Mary Harney (Dublin Mid West, Progressive Democrats)

I move amendment No. 1:

To delete all words after "Dáil Éireann" and substitute the following:

"—reiterates its support for the comprehensive work by the Government to bring cancer care, treatment and survival to the best international standards and to offer every person in Ireland equal access to the best possible cancer care in eight designated centres;

welcomes the additional €15 million in 2009 allocated for this programme of work under the leadership of Professor Tom Keane of the Health Service Executive;

supports the Government's introduction already this year of the first comprehensive, free national cervical screening programme for all women between the ages of 25 and 60, at a full year cost of €35 million, which is an immediate step towards reducing deaths from cervical cancer by over 80%;

welcomes the fact that approximately 100,000 women will have been screened by the end of the current year;

supports keeping a HPV vaccination programme under active review in future funding decisions relating to overall cancer control priorities;

recognises the need to prioritise the use of public resources in very challenging economic circumstances, including in relation to health services; and

supports the Government's prioritisation for existing services in the allocation of funding for health services in 2009."

I welcome this debate, even though we had another debate last Thursday. In this debate, it is important that we are all fair and reasonable. I have a document in front of me which was published in January 2007. It was the health priorities of the Fine Gael Party and the Labour Party if they were in Government, and there is no mention of cancer in the document. I also have a document published by the Fine Gael Party during the election, which emphasis the importance of screening. There is no mention of vaccines. In the run-up to the budget, the Fine Gael spokesperson on finance suggested there should be a 3% cut in the health budget, totalling €700 million in cuts. I asked Deputy Reilly to tell me from where that €700 million would come.

In debates like this, it is important to take perspective into account. Unlike all the other countries mentioned by the Opposition Deputies, for example the UK which has had screening programmes for 20 years, we have only just begun to roll out a national screening programme for cervical cancer in September. By the end of the year, 100,000 women will have been screened. In the month of October alone, 30,000 women registered to be screened. Screening has the capacity to reduce cervical cancer by over 80% in terms of the population, and by 95% in an individual case, if a woman goes for all the screening. Therefore, in a country that does not have a national screening programme, the priority clearly must be to put in place a screening programme that will pick up women that have the pre-cancerous abnormalities, so that they can have treatment. Next year, €35 million is being assigned to the national cervical screening programme.

We live in a country where our cancer outcomes are not what they should be. The exception is in children's cancer, where we do as well as any country in the world, as children's cancer is organised and planned in one central location at Crumlin Hospital. However, we do not do well on other cancer treatments. That is why for the last two years we have been seeking to reorganise cancer services for the patients who currently have cancer, so that they can get a better outcome. Deputy Perry referred to Sligo. We do not have an appropriately organised service in Sligo, because we know from the expertise that in order to have a world-class service we need two surgeons with a specialist interest in breast cancer, two radiologists and two pathologists. We do not have that in the hospital in Sligo. We could not have that kind of resource and that level of expertise in hospitals with small volumes of patients.

The other priority is to resource the cancer control programme. Next year, an additional €15 million is being invested in that programme to recruit the skilled expertise that we need for the eight centres, so that the treatments we offer to cancer patients can deliver the best possible outcome that this country can afford. In that context, it was not possible to do everything. I do not need to be convinced about the vaccine. I am a strong proponent of the vaccine, but unfortunately we cannot do it this year. The Government could not engage with any company on the basis that we will not pay it this year, but we might pay next year.

There are over 100 different HPV viruses. Two particular viruses cause 70% of the cancers, and the vaccine can prevent those two particular strains. However, no 12 year old without a vaccine will not get screening with a 95% success rate. Equally, if a 12 year old got the vaccine, she would still have to be involved in the screening programme for the 30% of cancers that are not dealt with by the vaccine. We cannot start a programme this year that we cannot sustain next year and the year after. The decision not to proceed next year was made because we are seriously financially challenged. In the Department of Health and Children, we had to find €700 million worth of savings on planned expenditure for 2009. Since 75% to 80% of the costs are made up of payments to staff, the Deputies can imagine how challenging it is to find the sums of money in the remaining costs. If it were a once-off sum of money, it would not have been a difficult decision. It represents an ongoing sum of money for this year, next year and the year after.

Anybody who claims in this debate that we are sentencing girls to death knows that is not true. Every young woman who does not get this vaccine will be offered a screening programme. Any young woman who would get the vaccine would also have to be involved in a screening programme. The vaccine does not prevent cervical cancer, although it reduces its incidence in 70% of the cases. I accept that.

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