Dáil debates

Wednesday, 14 May 2008

Adjournment Debate

Cancer Screening Programme.

8:00 pm

Photo of Kieran O'DonnellKieran O'Donnell (Limerick East, Fine Gael)
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I am delighted to have the opportunity to raise this issue on the Adjournment and I thank the Ceann Comhairle for allowing me to do so.

Over the next couple of weeks, Limerick will be the only city in Ireland without BreastCheck in place. Since 1 March 2008, the breast clinic in Limerick Regional Hospital no longer carries out screening mammography and only carries out symptomatic mammography. With screening mammography, women in the 50 to 64 year age group were screened for breast cancer. Due to the closure of the breast unit in Barringtons Hospital and the unit in Ennis, the Mid-West Regional Hospital finds itself under severe pressure in terms of resources to simply deal with symptomatic mammography.

Professor Tom Keane decided that the unit in Limerick would be designated for symptomatic cases and would no longer provide screening mammography. This decision was made on the understanding that screening mammographies would fall under the auspices of BreastCheck. However, there is no date for the roll-out of BreastCheck in Limerick. BreastCheck is already in place in Dublin, the east, the midlands, the north east and the south east. Since December it has been operating in Cork and Galway. The service will be available in Waterford in the next number of weeks but it is still not available in Limerick, even though the numbers of women aged between 50 and 64 are well in excess of those in Waterford and many other areas. The CSO population statistics for 2006 indicate that Limerick has a female population of 10,178 between the ages of 50 and 59. It is an absolute disgrace that BreastCheck has not been rolled out in Limerick.

I note that the Minister for Health and Children is not here tonight, which is not unusual. It merely demonstrates her lack of commitment to health in general and cancer treatment in particular. I wish to put some startling statistics on the record. Of every 1,000 mammograms carried out, 5.3 indicate the presence of breast cancer. There are 1,800 breast cancer cases per year in Ireland, of which 134 are in the mid-west. Perhaps the most horrifying figure is that one in 12 Irish women develops breast cancer. We have a death rate of 36%, which is the fourth highest out of 25 developed countries, according to the World Health Organisation. Breast cancer is the most common form of cancer after skin cancer.

Deputy Jan O'Sullivan, the Acting Chairman, knows the situation in Limerick well. There is no screening programme in place in the county. I have telephoned BreastCheck but cannot get a definite answer as to when the service will be rolled out in Limerick. The women of Limerick fall under the static BreastCheck service in Cork but are to be served by a mobile digital mammography unit which must be put in place as matter of urgency. The Minister for Health and Children stands indicted that this service has not been put in place before now.

Before the screening mammography service was discontinued in March of this year, there was a four month waiting list for screening mammographies for private patients and a one year waiting list for public patients. Now there are women aged between 50 and 64 in the Limerick area who — based on rumours we have heard that BreastCheck will not be rolled out for at least another 18 to 28 months — could be waiting over three years for a screening mammography test. This is completely unacceptable, particularly given the fact that BreastCheck recommends that a mammography be carried out every two years.

I want the Minister to indicate tonight when BreastCheck will be rolled out in Limerick and, until such time as the service is rolled out, the interim measures she will put in place to ensure that the women of Limerick and the mid-west are able to avail of screening mammography services. If such measures are not put in place, women's lives will be at risk, which is completely unacceptable. I await the Minister's response and hope we will be hearing news that BreastCheck will be rolled out in Limerick as a matter of urgency and that the women of Limerick and the mid-west will not be discriminated against any longer.

Photo of Seán HaugheySeán Haughey (Dublin North Central, Fianna Fail)
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I am taking this matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. I welcome the opportunity to address the issues raised by the Deputy and to set out the current position regarding mammography services in Limerick Regional Hospital and the roll-out of BreastCheck. The HSE has designated Limerick Regional Hospital and University College Hospital Galway as the two cancer centres in the managed cancer control network for the HSE western region, which includes County Limerick.

The HSE has advised the Department that breast imaging services are available at the Mid-Western Regional Hospital, Limerick, through a breast clinic which provides rapid access for all women with breast disease symptoms. Mammography scheduling is based on clinical need and referrals to the breast clinic are assessed, prioritised and subsequently referred to the radiology department for imaging. Urgent referrals to the breast clinic for mammography are usually carried out within two weeks. Non-urgent cases are placed on a waiting list.

It is important that clear criteria are applied to distinguish between urgent and routine cases. Significant work has already been undertaken in the area of symptomatic breast disease services, supported by the Irish College of General Practitioners, regarding referral criteria and the development of appropriate referral forms to allow for appropriate triage of urgent and non-urgent cases.

The symptomatic breast service has traditionally provided 11 appointments per week to enable GPs to refer asymptomatic women, that is, women who do not have symptoms for screening mammograms. At present the waiting list associated with this service is up to 24 months. The service has recently been withdrawn in order to prioritise mammogram slots for the imaging of women presenting with symptoms. The HSE has advised the Department that this is the best use of the resources made available by the national cancer control programme.

The implementation of the national quality assurance standards for symptomatic breast disease will ensure that every woman in Ireland who develops breast cancer has an equal opportunity to be managed in a centre which is capable of delivering the best possible results.

