Oireachtas Joint and Select Committees

Thursday, 5 July 2018

Public Accounts Committee

2017 Financial Statements of the HSE
2016 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health

9:00 am

Mr. Jim Breslin:

No. I am sorry but we are at cross purposes. I will bring it back to the beginning. The trigger for an audit of a case is a diagnosis of cervical cancer and the CervicalCheck programme being informed that somebody has been diagnosed with cervical cancer. That is an individual notification. CervicalCheck asks then if the person has a screening history. On occasion the person will not have a screening history. Where the person has a screening history the audit looks at the engagement with that person to see when CervicalCheck last engaged with the woman. It is a case of whether they called her and whether she did not come, which is a possibility, or whether they called her and she came and she had a difficulty with the quality of the smear test, and it goes all the way through the chain. The most important issue, however, is around the reading of the smear test and, after that has been looked at through a process to try to determine if there is a discordance, to communicate - this is where it fell down - that discordance to the woman's consultant who is treating her for cervical cancer, and for him or her to inform the woman that a previous smear had missed a screening potential to send her in for further review.

To bring that forward, as I understand it as a non-clinician, and it would be helpful if Dr. McKenna were here, the pause is for a period. If somebody is diagnosed with cervical cancer, and there will be a lag in that information getting to CervicalCheck so there is always a lag in any event, that information would come to CervicalCheck and the pause is that the look-back or review is not done and communicated over that period. It is to be a very short period, as I understand it. In all likelihood it will be much shorter than the period that would normally arise from the woman being diagnosed and the result becoming available. I will use some very rough figures but it is not 3,000. If there are 300 diagnoses in a year on average and, for example, half of them have a screening history - I am using very rough figures now - we are talking about 150, and if that is spread over the course of a full year, we are talking about ten or so in any single month.

That means over two months or so approximately 20 cases have to be done.

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