Marie Moloney (Labour)
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I thank the Minister for Children and Youth Affairs, Deputy Frances Fitzgerald for coming to the House.

Women from County Kerry undergo breast surgery, when required, in the centre of excellence in Cork. Following surgery, the breast care nurse does the first fitting, after which women can access specialist bra or prosthesis fitting services in the community. This is not the case in County Kerry, however, and it is the reason I have tabled this Adjournment matter. In Kerry General Hospital, the nurse deals with all cancer patients and is not dedicated full-time to the care of breast cancer patients. This places great demands on the nurse, and her time for fitting bras and prostheses for breast cancer patients is limited.

We are looking for a place in County Kerry where women can go to have a fitting for their bra or prosthesis in private. If one needs a wig following cancer treatment, one can go to Boots and can avail of a cubicle while they fit the wig. We are looking for a similar service for women who have had mastectomies and are wearing prostheses.

A prosthesis needs to be fitted by a specialist. The body shape can change when a woman has a single mastectomy and the garment needs to be fitted properly. While I know the Minister will tell me there is a service in County Kerry, this is very limited and many women are directed to Cork. We are the only county in the country in which the women must go to the breast care nurse for a fitting, while in other areas, the women can go directly to specialists without having to go through the hospital.

I will await the Minister's reply and comment further at that stage.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I am taking this Adjournment on behalf of my colleague, the Minister for Health, Deputy James Reilly. I welcome the opportunity to address the House on the issue of breast cancer and, in particular, in regard to women who have had mastectomies.

Since 2001, all women who have had breast cancer surgery are entitled to their first prosthesis and two mastectomy bras free of charge, irrespective of their medical card status. This service is normally provided by breast care nurses and trained mastectomy fitters. Medical card holders are entitled to a prosthesis every two years, as well as two mastectomy bras annually. This is organised on prescriptions from their breast care nurse or GP. Prescriptions are processed through local health centres to enable women to avail of the services from suppliers who are authorised by the HSE to provide prostheses and mastectomy bras. The HSE can also provide assistance with specialised clothing and wigs to medical card holders in some circumstances. The community welfare services may also assist in cases of exceptional need.

Significant progress has been made in breast screening and in the treatment of breast cancer in recent years. BreastCheck, the national cancer screening programme, provides free mammograms to all women aged 50 to 64, the years through which the incidence of breast cancer is highest. Cancer services are centralised in eight designated cancer centres established in four managed cancer networks. Symptomatic breast clinics, as well as rapid access lung and prostate clinics,have been established in each of the eight cancer centres.

The national cancer control programme has developed national GP referral guidelines and electronic cancer referral for breast, lung, and prostate cancers, making the referral process seamless, safer and more efficient. A national hereditary cancer programme, primarily focused on breast, ovarian and bowel cancer, has been established in collaboration with the National Centre for Medical Genetics in Crumlin. This initiative aims to improve access to assessment and genetic testing for patients, and their families, whose cancer may have a hereditary component.

Breast cancer survival rates are improving as a combined result of screening, early detection and more effective treatment. Every effort is made to meet the needs of women who have had a mastectomy and who have prosthesis. Breast cancer five year survival is estimated at 81.8% for people diagnosed between 2003 and 2007, up from 76.8% for people diagnosed between 1998 and 2002. The Minister wants to inform the Senator that he will continue to work with the HSE, clinicians and voluntary organisations to ensure treatment outcomes for cancer patients continue to improve.

I am aware Senator Moloney raised a very specific issue but she did not mention the services for the women in County Kerry in particular in her question. I take on board the points she has made. Perhaps she will communicate with, and have the issue of the local service followed up by, the Minister for Health. The reply deals with the service in the national context.

Marie Moloney (Labour)
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I thank the Minister for her response, but my question referred specifically to the service in County Kerry, so unfortunately I have received the wrong reply as there was no mention of Kerry in it.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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It was not mentioned in the question.

Marie Moloney (Labour)
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Obviously somewhere along the line, the question got changed from what I dictated. I wanted specific answers for the Kerry area and that was not provided. I ask for leave to submit the question again at some stage. Do I have to wait a specific length of time before I can raise this issue again?

Paddy Burke (Fine Gael)
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We might be able to allow it in the circumstance.

Marie Moloney (Labour)
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I will resubmit the question after Christmas.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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The Senator should communicate with the Minister in the meantime.

Marie Moloney (Labour)
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I will. I thank the Minister for that.