Mr. Damien McCallion:

In terms of screeners, there are challenges around the world whereby those who work in cytopathology are moving away from the field. This is because of the general trend away from cytopathology and into HPV testing. Dr. McKenna may want to comment on this as well. Having said that, we will offer more opportunities in terms of the Coombe - the public system. What most countries have done is try to train people in order that they can operate both HPV and cytology and they obtain both skill sets. That has been the model. From our experience of looking at HPV implementation in other countries, that is one of the lessons. We will try to build that into our workforce plan in the context of screening. While, as I say, it is small in terms of numbers, we will do whatever it takes to ensure we provide career paths and skills for people and that they can operate within that. Equally, we will have to look when we go to tender at ensuring that whoever we work with will be able to maintain those skill sets and have sufficient capacity that can deal with fluctuations because we have had previous fluctuations in the programme. The Vice Chairman referred to the Jade Goody effect some years ago. In that period, significant backlogs emerged as well. This can happen in the future. We need also some capacity to flex the programme so that it is not so tight that if an issue arises there is not capacity to grow.

In terms of the public system which we have direct control over, we will certainly make sure we develop that further, develop skills and work with the various bodies to try and do that. There are discussions on that all the time. Separately, in terms of the contract that we will need to put in place for HPV, we will ensure that whoever we select, one of those criteria will be to make sure that it is sustainable and also that we can flex the system somewhat, as we might need to do in any event.