Treasury debentures: more consultation needed

Dear Sir,

During budget time I wish to express my view that I believe it is time for a shake-up of the cumbersome debenture-issuing process.
We all remember the shambles of November 2008 when the Government suddenly issued a Special Issue of Monthly Pensioner Debentures offering three and a half per cent - one and a half per cent higher than the regular Monthly Pensioner Debentures existing at the time. This created a huge and unnecessary administrative burden for the hard-pressed Debentures Office staff and resulted in many pensioners queuing up around the Treasury Building from well before 9 am in the cold winter of that year.
Why was this "unnecessary"? Because the Government then proceeded to increase the interest rate on the existing regular Monthly Pensioner Debenture to the same level as that of the new Special Issue, which meant that the exchange of hundreds - or possibly thousands - of pensioners' certificates, which resulted in pensioners queueing at the Debentures Counter and around Treasury Building for hours, could have been easily avoided. How? Merely by raising the interest rate on the existing regular Monthly Pensioner Debentures without issuing a new Special with the higher rate. Elementary, surely.
The problem seems to be that decisions on new debenture issuance are taken by Government consulting the Debentures Office staff, who are the ones that have to carry out these massively wasteful exercises in both paper and human resources no doubt including many hours of overtime, or the long-suffering pensioners who need to queue up endlessly - inside the building, if they're lucky - or stand outside in the cold if it's winter and massive queues build up as was the case in November 2008.
It will be interesting to see whether the Government announces the issue of a further debenture with an attractive interest rate in this month's budget. The latest auditor's report reveals that the public debt required to finance the massive infrastructure and other projects that are currently under way is being, in the main, funded by pensioners through their purchases of debentures (as revealed in Panorama on 9 April this year, pp. 2-3).
Government will have to maintain the momentum of funding borrowing by continuing to attract pensioners' funds. They tried to tap the 'non-pensioner-specific' (i.e. where you don't have to be a pensioner to invest) market in last year's budget but that backfired when large numbers of pensioners rushed to transfer their savings from pensioner debentures to the new three-year 'non-pensioner-specific' debenture paying 4 per cent interest meaning that, instead of raising fresh funds, it ended up costing the Government half a percentage point more in interest payable to the many pensioners who transferred savings from the Special Issue or from the regular Pensioner Debentures, both of which were paying, and still pay, three and a half per cent.
No doubt in an attempt to try and avoid a repeat of the long queues of November 2008, applications to transfer funds to the new three-year 4 per cent 'non-pensioner-specific' issue in 2009 had to be deposited in a box at the entrance to No. 6 Convent Place rather than at the Treasury Department itself. Yet fast-track transfers from the maturing April 2010 six per cent issue to the three-year four per cent 'non-pensioner-specific' issue were to be delivered to the Treasury and not No. 6. Confused? I'm not surprised. And there must have been massive demand from pensioners to transfer to the 4 per cent debenture (that had really been aimed at attracting 'new money' and not pensioner transfers) because applicants reportedly did not receive approval of their applications for many months.
Government will have to come up with a clever ploy to attract more funds to finance the burgeoning public debt without again inconveniencing pensioners by obliging them to rush to transfer their savings from one issue to a new one in another massive wasteful paper exercise for them and for the long-suffering Debentures Office staff. I think I know how this can be done efficiently but will let the Government try and figure it out for themselves. I just hope they don't make a mess of it again this time. They cannot afford to again inconvenience the very people that are funding a major share of Government borrowing.
Let's hope the Government takes the above into consideration, should they decide to issue a further debenture in their budget this year. Planning and consultation with relevant Debentures Office staff - apparently conspicuously absent in recent debenture issues - should be paramount.

