Liam Twomey (Wexford, Fine Gael)
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Question 59: To ask the Tánaiste and Minister for Health and Children the health screening measures which have been implemented since 1997; her proposals for the future; and if she will make a statement on the matter. [15625/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The national breast screening programme commenced in 2000 and covers the east, north-eastern, midland and parts of the south-eastern areas of the country. Screening is offered free of charge to all women in those areas in the target age group of 50 to 64 years of age. Since the programme commenced in 2000, cumulative revenue funding of approximately €60 million and capital funding of €12 million has been allocated to support the programme. To the end of 2004, the number of women screened by BreastCheck was in the region of 185,000. The cancer detection rate is approximately 7.4% per 1,000 screened and to date more than 1,300 cancers have been detected.

The national roll-out of the programme is a major priority in the development of cancer services. I am confident that the target date of 2007 for the commencement of the roll-out of BreastCheck to the west, north west, south and south east will be met. Last week I gave approval to BreastCheck to advertise for the appointment of a design team to work up the detailed plans for the design and construction of two static clinical units, one in Cork and one in Galway. I also approved the development of a symptomatic breast centre at University College Hospital Galway. The total capital approved amounts to approximately €25 million. Tender notices have already been advertised in the EU Journal.

I am also committed to the national roll-out of a cervical screening programme in line with international best practice. Careful planning and consultation with relevant professional and advocacy stakeholders is required before I make definite policy decisions on a national roll-out. The former Health Board Executive commissioned an international expert in cervical screening to examine the feasibility and implications of a national roll-out. The examination included an evaluation of the current pilot programme in the mid-western area, quality assurance, laboratory capacity and organisation and the establishment of national governance arrangements.

The pilot cervical screening programme commenced in October 2000 and is available to eligible women resident in counties Limerick, Clare and north Tipperary. Under the programme, cervical screening is being offered free of charge to approximately 74,000 women in the 25 to 60 age group.

My Department is now consulting the relevant professional and advocacy stakeholders. The consultation is well advanced and will be completed in a matter of weeks. In addition, my Department allocated a further €1.1 million to the programme in 2005 on an ongoing basis to complete the transition of the remaining laboratories to new and more effective testing and to support the development of quality assurance and training programmes.

Liam Twomey (Wexford, Fine Gael)
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It is not often I remind the Government of another initiative it introduced. Heart Watch is a secondary preventative programme that was introduced after 1997. Having been in office for eight years, the Government has only implemented two screening programmes of any sort. With all the emphasis we should be placing on primary care and the role of health promotion in preventing ill heath, only two screening programmes have been implemented. One is BreastCheck which covers only half of the country. The other is the cervical screening programme which is still very much a pilot programme. Heart Watch has been successful because general practitioners supported it. One cannot join the Heart Watch screening programme unless one has had a heart attack. Therefore, there is no primary screening of any condition apart from breast cancer.

Last week or this week, the Tánaiste made an announcement that she saw no merit in prostate cancer screening, yet 1,200 cases of prostate cancer are detected every year and approximately 600 men die from the cancer every year. The Tánaiste should clarify to the public her remarks to the effect that there is no need for prostate cancer screening. There is merit in introducing such a screening programme and research is being done which will show that. By not introducing such a programme we are dismissing screening as a preventative tool in the health care service. We continually focus on the mechanism of dealing with disease after it has arisen and apportioning increasing amounts of money to hospital services. The introduction of such a programme would save money in the long term. The Government parties have been in office for eight years, yet only half the country is covered by the BreastCheck screening programme, the take-up of the Heart Watch programme has been sporadic and that is the sum total of its health screening and prevention programmes. That is a damning indictment of the approach the Minister is taking to primary care. I would like to hear her views on that.

Mary Harney (Dublin Mid West, Progressive Democrats)
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On prostate screening,I took the recommendation from the Cancer Forum. It states that there is currently insufficient evidence to recommend the introduction of a population based prostate screening programme in this country. It goes on to state that this is in line with EU recommendations and that one must introduce cancer screening programmes which have demonstrated their efficacy having regard to professional expertise and priority settings for health care resources.

In regard to Heartwatch or managing chronic illness, which is the big issue in the developed world, managing people who in the past died from the illness now live very good lives for a very long period. Therefore, managing chronic illness is a big challenge, which essentially will be done at GP level. In the context of the new contract, if we can get around to discussing it with the IMO, among the issues I want included is cervical screening, which can be done at GP level, rather than have another parallel programme rolled out with BreastCheck. Many of the issues referred to by Deputy Twomey are appropriate for the development of primary care. At GMS level, the remuneration to general practice has doubled over the past five years, even though the number of medical card holders was reduced by 100,000 in the same period. As we go forward, no doubt more and more money will go to general practice. We want to ensure that we introduce at that level some population screening such as cervical screening.

Liam Twomey (Wexford, Fine Gael)
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The Minister just admitted to the success of this approach. We should make an effort to move forward on the issue because it is a winner in overall health care. We must consider other aspects which could be tackled easily in regard to screening, including blood pressure, diabetes and obesity. As these are significant issues which are getting out of control, we should be putting huge resources into this type of screening.