Sheila Terry (Fine Gael)

I welcome the Minister of State and many of the aspects of A Strategy for Cancer Control in Ireland. One hopes the proposals will be implemented as soon as possible and one could ask why we have been waiting so long for them to be implemented.

The Minister of State and everybody else will know very well that it is far cheaper to prevent cancer than to treat it, irrespective of the fact that prevention would save many lives. Over the years, we have missed the opportunity to save lives and, because of our inaction, we have put many people through a lot of pain. Had their cancers been diagnosed earlier, their treatment would have been far less aggressive.

While I welcome the strategy, I must state the circumstances that now obtain are a disgrace. We all know early detection is the secret to preventing the spread of cancer and saving lives. As my colleague Senator Browne stated, early detection and the kind of treatment one receives depend on where one lives. BreastCheck is one of the best services I have ever availed of and I highly commend the efficiency of the people involved. It amazes me because we are not used to that kind of service. I had an appointment recently for around 4 p.m. and expected to have to wait in a queue but I was the only person there. I was in and out in ten minutes. BreastCheck is a free public service. Women are invited to come in to have their breasts checked. I missed my appointment on one occasion but BreastCheck wrote to me telling me that I had missed it and offering me another appointment. It is an excellent service and the people involved are fantastic.

After the examination they write to the person to inform her, thankfully in my case, that everything is fine. When cancer is detected, women are given the opportunity to get treatment at an early stage and therefore have a much better chance of survival. Unfortunately, women in other areas of the country currently are not entitled to that service. While I welcome the fact that BreastCheck will be rolled out in the coming years, it must be done as quickly as possible. It should be in place already, as I said earlier. I will not bore the Minister of State by repeating it; he accepts that the service should be in place already. Similarly, cervical cancer screening should be in place. We should have a national screening service because as the Minister of State said in his contribution, there are approximately 200 deaths every year as a result of cervical cancer. Most of those deaths would have been avoided had they been detected at an earlier stage.

The cost of attending for a cervical test currently prevents many people from doing so. Another aspect that concerns me is the delay in getting the results of a test. If the results of the test do not come back for some months in the case of somebody found to have cancer cells, that delay can be extremely serious. We must have a national screening service for cervical cancer and ensure that the results come back speedily. The same applies to prostate cancer, which is very treatable if found at an early stage, and colorectal cancer. We have much catching up to do in that regard and I am not surprised that we fall way behind other countries in terms of detection and successful treatment.

We must focus on cases where there is a family history of cancer because we know that specific genes in families cause cancer. Family members should be tested regularly and followed up, regardless of whether it results in a death. If there is a history of breast cancer, colon cancer or other types of cancer in families, those family members should be screened on a regular basis. There is no reason that is not being done but I understand that is the case.

We must plan ahead. We look forward to the further report the Minister will publish in the coming weeks outlining the location of the centres. We must plan and ensure that the expertise and the trained staff are in place. That will take some time but we must plan now because we are playing catch-up in that regard.

Another issue I want to raise is palliative care for persons dying of cancer. I understand it can three to six weeks to get hospice home care. The hospice service is wonderful but I am sure the people involved are stretched in terms of resources. I was told by a public health nurse last night that it can take from three to six weeks to arrange to have a patient visited on a daily basis. We must not leave the provision of that service to charities. We must put a system in place to allow families care for their sick and dying loved ones. A package of community care must be put in place. We all know someone, whether a family member or a friend, who has died at home. Where possible, families want to have their loved ones at home with them but a great deal of support is needed both for the family and the patient, which is not available. I have seen that at close hand and am aware of the difficulty in getting such help.

The hospice home care team does wonderful work and the Irish Cancer Society also provides an excellent service to families. I would like to recognise its work but I want the Minister of State to focus on providing that type of care, which is part of the overall package. If someone is not responding to treatment and is dying, we must ensure we can support that patient and his or her family in the best way we can, namely, by providing all the necessary services. Services that are available in other countries are much better than those we provide here.

I agree with the provision of centres of excellence. The best treatment can be given in centres where all the necessary expertise is provided. I realise that causes difficulties for many families who must travel, particularly those who require radium treatment on a daily basis, but if people have a life-threatening illness they will go where they know they will get the best service. Ensuring we put all the systems in place to support them is essential. It would help if accommodation can be provided nearby to support families who have a loved one in hospital.

The key aspect is early detection and early treatment. It is all very well if one can attend the Blackrock Clinic or the Mater Private Hospital as a private patient where, if cancer cells are found, one can get treatment within a few days but that is not the position for public patients. That inequality should not exist.