David Norris (Independent)

I am also glad to have the opportunity to take part in this debate and I would like to take up something which my colleague, Senator Keaveney, said in reference to a Minister of State, Deputy Tony Killeen. I commend him on his courage as this is quite a private and sensitive matter. It took courage for him to come out and say that he had this form of cancer. This will encourage people to get screened. It was a very important and courageous act and we should salute it.

Speaker after speaker has said that we all seem to have been supplied with the same statistics but there is no harm in repeating them. There may be no active harm but it is a pain in the fanny. It does not do much good because what do we have for an audience? We have distinguished people from the Irish Cancer Society and former Senator O'Meara. Although they may take up some of the ideas we have, it is unlikely to be covered by the broadcast media. Perhaps it will be by one person. I do not see much point in repeating the statistics, although the incidence and late diagnosis is very worrying.

Like some of my colleagues, I will speak from personal experience, as my oldest school friend died of cancer of the colon on Friday night and I will be at his funeral tomorrow. I learned an enormous amount from him, primarily about the very high standards in Irish nursing and the remarkable facilities we have. We must bear in mind that there are a several matters that are important from the patient's perspective.

This was particularly difficult for him because he was a very gentlemanly person, although not in any effete way, as he was quite a masculine man. He was refined, fastidious and disliked anything to do with mess or unpleasantness. It was terribly ironic that this horrible illness should have struck him in that area of the body. One must be sensitive but I learned an enormous amount and my life has been enriched by the six or eight weeks that he lived since the diagnosis.

I saw the way somebody in considerable distress could face with dignity a judicious approach to everything, with kindness and understanding for the people and friends around him who were distressed by this illness. I also learned that it is sometimes selfish and cruel to try to persuade people to take the chance of prolonging their lives with chemotherapy. This man had seen his sister and other relatives die awfully in the same way.

Things have improved and I have let positive issues out in order to keep both options open. Eventually my friend went for chemotherapy and it seemed to be doing an enormous amount of good. I do not know whether it was because chemotherapy was so severe as to weaken the wall of the bowel but there was a rupture and he had to have invasive surgery, which was very unpleasant. Two days later he had a massive heart attack in the intensive care unit. I am quite glad for him because that was the best outcome.

I am glad that he took the chance of having chemotherapy but in those matters it is a question for the individual. It is unfair when somebody has what is very probably a terminal illness to bully them, either family or surgeons. Doctors should be very careful about what they say. For example, it is not helpful to say when somebody has been operated on that a stent was inserted into a liver, for example, to drain poison but the spread or severity of the cancer is much worse than first thought. I am not accusing the particular surgeon in this case and there were other elements involved. It can have a depressing effect to be told that so bluntly.

When people say they are dealing with such issues every day, it is meant to be helpful but it is not, because each individual diagnosis and progress towards death is quite personal and unique. My friend was extraordinarily lucky because he had a very strong religious faith, which I happen to share. That cannot be overestimated because it is as good as or better than the drugs, although I do not undervalue drugs. We must consider such options.

We must also understand that apparently small issues such as diet are very important. When people are at that stage they must be allowed eat whatever they want. They do not need to be told that they should eat this, that or the other. They should be left at it.

Looking at the broader scheme, I have been aware since I was a student of bowel cancer because one of my great pals was a medical student. She told me the story of a young man, just married, who had bowel cancer. I asked if anything could be done and she told me it was too late, which was awful. We know the old phrase that justice delayed is justice denied but screening denied is fatal.

I will put on record some comparative statistics. We have cervical screening, which costs €42 million and breast screening at a cost of €24 million. The cost of bowel screening would be €14 million or €15 million, which is comparatively small. Considering the first two figures I mentioned — they were not put on the record before — deal only with one very valued half of the human race, women, bowel cancer screening would get twice the value, and it would pay for itself inside five years. The Minister of State would know better than I do that we are approaching a five-year plan, according to the Taoiseach. Let us consider including in the five-year plan this financially sound approach to medicine.

We understand 70% of people would attend for bowel screening, which is a very high rate. I have certain intestinal difficulties and although I do not believe they are cancerous, we are trying to find out what is going on. I have had things stuck in everywhere. The minute I felt a bit awkward, I went to the doctor as I do not give a damn and I have absolutely no shame. I got on to the problem straight away and had a colonoscopy immediately. This was because I am on Plan E in the VHI; I was not going to give my place to another person as I am not that much of a Christian.

However, that is not appropriate and in matters of life and death we should not have a two-tier system. We need to do what we can to reduce this problem, as a four-week result system is the best. We still have people waiting more than six months, which can do real damage to their health. We need investment in more gastroenterologists. Prevention is possible, although not in all cases, if people have a good diet, watch their weight and enjoy pleasures moderately with not too much smoking and drinking.

Will the Minister of State be kind enough to pass on to his colleague, the Minister, Deputy Harney, a message from all sides of the House concerning cystic fibrosis? I raise this because we were invited to do so by the Leader, Senator Cassidy. When we tried to raise the matter this morning, he said we would have an opportunity to do it when the Minister for Health came to the House. She is not here so I hope the Minister of State does not think it inappropriate for me to ask him to carry the message to her that we are all thrilled that this commitment has been given.

It is very difficult to believe that any builder will engage in a major building programme in this way. May we have facts, figures and a commitment to a commencement date? It would be cruel in the extreme to deceive people with cystic fibrosis. Will the Minister of State use his good offices to persuade the Minister, Deputy Harney, to come into the House to give us a clear and cast-iron commitment on the matter?