Dáil debates
Wednesday, 9 February 2005
Hospital Services.
Cancer Screening Programme.
9:00 pm
Máire Hoctor (Tipperary North, Fianna Fail)
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Gabhaim buÃochas leis an Cheann Comhairle as ucht an deis seo a thabhairt dom labhairt faoin ábhar tábhachtach seo. I am grateful for the opportunity to address this pressing issue in the mid-west region. I call on the Tánaiste and Minister for Health and Children, Deputy Harney, to give an update on and provide a timeframe for the start-up of the urgently needed BreastCheck screening service for women in the mid-west region.
In my first speech in the House shortly after I was first elected to the House to represent the people of north Tipperary in May 2002, I addressed this issue and called on the then Minister for Health and Children, Deputy Martin, to advance the breast screening service available in the mid-west region, which includes north Tipperary, Limerick and County Clare. I am aware the BreastCheck screening service commenced operation in various areas in March 2000, with the regions covered by the Eastern Regional Health Authority, the Midland Health Board and the North Eastern Health Board reaping significant benefits from the project at the time. It operated on the basis of screening women from the ages of 50 to 64 years, the period in their lives when breast cancer is most frequently diagnosed.
It is essential that the breast screening programme is extended throughout the country to include the mid-western region. I understand the pilot projects in the three regions to which I referred have been a tremendous success. We in the mid-west region recognise the success of the cervical screening programme which was first piloted in the region. Other regions now await its roll-out. My focus tonight, however, is on the breast screening programme urgently needed in the mid-west region, including north Tipperary. I stress its importance because of the loss of the mammography unit in Nenagh Hospital in 2002. While we felt this loss, it was pointed out to us at the time by experts in Limerick Regional Hospital that the unit was no longer reliable and was failing to detect cancer in some women. We decided, therefore, not to campaign for the retention of a service which did provide full detection.
We are grateful for the oncology services available in Limerick Regional Hospital, which the Minister of State no doubt supports. Nevertheless, we need access to the BreastCheck screening programme, which is administered by mobile units in the pilot regions. Under the programme, women are encouraged to present themselves for screening in order that cancers can be detected at an early stage. Approximately 1,700 women are diagnosed with new cases of breast cancer each year. It is alarming that the absence of this service in the mid-west region means cancers among women are not detected.
I appreciate that once the process of planning and organising the roll-out of the breast screening programme nationwide is completed, the service will be extended to the mid-west region and that we will benefit from the experience gained in phase one of the roll-out. The major question, however, is when this will take place. Various times have been given. Will the Tánaiste give a specific timeframe? According to the original commitments, the service will be in operation at this time next year. I am aware that a design team was appointed while the former Minister for Health and Children, Deputy Martin, was in office and the design of the building at the Galway unit has been approved by the Tánaiste. I understand, however, that she is awaiting approval from the Department of Finance.
From my discussions with the Tánaiste prior to Christmas, I am certain of her commitment to fast-track the extension of this programme to the mid-west region. I have tremendous regard for the Tánaiste and I know she means what she says. I want action and the service to be fully operational in the mid-west region as soon as possible.
The recruitment of staff is often used as an excuse for the long period required to implement the programme. I ask that, under the new Health Service Executive, the extension of the programme will no longer be delayed so that the women of north Tipperary can look forward to excellent breast screening services.
Tim O'Malley (Limerick East, Progressive Democrats)
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I thank Deputy Hoctor for raising this matter on the Adjournment. I welcome the opportunity to set out the current position regarding the BreastCheck programme and, in particular, its extension 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 â¬60 million and â¬12 million capital funding has been allocated to support the programme. As of September last year, 167,000 women had been invited for screening and approximately 120,000 had availed of the service. It is estimated that the cancer detection rate is approximately 7.8 per 1,000 women screened and to date more than 1,000 cancers have been detected.
The national roll-out 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 have access to breast screening and follow-up treatment where required. A capital investment of â¬21 million has been approved to construct and equip two static 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, including women in the mid-western area.
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.
Capital funding for the facilities at Cork and Galway has been identified under the capital investment framework 2005 to 2009 and both developments will be progressed simultaneously. Funding has also been approved for the relocation and development of the symptomatic breast disease unit at University College Hospital, Galway. This unit will be developed in tandem with the BreastCheck development.
The Health Service Executive, in conjunction with the Department, is examining the health capital investment framework with a view to initiating as quickly as possible new capital commitments, both for this and subsequent years. The majority of women diagnosed with breast disease are treated outside of the BreastCheck programme. The report on the development of services for symptomatic breast disease published in 2000 found that the establishment of specialist breast units could best provide the necessary care. The report recommended the development of 13 such units strategically placed throughout the country, including one in Limerick, each treating a sufficiently large number of patients in order to maintain expertise and to promote best practice. Six of the units recommended in the report are now fully operational and the remainder is at advanced stages of development. Since 2000, more than â¬60 million has been made available for the development of symptomatic breast disease services throughout the country.
As regards the Health Service Executive mid-western area, there has been a cumulative additional investment of approximately â¬60 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 eight consultants in key areas of cancer care. These include a surgeon with a special interest in breast disease. The funding has also provided for the appointment of 22 cancer care nurse specialists across the mid-western 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 appointment of a design team will be placed in the EU journal in the coming weeks and I am confident the target date of mid 2007 for the expansion of BreastCheck nationally will be met.