James Reilly (Dublin North, Fine Gael)
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Question 23: To ask the Minister for Health and Children her plans to roll out a national colorectal cancer screening programme in view of the fate of the cervical cancer vaccination, which was also recommended by the Health Information and Quality Authority; when the first phase of roll-out will be implemented; and if she will make a statement on the matter. [26719/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Approximately 2,000 new cases of colorectal cancer are diagnosed and around 950 deaths occur from this disease each year in Ireland. Due to our ageing population and the long period in people's lives over which risk factors are built up, we can expect an increase in the numbers of colorectal cancer cases in the coming years. The national cancer registry has projected that approximately 3,400 new cases of colorectal cancer will be diagnosed per annum by 2020.

As with many cancers, early detection and treatment is one of the most effective measures of avoiding premature death. This is the reason population based screening programmes are so important and it explains why the national cervical screening programme was accorded a higher priority than the HPV vaccine programme. CervicalCheck is being implemented at a full year cost of €43 million. There are between 250 to 300 new cases of cervical cancer per year and 70 to 100 deaths. The successful implementation of CervicalCheck will result in a reduction of up to 80% in deaths from this disease.

On 17 June, two reports were published on screening for colorectal cancer. The first was a report by the national cancer screening service board on the development of a national colorectal cancer screening programme. The second was a health technology assessment carried out by the Health Information and Quality Authority. Both reports confirm that a properly organised screening programme would have huge public health benefits and that population based colorectal cancer screening would be highly cost effective. Notwithstanding the current budgetary situation, I am anxious to introduce such a programme at the earliest opportunity. Accordingly, I have requested HIQA to explore ways of delivering a high quality colorectal cancer screening programme within existing cancer screening resources and based on the range of advice contained in the two expert reports. That work will be overseen by an expert advisory group comprising representatives of key stakeholders, including my Department, the national cancer screening service, the HSE national cancer control programme, the National Hospitals Office, the Irish Cancer Society and clinicians.

HIQA's report is to be provided to me by the end of September and I will decide how to proceed when I examine it. The national cancer screening service has advised that based on previous experience it would take in excess of two years to proceed from policy and funding approval to the commencement of a national screening programme.

James Reilly (Dublin North, Fine Gael)
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The Minister's figures are correct. We have been told that we could save more than 340 lives annually by rolling out screening for colorectal cancer. However, I am concerned that she has delayed implementation of the programme even though HIQA has advised that it provides value for money and the national cancer screening service wants to proceed with it.

Cervical screening was first introduced as a pilot project in late 1999 and early 2000 but ten years passed before it was rolled out nationally. The national roll-out of BreastCheck has been similarly protracted. Colorectal cancer screening, which has been costed at approximately €15 million, should be available sooner rather than later. What price is put on lives? When will the Minister make screening available?

Mary Harney (Dublin Mid West, Progressive Democrats)
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Deputy Reilly will have to become accustomed to the reality that not every new service or initiative can come with a new price tag. Given that additional moneys will not be available for health services for the foreseeable future, it is a question of reprioritising resources.

The programme recommended to me had an upfront capital cost of €14 million but I want to see it done within existing capital infrastructure. The programme envisaged that doctors will perform colonoscopies but within Cork University Hospital nurses are already performing such procedures. The most effective programme involves sending individual kits to the population being screened, of whom about 6%, or 11,000 people, would require follow up colonoscopies. At present, we conduct 50,000 colonoscopies nationally.

I have met representatives of the Irish Cancer Society, which like me regards this issue as a priority. If we have to make choices, this will have to be next. The society has generously offered to provide funding from its private voluntary fundraising activities for the initial roll-out of the programme.

Screening programmes are substantially more expensive here than across the Border or in other countries because of the fees paid to professionals. In an environment where money is extremely limited, we have to explore the most innovative ways of introducing new programmes.

James Reilly (Dublin North, Fine Gael)
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The big cost arises not from colonoscopies but from screening through fecal occult blood tests. I have no problem with finding money from within existing services given the huge level of waste that obtains. This has to be a priority and should be introduced sooner rather than later.

Last December, the Minister indicated that she wanted to see colonoscopies being performed within one month of referral. In April, however, the HSE revealed waiting lists of two years and more for colonoscopies in certain areas. I again ask her when we can expect the roll-out of this programme, irrespective of how it is funded. The money can be found, even if it has to come from the existing health budget of €16 billion.

Mary Harney (Dublin Mid West, Progressive Democrats)
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Every week a new priority is identified. Last week it was Crumlin and the previous week it was orthodontics. Everything has to be an exception or involve additional moneys.

This is an important issue. The home kits will cost approximately €4.5 million but they is not the biggest element of the programme's cost. Between 75% and 80% of colonoscopies are performed within one month in respect of urgent cases. Professor Drumm has established a group to make that a reality for all cases. Challenges arise in two hospitals, Tallaght and Letterkenny. The group appointed by the professor will report directly to him on the issue. The two year waiting list to which the Deputy referred was for repeat colonoscopies rather than urgent referrals. We are making significant improvements and when I receive the report from HIQA at the end of September I will be in a position to make a decision.