Barry Andrews (Dún Laoghaire, Fianna Fail)

I am glad to have the opportunity to speak on this issue and conclude the debate. I thank all the speakers for their insight, empathy and particularly the encouragement given to my colleague, the Minister of State, Deputy Killeen, in his bravery in highlighting the issue. Senator Glynn pointed out that men are not great at acknowledging their vulnerability at times and the Minister of State, Deputy Killeen, has done much work in that regard. It would have been easy for him to absorb the benefits of the medical system and of his treatment without giving anything back and for him to show that courage in the face of adversity is something many speakers highlighted, and I would like to add my voice to that as well.

The type of cancer we are referring to is of a relatively high incidence in this country. It is the second most commonly diagnosed cancer here. As this is bowel cancer awareness month, so designated by the Irish Cancer Society, it gives us all an opportunity to reflect on that. The society will be delighted to know that I have the poster in my constituency office in Blackrock. I thank it for circulating that and I hope that taking this initiative will serve the general population well.

I congratulate John McCormack and his team, who are present, for all the work they have done on behalf of sufferers and in raising awareness. I thank them for the many briefings they have given to me and other Members of the Oireachtas over the years. I know they have more than one item of interest in the proceedings of the Oireachtas today, and I wish them luck in all those matters as well.

For those patients who are referred by their general practitioner for further investigations following the noticing of symptoms, there is a need for speedy access to diagnostic procedures including colonoscopies, and while the Minister of State, Deputy Hoctor, on behalf of the Minister, Deputy Harney, acknowledged pressures in this area, the Minister, Deputy Harney, has requested the Health Service Executive to ensure that all those patients who require urgent access to colonoscopies should be seen promptly.

It is worth noting that waiting times have fallen considerably in the past 12 months. For those waiting longer than three months it is down by almost half. However, it is without question that great improvement must be made in this area in terms of waiting times. The National Treatment Purchase Fund has been requested to arrange colonoscopies for any patient waiting more than three months. At the same time, the HSE is working to address service pressures in this area to further reduce waiting times. Of all patients referred for colonoscopies only a small proportion will be diagnosed with cancer but for those who are, the next step is access to the most appropriate treatment, delivered within a framework that maximises optimal outcome.

In that regard, I take this opportunity to mention the national cancer control programme and the work it is doing in the reorganisation of cancer services here generally. It is important to acknowledge the considerable progress made in the implementation of this programme under the directorship of Professor Tom Keane. It is also worth noting that additional funding for this programme was allocated during 2009 despite the obvious circumstances in which we find ourselves generally.

Regarding colorectal cancer in particular, there is widespread agreement that rectal cancer surgery must be performed by surgeons who specialise in this area. Following the first national audit of rectal cancer services requested by the programme, the number of hospitals where rectal cancer surgery is performed will be reduced significantly to 14 in the first instance, before being centralised further to eight. It is notable that the Irish Society of Coloproctology backed this proposal, and I believe there is not much dispute about the benefits that will accrue to the general population by the carrying out of this type of surgery in designated centres. In regard to colon cancer, similarly, there will be a requirement to reduce the number of hospitals where this type of surgery is performed. The programme will continue to engage with the society in that regard.

The Irish Cancer Society is widely acknowledged as Ireland's primary cancer charity and has done enormous work fund-raising, in addition to the items mentioned earlier. Along with the Minister, Deputy Harney, I welcome its initiative in regard to this awareness month.

As much as it is vital to be aware of the symptoms, it is also very important from the point of view of prevention that people should be aware of the risk factors for colorectal cancers. Senator Keaveney raised the issue, as did others, of the symptoms. I understand that symptoms include blood in a stool, loss of weight and tiredness and the obvious recommendation, if any of those are noticed, is to refer to one's general practitioner without delay.

It must be noted that some of the risk factors cannot be avoided. Approximately 5% of those diagnosed with colorectal cancer have an inherited predisposition to colorectal cancer, and another 15% to 20% of patients are at increased risk because of family history.

A number of speakers referred to lifestyle factors and the importance of prevention over cure. They referred to obesity and lack of exercise, the failure to maintain a proper diet and smoking, which is at the heart of so much of our cancer problem. By addressing all of those factors, to which Senators Corrigan and Keaveney referred, we can help to reduce our own risk of developing this disease. People are rightly political in this House and because it is a political House there tends to be an over-emphasis on the failure of the Government rather than the responsibility of the population in general, but that is part and parcel of the manner of the debates we have here.

Senator Healy Eames raised the issue of the errors in laboratories in Galway. It is worth noting that those errors occurred in 2004 and 2005, since when the Faculty of Pathology has developed protocols that have been adopted generally by the HSE in hospital laboratories. New procedures have been adopted since the end of last year for the recruitment and monitoring of locums. References are always checked for locums. These developments have occurred since those errors came to light.

Senator Fitzgerald asked when a decision would be made about a national colorectal screening programme. The Minister requested the board of the National Cancer Screening Service to advise on the introduction of a population based screening programme for colorectal cancer. It was anticipated that the advice would include who should be screened, at what intervals screening should take place and the type of screening test that should be used. This expert report was submitted by the board to the Minister last December.

In addition, the Health Information Quality Authority was asked to conduct a health technology assessment on a colorectal screening programme. The Minister understands this assessment has been completed and will be submitted to her shortly, at which time she will give further consideration to the introduction of a screening programme and the resources necessary for that. Many speakers, including Senator Norris, referred to the obvious economic benefits in the long term from the rollout of the screening programme, which I do not believe anybody will dispute.

I again commend the role of the Irish Cancer Society in promoting public awareness of colorectal cancer. The Government remains committed to enhancing diagnostic and treatment services for patients with colorectal cancer, and I am confident that survival rates for patients will continue to improve.