Brendan Ryan (Labour)

When one has been affected by the incidence of cancer in one's immediate family, one can appreciate, as I do, the extraordinary quality of service that can be available. I happen to live in a city where, as Senator Henry said, if one has the means, a high quality level of cancer care is available. When one is a politician, the incidence of cancer within one's family circle focuses one on what is wrong in the system, what is missing, what is uneven, what might have happened if one's family lived somewhere else or if one's family was on an income level that meant they either had to depend on public health and, by implication, could not afford to pay for private health insurance. A significant number of people are between the extraordinarily ungenerous level of income at which a full medical card is made available and an income level at which private health insurance can be paid for without enormous sacrifices being made.

I always find it a little distasteful to make something as personally sensitive to everybody who has encountered it — and those who have not — into a political issue. However, I am also concerned that while, on the one hand, this is a high profile illness, on the other, it is not an issue which on a day-to-day basis can grab headlines in the way that people on trolleys in accident and emergency units can. It is not tangible, quantifiable and immediate in the way that the scenario of people lying on trolleys in accident and emergency departments is.

Men will now talk about female-specific cancers like breast cancer or cervical cancer where they would not have discussed them 25 years ago. However, many men still believe that the issue should be left to women. Therefore, it frequently does not assume the central role in political discourse that it should.

We cannot dispute the fact that death rates from cancer are higher than they could or should be. We have had ten years of unprecedented prosperity and while some progress has been made, it is still implied that it is acceptable to have a rate of progress which leaves significant numbers of women at risk of dying young from cancers that are both treatable and preventable because either the treatment or the initial investigations are not available at the right time and in a location which these women can access.

I will now turn to the subjects of breast cancer and cervical cancer, which are mentioned in the motion. We know that breast cancer is eminently treatable when it is diagnosed at a sufficiently early stage. Treatment is difficult and traumatic for many women but the disease is still treatable. However, it needs to be diagnosed early. I understand that early diagnosis is extremely difficult in the case of certain cancers. Pancreatic cancer is frequently cited as an example of such a cancer. However, it is scandalous to have available to us the means, technology and skill to provide early diagnosis of cancer but fail to do so.

It is worth pointing out that the decision in principle to introduce a national breast cancer screening programme was made during the tenure of the rainbow Government. This decision was taken ten years ago at a time when the country was possibly in the first year of its spectacular and welcome economic growth which saw it catch up with the rest of western Europe. We are now told that the screening programme will be rolled out 11 years later in 2007. Those of us living in Cork will wait to see it rolled out and fully established. I have heard some of the very dedicated staff connected with the programme explain the logistical problems but I am also aware that resource issues delayed decisions at various stages. Possibly resource issues do not delay decisions now but there is no doubt that it took a long time and a ferocious political campaign to secure the decision in principle to move from a pilot programme in a number of regions to a national programme. People are still waiting for the national programme.

The Government must move on and also examine its commitment to cancer treatment. I accept the argument that it is not possible to provide high quality treatment for breast cancer if it is scattered over a vast number of regions. However, it is astonishing how little those who plan our medical services think of the consequences of centralising treatment for those who must travel for treatment. They appear to think that people can travel from 50, 60 or 100 miles away to the centre in Dublin. We are talking about women who are frightened, have families and might feel sick. Nobody has thought about how to permit these women to travel to Dublin in a humane, efficient and effective way, a feature of the entire programme which I find astonishing.

The amendment is very short on specifics. It is full of phrases like the "decision of the Tánaiste and Minister for Health and Children to ask the HSE to prepare the roll-out of the Irish cervical screening programme". No timescales or quantification have been given. According to the amendment, the House should commend the progress that has been achieved on the Government's national plan for radiation oncology services. Again, no quantification or specifics have been given. One would hope that the situation is better than it was but we need to know when it will be complete.

The amendment refers to the reduction in the cancer mortality rate among people under 65. What does this mean? Does it mean that people over 65 do not count? We want to see a global reduction in cancer mortality rates. This amendment appears to imply that people over 65 do not count as much as those under 65, which is extraordinary. I am sure the Minister of State's script does not address this issue but I invite him to address it and tell me why the Members on the Government's side of the House saw fit to insert a reference to a particular age group in the amendment and imply that those outside this group do not count even though the highest rate of cancer incidence is among people over 65. The motion plays with statistics and suggests an indifference to the lives of some people.