Yours faithfully
M J Ashbey

In Defence of Democracy

Dear Sir,

One must make some pretty hard but justified criticisms of GBC refusal to grant an interview to the leader of the opposition Joe Bossano after his intervention at the United Nations before the Committee of 24.
Its worth getting a few facts straight the purpose of having a television and radio station in this country – which is paid by the tax payers not Peter Caruana and his GSD party is for the purpose of Citizens achieving the best possible result in news and information in which both Government and opposition have the same right to it – no more no less.
There is no statutory Policy – no law that binds the Chief Minister or the board to an arbitrary decision on the use of radio or television by the elected opposition to inform citizens on matters of National importance.
This refusal represents a threat to GBC independence and the freedom of the elected Opposition informing the electorate which they represent of an important issue.
GBC must remain open to the free expression of views a spanning the whole spectrum of Political Views and not into a mouthpiece for the policies and propaganda of Government.
Unfortunately during the debate in Parliament on GBC objectives clearly designed to control GBC were unveiled by the Chief Minister.
Though this is a disturbing issue perhaps I may be forgiven for now seeking the readers attention to the intervention of the leader of the Opposition at the United Nations.
For rarely has a politician in this country displayed so determinedly and so justifiably its readiness to say to the 24 committee at the United Nations and indeed the world as the leader of the Opposition Joe Bossano did on the subject of the right to self determination and decolonisation when he said ‘it is not Spain’s Territorial Interity that is under attack and requires your protection, but ours…’

Yours sincerely
Francis Gonzalez

Pay freeze

Dear Sir,

Unite the Union wishes to issue the following statement regarding the UK Budget and the announcement in the House of Commons that the Cameron Government will be implementing a two year pay freeze in the public sector.
This will have immense repercussions in Gibraltar for those workers whose salaries and wages are derived from the parity concept. As we have seen there will be a two year pay freeze in all public sector salaries and wages. The only ones escaping from that measure both in UK and locally are those public sector workers earning below £21,000 who will be getting a yearly £250 increase.
Some will be more fortunate in that industrial and non-industrials in the Gibraltar Government have a three year deal that will be respected and is set to end in August 2011. After that their wages will be frozen.
Unite will continue our 'jobs for Gibraltarians' campaign aimed primarily at the private sector, and advocating training schemes and a system of fiscal incentives to private sector companies to encourage the creation of employment opportunities for local residents.
As predicted in my May Day message earlier this year, the election of a Conservative administration in UK has meant a drastic reduction in public expenditure.
The irony of this is that the crisis brought about in the international banking sector as a result of the collapse of Lehman Brothers in the US, led to a rescue package of the industry with millions and millions of pounds from the public purse.
The public funds used all over Europe to maintain the banking sector, meant that sooner rather than later, working people would be called upon, as we are seeing now, to foot the bill for this policy. A year later we are being told by the Chancellor of the Exchequer in UK that massive spending cuts will be implemented in the public sector. Once again working people and the lower paid sections will be suffering the brunt of this capitalist crisis.
Yesterday was the international day of Public Services, which has been ‘celebrated’ by a massive attack on the public sector. This is not unique to UK. In other countries the situation is worse, and we will soon be seeing Privatization of public sector assets across Europe. Fortunately the Gibraltar Government is against privatization and this has been stated publicly.
We should not forget that when the GSLP was in power, they privatized nearly all public sector utilities and closed all training centres. Unite is always against privatizations and restrictions in public spending.

Charles Sisarello
Regional Officer

 Congratulations!

Dear Sir,
As Business Advisors to Gibsights we are proud to congratulate the team for an outstanding success at the Young Enterprise (Yorkshire Humber & Gibraltar) regional final held in Hull on the 17th June 2010. Gibsights, who had also previously won the Gibraltar competition, will now represent the region at the UK finals of Young Enterprise in London next month with the possibility of reaching the European finals in Sardinia should they achieve victory once again.
The competition consists of student teams assisted by business advisors and link teachers managing their very own companies and selling a real product or service for an entire school year. This is the second year Vasquez Consulting Ltd have participated as Business advisors and Gibsights is now one of the best 11 teams of a total of 2500 participates.
The Young Enterprise programme is a vital part of team development at Vasquez Consulting Ltd. We have invested heavily by having both our Directors working on a personal basis with the students, mentoring them and passing on key business skills which will give them an added advantage on the road to a successful career as well as providing them with an enjoyable experience.
As Accountants & Business Consultants participation in the Young Enterprise programme fits in very well with our business ethos and we are committed to continue our support in the future. We hope our input will give students the tools they require to succeed.
Congratulations to Gibsights (Mark Moreno; Syanne Agius; Sarah Martinez & Joel Williams) We also wish to thanks the Link Teachers Roin Sampere & Daniel Benrimoj for their outstanding contribution towards a magnificent team achievement.

