Frances Fitzgerald (Fine Gael)

I welcome the opportunity to speak on cancer awareness, given that today has been designated national no smoking day. It is particularly appropriate that we are having the discussion on our cancer services today and I shall focus on those areas concerning which I have questions for the Department as regards its policies and how it intends to develop them in key areas.

The Minister of State outlined the great progress that has been made in this area, and I acknowledge that. I acknowledge the move, for example, to the specialist breast cancer services. Despite some hiccups in the course of that transformation, it is extremely important that people are treated in specialist centres and this has been shown, undoubtedly, to have a clear advantage for the patient. It does not mean there are no issues as regards transferring from one service to another. Recently I came across a woman who had transferred from Tallaght Hospital to St. Vincent's and there are difficulties with such transfers. We have to take patients' needs very seriously to ensure the transfer from one service to another is achieved with all possible support for the patient. This is particularly important when the patient is in the middle of his or her treatment, when great care and support is needed during the transition.

I shall focus first on the area of smoking. It is very clear that this is an enormous problem in Ireland, given that smoking is a causative factor in 30% of cancers. Some progress has been made, undoubtedly, but I am extremely concerned that cancer society experts believe the Government has still not faced up to the need for a well-funded countrywide and co-ordinated "stop smoking" service. How to give up smoking is the big problem for individuals, as well as finding out what supports are available. It is clear from statistics internationally that if well-funded support services are in place for the 5% of the population approximately that need them, there will be a corresponding decrease in smoking. It is very worrying to read about the high levels we still have, equivalent to 29% of people living in Ireland. Obviously, there is a correlation between the effectiveness of the "stop smoking" initiatives and the amount of expenditure on them. We are all looking for value for money and I am aware money cannot be handed out lightly these days.

However, one needs to look at the returns for such expenditure. Some 30,000 people will be diagnosed with cancer in Ireland this year and new cancer cases are expected to reach more than 43,000 by 2020. One can see, therefore, that prevention is extremely important. We must encourage people not to start smoking, but if we can reach those who do, then the savings will be enormous both in cash and in health terms. It is a matter of some concern that at the height of the discussion about the ban on smoking in 2004, Quitline got 19,000 calls, while in 2009 it received just 5,765 calls. We need to examine the national approach to the co-ordination of such services. If we are serious about prevention and getting the message to smokers that they can quit, although needing help, then plans should be put in place to ensure this happens.

The second policy area I should like to address is the breast cancer mammogram service. That is now a countrywide initiative, but it is outrageous that it has taken ten years. I hope this will not be a precedent for how long it will take to roll out other countrywide screening programmes for various cancers. Too many people died while we were waiting for that service to roll out, and I do not accept the excuses that were made.

Further issues need to be addressed in this regard. We need to extend the age group that can avail of the service, as there is a false sense of security among women of 65 and over because the service ends at that point, since we know that breast cancer incidence increases with age. The programme should be extended to 70. In terms of younger women, I understand the evidence is still being studied as regards whether the service should be made available to those aged 45, as in other countries.

As regards lung cancer, it is very disturbing that the outcomes are so poor in Ireland. It is extremely disturbing that by the time many patients are diagnosed with lung cancer, it is too late to treat them. There are enormous issues as regards awareness of symptoms and getting to the doctor early. It is disturbing, too, to note that more women are now going to die from lung cancer than breast cancer, since more and more have taken up smoking. There are major challenges in that area in terms of reaching young women in particular. The same applies to young men in terms of cancer prevention, the need to be aware of the services that are available, getting to GPs early and dealing with the issues.

Undoubtedly, there has been progress, but the challenges are enormous. I should like to see more focus on health promotion, because it is clear there are enormous lifestyle issues connected to the incidence of various cancers, although not all, and this needs to be addressed in Ireland. These vary from smoking, which is well-proven, to obesity and lack of exercise. Most people are aware that some of the incidences reflect a combination of lifestyle factors that have precipitated the development of particular forms of cancer. These are factors which must be taken very seriously.

I also want to raise the whole area of sunbeds. The Minister promised legislation in relation to this, and very disturbing information is emerging as regards the use of sunbeds. I want to put some of this on the record and ask the Minister of State when the legislation will be introduced to deal with this. The very least we should be doing is banning the use of sunbeds for children under a certain age, whether 16 or 18, and I am sure the Minister is examining that. However, should we not be considering whether these products are so dangerous that they should be banned completely? This is certainly open to question, given the information emerging internationally in relation to them. Young women in particular, rather than young men, are very much at risk as regards the use of sunbeds. They were regarded for a long time as being quite innocent, but it has emerged that they are not as innocent as they might look. The International Agency for Research on Cancer, IARC, has stated they are as carcinogenic as cigarettes. It is problematic when people see them as quite innocent when they are not. We need, therefore, an information campaign on the dangers of sunbeds. In its international study of sunbeds, the IARC also found lax operating procedures in tanning salons. Regulation through legislation is much needed in this area as it is far too dangerous to leave untouched.

Concerning statistics have emerged about waiting times for colonoscopies. Susie Long was not able to access a colonoscopy when she needed it and subsequently it led to her death. When her case was debated, we were promised no one in urgent need of the procedure would have to wait more than four weeks. The number of patients, however, now waiting more than six months for the procedure across all hospitals has increased by 34%. At Tallaght hospital, for example, it has doubled from 90 to 177. I accept people's awareness has increased and more people are being referred for colonoscopies. Will the Minister of State clarify how these services will be further developed? When will the colonoscopy screening programme be fully rolled out? When will it be extended from the 60 to 69 age group to the 55 to 74 age group? Will the services be provided in the eight regional centres or on a more widespread basis?

I appreciate more moneys are being spent on cancer services. This was necessary, however, given the toll it takes in Ireland. Will the vaccine for cervical cancer be available from September or will it be rolled out in April to benefit current school goers?