Máire Hoctor (Tipperary North, Fianna Fail)

The immediate issue is the question of introducing a HPV vaccine, but it is important to set the matter in a wider context.

In September 2007, the Government endorsed the establishment by the HSE of a National Cancer Control Programme, NCCP, to manage, organise and deliver a national programme for the entire population, in line with the National Cancer Control Strategy approved by Government in June 2006. Professor Tom Keane took up his post as national cancer control director on 19 November 2007.

Our first priority, therefore, during the past 18 months has been to invest in putting in place eight designated centres with a multidisciplinary team of experts to be able to care for patients who are diagnosed with cancer. The second priority is screening programmes. Many other European countries and countries beyond Europe have been involved in screening programmes for some considerable time.

As a person living in the mid-west, we were one of the first groups to benefit under the pilot scheme for the cervical screening programme. That was a great success where the vast majority of women turned up at the general practitioners' clinics and where the nurses carried out the cervical screening programme. We in the mid-west led it in some ways and we see that it has been a great success. We are delighted to see the roll-out of a national cervical screening programme, which began in September of this year.

Cervical screening has the capacity to prevent 80% to 90% of cervical cancers. Some 70 to 100 women present with cervical cancer each year. A national screening programme for women aged between 25 and 60 has the capacity to eliminate the incidence of cervical cancer by 80% to 90%. The cervical screening programme will cost €35 million in a full year. An extra €25 million will be allocated to that programme next year and an extra €15 million will be allocated to the cancer control programme to allow Professor Keane continue to recruit the expertise we require in the eight centres to provide, in particular, multidisciplinary care. That €50 million funding has been identified for those two programmes. Surely this is evidence, if evidence were needed, of the Government's commitment to tackling cancer in all its forms, and cervical cancer in particular.

Despite the extremely difficult economic circumstances facing us, the Government has been able to make a total additional allocation of €15 million to the National Cancer Control Programme in 2009 for service developments. With this funding the National Cancer Control Programme will concentrate on developing high quality services to combat lung and prostate cancers which together account for over 2,000 deaths each year.

On cervical cancer specifically, our immediate responsibility is to women who have already been exposed to HPV and who may already have pre-cancerous changes or undetected cervical cancer. Vaccination is a long-term investment which will only be offset by improved health outcomes and treatment savings in 15 to 30 years in the future.

Each year between 250 and 300 new cases of cervical cancer are diagnosed, with an average age at time of diagnosis of 44. The impression now being created by some people is that there is no preventative programme against cervical cancer in Ireland, which is entirely untrue. The clear international evidence is that the first step is to organise an effective screening programme, and to then follow it with HPV vaccination. This is exactly what we are doing.

Population based cervical cancer screening carries both immediate and long-term benefits. It carries the significant advantage of delivering earlier benefits than a vaccination programme. The requirement for a screening programme will not be eliminated by a vaccination programme, although in the long term, it is hoped that a vaccination programme would reduce the reliance on screening. The highest priority must be attached to implementing and sustaining the national cervical screening programme.

The national programme provides screening in a primary care setting every three years for women aged 25-44 and screening every five years for women aged 45-60. It will deliver a national quality assured, organised cervical screening programme and it will be implemented in line with best international practice. All elements of the programme will be quality assured — call and recall, laboratory services, and colposcopy will be managed to deliver a single integrated national service. Results will be available to women within four weeks of their smear test and all smear test slides will be read twice by two separate cytotechnologists.

Difficult times require that we make difficult decisions. These decisions need to be evidence based and scientifically sound. I am satisfied that we have got our priority right here in terms of our decision to invest, in the first instance, in rolling out the national screening programme.

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