Anationwide re-organisation of all cancer services. Finally. If the recommendations put forward by the National Cancer Forum become a reality, life for cancer patients and their families will change dramatically.

There will be a National Cervical Screening programme, which will hopefully reduce the number of women dying from cervical cancer by 80%. The BreastCheck screening programme will finally be extended to women living in the west of Ireland . . . also reducing the numbers dying unnecessarily because of late diagnosis. There will be a colo-rectal screening programme established for men and women, in recognition of the fact that it is now the second-most common cancer in Ireland. And the most common cancer . . . that of the skin . . . will be targeted by prohibiting children under 16 from using sunbeds outside their own homes.

Coordinating and organising all of this will be four major cancer control networks, each of which will be headed by a director of cancer control. No more local GPs working independently of each other. No more surgeons operating on just a handful of cancer patients a year. If this strategy is realised, specialist centres will be providing specialist care. And they'll be keeping a record of everything.

Does past performance inspire confidence in future results?

Hardly. It all started with the announcement in November 1996 by the minister for health, Michael Noonan, that he was setting up a wide-ranging 'national cancer strategy' with national breast and cervical screening and regional directors overseeing specialist cancer care. A familiar plan.

One year later, with nothing yet in place, the new minister for health, Brian Cowen, announced that preparatory work had yet to be done, and breast and cervical screening would now not be introduced until 1998. By 1999, there still was no sign of even a pilot cervicalscreening programme in the state.

BreastCheck finally began offering free breast screening to women aged 5064 in the then North Eastern and Midland Health Board areas in February 2000. A pilot cervical screening programme was introduced in October of that year.

An estimated 700 women died from cervical cancer in these 10 years. Five hundred and sixty could have been saved if a national screening programme was in place.

So what's different this time?

Everyone wants this to happen. The Department of Health, the HSE, the cancer experts, all gave a commitment last week to seeing the foundations of this strategy in place by the end of 2007.

Unfortunately, history shows that a government commitment is not a guarantee.

Yet there is an optimistic attitude among cancer experts that this time is different. Dr Harry Comber, director of National Cancer Registry Ireland, is confident there will be progress. "I was at the launch of the plan and I felt that the Tanaiste and Professor Drumm were very committed, " he said. "It remains to be seen whether the Department of Health will be able to come up with the funding, but I think that if the government commitment is there, then that is much more likely."

The public reaction is also favourable.

Opposition parties can find little fault with the plan except to criticise the lack of cost analysis, and the Irish Cancer Society are all but clapping their hands in delight at the prospect of a concentrated, patient-focused cancercare system.

However, given past reaction to major reorganisation within the health service, it would be foolish not to foresee the possibility of major delays when the location of the four major network centres are announced in the coming weeks. Political strife and public outrage are guaranteed.

So how long will cancer patients have to wait before any of this is in place?

The HSE says the aim is to have the National Cancer Programme in place before the end of 2007. This would encompass some of the most significant elements of the plan, including the establishment of the four major networks and the roll-out of a nationwide BreastCheck service. These are major reforms, and critics have questioned whether the HSE can accomplish such fundamental changes in an 18-month period. But the HSE is confident that the deadline is realistic.

"Most of the elements for the plan are already in existence. It's just a question of joining them all up in the most effective manner, " a spokesman said.

As regards the much-anticipated National Cervical Cancer Screening programme, Minister Mary Harney is committed to having it in place by 2008.

Nice plan . . . but how much will it cost?

Nobody knows. Not even Mary Harney.

Over the next six to eight weeks, the HSE will be working on a "means assessment" to find the level of funding required. A HSE spokesman said it can't yet even give an estimate of what's involved.

"We haven't put a price tag on it yet, " he said. "At this stage, it would be premature to suggest a figure."

Despite this, there is little fear that the Department of Health would have insufficient funds for the eventual cost of the plan. "All major projects obviously need major capital investment, " said the HSE spokesman. "But the level of commitment that has been given by the government in relation to the National Cancer Programme is very strong, so the HSE would not be concerned that the funding wouldn't be available."