Brian Lenihan Jnr (Dublin West, Fianna Fail)

I am responding on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. The HSE's national cancer control programme was established in 2007 to implement the strategy for cancer control in Ireland. The goals of the programme are better cancer prevention, detection and survival through a national service based on evidence and best practice for all cancers. This involves significant re-alignment of cancer services to move to a system which is consistent with best international practice in cancer control.

More than 2,300 women are diagnosed with breast cancer each year in Ireland. The first priority for the national cancer control programme has been the reorganisation of breast cancer services. I am sure the Senator is well aware of the nature of that reorganisation. Three years ago, there were 33 hospitals in Ireland providing breast cancer surgery. Today, there are nine. By the end of this year, all breast cancer diagnosis and surgery will take place in eight cancer centres, with an outreach service from University College Hospital Galway to Letterkenny General Hospital. The final service to be transferred will be transferred from the South Infirmary Victoria Hospital to Cork University Hospital next month when the new cancer centre opens at the latter following a €5 million refurbishment project.

This is a radical transformation of breast cancer services. I very much welcome the fact that the designated cancer centres are achieving the target of seeing 95% of urgent cases within two weeks of referral. In addition to the reorganisation of diagnostic and surgical services, prevention and early detection are key features of the national cancer control strategy.

Community oncology has been subject to considerable work. The major focus of this work has been on creating capacity and knowledge among health professionals in the community to promote best practice in cancer control. A great amount of work is ongoing in respect of the development of referral pathways and the education and training of general practitioners and their staff on the appropriate care and follow-up of cancer patients outside the hospital setting. The development of community oncology has been described by Professor Tom Keane, interim director of the cancer programme, as perhaps the most significant change that the cancer programme will effect over the long term.

With regard to breast prostheses, the national cancer control programme staff have been made aware that there is a variation in the availability and type of prostheses that are provided to women in different parts of the country. The Irish Cancer Society has recently highlighted its concerns in regard to prostheses supply and fitting services throughout the country.

This service has been traditionally provided by the Health Service Executive's community health offices. Direct contact has been made by the cancer programme staff with the appropriate managers and it has been recommended that a national standardised approach to the management of this service be established. It is important to ensure the needs of this group of women, irrespective of where they live, be addressed in a consistent and equal manner and that women receiving this service receive the same high-quality service regardless of where they live. In this regard, Professor Keane stated when appearing before the Joint Committee on Health and Children on 21 October that he would be happy to engage with the Irish Cancer Society on this important issue.

Breast cancer services have been radically transformed over the past two years and breast screening has been extended to all parts of the country. Considerable progress is also being made in the development of community oncology. It is acknowledged that services in regard to the provision of prostheses require work and in this regard the national cancer control programme has been in contact with the relevant managers within the wider HSE structure and Professor Keane has indicated his willingness to engage with the Irish Cancer Society on the issue.