Joe McHugh (Fine Gael)
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I took due deliberation in preparing this Adjournment matter as it is one which should not be taken lightly. To address the broader perspective of cancer incidence, one in three people in this country will develop cancer. Another frightening statistic is that 60% of cancers will develop in the elderly. If this is the case, it is important we maintain cancer services on a regional basis and are not sucked into the madness of centralising cancer services, which is the mantra of many reports of recent years. Centralising cancer services is not the way forward and we must be careful not to go down that road.

To be parochial, Letterkenny General Hospital needs a colorectal surgeon, a breast surgeon and a radiation oncologist. These appointments must be made in the short term. In conjunction with these services, a super-regional centre from where these services will operate is also needed.

The leaked elements of the O'Higgins report suggest that breast cancer services will operate in a centralised manner. It has been insinuated that the north west will eventually link up with Altnagelvin Hospital in Derry. However, this will not be the case. The now defunct North Western Health Board exhausted every avenue in trying to link up with Altnagelvin Hospital. It is not good enough for reports to repeatedly state that north-west cancer services will be facilitated through that hospital or through Northern Ireland services. It is not and will not be the case and we must consider decentralising services.

There is need for a full-time breast surgeon at Letterkenny General Hospital. Recent reports suggest it will take until 2007 for breast services to be relocated or decentralised to the west and north west. This is a scandal for the simple reason that in 2000 other areas had their breast screening services rolled out. That women between the ages of 50 and 64 living in the west and north west will not have these services in the short to medium term is a scandal, a disgrace and a matter which must be addressed in every possible way by the Government.

While unnecessary bureaucracy is a problem, breast screening services must be rolled out. We cannot blame bureaucracy; we must believe there is political will, but many in the north west do not believe it exists. One frightening and glaring statistic is that cancer death rates can be reduced by 25% in women detected through a screening programme. These services do not exist in the west and north west and, therefore, the women who cannot avail of them are in more danger of developing cancer in comparison to their eastern counterparts. This is an absolute disgrace. People in the west and Donegal pay taxes. Do they not deserve a service that women in the east are receiving? This is a rhetorical question because it is a disgrace that women are faced with such a predicament.

Rory Kiely (Fianna Fail)
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The Senator has exceeded his time.

Joe McHugh (Fine Gael)
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I will finish on this point. In Northern Ireland alone there are four screening centres in Lurgan, Antrim, Belfast and Altnagelvin, spread out on a regional basis. Others areas in Northern Ireland are not disadvantaged by these services whereas the west and the north-west are so disadvantaged.

No consultant radiation oncologist is visiting Letterkenny at present. This means patients must travel to Dublin on the N2-A5 road for treatment. This road is an infrastructural nightmare, although that is an issue for another day. The situation in Letterkenny is disgraceful. Cancer services must be addressed because one in three people will develop cancer. Some 25% of women will survive if they are screened properly.

Rory Kiely (Fianna Fail)
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The Senator has exceeded his time.

Joe McHugh (Fine Gael)
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I appreciate the intervention and latitude, but this is something that I feel strongly and passionately enough about to speak on behalf of the women of the west and Northern Ireland. All they are seeking is a service to which they are entitled.

Seán Power (Kildare South, Fianna Fail)
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The national roll out of the breast screening programme to the remaining counties is a major priority in the development of cancer services. The Department of Health and Children has been working collaboratively with BreastCheck and the two host hospitals involved in progressing the roll out. I welcome the opportunity to describe the Government's position on the programme and to outline in detail the different stages undertaken so far.

The national breast screening programme commenced in the eastern and midland regions in February 2000. Screening is offered free of charge to women in the 50 to 64 age group. Since the programme commenced, cumulative funding of approximately €60 million and €12 million capital funding has been allocated to support the programme.

In February 2003 the Minister for Health and Children announced the expansion of the current BreastCheck programme to counties Carlow, Kilkenny and Wexford. Screening commenced in Wexford in March 2004. BreastCheck expects to commence screening in Carlow in April 2005 and screening will follow in County Kilkenny when the first round of screening in Carlow is completed.

In March 2003 the Minister announced the expansion of the programme to the remaining counties in the country. The national roll out required detailed planning for the development of essential infrastructure to provide for two clinical units, one in Cork and the other in Galway. This detailed planning involved considerable work by BreastCheck, University College Hospital, Galway, the South Infirmary-Victoria Hospital, Cork, and the Department of Health and Children.

The first stage of the development was the planning of the two static clinical units, one at the South Infirmary-Victoria Hospital and the other at University College Hospital, Galway. This necessitated the establishment of two capital project teams to develop briefs for the units' construction. The former Western Health Board prepared detailed option appraisals for the BreastCheck development at University College Hospital, Galway. The brief proposals, with cost and phasing options, were then evaluated by the Department and the most appropriate option was selected.

The South Infirmary-Victoria Hospital considered it necessary to commission a site strategy study to ensure the integration of the breast screening service into current and future developments at the hospital. The Department made a capital grant of €230,000 available for the study to be undertaken by professional architectural, engineering and quantity surveying experts. This study was completed in mid-2004 and proposals were submitted to the Department.

After the evaluation of both briefs the Department was then in a position to determine the capital funding requirements for the progression of both developments. These requirements were considered in the context of the overall capital investment framework and, in September 2004, approval for a capital investment of approximately €21 million was given for the construction of the units. This investment will also provide for the mobile units which will be available to screen women throughout the country.

Subsequent discussions took place between BreastCheck, the South Infirmary-Victoria Hospital, the Western Health Board and the Department on design issues surrounding the development of the static units. It was decided to relocate and develop the symptomatic breast service back to back with the BreastCheck development at University College Hospital, Galway. In December 2004, the Tánaiste and Minister for Health and Children approved additional capital funding of €3 million to support this development.

It is intended to progress both of the developments at Cork and Galway simultaneously and it is anticipated that the advertisement for the appointment of a design team will be placed in the EU journal in the coming weeks. The Tánaiste is committed to the national expansion of the breast screening programme. The design, construction and commissioning of projects of this nature generally take approximately two and a half years. The Tánaiste is confident that the target date of 2007 for the national expansion will be met.

Joe McHugh (Fine Gael)
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This is a frightening response because it does not give me clarity or hope to anyone who lives in the west or north west. The Minister of State said the Tánaiste is confident that the target date of 2007 for the national expansion will be met. What indicators has the Tánaiste used that allow her to be as confident? It means nothing to me because, in 2002, the target date was 2005.

Rory Kiely (Fianna Fail)
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The Senator was allowed a brief question only.

Joe McHugh (Fine Gael)
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Will the Tánaiste invoke confidence on this side of the House and in the people of the west by making a complete commitment to the programme's full expansion to the west? This area was not even mentioned.

Rory Kiely (Fianna Fail)
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I understand but the Minister of State must reply.

Joe McHugh (Fine Gael)
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The Cathaoirleach is in the same boat as myself, so I know he understands.

Seán Power (Kildare South, Fianna Fail)
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Does a "brief question" warrant a brief reply?

Joe McHugh (Fine Gael)
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An extended reply, please.

Seán Power (Kildare South, Fianna Fail)
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I accept the Senator's interest in the matter and I hoped I had explained the position sufficiently, but obviously not everyone is as satisfied with my answer. We have shown the commitment of the Government and the moneys it has made available in rolling out the programme nationally. In such situations there must be a beginning and an end. The last counties to be addressed will feel hard done by, but we have started. The mobile units to screen women will be available throughout the country.