Mr. Damien McCallion:

On the wider recruitment and retention problems, we have made some progress in recruitment. Ms Fitzgerald and others have joined in recent times. There is a wider recruitment challenge. There are specific challenges in laboratories and in trying to resource colposcopy. Each part of the pathway presents different challenges.

We made a decision towards the tail end of last year to develop a national cervical screening laboratory. An agreement was reached with the Coombe Hospital that it would be provided there. We believe this will take some time. The planning permission application is being made this week for the new build for the new facility. The design is completed and the Coombe has signed off on it. The building is expected to be finished by the end of 2021 and it was in the capital plan announced recently.

The challenge I alluded to in my opening statement relates to trying to attract and retain the staff we need to operate the laboratory. We also have a challenge with the fact that the Coombe Hospital has a very small base with regard to the programme. It has only been involved in it for a short period. Currently, it processes approximately 10% of the slides. It is a very important laboratory because in recent months it has also taken on additional colposcopy work, which is more complex with regard to the smears and the multidisciplinary meetings that need to follow. We have developed a workforce plan and a steering group to develop the project, which is jointly chaired by the Coombe and the HSE. We have people working full-time on developing it. We have identified 22 resources needed over coming years. Immediate approval has gone out for ten resources to be recruited and competitions are running for them. We are trying to be opportunistic with regard to where we can source some of these scarce resources, be they consultants or medical scientists. Currently, one permanent consultant and another locum consultant are working in the hospital. We have sanctioned a number of additional consultant posts but our challenge is trying to attract medical consultants into what is a specialised and quite a challenging area. We have had some success in identifying possible candidates and we are trying to work them through for additional posts. Up to four consultant posts will be authorised for the hospital but, as I have said, the challenge will be trying to fill them. There is also the scalability issue with regard to when we will be able to have growth in the Coombe. We believe we can get it to 40% to 50% over the next 18 months of the programme. Beyond this, it is contingent on being able to attract the right type of people.