Mr. Damien McCallion:

Colleagues may also want to contribute on colposcopy. I acknowledge the work doctors, nurses and support staff have done in the 15 colposcopy units around the country. Undoubtedly during the crisis they would have been the front-line point of contact for women who were understandably anxious and concerned. The staff have provided extra sessions and done a huge volume of work to try to bring about some stability. They are still challenged in the service. What has been put in place is a working group involving the acute hospitals, the women and infants programme, Dr. McKenna and CervicalCheck, under Dr. Doherty. There is a team in place to examine a number of issues, one being investment. As I stated, €2 million was allocated this year to try to support the service in regard to both staffing and equipment. A second aspect involves looking at the clinical pathways in the utilisation of the service. The third aspect involves GP education and guidance on referrals to the colposcopy service. In addition, it is a matter of considering alternative pathways for certain categories of patients in terms of ambulatory gynaecology clinics. Colleagues could speak about this. Finally, there is a focus on planning over the next few years as we move to HPV. As we have mentioned, there is a higher impact over a number of years as one moves through HPV screening in colposcopy. Alongside that, there is a workforce piece examining some of the issues referred to in terms of planning, including medically and in the areas of nursing and other models that would have been developed. An impact assessment was done. Dr. McKenna might speak about that first before tackling the wider point. Each unit was visited last year to consider the issues and what the solutions might be. They vary around the country based on the nature and shape of the units. Dr. McKenna might speak to that first and then talk about support.