Arthur Morgan (Louth, Sinn Fein)

I welcome the opportunity to address the cancer issue today. The decision by the Minister for Health and Children to cancel the cervical cancer vaccination programme is an absolute disgrace. The Minister announced the programme only three months ago but it has now been axed. The manner of the announcement was also a disgrace as the news was sneaked out under the door on the day of the US presidential election. The press release was apparently timed to go out after the Order of Business concluded in the Dáil, and as usual, it was late in the day, which made it difficult for Opposition spokespersons to respond.

The programme was designed to prevent the development of cancer in women and the Minister's hatchet job is another attack on public health by a Minister and Government whose stewardship of our health system has been disastrous. This public health programme is among the first to go on grounds of cost yet the budget left intact the tax breaks for developers of private hospitals. Estimates for the cost of the vaccination programme vary between €10 million and €14 million, yet in 2006 — the latest year for which figures are available — this Government gave tax breaks worth €10.6 million to the developers of private and for-profit hospitals.

In a budget that has slashed public services, those tax breaks were untouched, although they could have paid for this vaccination programme. Also untouched in this budget was the Minister's and Government's totally discredited private hospital co-location scheme. The Progressive Democrats may be about to disappear, as the previous speaker said, but its Thatcherite policies are alive and well in this Government.

Savings could and should have been made on the tax breaks for the private health industry and not on programmes which will enhance the health of women and prevent much greater cost in future, both in terms of the well-being of individuals and the cost to the health service of treatment.

Irish Cancer Society chief executive John McCormack said the Minister's decision to cancel the vaccination programme is "very disappointing". He stated: "If this is going to be the beginning of a pattern around hard-fought decisions being reversed, the Irish Cancer Society would be awfully concerned about it". This is a cancer prevention measure and €1 towards prevention is as good as €2 towards a cure. The Dublin Well Woman Centre has indicated the Minister's decision is both shortsighted and dangerous. The CEO of the centre, Alison Begas, said it was an illogical move that will cost even more in the long term. These are the voices the Minister should be listening to. We should not forget that we are talking about preventing cancer and saving the lives of women.

Cervical cancer is the second most common cancer in women under 45 and the third most common cancer in Ireland's women. Almost 200 women in the State, on average, develop the disease every year. In contrast to most other cancers, this type affects mainly younger women, with 60% of cases occurring in women aged 50 or younger. Approximately 70 women in the Twenty-six Counties die from cervical cancer each year.

A survey last year showed that only 29% of Irish women are aware that a vaccine for cervical cancer exists. Despite cervical cancer being the second most common cancer for women under 45, three out of four women did not know what caused the disease. It must be known as widely as possible that this cancer can be prevented by means of a simple test — the cervical smear test. It is a scandal and disgrace that successive Governments failed to roll out a national testing programme and that only this year is progress being made in this regard.

On 24 February 2005 there was a unanimous call from the Irish Cancer Society and 24 other organisations, including trade unions, professional bodies and women's networks, for a State-wide pre-cancer screening programme. Comprehensive screening, leading to early detection and treatment, can and will dramatically reduce the incidence and development of cervical cancer and the resulting all too terrible death toll.

There is still far too little information to show women that screening can save lives. Information and screening must be as widely available as possible and there must be quick progress in moving the screening programme forward. We have heard much from this Government recently about the excellent cancer service being developed across this State. We have heard about centres of excellence and I have seen a move in my own constituency, for example, where much of the Dóchas breast unit is being moved to Dublin.

I will relate an incident which happened recently. One of my constituents went to her GP four weeks ago with a concern about a breast issue. The GP shared her concern and referred her to the Dóchas centre as normal, and the doctor had not been advised of anything different. Over three weeks passed and she heard no word about an appointment so she phoned the centre in Drogheda to find out the date of her appointment. She was told that the Government had told the HSE to close the service, which is to be transferred to Beaumont in Dublin, and she had to contact that hospital because appointments were no longer being made in the Dóchas centre.

When she contacted the Beaumont breast clinic for the date of her appointment, she was told it was not making appointments. The clerk told her a pile of referrals was sitting on a desk but nobody had been put in place to arrange the appointments. In other words, this Government has begun closing services again on the pretext it is introducing better services, although this is not the case. No preparation has been made in that respect.

Is the Government not giving any consideration in such decisions to the stress and trauma suffered by the women involved and their families? Is there any appreciation in the health service or at Government level of the sheer worry, sleeplessness and torment brought about by these cases? This is what is happening.

The HSE wrote to GPs in the Dóchas catchment area on 23 October advising them they should make their referrals directly to Beaumont Hospital. However, that was a little late. It suggests the HSE was transferring patients to Beaumont at least two weeks before it informed the GPs what was going on, thus causing referrals to be processed by the Dóchas centre and sent on to Beaumont, which constituted a significant waste of time.

The Minister should comment on this development and whether she considers such treatment to be appropriate. Moreover, my constituent involved in this case received a letter from the HSE advising her that she had an appointment with Beaumont. It states, "we are writing to inform you that an alternative appointment has been made for you at the breast unit at Beaumont Hospital in Dublin". This was sent to her in writing but when she telephoned the hospital to ask when was her appointment, she was told that no appointments can be made because no one has been assigned there to arrange such additional appointments. She was also informed that because arrangements had not yet been concluded for the transfer of the consultants from the Dóchas centre to Beaumont, no one would be available to deal with her appointment in any event. The Minister should comment on this because some accountability in this regard would be timely.

The letter to my constituent also stated, "Many of the staff who have worked at the Dóchas centre will be moving to Beaumont Hospital to provide the new improved centralised service and we will continue to put you, the patient, first and ensure your health and safety are our primary concern". Nothing in this story demonstrates the Minister has patients at the centre or that they are her primary concern. Everything pertaining to this matter suggests this is another hatchet job designed to slash a service available to women in the north east and to centralise it into a service that is not ready to receive them and which will cause additional travel, pain and suffering to the patients involved. The Minister should comment on this scandal.

This week the HSE produced another review about the north east, the so-called look-back review of cancer patients. It demonstrated that of those concerned, at least one woman had a 60% chance of survival. Unfortunately she did not get that chance and has died. This is merely one of a litany of events in the north east. I will share some of them with the Minister, who may be divorced from some of it. The most recent event is the review of the X-ray scandal that was published on the day of the US presidential election. Second, I raised today the scandal in respect of the Dóchas breast unit. Third, there are issues regarding the report of Ms Justice Maureen Harding Clark into the Michael Neary episode — I refuse to call him "Doctor" — as well as the lack of an appointment of a clinical auditor. This still has not happened and therefore the possibility that abuses of that nature will recur is wide open.

Fourth, grave concern has been expressed pertaining to issues regarding the Rape Crisis Centre and the services provided to women in the north east. A significant number of representations have been made to me in that regard. Fifth, the ongoing scandal of the symphisiotomies never has been dealt with or cleared up. Although an external review was promised, nothing has happened in this regard. More than 400 such symphisiotomies were performed in Our Lady of Lourdes Hospital, Drogheda. In conclusion——

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