James Reilly (Dublin North, Fine Gael)

Is something wrong with the HSE given that it cannot find a partner abroad which does not have a record of fraud?

Quest, the cervical cancer screening company, has a margin of error of 15%, whereas our laboratories have a margin of 5%. A recent comparative study of 14,500 slides conducted by St. Luke's hospital shows that, even accounting for urgent cases, Quest's laboratory has an error rate of 30% in detecting high grade pre-invasive cancers. That equates to 2,000 missed cases per annum. Another study conducted in Cork showed an even higher rate of missed high grade smears. One could argue that a 15% margin of error is acceptable in a country where smears are done annually but it cannot be acceptable here in view of our intention to conduct smear tests every three to five years. Given our record, the interval will be five rather than three years. As we will not have a facility for multi-disciplinary team meetings between the smear reader, the cytologist and the colposcopist to discuss cases prior to treatment, we will not be pursuing best practice. Furthermore, the loss of 100 highly paid jobs will hardly encourage young people to take up science as a career option. We are going to lose this pool of expertise and it will not be available to us again. It will have been decimated when we realise in two year's time that we made the wrong decision. Why is the Minister persisting with this plan to outsource smear tests when medical experts believe that between 1,000 and 2,000 cases of pre-invasive cervical cancer will be missed per annum, thereby putting women's lives at risk? Will we have another Portlaoise on our hands in a few years time? Despite all of these issues and the fact that pathologists will have to go abroad to finish their training, the Government is gung ho to go.

I recently undertook a tour of Castlebar, Sligo and Letterkenny hospitals and University Hospital, Galway. I agree that a centre of excellence should be established, with proper resources and funding, at University Hospital, Galway. Mayo General Hospital, Sligo General Hospital and Letterkenny Hospital should operate as satellite units of the Galway centre of excellence. Mayo General Hospital currently operates as a satellite of University Hospital, Galway, as does Letterkenny Hospital under a locum. We propose that Sligo General Hospital should operate under the same guidelines and that all hospitals should be audited by HIQA annually to ensure the best outcome for women.

Professor Tom Keane, who is an expert in his field, is being used as a shield to protect the Government from its own decisions, much as it used Professor Brendan Drumm in respect of the HSE. Professor Keane has made it quite clear that he is here to implement a programme. Fine Gael subscribes to the concept of centres of excellence in the same way that I would have subscribed to the concept of the HSE as a single entity delivering health care to 4.2 million people. However, the manner in which the HSE was established was a disaster given that it in effect amalgamated 11 companies while promising that nobody would lose a job or move positions. That was an impossible place to begin by any standard. The Government failed in 2002 to bite the bullet on redundancies and today patients are dying and choking on that bullet. Once again, I fear that we have an excellent concept for specialist centres of cancer care but we are going about it the wrong way. Instead of providing the new resource first, the HSE wants to close down two centres that currently give excellent care on a promise of excellence to come in Galway, which is to shut down much of its services for the month of August.

When I visited Galway regional hospital this weekend, I found its medical and surgical wards to be operating at 100% capacity. In April 2007, 188 people were on trolleys overnight waiting for beds the following day. Last month, that figure rose to more than 440.

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