Colm Burke (Fine Gael) | Oireachtas source

I would like to ask about cases in which clinicians who were dealing with people who had been identified as having cancer were aware that those people had received smear test results at an earlier stage. Did it occur to front-line staff that they should go back and look at the smears that had previously been taken? Did front-line staff raise concerns to the central management system of CervicalCheck at any stage? Dr. Scally said earlier that there seemed to be a disconnect between front-line people and central management. Did he conduct an examination to ascertain whether people who were involved in CervicalCheck on a front-line basis might have dropped out at an earlier stage because of their concerns about central management? Does any documentation indicate that concerns were raised at a far earlier stage, perhaps before the audit was done?

The second question I would like to ask relates to the number of cases covered by the audit. It was decided to do an audit. As I understand it, the front-line staff were not aware that the audit was being done. Why was that information kept from the people who were dealing with the patients? It was only at a later stage that they became aware of the audit and the results of the audit.

I would also like to ask about the period of time that elapsed between smears being done and people being identified with cancer. Were there some cases in which the all-clear was given six or 12 months earlier? We have heard about cases in which mistakes were made in the reading of smears not once but twice. Serious questions are raised when a patient's smear is misinterpreted on two occasions.

I would also like to raise with Dr. Scally the number of people we have in the country and the number of front-line clinicians here. I understand there are approximately 135 consultants in obstetrics and gynaecology in this country, even though all the reports indicate that we should have 180. Do we have a sufficient number of people working on the front line at the moment? If not, what would be a sufficient number, based on a comparison between the ratio in this country and the ratio in other countries? Should we have many more people with the requisite expertise dealing with this area? What do we need to do to get more people into this area? I am raising this aspect of the matter in the context of the need to provide a far more comprehensive service and ensure the same errors are not made again.

The final matter I would like to raise is the educational process. This will not give an exact result every time. Regardless of the system that is introduced, there will be a failure in it. I understand that cervical cancer does not identify womb cancer. A clinician told me recently that there has been a huge increase in womb cancer in this country. It seems that there is some connection with the increase in obesity. I am not clear what the connection is. There is a higher incidence of womb cancer where there is obesity. The level of education regarding this issue has not been as comprehensive as we would need it to be. I wonder what Dr. Scally would do to get information out there. We need to make sure information is made available at an earlier stage to those who have a higher ratio of risk.

I will recap some of the issues I have raised. I referred to a ratio. I asked about the time gap between being given the all-clear and the cancer being identified. Has any information been identified in that regard yet?