Jerry Cowley (Mayo, Independent)
Link to this: Individually | In context

I am grateful to the Ceann Comhairle for providing me with the opportunity to raise this very important matter.

We all agree breast cancer is a terrible killer. There is no known way to prevent it. However, it is very treatable if detected early, according to the BreastCheck website. Unfortunately, health apartheid exists here, where half the population has had a service since 2000. The death rate from cancer can be cut by 20% to 30% by breast screening women aged 50 to 64. This has happened in Northern Ireland where between 1994 and 2000 the breast cancer rate fell by 20%. The same has happened in Scotland, the USA and all over Europe except for the south and west of Ireland. I have been spearheading a campaign for the national extension of BreastCheck for some years now.

Some 700 women die from breast cancer every year. About 100 need not have died, but did, in the south and west. The figure is at least 65, but due to the 30% factor, it is more than that — because of the negligence of Government to extend BreastCheck nationally. Based on those figures more than 300 women will die before BreastCheck is extended to the south and west. It is a national scandal. Today in the newspaper, Professor Michael Kerin, who previously directed the BreastCheck service, but who now works at University College Hospital, Galway, says that one in five women with cancer on the east coast have had mastectomies — he previously worked at the Mater hospital in Dublin. However one in every two women in the west has a mastectomy, and that is a disgrace.

In my maiden speech in the Dáil in 2002 I spoke of the need for BreastCheck. In February 2003 I arranged for the BreastCheck board and executive to appear before the Joint Committee on Health and Children. On 28 March 2003, together with the cancer campaigner, Ms Jane Bailey, I organised a march on the Dáil for the national extension of BreastCheck. The national extension of the programme was announced within 48 hours of the march, but we are still waiting for it. Professor Kerin is scandalised. He says the lack of a free screening service means that many women in the west have advanced disease by the time the cancer is diagnosed. The lump is much bigger. I know families where loved ones have died because of the lack of BreastCheck and it is a terrible tragedy. Exactly 296 women have died already since 2000 because of the lack of BreastCheck. Another 260 will definitely die in the south and west. It need not be like this, however. Why does the Government not do something about it?

On 11 February 2003, the Galway Clinic offered a BreastCheck service to the Government. If this offer had been accepted, 195 women who are now dead would be alive today. Their families would still have their mothers, aunts, nieces or grandmothers. The Government declined the offer because the clinic was offering a digital service, while the BreastCheck service was analogue. BreastCheck has now changed over to a digital service so there is no excuse to delay the extension of the programme.

If a drug were discovered that could save the lives of 260 women, we would all want it to be made available. However, all that is needed in this case is money. It will be 2009 before all eligible women will be screened and the cycle completed even though BreastCheck will come on stream in 2007. Surely BreastCheck can be fast-tracked to ensure that the lives of at least some women can be saved. It would even be worthwhile making use of the service offered by the Galway Clinic or using the National Treatment Purchase Fund.

In 2003, the chief executive officer of the Western Health Board, Dr. Sheila Ryan, stated it was unfair of any health board member to underestimate the Government's commitment to the BreastCheck programme. She stated she expected BreastCheck activities in the west and south to commence in mid-2005, but it is now 2006.

Seán Power (Kildare South, Fianna Fail)
Link to this: Individually | In context

I thank Deputy Cowley for raising this matter on the Adjournment. I welcome the opportunity this afternoon to set out the current position in respect of the BreastCheck programme and, in particular, to the extension of the programme to the remaining counties in the country.

The Tánaiste and Minister for Health and Children met Professor Kerin last year in respect of the roll-out of BreastCheck and the need to commence it as soon as possible. BreastCheck has advised the Department of Health and Children that an exact date for the commencement of screening will be announced during 2006 following receipt of planning approval for the new assessment facilities required and as the staff recruitment process proceeds. BreastCheck is working to secure the earliest possible commencement of screening in 2007. Staff recruitment commenced on 18 November 2005. All the resources necessary to meet the timelines for the commencement of the roll-out have been made available.

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. The extension to the south east commenced in 2004, following the opening of a new €5 million dedicated screening unit at St. Vincent's Hospital, Dublin. A mobile unit is now providing screening for women in Wexford. Screening commenced in Carlow recently and will be extended to County Kilkenny during this year. The expansion to the south-eastern counties will result in an additional 18,000 women being invited for screening.

Planning is under way for the roll-out of the screening programme to the remaining regions in the country. The Department's letter of determination to BreastCheck for 2006 provides for an allocation of €13.693 million. This includes revenue funding of €2.3 million to, inter alia, provide for the recruitment and training of staff to commence the national roll-out of the screening programme in 2007. An additional €200,000 is being made available for improvements in radiographer ratios in the regions covered by the current programme. Late last year, a once-off capital grant of €500,000 was made available to purchase new digital mammography machines as part of BreastCheck's replacement programme of analogue equipment. An additional once off capital grant of €280,000 was also made available to upgrade information technology equipment.

The national roll-out of the BreastCheck programme to remaining counties is a major priority in the development of cancer services.

Jerry Cowley (Mayo, Independent)
Link to this: Individually | In context

Why was it not rolled out in 2000?

Seán Power (Kildare South, Fianna Fail)
Link to this: Individually | In context

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 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 that mobile units are available to screen all women in the relevant age group throughout the country.

The design process for the two new units is progressing. The applications for planning permission for both clinical units have been lodged with the relevant local authorities and decisions are expected in March. It is anticipated that the design process, including the preparation of tender documentation, will be completed by mid-2006. Following the selection of contractors, construction of the two units will commence. As I have said, BreastCheck is confident that the target date of 2007 for commencement of the roll-out will be met.

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 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.

Since 1998, cumulative revenue funding of approximately €60 million and €12 million capital funding has been allocated to support the programme. Up until the end of December last year, the number of women screened by BreastCheck was in the region of 245,000. It is estimated that the cancer detection rate is approximately 6.7 per 1,000 screened and, to date, more than 1,639 cancers have been detected.

Jerry Cowley (Mayo, Independent)
Link to this: Individually | In context

If we could get it. The Galway Clinic could provide it in the meantime.

Jim Glennon (Dublin North, Fianna Fail)
Link to this: Individually | In context

The Minister, without interruption.

Seán Power (Kildare South, Fianna Fail)
Link to this: Individually | In context

The Tánaiste and Minister for Health and Children is committed to the national expansion of BreastCheck, the national breast screening programme, and she is confident that the target date of 2007 for the expansion of BreastCheck nationally will be met.

Jerry Cowley (Mayo, Independent)
Link to this: Individually | In context

We live in hope but people will die in the meantime.