Dr. Nóirín Russell:

I thank the Deputy for his questions. It is nice to chat to him about these things again. I think he and I had a productive conversation last week where we agreed that we have a common goal of rebuilding trust in our world-class screening programme. I have been a doctor on the front line and given that information to a woman who has been screened and goes on to get a cancer diagnosis. We all agree that it is a challenging and difficult place to be, as a woman, and it is worse still if that woman believes that somebody did not do their job right and that is why she is getting this diagnosis. However, as a clinician, I can tell the committee that a smear screening test will never detect all cancers. Every year, on the CervicalCheck programme, there will be women who have an interval cancer, meaning they will develop cancer after a normal screening test.

That is a reality. It will happen next year and it is happening this year, because screening will never detect all cancers. Internationally, few countries carry out reviews. When Public Health England reviewed slides for women who got cancer, four in ten women had an abnormality detected on look-back that was not seen on review. What we have found is very helpful is the Supreme Court ruling, which clarified that absolute confidence does not mean 100% detection. That is really important. The Supreme Court clarified that a new standard has not been introduced and that screening tests are not expected to detect 100% of cancers because, of course, that is impossible. The court also outlined in great detail the reasons a competent screener could be doing his or her job to the best of his or her ability with the tools he or she has, and a cancer may still not be detected. That was outlined in great detail in the Supreme Court and it is very welcome for cancer screening services.