Margaret Cox (Fianna Fail)
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I thank the Minister of State for taking this matter. It is timely that I raise this matter given that October is breast cancer awareness month. Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer related deaths in Ireland, with an average of 1,726 women diagnosed with breast cancer every year. Of that number, 700 women — mothers, sisters or daughters — die from breast cancer every year. Some 106 women died of breast cancer in the west in 2002.

Breast cancer screening is not available in the west. Such screening could reduce the mortality rate of breast cancer by 20% to 30%. In Northern Ireland, by 1998 the mortality rate for the disease was reduced by 20% and in Scotland it was reduced by 30%. Of the 106 women who died in 2002, 30 of those lives could have been saved if such screening had been available. Some 9.7% of women in Ireland have a mammogram compared with an average of 21% of women in the original 15 member states of the EU. Those percentages represent a significant difference and that is not acceptable.

The timeline for the roll-out of BreastCheck was 2000 when it was provided to women in the east and the midlands. In 2003, the Government promised that BreastCheck would be available in the west by 2005. However, in 2005, we were promised that it would be available in 2007. In 2006, the Government said that BreastCheck would not be available in the west until late 2007. In 2006, we were told that the construction of a screening facility would commence on 6 November and no doubt the Minister of State will tell me about that. It is a welcome initiative.

However, construction is scheduled to last for a period of 48 weeks. Why has the construction company not been told to complete the construction work in a shorter time? Buildings can be built in a shorter time and the work day does not have to be from 8 a.m. to 4 p.m. In the case of a project as important as this one, it is possible to provide incentives to building organisations and construction companies to ensure the completion date of the structure is delivered at an earlier date. Until the structure is in place, we will not be able to make progress. Instead of accepting that the construction work could finish on 9 October 2007 without any delays, the Minister should ask the builders who have been awarded the contract when can they deliver it and how much will it cost. If ensuring the construction is completed at an earlier date would involve an expenditure of a few million euro, is that price too great to pay for a facility that would save lives?

The age group invited for screening is women aged 50 to 64. An American report shows that between 1980 and 1987, the incident rates of invasive breast cancer increased among women aged 40 to 49 by 3.5% and by 4.2% in women over the age of 50. Significantly, we need to examine the impact of widening the age group invited for screening. When we deal with rolling out the programme throughout the country, we need to widen the age group not only at the upper limit of women aged 64 but also to reduce it below the age of 50. Increasingly, more women in their 40s are developing breast cancer and it is not detected until it is too late. The survival rate is 82% for women younger than 40 years of age. It is found that women younger than 40 and in the 40 to 50 age group who have breast cancer tend to have a more serious form of breast cancer and early detection is vital. It is important we focus on extending the age group invited for screening as soon as possible.

I raised this matter to clarify the position regarding a donation made by the National Breast Cancer Research Institute, NBCRI, to the Health Service Executive, HSE, for the provision of breast cancer services and there is a concern that this donation was returned by the HSE to the NBCRI one year later with interest. That does not make sense and I would like the Minister of State to clarify the position.

Another matter on which I seek clarification, and I accept the Minister of State may not be in position to do so, in which case I can raise it with my colleague, the Minister of State, Deputy Fahey, is regarding a newspaper reference to the Minister having been quoted as saying that the mobile testing units will get on the road as quickly as October 2008. I hope that was a typographical error in the newspaper concerned. I sincerely hope that in November 2007 when the doors to the BreastCheck unit in University College Hospital Galway are opened, the mobile units will be ready and equipped to travel to provide a screening service to women in Connemara, Mayo, Tipperary, Clare and the other regions that are not being served.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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I reply to this matter on behalf of the Minister for Health and Children, Deputy Harney. I welcome the opportunity to set out the position on the issue raised by Senator Cox and also to advise the House on the progress on the roll-out of the national breast screening programme.

