Brian Lenihan Jnr (Dublin West, Fianna Fail)

I am taking this Adjournment debate on behalf of my colleague, the Minister for Health and Children, Deputy Harney. The laboratory of the Royal College of Surgeons in Ireland at Beaumont Hospital has decided not to continue with the testing of cervical smears referred by general practitioners in the southern and north-eastern areas. Approximately 60 practices are affected.

This laboratory is private and contracted by the HSE to conduct liquid-based testing on cervical smears sent in by general practitioners. On 9 November 2006, the HSE wrote to general practitioners in Kerry affected by the decision asking them to refer cervical smears to Cork University Hospital instead of to the Royal College of Surgeons in Ireland. General practitioners were asked to implement this change with immediate effect. These are transitional arrangements necessary to ensure that general practitioners are aware of the designated laboratories for the testing of cervical smears taken at their practices.

The director of the Irish cervical screening programme is to meet representatives of Cork University Hospital again next week. The aim of the meeting is to deal with any issues the hospital may have in covering the additional workload involved. The objective of the HSE is to improve on an ongoing basis the turnaround time for receipt of cervical test results. The programme has provided training to laboratory staff at Cork University Hospital to conduct liquid-based testing. This test is more costly than conventional testing, is more accurate and tests can be conducted more quickly. It is more efficient as it results in fewer repeat smears. This means that significantly fewer women will be asked to have a repeat test.

The executive is concerned about the unacceptable turnaround time for conventional smears in the southern area. It has decided to refer smears to two private laboratories, one of which is in the United Kingdom. Contract approval was signed earlier this week following a competitive tendering process. Arrangements are now being made to refer samples to the two laboratories. The HSE expects to have test results available commencing next month.

The issue raised by the Deputy is also relevant to cervical screening generally. The Minister wishes to see the Irish cervical screening programme rolled out nationally as soon as possible, based on an affordable model and in line with international best practice. Significant preparatory work is well under way involving the introduction of new and improved cervical tests, improved quality assurance training and the preparation of a national population register. An additional €1.3 million was made available to the HSE in 2006 to prepare for the roll out.

The Minister will shortly establish a national cancer screening service to amalgamate BreastCheck and the ICSP, to deliver both programmes on a national basis. This will maximise the expertise in both programmes, ensure improved efficiency and develop a single governance model for cancer screening. The plan is to have cervical screening managed as a national call-recall programme via effective governance structures that provide overall leadership and direction, in terms of quality assurance, accountability and value for money. All elements of the programme, call-recall, smear taking, laboratories and treatment services must be quality assured, organised and managed to deliver a single integrated service.

The Minister will request the service to ensure that the laboratory elements will be delivered in an efficient and cost effective manner that ensures high quality and good turnaround time for results.

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