Ramon Vasquez & Alfredo Vasquez;
Directors - Vasquez Consulting Ltd

'Bullying'

Dear Sir,

I would like to refer to Mr. F. Buttigieg letter of 21st June 2010 titled 'BULLYING' referring to a lead- article that appeared in another daily on Tuesday 15th June 2010, titled 'New Coordinator against Bullying and Harassment at Work'
Although it is heartening to read that 'Unite the Union' has at last taken an interest in 'Bullying' it may be a matter of 'too little, too late,' as the pressure group 'Dignity at Work' has been declaring for many years that in Gibraltar 1 in 3 employees are suffering the consequences of bullying at work. This represents 31.8% of employees or well over 5000 (Five thousand) individuals falling victims or being targets of workplace bullying and suffering mental health alteration and deterioration of their general well-being.
It is not enough for the Union to appoint a new coordinator to tackle harassment and bullying at the workplace. Mr. C. Sisarello does not explain in detail what the Union's policy, modus-operandi, principles or measures will be to tackle this problem.
Both organisations mentioned above are in agreement that new legislation should be introduced to regulate this problem, but from a personal point of view I would like to question the efficacy of this potential measure. I would even go further and state that the present professionals and organisations who have a vested interest in the subject of 'Bullying; or 'Mobbing,' as it is also called, are not dealing with this very difficult problem in the right way.
As far as introducing new legislation to control, curtail and punish offenders is concerned would indeed be a very desirable measure. But we all know that legislation alone cannot stop anything. There are laws against violence, robberies, muggings, drugs etc. but they do not seem to stop the occurrence of these crimes.
Psychologists, counsellors, Union Representatives and well-meaning people may be able to offer some kind of therapy or official help to these victims but they do not deal with the culprits of these abuses i.e. the bullies. Nor does any kind of therapy or legal assistance gives the victims of such mistreatment the courage to repel further attacks by other bullies in future.
We must not fall into the trap of treating these victims of bullying or mobbing as mental patients in need of counselling or psychiatric treatment.
In my estimation, it is very important that all children at school who become victims of the proverbial school bully be taught some kind of self-defence so that the child can learn from a very early age to 'fight his own battles'
In life we are all alone. We all have to be tested. We all have to fight our own battles. If parents, teachers, priests, policemen and people in authority take away the natural challenges that come our way and wrap us around a protective layer of cotton wool then we will never learn to stand up for ourselves or develop as persons.
The school playground is the real testing ground for all children and this is where bullying usually starts and carries on into the workforce for many adult victims.
Bullies have no right to intimidate weaker or younger children, but quite often the parents and teachers cannot do anything about it. It has also been proven that a bully who takes advantage of a weaker child or adult person is a 'coward' himself and needs to be taught a lesson.
When bullies are not tackled or challenged at their own level they become stronger and more boisterous like little 'Hitlers' In fact, if Hitler himself had been tackled at an early age he would not have become the menace he represented to all humanity when he reached the full plenitude of his manhood. I have often been surprised to notice in all his photos and films that he had a perfectly shaped nose. It is incredible that no one gave such an upstart a deviated septum. The course of history might have been different if someone had taught Hitler a lesson early in life.
Once again I have to reiterate that children must be taught 'assertiveness skills' and 'self-defence' from an early age. I am not a defender or advocate of wanton violence, but when it comes to defending one's honour, dignity, space and physical integrity the words of Kenny Roger's song 'The Coward of the County' 'Sometimes you have to fight if you're a man,' might apply.
When the crunch comes, it might be better to lose a job than your dignity. As the saying goes. 'Una puerta se cierra y otra se abre.'
 

