Sheila Terry (Fine Gael)

I welcome the Minister to the House. I am happy to support this motion and I thank Senators Henry and O'Toole for their excellent presentations. I am disappointed with the Government's amendment and I ask Senator Glynn to consider withdrawing it. We all agree with the motion, particularly women but also men. We want to see the services provided as detailed in the motion. I ask that both sides of the House unite on this motion.

I wish I could speak with the passion of Senator O'Toole, who brought the message home. Although this is not solely a women's issue, it is great to see a man expressing that kind of passion when speaking about cancers from which women suffer in greater numbers such as breast and cervical cancers. Despite the increasing wealth in this country the financial contribution to women's health smacks of lip service. There is a lack of understanding that investment in areas such as prevention and health promotion would have long-term positive benefits. As the life expectancy of Irish women extends into their mid-80s, women deserve a good quality of life to enable them to fulfil the important contribution they have to make to society. It is unacceptable that the lack of investment in services results in the death of many men and women. If the funds used to treat those who develop cancer were targeted at prevention, they would be much better spent and lives would be saved in the long run.

The figures published in mid-2005 by the Irish Cancer Society are not as shocking as those detailed by Senator Henry. I hope the Minister of State will be able to provide exact figures for the incidence of breast and cervical cancer and the number of associated deaths. The Irish Cancer Society figures suggest that there are 288 new cases of breast cancer in women under 45 every year and an increasing incidence of breast cancer in younger women. The small additional amount of funding required to expedite the rollout of the screening programme throughout the country should be a priority for any Government.

One of the areas of women's health that is glaringly neglected is that of cancer screening. In particular, there are unacceptable delays in the roll-out of the cervical screening programme and delays in completing the BreastCheck programme. One can be lucky to live in the Dublin area or in other areas where the BreastCheck programme is operational, or unlucky to live in an area where the cervical screening programme, which is only available in one part of the country, is not in place. The rate of cervical cancer in Ireland is one of the highest in western Europe — shame on us. At present, approximately 77 women die each year from what is essentially preventable cancer. As this cancer mostly affects young women, it is a cause of death of many young mothers.

In the EU, the number of deaths caused by cervical cancer exceeds the number of deaths from AIDS or hepatitis B. However, in some EU countries the incidence of cervical cancer has been declining in recent decades, primarily due to the introduction and adoption of national screening programmes. The facts speak for themselves. For example, deaths from cervical cancer plummeted in the UK since it introduced a national screening programme in 1989. In Finland, cervical cancer screening was introduced in 1963, with regular updates to the programme since that time. This resulted in a very low incidence and mortality rate for the disease. In Ireland, where we do not have a national screening programme, the rate of cervical cancer and mortality is considerably higher and results in over 70 deaths at an average age of 45.

At present, in all parts of Ireland except the mid-west, the only way women can avail of screening is by attending their GP for a smear test. This is described as "opportunistic screening" and best practice suggests that this system does not work. Disadvantaged women will suffer the most and will be least likely to be able to afford the test. Therefore, we are compounding the poverty of such women, or worse if they develop the disease. Unlike many cancers, cervical cancer is highly treatable and preventable through modern screening methods. A national screening programme can save up to 60 lives a year and prevent up to 90% of cases. Smear tests miss 10% to 30% of abnormalities and, therefore, regular screening is necessary.

In addition to screening, new technologies may soon become available, among which is the HPV vaccine. At this time, the most modern technology, such as liquid-based cytology, the most up-to-date laboratory technology for analysing smear tests, is only available to those women who can afford to pay for it. This could be an important tool in the fight against cervical cancer when used in conjunction with screening programmes. HPV is a known cause of cervical cancer, yet women are still not tested in routine Pap smear tests.

If pre-cancerous types of HPV are treated early, it is possible to prevent cervical cancer completely. Potential prevention of cervical cancer is great news, but it is not a replacement for screening. A doctor from the National Cancer Institute in the US stated:

We need to use the principles "prevent, detect, modulate and eliminate". We have the opportunity to put more effort into the front end of the disease instead of the end. We will not beat cancer with yesterday's solutions.

What he had to say is very relevant to Ireland. We are even further behind than the US in terms of tackling a problem which it is possible for us to tackle. It is a disgrace that so many women are not able to access screening programmes that should be available to all women. I urge the Minister of State to ensure that the funding is provided as a priority so these programmes can be rolled out as quickly as possible.

In the long term the primary aim is to save lives. Early detection will save lives and by achieving this, we will save the health services significant resources in terms of the treatment of women. Early detection is cost effective, not to mention the fact that men and women will survive cancer, which is the aim. In this day and age, it can and must be done. However, the Government has dragged its feet. As Senator O'Toole stated, women in particular have stayed far too quiet when dealing with this issue. In the time remaining to the Government, we want immediate action. I hope the Minister of State will impress on the Minister that this action must be taken.