Frances Fitzgerald (Fine Gael)

Given the amount of money we have had here in the past ten years and the amount of money that has been put into the health service, it is very disappointing that a colorectal screening programme was not developed during the period of the Celtic tiger to address this disease that kills 900 people in this country every year and that affects so many others. I hoped the Minister would announce today in the House the allocation of at least €1 million to kick start the screening required.

I welcome the representatives of the Irish Cancer Society, and the volunteers who work with them. I congratulate it on the impact its awareness month is having. I understand the freefone line is receiving more than 100 calls a day. There is no doubt that there is a new awareness in the country about this serious disease. We must remember that approximately 2,200 cases of colorectal cancer are diagnosed and more than 900 people die from it each year. It is difficult to believe the number is so high. It is the second most commonly diagnosed cancer in the country. I do not think people realise that unless they have been personally affected by it or know somebody affected. I congratulate the Minister of State, Deputy Tony Killeen, Bill O'Herlihy and the various people who fronted the campaign because awareness is critical.

In her script the Minister reminded us that the BreastCheck programme is still not available in 26 counties. Given the amount of money that has been invested in the health service, what is it about the failure of health planning in this country that we cannot have universal screening and that it is taking so long to implement it? Screening saves lives. We should have a colorectal screening programme in place. That is absolutely clear when one considers the seriousness of the disease and the number of people dying from it. Irishmen have the fourth highest death rate internationally from this disease. Surely a screening programme should be a priority in the health service. In her speech, the Minister did not give any clear indications as to when a screening programme would be put in place. At the end of this debate, I want the Minister of State to try to give some indication of the timeframe for delivering a screening programme for colorectal cancer. It will not happen overnight, as we know. Will the €1 million to start the process be made available very soon or in the next few months? If we are to reduce mortality rates associated with bowel cancer and promote early detection, this is critical.

It is very worrying that 50% of patients with bowel cancer in Ireland are not diagnosed until the late stages of the disease. This is why the information campaign is so important. We must circulate the information, raise awareness and put the national colorectal screening programme in place. Research shows that 70% of people would definitely attend screening for bowel cancer if the Government offered the service free of charge to all adults over 50.

There is embarrassment about this illness. People with symptoms are reluctant to go to general practitioners or specialists. With the right type of awareness campaign people will begin to go to their general practitioners, to whom they should go in the first place. It is hoped they would then be referred for proper tests.

What is the most up-to-date position on colorectal screening plans for Ireland? Could we have a clear statement from the Minister of State in this regard? It is not in her script. People want to know the position. What is the timeframe and deadline and what actions are to be taken to ensure there will be colorectal screening in the near future?

Has a decision been made on the €1 million that was due to be given to the National Cancer Screening Service this year to prepare for the programme? If not, when will one be made? What is the timeline and financial provision in this regard? If the Minister of State could cast some light on this issue today, it would be extremely helpful.

The Minister of State referred to the Minister receiving a report on the health technology assessment for the bowel cancer screening programme. Has she the report? If not, when does she expect it? What is the current position on the assessment and when will the report be presented to the Government? These are critical questions I hoped would be answered on this very important day on which many serious budgetary decisions must be made.

There is also concern over the waiting time for a colonoscopy. We all remember our shock and upset when we listened to Susie Long before she died and to her husband after she died. Her husband referred to the stress on the family. Since Ms Long waited for a public service appointment, she did not catch her cancer in time. It is critical that the waiting time be short.

Best practice suggests a colonoscopy should be carried out within a very short period on those who are considered to be seriously at risk or who have serious symptoms. The Minister of State said there should be a four-week waiting time. Last November, 1,636 people were waiting more than three months and 900 people were waiting more than six months. It seems as if some progress has been made in this regard; the Minister of State referred to four-week waiting periods. I understand 194 people are waiting for more than six months – I will double-check this – and people are still waiting much longer than the optimal period. Will the Minister of State inform the House about the action to be taken to address waiting lists and ensure colonoscopies are carried out as quickly as possible after referral by a general practitioner?

It is not easy to solve this problem. If one considers statistics on the number of gastro-enterologists per capita, one will realise Ireland is not well resourced by comparison to other European countries. Austria has more than three gastro-enterologists per 100,000 while we have 0.65 per 100,000. Is there a plan in place to address this staffing shortfall? It is a critical issue. How can the tests be carried out if sufficient staff are not in place?

It is absolutely clear that there are many difficulties in this area. We need to hear from the Minister on screening, access to colonoscopies and gastro-enterologists. The Government needs to co-operate actively with voluntary organisations such as the Irish Cancer Society and set its mind and resources to dramatically reducing mortality from bowel cancer and promoting preventive measures alongside screening, which measures would lead to early detection and treatment.

We all know of the dreadful upset to families when cancer is discovered at a late stage. We know of the importance of early detection of symptoms, referral, screening and treatment. I refer not only to the personal cost and upset caused by late diagnosis, which are considerable, but also to its effect on treatment. Treatment is far more complex and expensive in cases of late diagnosis and the outcome is less favourable. For these reasons, I welcome the awareness month that is under way. It will do a great deal of good in promoting recognition of the disease and encouraging people not to be embarrassed and nervous but to seek the kind of help they need if they have the symptoms.

The Irish Cancer Society commissioned a survey of more than 1,000 adults nationwide. Some of its key findings are that 36% of people cannot name one sign or symptom of bowel cancer, 25% do not know factors that might increase their risk of developing bowel cancer, and 40% of people believe people under 50 years are most at risk of developing bowel cancer. Ninety percent of people diagnosed with the disease in 2005 were over the age of 50 and, therefore, there is a very false perception about the illness and a considerable lack of correct information. These factors inhibit people from seeking help.

The results of the survey show there is a worrying lack of awareness of the early warning signs of bowel cancer. This is why the Irish Cancer Society launched its awareness campaign. It gives very useful advice on what people can do to reduce the risk of developing bowel cancer. One should be aware of any family history of the disease, have a regular diet, take regular exercise and go to one's general practitioner if one has symptoms. All we can do today is state that, at national level, we want the screening process in place and the money to be given soon this year to start the process. We want the waiting lists to be tackled such that, if people are referred, they will be seen quickly. We want the public awareness campaign to continue so people will not be diagnosed at such a late stage of the disease, thereby allowing them to receive the intervention that will lead to better outcomes.