Thanking You
Tito Valerga

Lunar Walk and thanks

Dear Sir

It is that time of the year again and the Lunar Walk fast approaches... FRIDAY 2 JULY! Join us at Casemates from 9pm to register and at midnight, Mayor Olga Zammit will launch us on our way along Winston Churchill Avenue, to the airfield and around the Western end of the runway and to end at Ocean Village for a well earned drink...so get those walking shoes, pink gear and bras ready, it's charity walking time.
So many people & companies have helped and supported us over the year, as you may have seen via the media, THANK YOU! However we would like to thank our 'quieter' supporters: Paul Ruiz & his colleagues who cycled the whole Camino de Santiago for us and raised £200; the Calentita night 'cake supremos' Sarah Sheehan, Nicole Stevens, Lyanne Mor & Ivan Hernandez (plus the wonderful bakers: Yvonne Sheehan, Moira Mor, Glenn Mor, Fiona Mascarenhas, Geraldine Bell & Jennifer Poole for their delectable cakes) who raised £320, deliciously well done!
Always in the best interest of the women of Gibraltar (and some men), we are very happy to lobby for improved and increased services for breast cancer & disease care; thank you for your continued support and encouragement in allowing us to do this, your kind words mean everything to us and give us the impetus to keep going.
Committee, Breast Cancer Support Gibraltar

Bullying

Dear Sir,
Since September 2005 Dignity At Work Now (DAWN) has been campaigning through its Ban Bullying Day for the eradication of bullying at work. We work closely with employees, employers and others to this end.
DAWN have on many occasions encouraged and invited organizations to deal with the issue of bullying. We therefore welcome the news that Unite the union have finally decided to proactively tackle harassment and bullying at work and also welcome the appointment of Eddie Baglietto as Coordinator. We are happy that Unite will now use its resources and power and join in the effort of the eradication of this type of behaviour that is so prevalent in places of work.
The study undertaken by DAWN shows that 31.1% of employees consider themselves being victims of bullying at work, that’s almost 1 in 3. This means that over 5000 people are being bullied in Gibraltar today (Vielma & Buttigieg, 2007). These finding are corroborated by the numerous calls we get asking for help, advice or intervention.
As always, DAWN would like to reiterate that we are at the disposal of our community as well as organizations like unions, businesses, NGO’s and individuals. Needless to say DAWN is more than happy to offering its knowledge and experience in dealing with bullying.
Given the recent tragic suicide of an employee of Barclays Bank who we know was being a victim of bullying at work and was also a member of Unite the Union, DAWN met with Barclays CEO, Franco Cassar on two occasions to make him aware of the bullying situation that is going on within the bank. We also offered Mr Cassar that if he really wanted to know whether a problem exists within the bank that we would undertake a study to measure bullying. This offer has been sadly rejected by Barclays.
We are deeply concerned that so many employees are falling victims of bullying and their health being seriously affected by its devastating and chronic effects. For many years many have suffered in silence because of the general collective denial together with the negligence of employers and employees representatives.
Lack of anti-bullying policies and legislation on this issue largely contributes to the continuance of bullying going unpunished. DAWN is conscious of the amount of work still to be done and welcomes all who wish to contribute to dignity in our places of work.
Francis P. Buttigieg
Chairman of DAWN

