was provided for them in conjunction with Ballyfermot and Tallaght Well Woman centres managed to increase the number attending for smear tests until 90% of eligible women were screened. However, this free service ceased two years ago and, as a result, the number of Traveller women accessing the service has decreased substantially. That is an example of how lack of proximity can lead to longer term problems which will impose a cost on health services exponentially far in excess of the cost of a smear test.

The HSE does not emphasise prevention enough in dealing with cancer in the context of diet, exercise and physical education and schools, which are cross-departmental issues. A person who does not smoke and has a healthy diet is less likely to contract cancer. While no scientific analysis has been carried out in my constituency, there is anecdotal evidence that where pylons and telephone masts coincide in communities such as those located beside Ronanstown Garda station, the number contracting brain tumours increases. The HSE should carry out a cluster survey and compare the findings with those of a survey conducted in a community that does not have pylons and telephone masts to establish whether this is the case and, if so, what can be done about it.

Deputy McDaid mentioned the issue of human papilloma virus and cervical cancer screening. Care must be taken with the vaccine. For example, I have raised with the Minister the issue surrounding one medication, Deprovera, which can thin the lining of mucus and lead to an increase in STIs, even though health warnings in this regard are not carefully written on the label. A debate on whether vaccination should take place is needed, as happened in the United Kingdom. At the very least, a full and frank debate should take place, perhaps at the Joint Committee on Health and Children, because if deaths are prevented, all the better. Prevention is better than cure. Abstinence is the best way to prevent cervical cancer. This should be followed up by educating people about safe sex practices and screening. That could all be done in local communities at a lower cost than treating someone who needs a high level of cancer care.

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