John Minihan (Progressive Democrats)

I thank the Minister of State and his officials for coming to the House. I realise that the Minister of State and his Department, along with health service personnel, are working incredibly hard to meet the challenges we face. That both he and his officials are here to discuss this important issue is most welcome.

The motion referred to five broad topics, namely, the death rates from cancer, particularly among women; cervical cancer screening; the BreastCheck programme; colorectal cancers; and regional access to cancer services. Examining each of these topics in turn reveals the Government's determination to seek out the best expert advice on the provision of cancer care in Ireland and its determination to invest heavily on the basis of this advice. This is the appropriate way for us as a society to deal with this terrible set of diseases as best we can.

With regard to the first of the five issues raised by Senators Henry and O'Toole, as I stated on the last occasion when we debated this topic in the House, cancer is not a singular disease but a range of diseases. These diseases are the second most common cause of death in Ireland for both women and men. We know that the number of new cancer cases and the number of deaths from cancer have, unfortunately, steadily increased in both sexes over the past decade. In 1994, some 5,900 cases of malignant cancer were diagnosed in women. The figure is expected to reach approximately 7,400 this year. Approximately 3,500 women die from cancer each year in this country, which is testimony to the truly terrible toll this disease takes on Irish women, their families, friends and carers.

Although it is of little comfort, the reason for the rise in the incidence of cancer is the increasing life expectancy of and concomitant growth in the number of those aged 65 and over. I will refer to the remarks made by Senator Ryan. The amendment does not play with statistics. When one examines the statistics, one must consider the increase in the age profile and longevity of the population. The awful truth is that the risk of cancer increases with age. Research indicates that approximately one woman in seven will develop cancer by the age of 65, with the figure rising to one woman in four by the age of 75. Once adjustment has been made by population ageing, the annual death rate shows a slight decrease of approximately 0.8% each year.

The national cancer strategy correctly provides the expert basis for policy and investment in this area. Since 1997, €720 million has been invested in treatment and care services for people with cancer, which has made a real difference. More than 100 additional consultant posts for cancer care throughout the country have been created and, more important, the goal of a 15% decrease in the mortality rate from cancer in the under-65 age group was achieved in 2001, three years ahead of target. However, we must do more. The Health Research Board states that funding of approximately €1.8 million has been made available for research into breast cancer and €0.35 million has been made available for research into prostate cancer. Awards of more than €3.5 million have been made available through the board to support this initiative in nine hospitals throughout Ireland.

The second issue relates to screening programmes. The House will be aware that comprehensive, well organised and high quality screening programmes, incorporating appropriate specialist follow-up treatments, are an effective way of reducing breast, cervical and colorectal cancer mortality rates. This is why the Government is committing more and more resources to such programmes. The Independent group motion makes specific mention of the pilot cervical screening programme, which commenced in October 2000. This is available to eligible women in Limerick, Clare and north Tipperary. Cervical screening is offered free of charge to approximately 74,000 women in these counties.

The Tánaiste is fully committed to the national roll-out of a cervical screening programme in line with best international practice. The Department has requested the HSE to prepare a detailed implementation plan for a national programme. Significant preparatory work is well under way in this regard. This involves the introduction of a new and improved cervical test, improved quality assurance training and the preparation of a national population register. An additional €9 million has been made available to the HSE for cancer services development in 2006, including for the roll-out of the programme.

Regarding BreastCheck, this excellent national breast screening programme has been made available to women in the 50 to 64 year age group in the eastern, north-eastern, south-eastern and midlands regions. This target age group represents approximately 160,000 women in these regions. If we needed evidence of the importance of BreastCheck, one should consider the 1,600 cancers detected since the programme commenced. BreastCheck operates with a team approach and in partnership with other health care providers. Their value reaches not just those who have problems identified and who receive treatment, but those they reassure. The vast majority of women are found to be perfectly healthy.

On the roll-out of the programme to the remaining regions, there are 130,000 women in the target population for screening in the southern and western regions. BreastCheck is confident that the target date of next year for the commencement of the roll-out will be met. I am equally aware of the campaign in the southern area in Cork, to which Senator Ryan referred. The experts are confident that this roll-out date of 2007 will be achieved. On colorectal cancer, the National Cancer Forum provided a strategy for cancer control in Ireland in 2006 to the Tánaiste last month. This strategy will include recommendations on the criteria for decisions on the introduction of a population-based screening programme.

The Government is determined to make the full range of cancer services available to cancer patients throughout Ireland. This must and will be done in line with best international practice. I commend the Tánaiste, the Minister of State, the Department, the HSE and the dedicated experts and medical practitioners on the progress we are making. I urge them to continue on this course.