Feeling the pinch

Dear Editor,

Indeed we are suffering our economic recession well after mainland Europe and traders have indeed felt the pinch. However, part of this recession is due to the uncaring and arrogant behaviour of the Royal Gibraltar Police FORCE.
Although I do not deliver personally with great regularity, I have witnessed how police officers are especially hard on delivery drivers. Many of these drivers strive to park without hindering or obstructing other vehicles and pedestrians and are even careful not to park on part of a zebra crossing. Many of these conscientious drivers ask police officers who may be at the scene if they can park to deliver goods and are told that they can but to hurry up. It is to their surprise when they return to their vehicle and find the mentioned constable in the process of issuing a parking ticket. When asked why this action has been taken, the answer is that his superior has just informed him to fine the vehicle and that he has already started writing the ticket out and has to issue it as he cannot cancel it.
We know that Government is short of cash and that, according to the Police Authority, there is a very low crime rate in Gibraltar but, just because officers are placed on traffic duties and want to earn their stripes as a means of promotion, they should use their discretionary powers, if they have any. Why be so UNREASONABLE!! Why don't they make sure that bikes and private cars are not parked on loading bays for days on end, making the lives of people trying to go about their usual business, a misery? Has this been tackled by Government in their proposed traffic plan?
I hope that the powers that be do something about this unfair state of affairs. It is a complete harassment of people who are trying to do a decent day's job for a decent pay.

Yours faithfully,
John Carreras

A Government that pleases Spain

Dear Sir
It is no longer news to read that the Paramilitary Guardia Civil vessels are continuously systematically invading our Territorial waters and with arrogance provoking Gibraltar's maritime Police with their 'third world' patrol vessels.
Then what was special about it? It was the fact that despite the fighting tone adopted by the Chief Minister in Parliament a year ago, that the Government intended to acquire vessels of a much important size and capacity with which to exercise and by force jurisdictional competence - the situation lamentable remains the same.
No policy decision has been taken by Government to acquire those vessels for the Police which is deeply disturbing. Again it is question of another broken promise in Government’s legacy of broken promises to the people of Gibraltar.
What is abundantly also to be found here, however, is evidence that no matter what the nature of the intimidation is or of those in Spain who have traditionally challenged our right to our homeland the Chief Minister is only too happy to accommodate and please Spain.
This process is manifestly no new phenomenon. We had the episode of the paramilitary vessel who invaded our Territorial waters and inside our harbour including our land and its crew detained, but two hours later were let free without charges, clearly a degenerate corruption of our laws to please Spain.
We also have the federation of local anglers waiting for legislation to safeguard their right to freely fish without interference from outsiders and the protection of our fishing grounds against the invasion of Spanish Anglers.
I cannot, of course, leave this subject without referring that the Government will now be introducing legislation, but I certainly take no satisfaction from that the anglers from Spain will not be barred. It would be foolish, however, to assume knowing the chief minister that he would completely stop the Spanish anglers.
But due to the nature of our territorial size and seafront which cannot be compared with other countries we therefore do not have the same freedom of movement. There must certainly be restrictions and limitations to those that come from Spain to balance this disadvantage.
A few words are also necessary about other aspects of government policy to appease and please Spain. Laws on restrictions and limitations on the sale of tobacco and subjecting ordinary citizens going about their business, to surveillance which is obnoxious and intolerable in a free and democratic country, all to please Spain.
There are also the many increases in prices on petrol and diesel through the year. What it does mean however is that its shadow darkens all areas of our cost of living.

Yours sincerely
Francis Gonzalez

GBC hiccup, and no apology

Dear Sir,
While in Gibraltar recently I soon became aware that GBC television is not held in the highest esteem. But now I have confirmation, I regret to say.
Before leaving at the weekend, I was watching last Friday what is known as the Newswatch replay at around 11pm.
To my amazement, this news bulletin started abruptly which, itself, drew my attention. But surely this was not the beginning of the bulletin...no, it waan't!
After several minutes the programme was stopped, there was a short filmed snippet about something or other, and then the Newswatch started where it should have started in the first place - at the beginning, and not half-way through as happened initially.
I was further surprised that there was no explanation for this serious hiccup, much less any apology.
I say this because that same day, on one of our ITV channels, the England match was also interrupted. The difference was that there was someting of an uproar in England - and ITV had the decency of apologising.
Oh well!
Yours sincerely,
Charles A. Horton

Turning the screw?

