Victor Boyhan (Independent)
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I welcome the Minister of State at the Department of Health, Deputy Butler, to the House. As always, it is good to see her. She always gives a very comprehensive response to Commencement matters or any other matter that might come before the House. I raise issues with BreastCheck, CervicalCheck and bowel screening. I am a former director of the National Treatment Purchase Fund - I do not know whether the Minister of State knew that - so I am very aware of the importance of waiting lists, how they are managed and the significance of screening for cancer. Early detection means better outcomes for people struggling with the terrible disease of cancer. There is also anxiety arising from having to wait for screening, which is not good for patients or anybody else. I accept that Covid-19 has had a significant impact on waiting lists and our health services. These three issues were covered in the Sunday newspapers yesterday, strangely enough, although I had tabled this Commencement matter a few days ago.

There are substantial waiting lists and backlogs for BreastCheck, CervicalCheck and bowel screening. The number of women who had a complete mammogram last year was just over 56,000, which was behind target by 128,730 patients. The number of women who had one or more cervical smear test in primary care cases was 143,000, behind target by 111,000 patients. As for bowel screening, there were 50,000 tests, yet this was behind target by 75,000. Bowel cancer that is detected early can be treated very successfully.

Doctors and patients have called for a strategy to tackle these backlogs in respect of cancer diagnosis and that is important.The National Screening Service also says it is under pressure in terms of capacity and wishes to come back on target in respect of the stated objectives regarding issues surrounding analysis and diagnostics. As the Minister of State is aware, there were over 5,600 GP referrals for cancer in March 2021 alone, compared with 2,234 in 2020 so the figure has gone from over 2,500 to over 5,500 in one year for one month. Alarm bells must be ringing in respect of these issues. Diagnostic services such as colonoscopies are critically important. We know colonoscopy is the most accurate test for cancer of the colon and rectum and is proven to detect disease early so that the disease is treatable and curable and people can get on with their lives. Diagnostics is really important.

I am conscious that the three biggest challenges for the Government are health, housing and jobs. The Government and all politicians on all sides of the Houses will be judged on how they perform. I believe that without one's health, one does not need a house or a job. Health is primary. It is at the top of the matrix in terms of how we can deliver for our people. I accept, understand and acknowledge the enormous pressures faced by the Government. I am not here to blame anybody. Like the Minister of State, I am here to get us back on track and I would like to hear what the Government has in mind in terms of getting these three critical cancer screening services back on track for the well-being of our people and our health service.

Mary Butler (Waterford, Fianna Fail)
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I thank Senator Boyhan for giving me the opportunity to update the House on this important matter. There is probably not a house in Ireland that has not been affected by cancer. I did not realise the Senator was a former director of the National Treatment Purchase Fund so he has a very good understanding of how it actually works.

I am pleased to say that our three cancer screening programmes - BreastCheck, CervicalCheck and BowelScreen - are operating. All programmes were paused for a time in 2020 due to Covid-19. While screening services resumed throughout last year, it was at reduced capacity. BreastCheck was paused again in January and February of this year due to the Covid-19 situation and resumed screening on 8 March 2021.

The National Screening Service has done a significant amount of work to mitigate against Covid-19 risks and support the safe resumption of services. This has included the vaccination of front-line staff in screening services. The latest data show a good increase in numbers screened during March and April. In March, CervicalCheck screened over 45,000 women and the provisional data for April indicates that over 28,000 women were screened. This is significantly above the target of 24,000 and I acknowledge the huge effort by CervicalCheck, primary care services and GPs and the laboratory services in achieving this level of activity. The provisional April data for BreastCheck show that over 12,000 women were screened and in BowelScreen, over 24,000 invitations were issued. Again, I acknowledge all the teams in screening services and clinical pathways for their ongoing work to get screening back to full capacity.

The focus of the resumption of cancer screening services includes the management of capacity across the whole of the screening pathway, which includes follow-up assessment and treatments so while invitations for screening were paused, it is important to note that follow-up assessments and treatment continued throughout the pandemic with a particular focus on urgent and time-sensitive cases.

In resuming screening, those who may be at highest risk of disease are being prioritised. The Senator was quite right when he said that early detection is vital. It is also important to emphasise that screening is a population-based measure aimed at healthy people who do not have symptoms. People who may be between screening appointments or who are waiting for rescheduled appointments should contact their GP if they are concerned about any possible symptoms.

In terms of funding, an additional €10 million was allocated for cancer screening services to the HSE for 2021. Many of the new developments being funded in 2021 will enable the management of screening service users with deferred appointments due to Covid-19. One important initiative prioritised for 2021 is the development and opening of semi-permanent BreastCheck units in two locations in Donegal and Dublin later this year.In light of all of this, I trust the public can be assured of the ongoing commitment to our national cancer screening programmes and to getting services back to full capacity as safely and as quickly as possible.

Victor Boyhan (Independent)
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I note the additional funds and resources that have been allocated to address this issue. I thank the Minister of State for that. I am particularly pleased about the confirmation of the services for Donegal today because there is a substantial level of concern about the issue in the county. That is good news for the people of Donegal, for the people who represent them and for the people of Dublin. This goes back to the fact that the delayed detection of late-stage cancers will mean fewer treatment options and not very successful outcomes. This is the impact on people, in terms of their survival, and their families to which the Minister of State referred.

I ask the Government, the Department of Health and the Minister of State's officials to keep this as an issue a priority, to review the national cancer strategy, to address any further shortcomings and to monitor developments on a month-by-month basis. We must remain on the case and keep monitoring. In another few months, if there is a reduction in the figures, we need to examine that. Ultimately, I would like the Minister of State to publish a comprehensive capacity and workforce plan. It is important that we stay focused on this issue and continue to publish the figures. I thank the Minister of State for her comprehensive reply.

Mary Butler (Waterford, Fianna Fail)
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As the Senator said, every area of the health services has been affected by Covid-19 and our national screening cancer services are no exception. The HSE and the National Screening Service are working hard to provide cancer screening in a safe environment and to get screening back to full capacity. I take the Deputy's point and I agree with him wholeheartedly that we have to ensure that this matter remains a priority. It is essential that we do so.

As I outlined, the data for March and April show a significant improvement. The National Screening Service continues to provide up-to-date information for the public on its programme websites, including regular updates with respect to Covid-19. Due to the difficulties we are encountering in the Department of Health and the HSE because of the cyberattack, I encourage anyone who has an appointment this week to check the website, if possible, before attending because, unfortunately, many appointments have been affected. It is awful when we are finally getting back on our feet that people who have been waiting for an appointment for quite a while might have it cancelled.