The BreastCheck programme delivers screening to women in their local community through the use of static and mobile screening units. The 4% of women who need follow-on treatment receive it at one of the four BreastCheck static units located in the western, southern and eastern regions. The BreastCheck programme is designed to offer repeat screening to the eligible population, that is, women aged 50 to 64, within an interval of 21 to 27 months.

BreastCheck recently became the first national screening service provider worldwide to offer a fully digital mammography service and women in the mid-west will be screened from a mobile digital screening unit. The mobile unit will remain in an area until all women known to the programme have been offered a mammogram. This time period varies from county to county based on the numbers of women to be screened and uptake levels.

The roll-out to individual counties, including County Limerick, will be dictated by BreastCheck's management and operational considerations. The estimated total screening population in County Limerick is 12,976.

Undoubtedly, the development of the country's cancer services can provide the most effective testimony to how change driven by quality and safety can result in faster access to better services with best outcomes for the patient. We are now well into the initial stages of delivering a model of service for cancer care which will have all the characteristics of the modern and effective systems enjoyed by other developed countries, not least better outcomes for patients.

9:00 pm

Photo of Kieran O'DonnellKieran O'Donnell (Limerick East, Fine Gael)
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That does not answer my question. The reply does not indicate when BreastCheck will be rolled out. It is a disgrace that the Minister for Health and Children is not in the House tonight.

Photo of Fergus O'DowdFergus O'Dowd (Louth, Fine Gael)
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I thank the Ceann Comhairle for allowing me to raise this matter. I refer to the Le Chéile Educate Together school at Mornington, the official address of which is County Louth, although the school is actually in County Meath. On a technical point, it is in Drogheda, County Meath. It is a very successful national school. The enrolment next year is expected to be 366. The school is seven years old, multi-denominational and doing extremely well. It has the support of parents from far and near. However, the school has no fixed buildings and consists of all prefabs. Children who are now seven years old will be leaving a primary school which has only prefabricated buildings.

A site is available and the teaching staff are excellent. Currently, the waiting list for next autumn has 183 applicants for 56 places on a first come basis and 197 children are already on the waiting list for the following year. This is a school in great need. The teaching staff have been very supportive of all the children.

It is not acceptable that a decision has not been reached on a design team for the school. The advertisement has been published in the EU Journal with a closing date of 13 February, three months ago but no progress has been reported. Is it a fact that the submissions lie unopened on the desk of the Minister for Education and Science and that the design team may never be appointed unless those envelopes are opened and the quotations are examined? A 16-classroom school has been agreed. Everything is working well for this school but they have no building. Those of us who have been teachers know that prefabricated classrooms are too hot in summer and too cold in winter. This is a most inefficient and ineffective way of running a school. These prefabricated classrooms have been rented for almost seven years and this is a waste of money.

The parents, teachers, students and principal want to know the current position regarding the appointment of the design team which should have been announced on 1 May. The former Minister for Education and Science, Deputy Mary Hanafin, visited the school recently so before she left her desk to go to the Department of Social and Family Affairs she knew exactly what was the situation regarding the school. The parents, teachers and the students are demanding action from the Minister of State tonight.

Photo of Seán HaugheySeán Haughey (Dublin North Central, Fianna Fail)
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I thank the Deputy for raising this matter as it provides me with the opportunity to outline to the House the Government's strategy for capital investment in education projects and also to outline the current position in relation to the building project proposed for Le Chéile Educate Together national school, Mornington Road, Drogheda.

The modernisation of facilities in approximately 3,200 primary and 730 post-primary schools is not an easy task given the legacy of decades of under-investment in this area as well as the need to respond to emerging needs in areas of rapid population growth. Nonetheless, the Government has shown a consistent determination to improve the condition of our school buildings and to ensure that the appropriate facilities are in place to enable the implementation of a broad and balanced curriculum.

The Government has dramatically increased investment in the school building programme from just over €90 million back in 1997 to almost €600 million this year. Under the lifetime of the national development plan, almost €4.5 billion will be invested in schools. This is an unprecedented level of capital investment which reflects the commitment of the Government to continue its programme of sustained investment in primary and post-primary schools.

As the Deputy may be aware, a developing areas unit was set up recently in the Department to focus on the school accommodation needs of rapidly developing areas. The main emphasis in 2008 is on providing sufficient school places in these developing areas, as well as delivering improvements in the quality of existing primary and post-primary school accommodation throughout the country.

The Le Chéile Educate Together project has advanced to the stage where the Department has agreed the schedule of accommodation for a new 16-classroom school. The site required for the new school has now been acquired and the process of appointing a design team has commenced. The Department published the advertisement seeking qualified consultants on the public procurement website in January 2008. These pre-qualification questionnaires have been received in the Department for assessment and the Department will be in contact with the school authorities on this matter as soon as possible.

Photo of Fergus O'DowdFergus O'Dowd (Louth, Fine Gael)
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When will that be?

Photo of Seán HaugheySeán Haughey (Dublin North Central, Fianna Fail)
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As soon as possible. In the interim period, pending the provision of a new school building, the Department has approved the rental of one further temporary classroom for this school for September 2008 to cater for its immediate accommodation needs. In addition, the Department also funded grant aid of approximately €394,000 for the provision of adequate car-parking facilities for this school. I thank the Deputy for raising this matter.