In June 2003, BreastCheck accepted a donation of €340,000 from the National Breast Cancer Research Institute for the purpose of purchasing a mobile screening unit to be deployed in the western area. In June 2004, the institute decided to redirect the funds towards the upgrading of mammography services at University College Hospital Galway and elsewhere in the region. The institute requested the refund of the moneys donated. BreastCheck refunded the donation made by the institute with interest, as Senator Cox pointed out. I acknowledge the important contribution the institute is making to the development of cancer services in the west. My colleague, the Minister for Education and Science, Deputy Hanafin, spoke at the institute's annual fund raising gala ball last week.

With regard to the national roll-out of the breast screening programme, the Minister for Health and Children, Deputy Harney, has met representatives of BreastCheck who are fully aware of her wish to have a quality assured programme rolled out to the remaining regions in the country as soon as possible. For this to happen, essential elements of the roll-out must be in place, including adequate staffing, effective training and quality assurance programmes.

At a meeting with Department officials recently, BreastCheck reported on significant progress that has been made in preparation for the roll-out. Additional funding of €2.3 million has been made available to BreastCheck to meet the extra costs of roll-out and a further 69 posts have been approved. BreastCheck has appointed clinical directors for the southern and western regions, both of whom will take up their positions next month. The recruitment of consultants and other staff, including radiographers, is under way.

BreastCheck also requires considerable capital investment in the construction of two new clinical units and in the provision of five additional mobile units and state-of-the-art digital equipment. The Minister is committed to meeting the capital requirements of BreastCheck and an additional €21 million in capital funding has been made available for this purpose. Construction teams have been appointed for the static units in University College Hospital Galway and South Infirmary, Victoria Hospital, Cork. Pre-award meetings took place with the construction companies last week and mobilisation for both sites is scheduled for 6 November next. The BreastCheck clinical unit in the western area at University College Hospital Galway will have two associated mobile units. Almost 58,000 women are in the target population for invitation to screening.

A breast screening programme is a complex, multidisciplinary undertaking that requires considerable expertise and management involving population registers, call and recall systems, mammography, pathology and appropriate treatment and follow-up. A programme must be quality assured and acceptable to women who attend for screening. The first phase of the programme is of a high quality and a similar quality in the west and south is essential. BreastCheck is confident that the target date of next year for the commencement of roll-out to the southern and western regions will be met.

Margaret Cox (Fianna Fail)
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I thank the Minister of State for clarifying the position regarding the donation. On behalf of the women of the west, I wish to send a message to the Minister and the Department that a timescale of 48 weeks is unacceptable. We can afford to shorten that schedule. Even if we only shorten it by eight weeks, that might save a life. There are many life-saving initiatives that can be put in place now because of our prosperity. Given that women in the west have waited for BreastCheck for seven years, I ask the Minister for Health and Children, as a female Minister, not to simply say she is satisfied with the roll-out in November 2007 but to ensure that it is done to the best possible standards. We must pay back the women in the west and ensure they receive the kind of treatment that is available in the rest of the country.

I have no doubt the Minister of State will relay my message to the Minister for Health and Children. It would be marvellous if we could achieve the aim. It would be a significant statement on the treatment of breast cancer. I am concerned about imbalances in the delivery of health services. I heard a representative of the HSE on "Morning Ireland" this morning talking about improvements in the accident and emergency services in Dublin. She said the HSE targeted the hospitals in Dublin.

In that context, I am concerned that people from the most peripheral part of the country are being forgotten. The focus is on the centre and by that, I do not mean Athlone and Tullamore, but Dublin. There is more to this country than the area surrounding Dublin. I am aware that the Minister of State represents the Dublin area but I wish to make a case on behalf of those on the periphery. We must move services out to the regions.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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I thank Senator Cox for her comments. BreastCheck is confident that the service will roll out next year, which is a tremendous development.

I agree that we must value and develop all our regions equally. In fact, the disproportionate growth in the population of Dublin is not necessarily welcomed by persons who have the honour of representing that part of the country.