Erin McGreehan (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Minister of State is very welcome to the House. It is great to see him. It is the first time I have had the privilege of speaking to him in the Chamber. I am raising this Commencement matter on breast cancer services and cancer screening in general, which is of major concern to me. Currently, people are not being screened due to the restrictions, which is understandable, but they are not getting the cancer treatment they need. We must make certain that we as a Government ensure the resumption and continuation of cancer screening services and that the system is adequately resourced to allow us catch up on screening.

I raise this Commencement matter today specifically to highlight breast cancer screening and the fact that the national screening service, NSS, advises that the current round of screening, which is usually 24 months, potentially will take 36 months due to the impact of Covid-19. To highlight the prevalence of breast cancer, one in nine women in Ireland will be diagnosed with breast cancer. It is the second most prevalent cancer in the world. In 2016, 85,500 people in Europe died from breast cancer. It is a major concern of mine.

I am hearing from many women about the lack of capacity in the system. Some may choose to pay for it, and Senator Conway said that if you choose to pay, you can get the health service you need. This two-tier system is intolerable and highlights, as Senator Conway said also, the need for universal healthcare here. An individual's health should not be disadvantaged by his or her ability to pay. We need to examine the capacity of private screening because if you want private screening, you can get it within a week and not have to wait. We need to expand that private screening capacity for the benefit of public patients.

I have been working with Councillor Teresa Costello, who is a member of Dublin City Council. I commend her on her incredible work. She is a young woman who is a breast cancer survivor. She set up one of the largest support communities for breast cancer patients in the country called Breast Friends. She would like me to highlight on behalf of all the women in the country that more and more women are being diagnosed with breast cancer. Thirty per cent of all women who get a breast cancer diagnosis are between the ages of 20 and 50, 34% are between the ages of 50 and 69, and 36% are older than 70. As the Minister of State is aware, the screening is only for women between the ages of 50 and 69, which means we are missing and not screening 66% of breast cancer patients. I urge him to bring the message to the Minister that we need to expand that screening capacity to include women from the age of at least 40 and up.

I ask also that there would be a breast cancer awareness campaign to ensure every woman, younger and older, is empowered to check her breasts manually for signs of cancer. General practitioners might work with the Department to provide for that manual check and the automatic ability to get a mammogram if a woman is under 50 years of age, because if they have a concern, they are not automatically referred to BreastCheck. That is a real issue for me and for many women.I would appreciate it if the Minister of State could bring those notes back to the senior Minister on screen enhancement for all women, a manual check to be carried out by a GP, and an awareness campaign.

Robert Troy (Longford-Westmeath, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

First, I thank Senator McGreehan for giving me the opportunity to update the House on this important matter in behalf of the Minister, Deputy Donnelly. The Government is fully committed to supporting our population screening programmes, which are valuable part of our health service. As the Senator is aware, BreastCheck, along with other cancer screening programmes, was temporarily paused last year due to the impact of Covid-19 on both our health services and communities. While BreastCheck resumed in October 2020, unfortunately it had to be paused again, and issued new invitations in January and February of this year.

I am pleased to inform the Senator that it has resumed again last month with more than 8,000 participants having been screened. The programme has done a great amount of work to support the safe resumption of screening by taking measures to reduce the risk of Covid-19 infection to the participants and staff.

The focus of the resumption of breast screening includes the management of capacity across the whole screening pathway, which includes follow-up assessments and treatments. I would like it to be noted that even when screening was paused, the programme continued to operate follow-up clinics. Breast screening involves close contact between staff and participants, and with Covid-19 safety measures in place, it will obviously take longer to get through the current screening round.

However, in Ireland we are fortunate in that we screen more frequently than many European countries, meaning it is expected we will still be in line with international norms for breast screening. An additional €10 million has been provided in 2021 for cancer screening service in the HSE national service plan.

One important initiative prioritised for 2021 is the development and opening of semi-permanent BreastCheck units in two locations. These new units and the recruitment of more staff will help to enhance the capacity of the programme. In line with the commitments in the programme for Government, BreastCheck is currently implementing an age extension project that will see all women aged between 50 and 69 years being invited for routine breast screening.

As to consideration of any further age changes, such as reducing the age to people under 50 years of age, as the Senator has suggested, it is vital we remember that breast screening is a population health screening measure and is not an individual diagnostic test. The balance between the benefits of screening and the potential harms or risks to the population as a whole require careful evidence-based consideration and balancing.

As with all national screening programmes, BreastCheck delivers its services in line with international criteria for population-based screening programmes that are kept under constant review. Decisions about changes to our national screening programmes will be made on the advice of our national screening advisory committee. This independent expert group considers the evidence for changes in a robust and transparent manner. This ensures policy decisions are informed by the best available evidence and advice. It may be of interest that the committee recently published its first annual report, which is available on the Department of Health’s website.

BreastCheck provides a lot of information for the public on its website breastcheck.ie. This includes educational materials to encourage women to be aware of general breast health and, crucially, the common symptoms they should seek medical advice on. It runs social and digital media campaigns and provides valuable information on its website, including regular updates on Covid-19.

I take this opportunity to emphasise that screening is for healthy people who do not have symptoms. People who are between screening appointments or are waiting for a rescheduled appointments are asked to be aware of symptoms, and if they have concerns or worries, they should contact their GP who will arrange appropriate follow-up care. In light of all this, I trust that the public can be assured the Government is committed to our national screening programmes.

Erin McGreehan (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State and I very much welcome the additional €10 million. I am very aware of the development of and the increased funding in the breast and cancer services. I understand there is a balance of benefits between screening and potential harms.However, at the moment, because they are not being automatically screened, many breast cancers are not being diagnosed. From brief research and talking to breast cancer survivors and patients, it is unfortunately clear that, because younger people are being diagnosed at a later date and not getting screened, they are being diagnosed with stage 4. Many of them are incurable.

There is helpful information on the websites but we need to bring that information to women more and to highlight it to empower young women and girls to check themselves. I would not be 100% certain about how to check myself. We have to know that. Just because someone is not in the category being screened, GPs must know they have an option to request a mammogram and check. I thank the Minister of State for his time and I hope he relays the matters I raise to the Minister, Deputy Stephen Donnelly.

Robert Troy (Longford-Westmeath, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I thank the Senator. She has made a strong case and I will relay her suggestions to the Minister. To be fair to the Senator, she acknowledged the extra €10 million invested in the National Screening Service this year. That demonstrates the commitment of this Government to national cancer screening services.

I, too, compliment Councillor Teresa Costello on the really good advocacy work she has been doing. It takes guts and commitment for somebody who has come through what she has to turn a negative to a positive. She has been a strong advocate.

As I said, I commit to relaying to the Minister the points the Senator raised today.

Victor Boyhan (Independent)
Link to this: Individually | In context | Oireachtas source

We have a slight change of plan. I have spoken to the Minister of State, Deputy Joe O'Brien, who can be back in the House in three or four minutes. In the meantime, the Minister of State, Deputy Troy, has agreed to take the final Commencement matter now if that is agreeable to the House? Is that agreed? Agreed.