Dr. Peter McKenna:

I will make one observation for the sake of completeness. I would like to take it away from an individual patient into the abstract. If an individual patient has a private smear that shows a high grade abnormality, and attends the colposcopy clinic where they do not see that much and they take a biopsy, which shows only a minor degree of abnormality, the correct procedure would be that the patient would then be subject to a multidisciplinary meeting or tele-call and part of the condition of the State laboratories is that they make themselves available for this.

This facility may not be available in the case of a private laboratory, and consequently, important elements of decision-making for an individual patient - that is, colposcopy, cytology and pathology - may not be able to be taken into consideration. I am not speaking about an individual patient, but that is why all the components of cytology, colposcopy and pathology should be available for consideration at a multidisciplinary meeting, and that is why it is better for smear tests to be done within the public health system. Clearly, the public system has not been functioning appropriately for the last year or so, which is why, in the particular case the Deputy referred to, the woman went for a private smear. Given the emergency circumstances, this should have been accommodated.