Timmy Dooley (Clare, Fianna Fail)

I welcome the opportunity to contribute to this debate, which has been allowed, by some contributors, to become highly charged and emotive. Some Members have taken a populist approach to this issue, but that is certainly not so in the case of my colleague and friend, Deputy McDaid, who comes to this debate as a person with medical training and knowledge. It is something I and others do not have. Those who have taken a populist approach in this debate have referred to "children" and "imminent death" in the same breath in an effort to conjure up misplaced concerns among the parents of young children. There is no basis for the claim that young children will suffer as a result of the Minister's decision to postpone the introduction of the cervical cancer vaccination programme until some time in the future.

The facts circulated by some individuals are misleading. An e-mail campaign under way today highlights the orchestrated nature of the effort to mislead in an underhand and callous way. Nowhere in the instructions or directions in the chain mail is any effort made to explain the complex nature and causative factors of cervical cancer. Nor is any effort made to explain the limitations of the HPV vaccine or to identify the immediacy of the requirement to detect pre-cancerous conditions through the national cervical screening programme.

As I understand it, the two vaccines licensed for use in this State have a capacity, at best, to vaccinate against 70% of cases of cervical cancer. Therefore, there will remain 30% of women whose cancer will not be prevented by the introduction of a vaccination programme. I understand the long-term benefits of the vaccine have not been established in medical trials longer than five years. This is not to take from the importance of putting the vaccination programme in place. However, it is more important, prior to implementing that programme, to put in place an effective screening programme that caters for the entire population. As the resources become available, a vaccination programme should be introduced in the future, in line with other vaccination programmes. However, it is important to recognise that those vaccinated will still be required to undergo screening, as the vaccine does not guarantee protection against all forms of HPV.

In the delivery of identification and preventative medicine in regard to cancer in general and cervical cancer in particular, priority must be given to women who already have cervical cancer or pre-cancerous conditions of the cervix. To this end, a well resourced national screening programme based on the cervical smear test is the best solution. As the Minister of State, Deputy Hoctor, remarked, it has already been rolled out as a pilot programme in the mid-west region, where it has been very effective. Lest anybody think that women in the mid-west have been treated more favourably than others, we are still awaiting the full roll-out of the breast screening programme. That too will be welcome when it is introduced in the mid-west. Resources have clearly played a role in regard to the roll-out of breast cancer screening services. This has always been the case in terms of the roll-out of preventative medicine. The cervical cancer vaccination programme can be no different, particularly in the stringent times in which we are operating.

The McCoogan report of 2004 alludes to research in Britain which shows the benefits of a national screening programme. It is estimated that the introduction of such a programme in this State will reduce current mortality rates by 80%. This is a good benchmark towards which we should aim. We must get the screening programme right before focusing on the vaccine. Screening is not a test for cancer but rather a method of preventing it by detecting and treating early abnormalities. It is a method we must embrace.

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