Olivia Mitchell (Dublin South, Fine Gael)

I too urge the Minister to reconsider this decision. I support my colleague, Deputy Reilly, in all he has said. This decision is so irrational and so out of character for the Minister that I can only conclude it has not been afforded the type of rigorous assessment or consideration it merits and which I would generally expect of the Minister.

I was briefly Fine Gael spokesperson on health when the now Minister for Foreign Affairs, Deputy Martin, was Minister for Health and Children. I raised with him on many occasions the failure to roll out the pilot cervical cancer screening programme throughout the population. The pilots were set up when my colleague, Deputy Noonan, was Minister for Health and Children. The issue at that stage was that there simply was not the testing capacity within the State, with some women waiting months for results. I was delighted when the then Minister for Health and Children, Deputy Martin, finally announced that the pilot scheme was to be rolled out nationwide, albeit with testing being outsourced to the United States.

In the intervening years, news of the availability of a new cervical cancer vaccine filtered through to the great excitement of all. For the first time, a cancer could be definitively linked to a virus, and prevention by vaccine was not only possible but feasible. Vaccination programmes have since been introduced in many countries, with a rash of states currently preparing to introduce such programmes. There has been such a strong take-up internationally because vaccination programmes are efficient and effective, representing good medicine and good economics. That is the reason the Minister supported the introduction of such a scheme. She has observed many times that the trend in managing population health is towards prevention, by keeping people healthy, disease-free and out of hospital through vaccination programmes and lifestyle changes, and, when people get sick, early detection through regular check-ups and screening programmes.

Not all vaccines and screening programmes justify population-wide delivery in terms either of improvements in the health of the population or health expenditure savings in the future. However, this is not the case with the HPV vaccine for which there is strong international evidence of its efficiency. It saves lives and can ultimately eradicate the disease. Moreover, it can obviate the need for invasive treatments that may render women who contract the disease incapable of having children. The vaccine is cheap, at a fraction of the cost of one day in hospital, and it will become cheaper over time as worldwide demand increases, as it inevitably will.

As I said, it is good medicine and good economics. This was accepted by the Minister, the Health Service Executive and the medical profession. In August, the Minister considered the introduction of a vaccination programme to be a good idea. What happened in the intervening ten weeks to make it a bad idea? It is not that the Minister was unaware in August of the poor condition of the public finances. She had already been asked by the Taoiseach to identify cuts in departmental expenditure as part of a penal budget. The Minister tackled that job with gusto. Nevertheless, she recognised that this vaccination programme was worth including in the proposed expenditure of her Department. She said at the time that the cost and take-up might cause a delay. However, neither the cost nor the take-up has changed. The Minister did not know then what the cost or take-up would be and she still does not know. Therefore, they cannot be the reason for her change of mind.

Will the Minister explain how this U-turn can be justified? The public demands an answer. If I were the mother of an 11 or 12 year old girl, I would be absolutely incensed at the prospect of the Minister refusing to take action that could prevent the possibility of my child contracting a serious illness that could lead to infertility and even death. The Minister must know that this is how people will react. How much more awful will it be for the Minister when some of the current cohort of 12 year olds develop cervical cancer? It is inevitable that some of them will given the current rate of 200 new cases per year. How could she live with herself? Knowing the Minister as I do, I honestly believe she would be unable to do so. I ask her, therefore, to change her mind.

Within the €16 billion budget for the health service, surely €10 million can be found to save these lives. At the very least, and I am, with great reluctance, offering the Minister something of a get-out clause here, she could make the vaccine available to those 12 year olds whose parents have a medical card and, for everybody else, ensure that tax relief is available at the marginal 40% rate. Many mothers will make sacrifices in order to ensure their daughters are vaccinated.

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