Paudie Coffey (Fine Gael)

I welcome the Minister of State and his officials to the House to debate this very important Bill. I want to focus on specific aspects of the Bill, those being the dissolution of the Women's Health Council and the National Cancer Screening Services board and the transfer of all their rights and liabilities to the board of the HSE.

We are all aware of the national cancer strategy and a lot of faith has been placed in it by the Government under the stewardship of the HSE and Professor Tom Keane. I want to focus on the south east and on Waterford Regional Hospital which has been identified as a regional centre of excellence. Recent studies have noted that the word "excellence" needs to be re-examined owing to the many shortcomings identified in the delivery of cancer care in the region, due mainly to a lack of resources, staffing and other issues. Questions still need to be answered on the appropriate and proper delivery of cancer care in the region.

All the cancer care disciplines are delivered in Waterford Regional Hospital, bar one very important treatment, namely, radiotherapy. It is currently delivered through a private contract with the HSE and the Whitfield Clinic in Waterford. It has been reported in local media that there are contractual problems between the HSE and Whitfield Clinic with regard to the clear understanding of the radiotherapy services that are available and are being delivered in the region. It is something the Minister and the HSE need to focus on to iron out any difficulties or problems.

There have been many public rallies in Waterford calling on the Government to provide public radiotherapy facilities at Waterford Regional Hospital. That is the position of many people in the region and remains so. They will not be happy until there are full public radiotherapy treatment facilities available at the centre of excellence, as the HSE likes to call it, in Waterford Regional Hospital.

With regard to women's health and cancer care, I have raised the issue of BreastCheck on a number of occasions in the House, as have some of my colleagues in the Dáil. My understanding is that BreastCheck is not fully rolled out in Waterford. It is in Dungarvan, a larger county town, but not in Waterford city and many of the county areas.

There is no better way to display how a service is delivered than to see the evidence locally. I was contacted by a lady in her late 50s who has a long history of cysts on her breasts and, unfortunately for her and her family, there is a history of the same cancer in the family. She is considered a very high risk patient. Since the discovery of the cysts on her breasts, she has had a mammogram every 12 months in Waterford Regional Hospital until two years ago. When the consultant, Mr. Gordon Watson, retired - he had delivered great service to Waterford - a replacement was appointed. BreastCheck was then supposedly implemented and brought into the Waterford area. The lady was told by the HSE in Waterford Regional Hospital that she had been transferred onto the BreastCheck list for her annual check-ups. When she enquired with BreastCheck as to when she would be examined, she was told examinations were held occasionally in Dungarvan and not in Waterford city, and no date was given to her. She has now been waiting almost three years for a mammogram, which is totally unacceptable for a women in her position.

We are discussing women's health. She is a women who has a history and has already had cancer identified in her and her family. She cannot present for an annual mammogram in Waterford Regional Hospital unless she already has a lump. If we are discussing early detection of cancer, it is a disgrace for a person who is already high risk and has been identified as such not to be allowed to have a mammogram in the public service. When she went where she had been referred to, she again could not get a date from BreastCheck. It is not acceptable that this situation is pertinent. This is the state of play of our cancer care and is how we are looking after our women in the present climate. I appeal to the Minister of State and his officials to bring this to the attention of the Department and the HSE to find out whether this issue can be resolved once and for all. BreastCheck must be fully rolled out for those women who present with real concerns and who are not sleeping at night due to the worry of their cancer history. This issue should be prioritised by the HSE and the Department so that when women present for BreastCheck, they will be seen and their minds put at rest. Early detection will save the State money, save lives and improve health. If it is implemented properly, it will do justice to the health needs of all in this country.

Waterford city has the largest population base in the south-east region but it still does not have BreastCheck. The cancer care services, while they have developed to some degree in the region, are not the centre of excellence the HSE would like us to believe they are. We should strive for that excellence. This side of the House will co-operate when we see the results delivered.