Dr. Gabriel Scally:

I am not aware of colposcopists who left because they were unhappy. It may well have happened. Certainly at the time of the outsourcing of the laboratory work, there was clear evidence of cytopathologists being extremely unhappy about that.

On the issue of the overall numbers, workforce planning was not part of our remit. However, we made it clear in the report that there needed to be a workforce review of the cervical screening programme to ensure it was properly staffed and had proper access to the expertise it needed. One of the most important recommendations is that there should be a national screening committee because the means of making policy decisions on the screening programmes, including issues relating to staffing, is quite unclear. There needs to be a national screening committee with expertise and independence which can advise about the programmes, about new programmes and about any changes or modifications needed to existing programmes. That does not exist, which is why it is one of our key recommendations.

Education is extremely important. I take that two ways. I draw the committee's attention to one thing I did not address in the report and perhaps should have done. There is no requirement for training in taking samples or indeed working with women to have a successful cervical screening experience, in other words, getting a good sample and getting the consent of the woman. Some very good training is carried out, but it is entirely voluntary. I wonder whether that should be compulsory and that a modicum of training should be provided for all the clinicians involved in taking the samples and dealing with the women, if only to ensure they can explain properly to the woman what is happening and also in the context of the whole programme shifting quite significantly next year to the HPV testing as a primary test, which will be much more accurate.