Ruth Coppinger (Dublin West, Solidarity) | Oireachtas source

At the weekend I met a woman; let us call her Anna. She had two smear tests, one in 2011 and one in 2015. Both came back as negative from Quest Diagnostics. A year later in April 2016, Anna was diagnosed with an 8 cm tumour. Thankfully today she is in remission, but the treatment means she cannot have children, which is a huge blow to her, a woman in her 30s, and her husband. We cannot adjudicate here as to whether it was excusable not to detect her cervical cancer. However, why is there an aura of such confidence in smear tests when they are, in fact, so fallible? Why were women with symptoms like Anna's dismissed by their own GPs when the clear smear test was cited to refute their concerns?

Last week Anna listened as the head of the HSE, Mr. Tony O'Brien, told the Joint Committee on Health that every slide is examined by two pairs of eyes. He was categorical about that. Last week, at the same committee I asked doctors from CervicalCheck if there is any difference in the results between the three labs, the public lab here in Ireland and the two private outsourced labs, one of which is in the US. They said "No". Strangely, they did not have the figures to back that up, but those figures have since become available when one went looking on the website. They reveal that over three years the outsourced labs have consistently lower detection rates, in particular Quest.

Let us consider the year 2013-14. I believe the Taoiseach took over as Minister for Health during that year. In the Coombe, the detection rate for abnormalities logged was 14.1%; for MedLab, it was 12.4%; and for Quest, it was 5.8%. The following year, the Coombe was 13.07%, MedLab was 11.2% and Quest was 7.8%. In 2015-16, the Coombe was 11.7%, MedLab was 9.3% and Quest was 8.46%. I know differences in demographics have been cited, but there would want to be massive differences in demographics to bring about those differences in results. The detection rate at Quest was nearly half of that of the Coombe, for example.

Why was Quest repeatedly given the contract when it has consistently shown these lower detection rates over these years? This is particularly true for lower grade abnormalities. Do Quest and the outsource labs meet the standard in the CervicalCheck quality assurance document of screeners not screening for more than five hours a day? Do its technicians screen not more than the 12,000 per annum or 50 a day? Why, based on the tendering document I have seen, are we not meant to give contracts to companies whose directors have been convicted of conspiracy, corruption and bribery and yet everybody knows the history of Quest from the 1990s, making settlements of $40 million in one decade, paying $11 million to the US Government in respect of lies over testing; and paying doctors kickbacks? Does the truth lie elsewhere in the tendering document that the most economically advantageous tender is the one that has to be accepted? Would the Taoiseach agree that it is serious cause for concern that for-profit private companies have been handed such a vital part of our women's healthcare?

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