Dear Sir,

With His Excellency the Governor's words viz a viz the Bay incursions hardly dry on paper, the Spanish government's reply is almost instantaneous.

This morning (the 9th) a Spanish naval vessel, the survey ship TOFINO pennant No A 32 appeared in the Bay of Gibraltar and conveniently sailed along the "median line". Could this have been an innocent passage, or the start of the turning of the screw ?

What next ? Will they send the aircraft carrier Principe de Asturias or will they resurrect " Smokey Joe".

Interesting time ahead !

Yours Faithfully
Michael Sanchez

Stupidity at its best by our Health Service

Dear Sir,

A friend of mine, whose wife, like mine is suffering from Alzheimer's at St Bernard's hospital, requested that his wife should be given physiotherapy treatment but has been told his wife is not a patient at the hospital but that she is just waiting for a vacancy at the Elderly Care Unit.

My wife has been in hospital for the last two years and now she cannot walk, move her head to either side nor lift it up. She is confined to a seat where she cannot move. In other words, this patient is becoming a vegetable.

I am convinced that a mass murderer in a prison cell is treated and looked after better.

Yours faithfully
J L Soiza

Action on air pollution!

Dear Sir,

The European Commission has warned Gibraltar that air pollution levels are above acceptable levels and represent a health risk. If action is not taken the Commission may issue action against Gibraltar. This is not a simple legal issue of compliance. Ignoring these warnings endangers the health of our citizens. Government needs to act to bring the levels of air pollution down. There are ways of doing so.

The major sources of man-made air pollution include the combustion of fuels, such as petrol/diesel by vehicles; energy generation from power plants and industrial activities such as building, mining, manufacturing of cement, ceramic and bricks.

The effects of inhaling particulate matter have been widely studied in humans and animals and include asthma, lung cancer, heart disease and premature death. It has been suggested that air pollution is related as a cause to brain damage as that found in Alzheimer patients.

Particulate matter pollution is estimated to cause 200,000 deaths per year in Europe. For this reason the EU has set standards for particulate matter concentrations in urban areas.

There will be a tendency for many to try and blame this increase in particulate pollution in Gibraltar with natural processes such as airborne dust brought by southerly winds from the Sahara. However, increases in traffic, a boom in construction, extremely polluting generating stations that posses no electrostatic precipitators and a neighbouring petrochemical refinery are more likely sources of this type of pollution.

There are different methods in which particulate matter pollution can be tackled. A simple and effective way is by planting coniferous trees, which have been demonstrated to actively trap particulate matter. Traffic management, improvement of our public transport and the promotion of hybrid technology and electrical vehicles would also help reduce particulate pollution.

Better regulation of what has seemed to be a ‘free for all’ in construction in recent years would also have resulted in less of this type of pollution being emitted.

Also the use of electrostatic precipitators in generating stations would reduce the emission of these sooty particles into the environment. Government must ensure that sensible policies that aim to reduce this harmful pollutant are implemented in order to minimise the health hazards associated with this as well as preventing embarrassing and costly litigation at a European level.

Government should not pay lip-service to environmental measures by supporting World Environment Day but then failing to act in this important area. The issue of minimising air pollution is crucial for the improvement of health of our citizens.

The Government needs to take measures to bring down the dangerous levels of pollutants being emitted in Gibraltar. We are setting out some constructive suggestions which would help to deal with this problem. It is now up to Government to act.

Dr Gavin Gafan
PDP environment spokesman.

Against dolphinarium

Dear Sir,

Having met with John Cortes and Eric Shaw from GOHNS, I had pleasure in joining them to condemn the proposed dolphinarium planned for inclusion in the redevelopment of Rosia Bay.

