Yesterday, I spent some time at the hospital bedside of a man I know well who is dying of cancer. His wife sat there holding his hand as the end approaches. Many Members will have had this experience with a family member, an acquaintance or a friend.

Today's report of the National Cancer Registry dealing with the discrepancies in cancer treatment throughout the State makes one realise the lottery for life with which people must contend. It very much depends on where one lives. The report indicated that women suffering from breast cancer have a 30% higher chance of dying if they live in the west and the midlands than if they live in Dublin. Men with prostate cancer are twice as likely to die within five years if they live in the mid-west than if they live in the east.

One cannot even get a hospital bed in the west.

If I want Deputy Cowley's assistance, I will call upon him. The appalling discrepancies in cancer treatment are an indictment of the Government's programme to provide a world class health service. The varying rates of survival, indicated in the report, will frighten many. The survival rates for breast cancer in the north east stand at 72.3%, 73% in the mid-west and 73.5% in the south east. Surgical services are widely unavailable in the regions while the availability of chemotherapy and radiotherapy leaves much to be desired.

The Deputy's time has concluded.

Does the Taoiseach have any idea why chemotherapy is likely to be used in three times as many cases in the west for prostate cancer as it is in the east? In January of this year we learnt that the national plan for radiation oncology services, announced by the Government in 2005, was completely hollow and shallow because it had not been thought out by the Government in this first instance. We should remember that the targets set out in that plan were described by senior officials of the HSE, responsible for the programme as not being achievable. Does this not make a mockery of the Government's strategy for a world class health service in the area of cancer treatment services? The issues identified by those officials indicates that the plan was not thought out and that the words of the Government in respect of it were hollow. While cancer can strike any person, it is difficult when people such as the couple I spoke to yesterday say "Why has the Government let us down in this region in terms of the availability of services?" Arising from this report, does the Taoiseach believe it is right or fair that a person's address indicates the place in his or her lottery for life as a result of the Government's inadequacy in the provision of cancer services?

I welcome the publication of the report by the National Cancer Registry on survival patterns of care. The report cover the period up to 2001, some six years ago. It shows improvements in survival rates for breast, colorectal and prostate cancers but not for lung cancer at national level during that time. It shows improvements in all regions for breast and prostate cancers and in most regions for colorectal and lung cancers. There is no doubt that there are regional disparities in cancer survival rates. The cancer strategy published last year, which was welcomed by all the stakeholders, is designed fundamentally to change that. One of the major objectives of that strategy is to improve the outcomes for cancer patients in every region.

How can the position improve when people have to wait——

Allow the Taoiseach to reply to Deputy Kenny's question.

We are funding and organising cancer services to ensure that patients from every region will be benefit equally from top quality cancer care. Using more specialised care in the major centres is the way to achieve this. That is what all the experts indicate and all the evidence shows that. It is vital that cancer specialists treat a sufficient number of cases to maintain and grow their skills. That has been pointed out in a number of reports published during the last six or seven years.

We are again this year making a large allocation available for cancer control, screening, acute services and research. The increase in investment this year is almost three quarters more than the comparable investment for the previous year to support the implementation of the national cancer control programme.

The HSE and the Department of Health and Children are also working on the means to implement the national plan for radiation oncology services to meet the timeframe. The Deputy will be aware that the timeframe for the rolling out of that programme nationwide is another four years. The Deputy raised this issue with me previously. It is considered by all the people involved in the programme that it will not be rolled out any faster than that. It will take until some time in 2011 to roll out radiation oncology services on a national basis.

I am sure the Taoiseach is aware from his discussions on this area that early detection and early intervention save lives. When I was in Tralee recently the consultants I met made it perfectly clear that people die in that region because they are waiting for endoscopies and analysis — they die. Why have mobile screening units not been provided throughout the west and north west? There was no waiting list in Sligo General Hospital last week and a great service is available in that hospital. However, many women may well have much shorter lives than they expect because they may have breast cancer but have not been screened. Mobile screening units should have been made available throughout the country to provide such early analysis but that is not the case.

Why is chemotherapy used three times more often for the treatment of prostate cancer on men in the west than in the east where surgical treatment applies? What is the reason for that if there is supposed to be a national standard? Can the Taoiseach explain that? Deputy Twomey published a document on this issue in 2004 in which Fine Gael proposed a screening test for every man and woman for the detection of early signs of these problems. Does the Taoiseach accept that would be a vital and essential service?

I note in his sprint on Saturday, the Taoiseach outlined, in breathtaking fashion, his proposal for free screening for breast cancer, cervical cancer and prostate cancer.

The Deputy's time has concluded.

What does that mean? Following last Saturday night's exclamations, when will those services be rolled out? Does the Taoiseach believe this report, which clearly indicates that mortality in Ireland in 2007 is directly related to where one lives, is indicative of the world class health service he and his Government promised in view of the glaring discrepancies in treatment for those who require chemotherapy, radiotherapy and so on? What are the Taoiseach's comments in response to those questions?

As I said, last year there was a 75% increase in staff resources. That investment was to support implementation of the Health Service Executive national cancer control programme. It was for screening and acute services but men, in particular, and Deputy Kenny has been talking to some cancer consultants, are slower to come forward for screening programmes. It is only through active screening programmes for prostate cancer that we will have success in the fight against prostate cancer. That is the reason we invested those resources.

This report covers the period from 1994 to 2001 but as a society we invested €1 billion in cancer services nationally in the past few years. That is a significant level of resources and it has been invested substantially in all regions to improve cancer survival rates.

Deputy Kenny mentioned Sligo. He will be aware that some of the best consultants are located in the west and operate from a Galway base. Many of them trained abroad but now work in the west because that is from where they hail. One hundred additional consultants have been appointed in the key areas of medical oncology, radiology, palliative care, histopathology and haematology. If the Government can complete the contract with the hospital consultants, we will move quickly to employ several hundred more consultants, including in the area of the national cancer services. We have employed 245 clinical nurse specialists who have also been appointed in the cancer services area. Nearly 94,000 inpatients and day patients were discharged from hospitals following a diagnosis of cancer, an increase of nearly 70% on the figure ten years ago.

I regret that people continue to die from cancer, including friends of Deputy Kenny, but there has been an enormous improvement in the cancer services that have been rolled out — over 70% in terms of patients discharged compared to the number of patients discharged in 1997. This year we set up the National Cancer Screening Service Board. That amalgamates BreastCheck, which was established by the then Minister for Health, Deputy Martin, in 1998 and the Irish cervical screening programme, both of which are now part of the national screening programme. Both BreastCheck and the national cancer screening programme are being rolled out nationally this year.

It took a good while.

That new service alone has been allocated €33 million which is an increase of more than 70% over last year. That service will also advise on the implementation of the national colorectal screening programme.

What about the mobile units?

It is possible to use mobile units but treatments such as radiation oncology are best carried out in national hospitals and some private hospitals, which also provide the treatment. The mobile centres are not very expensive, but the main accelerators cost several million euro. These are based in the hospitals as are the other back-up services such as medical oncology and the consultants in radiology, histology and haematology. To be successful they need to have experience of dealing with a large number of cases. The mobile clinics are used for screening purposes only and patients must be referred to hospital centres. Resources are used to build up national centres of excellence that can deal with a critical mass of patients. I acknowledge that our success rate is not at the level of the rates in the United States where screening is continually undertaken, but our rate has improved dramatically in the past decade.