Ms Fiona Murphy:

Deputy Tóibín noted that there were currently 230 cases in the courts system, approximately 160 of which are in legal proceedings while the others are notifications. A number of those cases, I imagine and hope, will go through the CervicalCheck tribunal, which started on 1 December, and people have started to put those claims through. It will be very useful for all of us to see the outcome of the tribunal and the results that come through. To date, relatively few cases have gone to court. Some have been settled before they went there. It is always the State Claims Agency's intention to use mediation to prevent people having to go to court if they can, although a few tragic cases have gone through the High Court and had their evidence assessed. There is not a medical intervention known to us that has not on occasion been found to be negligent, but they are very small numbers. We do not anticipate that all 230 cases that are going through now will show evidence of negligence. As Dr. Russell outlined, the unfortunate reality of a test that is not perfect is much better now, thank goodness. Even at that, however, interval cancers will continue to come through in future. Our concern is how we try to avoid people going to court in future. Patients rightly say they hate it and doctors do not like it either.

We have to find some other way of thinking about and addressing the issue that we will continue to have interval cancers. One of the good things about screening is that we repeat it regularly. In the case of cervical screening, for example, anyone who tests positive now for HPV will come back for another test a year later and then go on to have cytology. We call people back on a two-, three- or five-year schedule, depending on their risk levels, so the chance is always there that if the cancer is not picked up on the first screen, it might be picked up on the second. Because these are generally slow-growing cancers, we will often pick up the cancer at a later point. Over the course of the next cycle or round of screenings - in other words, from 2018 until now - all the women who were called previously will be called again this time. Therefore, a patient's call for looking back at those will be done anyway because we will recall and look at everybody's screen. If they come for screening, we will look at their tests again over this round. Once this round is finished, we will start the next round. We do repeat screening all the time, so I do not see a benefit in taking a further sample. If we are talking about one or two per 1,000 who might have an abnormality that we have failed to pick up, there is a risk that either we will do that again in the subsequent screening, as Dr. Russell said, or that the numbers will be so small that they will be impossible to find, unless we repeat the entire round, which we are already doing. Screening is a complicated system, but I hope we can offer some reassurance that by repeating and screening regularly we increase the chance of finding anything that perhaps was not found in a previous round.