The American company Ocean Embassy, also planned to open one of these facilities at Playa Coronoa in San Carlos; this was abandoned due to public opposition and through a note sent to the Aquatic Resources Authority of Panama.

The same can happen for the proposals by Ocean Embassy to build a dolphinarium here in Gibraltar, but not without public awareness and subsequent opposition and action.

The link to youtube below is a video of dolphins in captivity and their experiences to get there, please watch it and see what will happen to our native dolphins should this project come to fruition:

http://www.youtube.com/watch?v=Q-bQ6BLur6w

Now see 'Dolphin Safari's' website footage of the beautiful mammals in their proper, natural environment:

http://www.dolphinsafari.gi/dolphin-videos/

Now take action! As well as showing your support for GOHNS (Gibraltar Ornithogical and Natural History Society) by joining through their website at http://www.gonhs.org/contact.htm . Forward this email to all in your contact list and friends, or join the facebook based support at:

http://www.facebook.com/group.php?gid=123991324284696.

Dolphins are probably the next most intelligent mammal to us, there are many recorded instances of them helping people in distress who may have perished otherwise. Let's try to repay them by uniting in opposition to the senseless and unnecessary cruelty in a world where we are aware of the importance of conservation and preservation. We have a duty as custodians of our world to protect it and slow the damage done by modern times and human convenience and 'pleasures'.

Support the cause further when in Gibraltar and other places where these magnificent animals are indigenous, by going on a trip to see them in their natural habitat.

Thank you.
Charlie Ellington,
Dolphin Safari.

Imminent Breast Screening Programme

Dear Sir,

Breast Cancer Support Gibraltar is extremely excited that their primary wish, Gibraltar's own Breast Screening Programme (BSP), is to be realised and to start any day now with a pilot programme. The Charity has worked very hard these last three years to ensure that all measures necessary to provide a BSP have been put in place by the GHA. It has lobbied the GHA for the delivery of a service which Gibraltar can be proud of on a par and in many ways better, than the approved NHS BSP in the UK. As opposed to the UK, which screens women every three years from the age of 50 to 70, Gibraltar will screen women from 40-49 yearly, 50-64 every two years and 65-74 every three years.

The Charity feels it is important that the women of Gibraltar are informed of all the facts surrounding a BSP so they can make an informed choice when they are invited for screening. Once the BSP starts to roll out to all women in Gibraltar over the age of 40, public information leaflets will be made available, providing details of the logistics of the programme and how it will work.

We have consulted with Breast Cancer Care, (a leading breast cancer charity in the UK), to ensure that the information we provide is correct. It is important to stress that breast screening saves lives and it means that cancers will be detected at an earlier stage, increasing the rate of successful treatment and survivability. As with any medical investigations, there is a small risk of false readings which can cause alarm but can also be addressed by an in-house radiologist by referring to other diagnostic imaging tools at his/her disposal. According to a report by Peter Gotzsche et al in the BMJ 21 February 2009, their statistics show that for every 2,000 women screened regularly over 10 years, one will avoid dying from breast cancer and 10 women will receive unnecessary treatment. Breast Cancer Care UK is very careful to point out that despite this minimal risk with breast screening, it leaves no doubt that screening is good for women and they advise women to attend routine screening when invited and we concur with that view.

Gibraltar plans to use a mammography unit for the BSP, as in all breast screening programmes around the world. After a request from the then GHA Breast Radiologist Dr Bernathova, and consultation with Dr Wilson, Head of Radiology at the Royal Marsden Hospital, Breast Cancer Support Gibraltar successfully convinced the Bonita Trust to purchase a Digital Mammography Unit with Computer Aided Detection (CAD). This is a fabulous IT tool built into the unit which highlights areas of discrepancy in the breast image even before the radiologist has scrutinised it. After selection and approval by Dr Bernathova, we are thrilled that the Bonita Trust purchased the equipment last August, (not all BSP centres in the UK have yet bought such advanced digital technology).

