Dr. Nóirín Russell:

I thank the Senator for her excellent questions. I will respond on the messaging about HPV and what we did when the programme changed last March. We had a full campaign that had been worked up and was ready to go. We were ready to launch our new improved cervical screening programme, moving from a cytology-based service to primary HPV, but it coincided with the Covid pandemic. As the Senator rightly pointed out, there was a great deal of messaging at the time. We decided, therefore, not to launch our full campaign in March. As such, while we changed the programme, we are behind in the messaging about HPV.

Since we restarted on 6 July, we have been running a campaign to inform women about the new primary HPV programme. We have had significant uptake in recent months. November was a bumper month for the cervical screening programme. We expected to screen 21,000 women but 24,000 women attended for screening. The Senator is right. Initially, we were worried that women would not respond to their invitations to attend cervical screening but women are attending in huge numbers and we are delighted with that. Again, that is thanks to the screeners, GPs and practice nurses who carry out these screening tests for us. We have that engagement. Our public health awareness programme, which involves media campaigns and advertisements, is up and running. We plan to do more of that in the future.

To answer the Senator's question about young women, she is correct in this regard. We know that 25-year-olds have a lot going on in their lives and their first screening test is not always top of their priority list. Our communications team is working on that engagement. We are also working on our website as younger women engage with messaging differently from older women. We are always looking for new ways to engage with younger women about the programme so we would be delighted to consider any suggestions the Senator may have.

As to whether there has been a change in how people react to healthcare, there has been an incredible amount of fear over the last year. We have seen that with all healthcare services across the world so it is not just an Irish issue. People were terrified to go into healthcare settings because of the risk of catching Covid-19. We know a lot more now than we did in March and we are a lot clearer about how to reduce the risk. What we are seeing now is people re-engaging with healthcare. We need to keep working on this issue but I am confident from a CervicalCheck point of view that women are re-engaging with the service. I am delighted to see that.