Kathleen Lynch (Cork North Central, Labour)
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This matter concerns the extension of BreastCheck to the rest of the country and not only to the Dublin area. I thank the Minister of State for taking this matter but it is time the senior Minister started to take these issues more seriously.

A newspaper article stated:

The BreastCheck screening programme is being extended to three more counties, the Minister for Health, Mr. Martin, has announced.

The service, aimed at women aged between 50 and 64, has up to this only been available in the Eastern Regional Health Authority . . . and Midland Health Board areas. It will now be extended to Carlow, Wexford and Kilkenny [and the south].

That statement appeared in a newspaper article of 11 February 2003 and it is now 9 February 2005. However, we should not be surprised about the failure of the Department of Health and Children and the former Minister to meet that commitment. Despite the fact that the current Minister for Health and Children has been in office for a considerable period, the fact the promises made by the previous Minister, Deputy Martin, are unfulfilled is scandalous. BreastCheck must be made available to women all over the country. Anything less puts women's lives at risk.

The previous Minister, Deputy Martin, announced the rollout of BreastCheck to the Cork area in 2002 prior to the last general election. As soon as the election was called work on this stopped. Premises for the facilities had been purchased at the South Infirmary-Victoria Hospital and it was intended that three mobile units would operate from that unit in the general Munster area. It appears that the site brief, which includes the BreastCheck unit, was only completed in April 2004, some two years after it was originally announced. From April 2004, it would take a further 18 months for contracts to be signed. This is yet another unacceptable delay. This delay means that some women will not receive the treatment to which they are entitled. That is a straightforward fact. If there is not early diagnosis of such cancer, women will not get the treatment they need. Given the statistics that 600 women die every year from breast cancer, any further delays are unacceptable.

I hope the current Minister is not deliberately delaying the availability of this service so that she can once again announce it in the run-up to the next general election. It appears from the executive officer of the South Infirmary-Victoria Hospital, where the unit is to be based, that according to the Department of Finance the moneys for the BreastCheck unit will not be available until 2008. People will no longer by fooled by such promises.

All the evidence suggests that the BreastCheck programme is a tremendous success. There has been a 73% uptake rate among women invited for screening, which exceeds the target uptake to June 2000. The programme has exceeded its target for the diagnosing of cancer. In other words, BreastCheck works.

A recent report from Northern Ireland states that after ten years the evidence is clear that BreastCheck works and early diagnosis is vital in the fight against this disease which affects women. Most of these research pieces take approximately 30 years to be published, but it took only ten years to publish this one. Those involved in it were so convinced of the validity of the research that they published it.

Another newspaper article stated:

If ever there was a damning comment on how Ireland measures it medical priorities it is that we are spending more on eradicating disease in the farmyards than on breast cancer.

This fact emerged at an Oireachtas committee where BreastCheck, the cancer screening unit, said it needs €21 million to roll out its service nationwide.

It is a sign of the times, however, that badly needed funding has dried up, while this year €217 million will be spent on eradicating disease in farm animals.

As a result of the cutbacks, a nationwide expansion of the vital breast check service will not be achieved for years.

So, despite the Government's solemn commitment to underwrite this crucial service, tens of thousands of women are left facing a cancer risk. This means a service which saved the lives of many women is not yet available in Connacht or Munster.

What does that say about the priorities of a system that puts the eradication of animal disease before detection of cancer in women?

That newspaper article was from 14 February 2003. If the new Minister Health and Children has any clout or intends, unlike her predecessor, to make any fist of the Department, I advise her that the women of Munster can wait no longer for the provision of this service and they definitely cannot wait until 2008.

Tim O'Malley (Limerick East, Progressive Democrats)
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I thank Deputy Lynch for raising this matter. I take this opportunity to set out the current position on the BreastCheck programme and, in particular, on the extension of it to the remaining counties.

The national breast screening programme commenced in the eastern and midland regions in February 2000. Screening is offered free of charge to women in the 50 to 64 age group in these regions. Last year the programme was extended to cover counties Carlow, Kilkenny and Wexford. The expansion to the south eastern counties will result in an additional 18,000 women being invited for screening.

Since February 2000, cumulative revenue funding of approximately €60 million and €12 million capital funding has been allocated to support the programme. Up to September last year, 167,000 women had been invited for screening and approximately 120,000 women have availed of the service. It is estimated that the cancer detection rate is approximately 7.8 per 1,000 screened and to date over 1,000 cancers have been detected.

The national rollout of the BreastCheck programme to remaining counties is a major priority in the development of cancer services. The expansion of this service will ensure that all women in the relevant age group throughout the country have access to breast screening and follow-up treatment where required. A capital investment of €21 million has been approved to construct and equip two static clinical units, one at South Infirmary-Victoria Hospital, Cork and the other at University College Hospital, Galway. This investment will also ensure that mobile units are available to screen all women in the relevant age group throughout the country.

Detailed planning for the static units is progressing as a matter of priority. A project team was established to develop briefs for the capital infrastructure required for the two new units. The design briefs for both sites were completed in January 2005. The next stage is to appoint a design team to complete the detailed design of the two units. Given the scale of the investment involved, EU tendering procedures will apply.

It is intended that the facilities at Cork and Galway will be progressed simultaneously under the capital investment framework, 2005 to 2009. Capital funding in both cases has already been identified under the framework. The HSE, in conjunction with the Department, is examining the health capital investment framework with a view to initiating as quickly as possible new capital commitments for this and subsequent years.

The majority of women diagnosed with breast disease are treated outside the BreastCheck programme. The report on the development of services for symptomatic breast disease, which was published in 2000, found that the necessary care could best be provided by the establishment of specialist breast units. The report recommended the development of 13 such units, strategically placed throughout the country, each treating sufficiently large number of patients to maintain expertise and to promote best practice. Six of the units recommended in the report are now fully operational and the remainder are at advanced stages of development.

Since 2000, more than €60 million has been made available for the development of symptomatic breast disease services throughout the country. As regards the Health Service Executive southern area, there has been a cumulative additional investment of €76 million for the development of appropriate treatment and care services for people with cancer, including breast cancer, since 1997. This funding has provided for the approval of an additional 11 consultants in key areas of cancer care. These include two surgeons with special interest in breast disease. The funding has also provided for the appointment of 27 cancer care nurse specialists across the southern area.

The Tánaiste is committed to the national expansion of BreastCheck, the national breast screening programme. The design, construction and commissioning of projects of this nature generally take approximately two and a half years. It is anticipated that the advertisement for the appointment of a design team will be placed in the EU journal in the coming weeks and I am confident that the target date for the expansion of BreastCheck nationally, of mid-2007, will be met.