Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

Once again the Dáil has to call to account Deputy Harney in her capacity as Minister for Health and Children for what I can only describe as yet another disgraceful decision that will have a most negative impact on the health of the people. Last weekend the Minister's party abolished itself but it is a great pity that the anti-people policies of her party, the Progressive Democrats, so long embraced fully by Fianna Fáil, were not abolished as well. Those policies unfortunately live on in Fianna Fáil and in this Government.

The decision to cancel the HPV vaccination programme arose from an ethos and a policy which puts public health in second place to petty book-keeping and a privatisation agenda. The Health Information and Quality Authority has estimated the total cost of introducing the HPV vaccine at €9.7 million. Allegedly to save this sum, a public health programme which would have saved women's lives is being axed by the Minister, Deputy Harney, yet the budget left intact the tax breaks for the developers of private hospitals at far greater cost. In the year 2006 alone, the latest year for which figures are available, the Government gave tax breaks worth €10.6 million to the developers of private for-profit hospitals. In a budget that slashed public services, those tax breaks were left untouched, although they could have paid for this vaccination programme several times over. Also untouched in the budget was the Minister's and the Government's totally discredited private hospital co-location scheme.

I would remind the Green Party Members, if they were present, of what their current leader, then their health spokesperson, the Minister, Deputy John Gormley, said of the PDs in this Chamber in February 2007:

Not only have the PDs failed to deliver on their promises, they have managed to deliver on things which they did not promise, such as the privatisation of the health service. They have absolutely no mandate for this ill-conceived proposal.

Deputy Gormley also said: "Ireland has one of the highest cancer rates in the world and with this Government refusing to deal with the problem, the statistics are likely to continue to grow". Deputy Gormley and his colleagues will no doubt troop in to vote down this motion side by side with their Fianna Fáil and ex-PD colleagues tomorrow. I would advise the Green Party it might in these circumstances change its logo from a sunflower to a banana. When it went into Government with Fianna Fáil, it was undoubtedly green. It then turned yellow. Sadly, we are witnessing day after day that, as with bananas, the inevitable happens and they become rotten.

The Minister announced the HPV programme only three months ago and now it has been axed. The manner in which the cancellation was announced was typical of the sly management of bad news by this Government in that it was released on the day of the US presidential election. The Minister has made what I can only describe as pathetic efforts to defend this decision — I listened to her contribution earlier on the monitor. She has repeatedly tried to make people believe it was somehow a choice between continuing the rollout of the cervical cancer screening programme or introducing the HPV vaccination programme. This is completely wrong and deceptive on two counts.

First, screening is not a substitute for vaccination. The vaccination programme is to prevent the forms of cervical cancer concerned, whereas the screening programme is to detect cancer when it occurs. It cannot be a case of either-or. To save women's lives, both programmes should be in place.

Second, the Minister's argument is false on the grounds of cost. I have already identified one area where much greater savings could be made while allowing this programme to proceed. It has also been pointed out that the public procurement of the vaccine on the scale needed would entail significant price reductions, in which the Minister claims to be very interested. One estimate puts the cost as low as €7 million. In terms of the delivery of the vaccine, there is no reason it cannot be administered in conjunction with other vaccination programmes. This is to say nothing of the savings to the health service that will be made by preventing this cancer. Beyond the figures and the book-keeping, let us not forget that what we are talking about here are the lives and health of women in this country.

When the Minister first announced the programme back in August, it was widely welcomed. HIQA stated it was a welcome decision and that "a vaccine programme, together with a cervical cancer screening programme, will have a significant impact on reducing the incidence of cervical cancer for women in Ireland". In June, HIQA published the Health Technology Assessment of the role of Human Papillomavirus (HPV) Vaccines in Reducing the Risk of Cervical Cancer in Ireland. HIQA pointed out that infection with HPV is the main cause of cervical cancer, the eighth most frequently diagnosed cancer in women in Ireland. In 2004 alone, 200 women were diagnosed with cervical cancer, while over 90 women died of the disease. HIQA continued, and I emphasise: "Vaccination against HPV therefore represents a new opportunity to reduce the incidence of, and mortality from, this form of cancer".

Following a request from the National Cancer Screening Service Board, HIQA agreed in July 2007 to carry out a health technology assessment on the role of vaccination against HPV in reducing the risk of cervical cancer in Ireland. The authority asked the National Centre for Pharmacoeconomics to undertake the health technology assessment. The purpose of this assessment was to establish the cost-effectiveness of a combined national HPV vaccination and cervical cancer screening programme compared to a cervical cancer screening programme alone. The results of this cost-effectiveness analysis showed that universal HPV vaccination of 12 year old females would be cost-effective. The report also recommended a once-off vaccination programme for 13 to 15 year old females. At older ages, the vaccine becomes less effective due to an increased likelihood of females being exposed to the virus before vaccination.

The final report, the findings of which were approved by the expert advisory group which was convened by the board of HIQA, was submitted to the Minister for Health and Children, the National Cancer Screening Service Board and the National Immunisation Advisory Committee. On that basis, the Minister for Health and Children announced in August her decision to proceed with the vaccination programme. Now all that careful assessment and analysis and all the expert advice has been turned on its head by her. The chief executive of the Irish Cancer Society, John McCormack, has said the Minister's decision to cancel the vaccination programme is "very disappointing" and added that "1 euro's prevention is as good as 2 euro of cure". The Dublin Well Woman Centre has said the Minister's decision is both short-sighted, dangerous and an illogical move that will cost even more in the long term.

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

When the Minister introduced the Bill establishing HIQA, she told the House:

The establishment of HIQA and the Office of the Chief Inspector of Social Services will bring about a safer health and social services system that entrenches quality at all levels and in all settings. We are all learning from the past and leaving the past behind.

The Minister's decision on the human papillomavirus vaccine shows that far from learning from the past, she and her Government colleagues are repeating the mistakes of the past. I appeal to them to reverse this decision. If the Government will not do so, then let those on the benches opposite, some of whom must share the Opposition's incredulity at this decision, vote against the Government amendment tomorrow night. Sinn Féin fully supports the Fine Gael motion.

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