Seán Haughey (Dublin North Central, Fianna Fail)

I am taking this matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. I welcome the opportunity to address the issues raised by the Deputy and to set out the current position regarding mammography services in Limerick Regional Hospital and the roll-out of BreastCheck. The HSE has designated Limerick Regional Hospital and University College Hospital Galway as the two cancer centres in the managed cancer control network for the HSE western region, which includes County Limerick.

The HSE has advised the Department that breast imaging services are available at the Mid-Western Regional Hospital, Limerick, through a breast clinic which provides rapid access for all women with breast disease symptoms. Mammography scheduling is based on clinical need and referrals to the breast clinic are assessed, prioritised and subsequently referred to the radiology department for imaging. Urgent referrals to the breast clinic for mammography are usually carried out within two weeks. Non-urgent cases are placed on a waiting list.

It is important that clear criteria are applied to distinguish between urgent and routine cases. Significant work has already been undertaken in the area of symptomatic breast disease services, supported by the Irish College of General Practitioners, regarding referral criteria and the development of appropriate referral forms to allow for appropriate triage of urgent and non-urgent cases.

The symptomatic breast service has traditionally provided 11 appointments per week to enable GPs to refer asymptomatic women, that is, women who do not have symptoms for screening mammograms. At present the waiting list associated with this service is up to 24 months. The service has recently been withdrawn in order to prioritise mammogram slots for the imaging of women presenting with symptoms. The HSE has advised the Department that this is the best use of the resources made available by the national cancer control programme.

The implementation of the national quality assurance standards for symptomatic breast disease will ensure that every woman in Ireland who develops breast cancer has an equal opportunity to be managed in a centre which is capable of delivering the best possible results.

The BreastCheck programme delivers screening to women in their local community through the use of static and mobile screening units. The 4% of women who need follow-on treatment receive it at one of the four BreastCheck static units located in the western, southern and eastern regions. The BreastCheck programme is designed to offer repeat screening to the eligible population, that is, women aged 50 to 64, within an interval of 21 to 27 months.

BreastCheck recently became the first national screening service provider worldwide to offer a fully digital mammography service and women in the mid-west will be screened from a mobile digital screening unit. The mobile unit will remain in an area until all women known to the programme have been offered a mammogram. This time period varies from county to county based on the numbers of women to be screened and uptake levels.

The roll-out to individual counties, including County Limerick, will be dictated by BreastCheck's management and operational considerations. The estimated total screening population in County Limerick is 12,976.

Undoubtedly, the development of the country's cancer services can provide the most effective testimony to how change driven by quality and safety can result in faster access to better services with best outcomes for the patient. We are now well into the initial stages of delivering a model of service for cancer care which will have all the characteristics of the modern and effective systems enjoyed by other developed countries, not least better outcomes for patients.

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