Mary Harney (Dublin Mid West, Progressive Democrats)

——that would cost a further €500,000. In response to Deputy Burton's question, the cost of vaccines here is approximately three times higher than in other countries in terms of GP charges. This vaccine would be administered by nurses and the Health Service Executive's estimate of that cost is approximately €5 million.

I accept the figures for costs outlined in the HIQA report. Deputy O'Sullivan asked me what changed my mind. When I made the announcement in August after the health technology assessment I said the programme would be introduced subject to two things. The first was that we could get the vaccine on a cost-effective basis and the second was that we could get an 80% take-up from parents. The advice is that if one does not get a penetration level of approximately 80%, then it would not be effective to introduce the programme. Subject to those two caveats we were going to introduce the programme from 2009 if we could get the money in the context of the Estimates.

What has changed dramatically since August is that in the context of next year the Minister for Health and Children was required to take €700 million off planned expenditure for 2009. That is not easy to do. There is no low-lying fruit here; it is not easy pickings. The decision was to continue with the screening programme because that would save women who have cancerous cells and pick up women currently at risk. That must be the priority. That programme will cost an extra €25 million next year. We have to organise our services to get better outcomes and that requires €15 million to be given to Professor Keane to recruit the expertise to allow us to establish the eight designated centres. Treatment for people with cancer and picking up people who have cancer have to be the priority.

Of course I want to see the vaccine introduced as quickly as possible. In August, I accepted that we could not do the catch-up for cost reasons. We would love to do that too. Unfortunately, we cannot do everything unless we have the resources. Therefore, I had to make choices based on the clinical advice, which said that screening prevents 80% to 90% of cancers and picks up the women now who are at risk of cancer while treatment deals with people who have cancer.

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