While researching for the Bonita Trust the advantages of digital mammography over analogue, we found clear benefits which we would like to share with you:

· The quality of the digital images are much better and clearer as the contrast is better

· Women with implants (after breast enhancement surgery) can have a successful mammogram with this technology as any changes in the breast tissue will be detected due to the improvement in image quality

· The compression plates are more comfortable, especially for women with implants & larger breasts and the patients are ‘under compression’ for less time

· The image processing is faster as images are sent directly to a workstation in real time; images can also be sent electronically to a tele-radiology centre

· There is reassurance for women as they can chat to the mammographer who will confirm the image is there etc. as the workstation is in same room

· A lower radiation dose is given as the mammogram is quicker and more efficient

· The images can be manipulated by the radiologist at the workstation who can zoom in to areas of concern; there would be fewer incidents of repeat mammograms being required to obtain a magnified view etc.

· More efficient use of radiologist’s time due to speed and accuracy of digital equipment

· As this technology takes the mammogram image more quickly, it is ideal for screening large numbers of women, i.e. a breast screening programme

· This technology is less likely to need an upgrade in the future, only of its IT

After screening the breast with the mammogram, in a very small number of cases, areas of discrepancy within the breast image that are still not clear will require further investigation. For these diagnostic purposes, ultrasound or an MRI can be used to highlight an area again. Ultimately only a biopsy and pathological investigation will determine what the change in the breast is. For this reason, after a request from GHA radiologist Professor Bodner, our Charity bought a Vacuum System for the digital mammography unit. This facilitates obtaining a biopsy by literally 'sucking up' a tissue sample using the mammographic equipment as a guide to localise the lesions. This avoids open biopsies (surgery) and processes more women more quickly, with less stress and anxiety for results.

Magnetic Resonance Imaging (MRI) is undergoing a clinical trial in Germany as a possible tool for screening, however this is still at the trial phase (as are many types of drugs, treatments & imaging technology) and may not be successfully approved after the necessary time period required in which to rigorously test the service. After some research into the matter and consultation with Breast Cancer Care UK we discovered that MRI is not used anywhere in the world for breast screening: it requires an inordinate amount of uncomfortable time for a woman to be in in order to image both breasts successfully (over two hours of staying absolutely still in a tunnel-like machine and if you move, start the process all over again), making it impractical and very time-consuming as a screening tool.

However, as mentioned earlier, MRI is an excellent diagnostic tool used to support the few unclear ultrasound or mammography images that cannot be read, and this is standard practice in all modern health services including Gibraltar. If there ever comes a time where MRI is approved for breast screening by the National Institute for Health & Clinical Excellence (NICE) and adopted by the UK's NHS BSP, Breast Cancer Support Gibraltar will be lobbying the GHA to do likewise in Gibraltar; until then, we await results on all clinical trials that affect breast cancer & disease care.

A word on Ductal Carcinoma in Situ (DCIS), which constitutes 20% of all breast cancers. Thanks to digital mammography technology, more DCIS is highlighted in women who are screened, which has led to some of the unnecessary treatment suggested by Gotzsche et al, mentioned earlier. Jackie Harris, Breast Cancer Care UK's Clinical Nurse Specialist on Breast Health & Family History, explains that as DCIS is a non-invasive breast cancer, since screening started over 30 years ago, many women have lived with DCIS without it becoming invasive or being of detriment to the health of women. However, a small percentage of DCIS does become invasive if left untreated; clinicians and experts in this field are investigating DCIS further in order to understand the disease better to suggest different treatment protocols to protect those women who would otherwise receive unnecessary over-treatment for it. The jury is still out there for DCIS; however Breast Cancer Care UK will keep the public informed of progress in this area as it gets it.

Breast Cancer Support Gibraltar would like to reassure the public that they are happy with the planned BSP that will be on offer in Gibraltar and that the Charity will always demand and expect the best. We are also happy to answer any queries or concerns the public may have about this or breast disease in general.

Breast Cancer Support
Gibraltar

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