Jan O'Sullivan (Limerick East, Labour)

I wish to share time with Deputy Emmet Stagg.

I welcome this important debate which I have been requesting on the Order of Business over the past two weeks. I thank the Labour Party Whip, Deputy Emmet Stagg, for pursuing the matter at the Whips' meetings.

I assure the Minister that we are fully supportive of a good, accredited and safe programme of cancer screening, whether for cervical or breast screening or any other type of screening. However, I do not know whether it was intentional on the part of the Minister but there was an implication in her contribution that this screening was not available in this country and this is not true. We have accredited laboratories of a very high standard. The awarding of the contract to a company outside the country implies that the expertise is not available here and this needs to be clarified. I urge the Minister to provide this clarification in her response.

I welcome the fact that the Minister has said that while Quest Diagnostics is the preferred bidder, the contract has not yet been signed and there is some time. I urge the Minister to listen to what we are saying in the House today and to what is being said by other people who are very concerned about the decision to outsource the entire cytology screening programme. One source of this concern is the editorial in this week's Irish Medical News which expresses serious concern that the outsourcing of the entire service is not desirable.

The awarding of the entire contract for the Irish cervical screening programme to one bidder, Quest Diagnostics, a US-based private company, will result in the loss of jobs and skills which the Government cannot ignore. This is not just a matter for the national cancer screening service even though the Minister has said it is nothing to do with her or with her Department. However, its consequences are of national concern. I would suggest we are being penny wise but pound foolish and there are serious long-term consequences of this decision.

It is important to explain the context of the decision. The Irish cancer screening programme was first established as a pilot programme in the mid-west region where I live. The intention was that this programme would be evaluated after a period, that any necessary lessons would be learned and a national programme would be subsequently rolled out. Along with thousands of other women in the mid west, I benefited from this screening and I welcome the fact it will be available to women in the rest of the country. The Labour Party is fully supportive of the need for the highest standard in the quality of the screening methodology and the expertise of those who carry out the tests. There is absolute agreement on all sides of the House and throughout the country on this. What deeply concerns us is the awarding of the entire contract to one private non-Irish company, to the exclusion of all the Irish laboratories. This puts accountability at a further remove and this is not a good idea. Cytology will be separated from other aspects of patient care and this will not result in an integrated, patient-centred service which is vitally important.

A number of measures were identified during the pilot programme which would require to be implemented in order to roll out the programme to the rest of the country. These include the need to improve laboratory facilities, introduce quality assurance and accreditation and train extra staff to facilitate the full roll-out. There was close co-operation between the pilot phase screening programme and the cytology laboratories in Ireland. General practitioners and other providers of service took the smears and sent them to a number of laboratories around the country. The laboratories did the testing and also set about improving their facilities and their turnaround time. At least three, if not more, Irish laboratories are now fully accredited and others are in the final stages of achieving accreditation.

The other significant action taken to prepare for the roll-out was the establishment of a specific higher education course to train medical scientists to carry out the smears. This was one of the recommendations of the report by Dr. Euphemia McGoogan who carried out the evaluation of the pilot programme. This state-of-the-art course is in place and is training highly skilled graduates at DIT Kevin Street.

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