Marian Harkin (Sligo-Leitrim, Independent)
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I wish to raise the matter of the report on cancer statistics published this week. Our cancer survival rate does not compare favourably with many countries in the EU 15. Cancer survival rates are linked to European geography but we learned that this is also the case on a national basis. This makes grim reading for the Minister but does not come as a surprise. Two years ago, a report compared cancer survival rates in Northern Ireland with the Republic. The figures showed that, for breast cancer in particular, a greater percentage of women died in the Republic than in Northern Ireland. This week we learn that women in four different regions, the midlands, the south east, the south west and the west, have a higher risk of death from breast cancer than in other regions.

Irish women have poorer survival rates from breast cancer than many of our sisters in Europe and Northern Ireland. Women in four regions, including the midlands and the west, have significantly higher rates of death than our sisters in other regions. This is a stark statistic. These are not minor variations. The risk of death from breast cancer is 28% higher if one lives in the midlands and 26% higher in the west. The poorer survival rates also apply to colorectal and prostate cancer.

The Taoiseach accepted the fact of significant regional variations in survival from those suffering from a number of cancers. As always, the Government states that matters are improving and will get better. There may be truth in this. Who takes responsibility for the failure of the past ten years? Who takes responsibility for the fact that BreastCheck is not available in the north west? Who takes responsibility for the fact that we are 40 years behind our European counterparts because we have no cervical screening programme? Who takes responsibility for the deficit of 18 urologists to treat prostate cancer in Ireland?

Who takes responsibility for the fact that, as the second richest country in Europe, people in the north west do not have reasonable access to a radiotherapy service? There is no promise of a service other than that in Belfast which can barely cope with demand in Northern Ireland. It has committed to take one patient per month. Is that good enough for those living in the north west?

Who takes responsibility for those who need palliative therapy in the north west? This will give them some quality of life as the illness progresses. They are too sick to travel long distances on inadequate public transport. Will anyone take responsibility for the poorer access to chemotherapy and radiotherapy in many regions? This leads to poorer chances of survival. Will the Government state that things are getting better? That is not good enough and does not represent being accountable in the way Ministers and the Government should be. Responsibility lies squarely on the shoulders of one Minister for Health and Children after another.

Will the Minister examine regional services in the context of best practice? Bigger is good, certainly, but it is not always better. Will the Minister ensure multidisciplinary teams are in place and that hospital networks share data with satellite units so that those who live in the regions, especially the west and north west, can have reasonable access to the very best services? This model is in place in a number of countries and it works well. I am asking that whatever new regime the Minister is putting in place, she will guarantee better service, better medical outcomes and geographical access for those in the regions.

Noel Ahern (Dublin North West, Fianna Fail)
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I am taking the Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney.

The Government welcomes the report on patterns of care and survival of cancer patients in Ireland between 1994 and 2001 which was published this week. This report, funded by the Department of Health and Children, adds significantly to our understanding of survival patterns of care for four major causes of cancer, namely, breast, colorectal, lung and prostate. This Government is making the full range of cancer services available to cancer patients throughout the country. Since 1997, approximately €1 billion has been invested in cancer services nationally. More than 100 additional consultants have been appointed in key areas of care such as medical oncology, radiology, palliative care and histopathology. An additional 343 clinical nurse specialists have been appointed in the cancer services area. Almost 94,000 patients were discharged from hospital following a diagnosis of cancer in 2005, an increase of 70% over 1997.

We have invested substantially in all regions to improve cancer survival. The improvements are evidenced in the report. It shows improvements nationally in survival rates for breast, colorectal and prostate cancers, but not lung cancers. There were improvements in all regions for breast and prostate cancers and in most areas for colorectal and lung cancers. For example, in the period 1994 to 1997, 73% of women with breast cancer survived at least five years. This figure had increased to more than 78% in the period 1998 to 2001. For colorectal cancer, the five-year survival rate for the period 1998 to 2001 in the north west increased to 53.5%, which is in excess of the national average of 51%.

We know there are regional variations in cancer survival rates, and Deputy Harkin has outlined some of those. The Government's national cancer control strategy, published last year and welcomed by stakeholders, is designed to change this fundamentally to improve outcomes for cancer patients in each region of the country. We are committed to investing significantly in the implementation of the strategy. The National Development Plan 2007-2013 includes major investment in the cancer area. We have made available an additional €20.5 million this year for cancer control, covering screening, acute services and research. This is an increase of 74% on the comparable 2006 investment and includes €3.5 million to support the initial implementation of the HSE's national cancer control programme.

The registry report confirms the importance of a national approach to improvements in cancer control. It is the intention of the Minister and the HSE to ensure patients, regardless of location, have timely access to high quality, specialised care that will lead to further improvements in cancer mortality rates. The HSE cancer control programme will manage, organise and deliver quality assured cancer services on a whole population basis, regardless of geography. The service plan for the HSE for this year sets out the detailed deliverables of the programme.

Evidence-based population screening programmes are an essential element of the strategy. On 1 January this year, the Minister established a National Cancer Screening Service Board. This amalgamated BreastCheck and the Irish Cervical Screening Programme, ICSP. Both BreastCheck and the ICSP will be rolled out nationally this year. The total allocation to the new service is €33 million, a 71% increase on the 2006 allocation to the programmes. The service will also advise on the implementation of a national colorectal screening programme. The findings contained in the registry report provide an essential benchmark against which we can monitor the provision of equitable cancer services. The Government is committed to continuing investment in cancer care. We will ensure that the full range of cancer services is available and accessible to cancer patients in all regions.