Tuesday, 26 April 2005
Home Care Grants.
Cancer Screening Programme.
I thank the Ceann Comhairle for giving me this opportunity to ask the Tánaiste and Minister for Health and Children to immediately place advertisements in the EU Journal for tenders for the static units required for the national roll-out of the BreastCheck programme to the south and west. The executive of the BreastCheck programme has stated this is necessary to ensure the 2007 deadline is not missed.
I have been pushing for the extension of the BreastCheck programme nationally for some time. I started the campaign for its extension. I pointed out that there was cancer care apartheid in Ireland which was unacceptable. In early 2003 I caused the board and executive of the BreastCheck programme to be brought before the Joint Committee on Health and Children to explain why the programme had not been extended. In March 2003 I co-organised a march on Leinster House to force the extension of the programme nationally. Its extension was announced within 48 hours of the march but it was only when the then Minister, Deputy Martin, was leaving the health Ministry in September 2004 that he sanctioned funding for the programme.
I introduced a Private Members' motion in the Dáil on 15 April 2003 on the BreastCheck programme and cancer services. I am glad the Labour Party has come on board in calling for the extension of the programme and that Fine Gael has also done so, having introduced a Private Members' motion on the matter the week before last in the Dáil.
It was the wrong decision not to extend the BreastCheck programme nationally ab initio. Some 65 women have died every year in the south and west since the programme was introduced initially and 65 more will die there every year until it is extended nationwide. It is predicted it will be 2007 before that comes to pass. I am convinced the decision was based on financial considerations. Justifying the failure to extend the programme nationally, the Department stated, "It was better to get the roll-out right than to get it done quickly". The Minister should try telling that to the families of the 300 women who have died from breast cancer who should not have died.
The good effect of breast screening programmes has been known internationally for at least 20 years. The death rate in Scotland was cut by 30% in only five years. There has been a screening service in place in Northern Ireland since 1993 and, as we know from a cancer report, the death rate has been cut by 20%. I calculate that over 300 women have died in the south and west needlessly since 2000 due to the decision to provide the BreastCheck programme in three health board areas in the eastern part of the country serving half the population.
On 11 February 2003 the Galway clinic offered a BreastCheck service to the Government. This offer could still be taken up. I asked the Minister if she would do this under the national treatment purchase fund but that request was refused. The women who are dying are mothers, sisters and nieces — all important members of families. That is not acceptable. I could name people who have died. I knew them and know their families who have to struggle without a mother or sister. Cancer could be detected 18 months before a lump is detected. It is amazing that half the population are on their second round of screening while the other half have still not received a service. The BreastCheck programme has picked up hundreds of cases of cancer but this is cold comfort to the families who are now without their loved ones. The women of the south and west deserve better.
Today's edition of the Irish Examiner carried the headline, "Breast cancer deaths rise in Cork". The pattern is the same in the west. The BreastCheck programme needs to be extended nationally, not just to women up to the age of 64 years but to women up to the age of 69. This is a proven treatment which would cut the death rate by 20% to 30%. If there was a drug that could do this, people would regard it as a wonder drug. This is all about money but there was no delay in providing €300 million for the racehorse industry when funding was needed.
The then Minister, Deputy Martin, announced the extension of the BreastCheck programme within 48 hours of the march in March 2003 but only sanctioned funding before he left office in September 2004. The excuse for proceeding on a phased basis was, in the words of the then Minister, "a reflection of the complexities involved in the screening process rather than the cost involved". That is balderdash. There was no complexity in providing the service for half the female population, the only complexity is in trying to understand why the Government could deny the other half of the female population an essential service such as BreastCheck which is supposed to be a national programme but is not.
I hope the Minister of State will tell me that the design has been completed and that an advertisement will be placed in the EU Journal to enable construction to start on the static units necessary in the west and south to ensure the extension of the BreastCheck programme nationally. I hope he has news for me.
On behalf of the Tánaiste and Minister and Health and Children, I am replying to the matter raised by the Deputy. I welcome this opportunity to set out the current position on the BreastCheck programme and, in particular, its extension to 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 year age group. The extension of the programme to the south east commenced last year with a mobile unit providing screening for women in County Wexford. Screening commenced in County Carlow recently and will be extended to County Kilkenny early next year. The expansion to the south-eastern counties will result in an additional 18,000 women being invited for screening.
Since 1998 cumulative revenue funding of approximately €60 million and €12 million capital funding has been allocated to support the programme. Up to the end of October last year the number of women screened by BreastCheck was in the region of 179,000. It is estimated that the cancer detection rate is approximately 7.4 per 1,000 screened. To date over 1,300 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 the service will ensure all women in the relevant age group will have access to breast screening and follow up treatment where required. A capital investment of €21 million has been earmarked for the construction and equipping of two static clinical units, one at South Infirmary-Victoria Hospital, Cork, and the other at University College Hospital, Galway. This investment will also ensure mobile units will be available to screen all women in the relevant age group.
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 this year. The next stage is to appoint a design team to complete the detailed design of the two units. The advertisement for the appointment of the design team will be placed in the EU Journal shortly.
Capital funding for the facilities at Cork and Galway has been identified under the capital investment framework 2005-09 and both developments will be progressed simultaneously. Funding in the region of €3 million has also been earmarked 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 Tánaiste is committed to the national expansion of BreastCheck, the national breast screening programme, and is confident that the target date of 2007 for its expansion nationally will be met.