Dáil debates
Thursday, 31 January 2008
Priority Questions
Cancer Screening Programme.
3:00 pm
James Reilly (Dublin North, Fine Gael)
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Question 4: To ask the Minister for Health and Children the date cervical screening will become available nationally; the reason this was not made available by the end of 2007; and if she will make a statement on the matter. [2926/08]
Mary Harney (Dublin Mid West, Progressive Democrats)
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The national cancer screening service is planning to roll out the national cervical screening programme on a national basis around the middle of this year. Women aged 25 to 44 years will be screened every three years while women aged 45 to 60 will be screened every five years. The service will be available free of charge to eligible women everywhere in the country. Approximately 230,000 women will be screened annually, assuming an 80% take-up by eligible women.
All elements of the programme, call-recall, smear taking, laboratories, colposcopy and treatment services will be quality assured, organised and managed to deliver a single integrated national service. The service is in the process of procuring quality assured internationally accredited laboratory capacity. The laboratories will be required to meet turnaround times of ten working days. This process is due to be completed by the end of March. The programme will be based on a turnaround time of four weeks for smear testing. The service is also carrying out a baseline quality audit of existing clinical colposcopy services in the State to establish their fitness for purpose in the context of a national cervical screening programme.
Additional revenue funding of â¬5 million was allocated to the service in 2007 for the roll-out of the programme and an additional â¬15 million has been allocated in 2008. Thirty posts have been approved to facilitate integration and roll-out of the programme.
James Reilly (Dublin North, Fine Gael)
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I will give a quick background. Fifty years ago in Aberdeen a pilot study was started in this area. Forty years later we undertook a pilot study, in 1999. Here we are nearly ten years later and it is still promised. With the best will in the world, the Minister told us last summer we would have it by the end of the year. She told us in the autumn that we would have it on 1 January. Then she told us later, coming up to Christmas, that we would have it some time in January. Then we were told it would be March. Now the HSE is stating it will be some time this year. Is there any real intent to achieve this in 2008?
I do not believe the Minister can do it. She has not put in place the laboratory facilities. We do not have the necessary facilities such as the accredited laboratory. She will outsource it to America or some place where we have no control of their quality and we have an issue with building into a system a factor that will make interpretation more difficult and, therefore, mistakes more likely.
This is an illness of which there is 240 new cases each year and where 74 people die each year. Had the Department put this in place it could have saved hundreds of lives. We are still here talking about it and promises are still being made. It is the one cancer of which I am aware that one can detect before it happens because changes occur in the cell which allows one to treat such cells and get rid of them so the cancer never develops.
I get the impression â I do not like to take this stance â that the Minister seems to be suffering from the disability from which the entire Government, and its leader, the Taoiseach, seems to suffer, namely, she does not seem to be able to give it straight, tell the story as it is, give us a deadline that she can meet and make a commitment that she can keep. It is all broken promises and excuses.
Furthermore, I want to know about the other part of cervical screening, namely, the vaccination. When will the national immunisation advisory board make its recommendation? I believe it is in a position to do it. I cannot understand why it has been held up because the combination of the two could rid us of this terrible scourge.
I want the Minister to give this House a firm commitment. I ask her to show us that she can do it, that she can give us a deadline that she will keep. I ask her to give us a date because this carry-on of leading people by the nose causes the public to lose faith and causes a drop in morale among the people who must provide the service.
Mary Harney (Dublin Mid West, Progressive Democrats)
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First, I never announced it was to be introduced in 2007. What we announced for 2007 was the provision of â¬5 million to begin the process of recruiting staff, etc. As Deputy Reilly well knows, that must happen in advance and sometimes there can be quite a long lead-in time. Second, we will do this on a full roll-out basis. It will not be done in the way BreastCheck was done, namely, region by region. The entire population affected will be done on one national basis and that is why we will be doing so many in one year.
Third, I accept what Deputy Reilly stated about other countries. If memory serves me, Canada introduced this service in 1969. The cost of these roll-outs in countries like Canada or Scotland is a fraction of what it is here. Among the issues that affect the cost here is the fee paid to general practitioners for vaccines, which Deputy Reilly well knows is three times higher here than in other countries.
That brings me to the vaccine. HIQA is undertaking a technology assessment of the vaccine and that will be completed shortly. The vaccine is obviously preventative for the future and I hope that we will introduce it. I believe we will, but I must await the technology assessment, which is now part of the law in this country, where we undertake a pharmo-economic assessment of new drugs and technology assessment so that we introduce products or treatments that are effective in an Irish context. The CEO of HIQA informed me at my meeting with her in the past two weeks that the assessment to which I refer will be ready in the next couple of weeks.
James Reilly (Dublin North, Fine Gael)
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Will the Minister just answer the question? Will she give us a deadline that she will keep and a commitment to which she will stick?
Mary Harney (Dublin Mid West, Progressive Democrats)
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I will not speak of deadlines. The middle of the year is what I have been told. I do not announce dates unless I can meet them. Deputy Reilly attended the launch of this year's Estimates on budget day when we were going through the moneys allocated to health. He was there and he was welcome. I stated on that occasion that it would not be January, February or March because until we knew the budget allocation was available the national screening service was not in a position to enter into contracts with anybody, either the providers of laboratory services or general practitioners. This will be a general practitioner-led service, as Deputy Reilly knows, and that is why it will be so accessible on a countrywide basis.