Alan Dillon (Mayo, Fine Gael) | Oireachtas source

I thank Deputy Smith for introducing this Bill. It is understood that this Bill seeks to amend the Organisation of Working Time Act 1997 to create a statutory entitlement to leave with pay from employment in order to enable an employee to avail of cervical, breast or colon cancer screening programmes provided by the national screening service or any other screening programme recommended to employees by his or her medical practitioner. Improving participation in the HSE’s national screening service is something we all recognise as a public health priority and while the intention to support participation in the service is understood, and while it is constructive, the Government opposes the Bill for two key reasons. First, the Organisation of Working Time Act is not the appropriate legislative mechanism for introducing a new health-related leave entitlement. Second, increasing access to screening services is considered a more sustainable and equitable solution than legislating for paid leave.

I will outline these reasons in further detail. Government is of the position that the Organisation of Working Time Act is not the appropriate legislative vehicle to provide for such entitlements. The Act is a statute with a specific and narrow function. It gives effect to the EU working time directive, and in doing so, it regulates maximum weekly working hours, rest periods, night work and paid annual leave. It is a framework for managing working time and not a framework for health-related entitlements. The Bill would extend the Act into areas that relate to public health screening, which are matters that the Act was never designed to address. The Act is not aligned with Departments or agencies responsible for public health. Placing a medical entitlement within a horizontally applicable working-time statute creates a structural misalignment between the nature of the entitlement and the purpose of the legislative instrument. Irish law has consistently located health-related and care-related leave such as maternity and parental leave, adoptive leave, medical care leave and carer’s leave in stand-alone Acts or within broader family- or care-related statutory frameworks overseen by the Departments of Health or of Children, Disability and Equality. These frameworks reflect the medical, care-based and equality-based nature of those entitlements. Placing health screening leave into the Organisation of Working Time Act would represent a major departure from these long-established approaches, and the Government is therefore satisfied that the Act is not the appropriate legislative home for such an entitlement.

My colleagues across government and I believe that enhancing access to the HSE’s national screening service is a more sustainable, equitable and inclusive solution than legislating for employer-paid leave. This work is already under way across all four national screening service programmes, which are BreastCheck, CervicalCheck, BowelScreen and Diabetic RetinaScreen. The service’s equity framework is designed to ensure that population-based screening programmes in Ireland are accessible, inclusive and effective for all eligible individuals, regardless of their background, socioeconomic status or employment situation. Screening eligibility is based on age, gender and clinical criteria and not employment status. This ensures that people who are unemployed, self-employed or in insecure work are not disadvantaged in being invited or receiving care. The national screening service carries out a range of programmes and projects to support accessibility and equity, and the outcome of these efforts is clear. Recent data from quarter 1 to quarter 3 of 2025 show strong and often above average participation, including that BreastCheck achieves an uptake rate in the region of 74.7%, exceeding the 70% target Deputy Smith outlined. CervicalCheck screened 74.8% of eligible women within a five-year period, against a target of 80% and BowelScreen reached 52%, above its 45% target. These results show that the public is highly engaged with preventative health programmes, which is an essential factor in early detection and reducing cancer mortality.

I will briefly explain some of the accessibility and equity programmes and projects which the service has developed, in addition to some recent improvements in the delivery of the programmes themselves. The national screening service has developed a wide range of initiatives aimed at improving equity, access and participation, including the community champions health promotion project, which trains community health workers to provide practical information and support about screening services, an intervention toolkit to support community workers to encourage screening uptake, a pregnancy-specific eye screening pathway for women with diabetes, accessibility training for staff to better support people with disabilities, a cancer prevention and screening project with the Traveller community, a literacy-focused initiative to support diabetic eye screening among Travellers, improved access to cervical screening within Limerick female prison and dedicated breast screening initiatives for Ukrainian women.

While increased flexibility of appointment times remains a key objective of health service policy, the national screening service is committed to actively promoting its service and ensuring that screening is accessible, inclusive and effective for everyone across Ireland. This approach not only aligns with national priorities but also guarantees equitable access, empowering individuals to take charge of their own health. Recent developments in each of the four screening services have also improved equity and accessibility for users. BreastCheck is currently offered through a network of 24 mobile and four static units nationally, enabling women to be screened close to where they live. These additional mobile screening units have been added since 2020. The service is also upgrading the mobile fleet and has identified three new sites for additional static units. BreastCheck now sends text reminders and appointment details through the HSE health app, making it easier for users to confirm, change and consent to appointments, helping to ensure that no screening slot goes unused. CervicalCheck is delivered by over 6,500 sample takers providing screening nationally through GP practices and clinics. There are 15 colposcopy clinics nationally providing follow-up testing and treatment for women who need it, also close to where they live. BowelScreen is now offered to people aged between 58 and 70. The number of BowelScreen units nationally has increased and the newest unit opened in late 2025 in Cork University Hospital, bringing the total number of units to 16. BowelScreen is accessible with a home test, making it widely accessible and flexible to people. Diabetic retina screening is provided through 146 screening locations nationally and a network of eight treatment centres for onward referral and treatment. A new screening mechanism is being piloted, meaning people will be able to drive to and from appointments, increasing accessibility.

In 2026 appointment information will also be provided through the HSE app to make it easier to confirm, change and consent to appointments.

Considering the breadth of existing initiatives under the national screening service, including ongoing improvements in accessibility and service delivery, the Government believes these measures represent a more sustainable and equitable approach than creating a new statutory entitlement to paid leave for employees. It is also important to be very clear the Organisation of Working Time Act is not the correct legislative vehicle for introducing a health-related entitlement of this type. For these reasons the Government is opposing the Bill.

See this speech in context