Jan O'Sullivan (Limerick East, Labour)

I am not quite sure how I am going to deal with that. I intend to share time tonight with Deputy Ó Caoláin and tomorrow night with Deputies Upton and Wall, with the permission of the House.

I compliment Deputy Reilly and the Fine Gael Party on tabling this motion. As the Minister said, we debated this issue last Thursday but it is very important to have an opportunity to return to it. Despite the three speeches I have just heard, I hope we can still persuade the Government to introduce this vaccine as intended in September of next year for 12 year old girls.

We must rescue this programme from the cutbacks. The cost is perhaps less than €10 million even though last week the figure of €14 million was mentioned. It is accepted now that it can be done for €10 million as a school-based programme, particularly with competitive tendering from the two companies concerned which can provide the vaccine. I will speak later about how we might save the money. I again ask the Minister to keep an open mind on the possibility of finding this money from somewhere within her budget for next year. I ask her not to let this programme go.

I believed the Minister was correct when she stated last August that she intended to introduce this programme. She said last August, "I accept the expert advice that the introduction of a universal high-uptake vaccination programme for young girls, in conjunction with population-based cervical screening, could significantly reduce overall cervical cancer rates". This is very clear and we should not quibble about whether it is more or less effective than screening. The fact is that it is effective, as the Minister agreed last August. I acknowledge that she stated in her contribution tonight that she did not want people to think she had somehow or other changed her mind. I accept that she has not changed her mind. However, she has decided that the money is not there to introduce the scheme, despite the fact that within a health budget of approximately €16 billion this will amount to €10 million or less. I urge the Minister to find that money.

As other speakers have said, a wide range of people, experts and organisations who care about this issue have strongly condemned the decision to put the programme on hold, including the Irish Cancer Society, the Marie Keating Foundation, the All-Ireland Cancer Foundation, the European Cervical Cancer Association, the Irish Family Planning Association, the Well Woman Centre and many others. Probably more important, many ordinary people had expected that their 12 year old daughters would be offered this vaccine next year and regarded this as an important preventative measure. Of all the cancers, cervical cancer can be almost eradicated within our lifetimes if there is a combination of the screening and vaccination programmes. This is not the case with other cancers which, even with our best efforts, will still kill a percentage of our population. However, in the case of cervical cancer, we have opportunities which we should avail of. The publicity has created an awareness of the vaccine and many parents will purchase this vaccine for their daughters. However, it is regrettable that many families will be unable to afford to pay to protect their daughters. There is something obscene, in my opinion, about having to make such a choice and in the inequality of choice.

I urge the Minister to rethink her decision. It should not be presented as a competition between screening and vaccination or a competition between treatment and vaccination. We should not ration our health resources in that way. I fully support the screening programme which is very good and I am pleased it is being rolled out this year. However, the vaccine should also be provided.

As the Minister of State, Deputy Wallace, said, this is largely an illness affecting women in the younger age groups. Many cancers do not strike until later in life but half of all those who develop cervical cancer do so before the age of 50. We are talking about women whose lives will be considerably shortened if they develop this illness. All those factors must be considered and I ask the Minister to change her mind.

The cost of the programme was discussed last week and whether it could be done for less than €14 million. I believe it can be done for considerably less than that amount. The companies concerned will be willing to offer a lower price. I note there is competition between Aldi and Lidl and Dunnes and Tesco and prices come down as a result of competition. There is a competitive element to the tendering which I believe will result in a good price.

A top-up rubella vaccine is given in schools to girls of that age. Would it be possible to save on administrative costs by giving this vaccine at the same time as the rubella top-up? I do not know if this is possible but it is a suggestion worth investigating. This might also encourage an uptake of the vaccine. The Minister would hope for an 80% uptake.

There is an obligation on us to address the issue of finding the money and various suggestions have been made. The HSE farms out work to various private companies. In the case of the health repayment scheme which cost €15 million, the HSE paid a private company to write to all the people in the north east whose X-rays were reviewed, a total of more than 5,000 people. We all know there are many people working in the HSE who are unsure of what work they should be doing, including many people at the higher management levels. There are many grades pushing paper around. We were asked to be patriotic with regard to the budget. Will the Minister ask the HSE to find people within its organisation who can do this work and save money? We did not find out until afterwards that the €15 million was spent on the health repayments scheme. I do not know what else they are planning to farm out to various companies. There are many demoralised people among the Department's civil servants and within the HSE who do not know what they are supposed to be doing. I ask the Minister to go back to the HSE to find whether it can save money in this area or otherwise find this money. The Minister should get to work with the HSE, her Department, the schools and the providers of the vaccine and seek to find a way in which she can introduce this programme at the time she had intended to do so. We should not give up on it.

Deputy Harney is the Minister for Health and Children, not the Minister for sickness. Prevention of illness is one of the most important jobs a Minister for Health and Children can do and this is a preventative measure. I urge the Minister not to close her mind to introducing it at the time she intended to do so. Not much has changed since August and I am sure what is a relatively small amount of money within the overall budget can be found.

The public was struck by the wrongness of this decision. With all of the various issues we were faced with in the budget, such as the medical card cuts for the over 70s, the education cutbacks and the variety of cutbacks outlined again today in the Social Welfare Bill, people were struck that the Minister could go back on a measure she announced in August that would prevent a deadly illness in the future. It is a preventative health measure that would cost relatively little within the overall budget. How could it become a victim of the cuts? People are genuinely shocked by this.

The Minister is a reasonable person, although I do not agree with her on many issues. It is possible to find this money. I urge that in this debate we should focus our minds on trying to find a way out of this and try to rescue the programme for next year.

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