Leo Varadkar (Dublin West, Fine Gael)

I acknowledge the willingness of the Minister to come to the House and answer questions in free format. If other Ministers were prepared to do so on important issues such as this we would have a stronger Parliament and democracy and perhaps a better Government.

I understood the role of the Radiological Protection Institute was to assess whether machines were dangerous in terms of their emissions and not their efficacy. Will the Minister clarify this? Did all of the women affected have symptomatic breast disease in that they went to their doctors with a lump or were they breast screening cases? Breast screening cases would raise a different argument. As a doctor I would be surprised to hear that in places triple assessment is not the norm for people who have lumps. I did not know this and it amazes me.

The phrase "centres of excellence" is a PR term. Let us be honest, we are not discussing centres of excellence we are discussing centres of adequacy and it is not what we have. The decision to have four centres in Dublin seems strange. Clearly, it has to do with university politics and I am disappointed the Minister did not take on the universities in the same way she did over the children's hospital and state they cannot all have a centre of excellence. Perhaps we should have had one or two in Dublin which would have been real centres of excellence like Sloan-Kettering. If hospitals in the north east or midlands come together and agree on one regional hospital is it open to consideration that at a later stage those new hospitals could become centres of excellence?

It will still be the case that women will have breast cancer diagnosed in smaller or district hospitals. Very often, when a person is in with a complaint such as a heart attack or pneumonia they are examined properly for the first time and a lump is detected. Is it envisaged that patients admitted with other conditions would be sent to a centre of excellence for triple assessment? It is important that it will still be possible to do mammography and biopsy on site as it is common for someone to come in with a different complaint and have a breast lump noticed during admission. Has this been considered?

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