Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I will be sharing time with Deputy O'Loughlin. I will focus my attention on the latest developments concerning the CervicalCheck screening programme and, more particularly, on the long delays that are being experienced by women all over Ireland. I would first like to take the opportunity, however, to acknowledge the women and families who came forward last year. Putting themselves into the public domain to champion this cause was not an easy thing to do. Actions like this come at a cost. They require bravery and perseverance.I would particularly like to acknowledge Ms Emma Mhic Mhathúna, who tragically passed away in October.

We all hoped that the issues surrounding the CervicalCheck screening programme would be resolved last year, and I acknowledge that genuine progress has been made on the issue of non-disclosure. We are, however, now facing another serious issue. Today women in every corner of this country are waiting for the results of their own smear tests. While just last year it took a few weeks to get these, it now takes many months. There are four questions I would like to ask on this issue. Just how long are the delays women are facing? Do these delays pose any clinical risks? What is causing these delays? Could these delays have been avoided?

Let us start with what we know about the delays. Up to last year, women typically waited two to four weeks for the results of a smear test. The HSE tells us that the waiting time is currently 22 weeks, which is almost six months, from the time of testing. My understanding is that there is variance around the country and that some women are waiting more than six months. Late last year my colleague, Deputy Lisa Chambers, uncovered that approximately 1,000 women needed to be retested because their samples had expired. They had not been put onto the slides quickly enough. We then found out that an additional 4,600 women would have to be retested. These women have what are called low-grade abnormalities and therefore have to receive HPV testing. The HSE advises that, due to the delays, these samples were not tested within the required time and that retesting is required. Added to this is an as yet unknown number of women who may have more serious diagnoses and who are potentially waiting longer than six months to get the results of their tests.

In light of all of these delays, we need to know if there are risks to patient safety. When the CervicalCheck scandal broke last year, loose language, some of which unfortunately originated from Leinster House, caused very serious and unfounded fears about the clinical impacts of non-disclosure. I therefore want to be very careful in what I say here this evening. I am making no assertions about clinical links between the delays and treatment or any other issues for the women affected. Rather, I would like to pose my questions to the Minister and ask him to provide a detailed response not for me, but for the many tens of thousands of women around the country currently waiting, many of whom are genuinely concerned about these delays.

The Minister stated yesterday that there was an exceedingly low clinical risk for the 4,600 women who need a recheck. Will he expand on that? How many of the women who are found to have more serious diagnoses, including high-grade abnormalities or worse, have been waiting many months to receive these diagnoses? If they are diagnosed with high-grade abnormalities or worse, does a delay of four, five, six or seven months matter clinically? If so, to what extent does it matter? I will leave the clinical issues at that. I just want to ask the questions, but the women involved need some very detailed responses to them.

The third issue I would like to address is the cause of these delays. In April of last year the Minister announced that any woman who had concerns about cervical screening could avail of a free repeat smear test with a registered CervicalCheck GP. This was done, as the Minister said, as part of efforts to reassure patients. The free rechecks started on 1 May and finished on 31 December. I want to be very clear; I welcomed this, as did many people in the House, as a part of reassurance efforts. However, I welcomed it with the understanding that resources would be put in place to deal with the additional demand. It would appear to be the case that such resources were not made available or could not be found. CervicalCheck usually processes approximately 250,000 screening tests a year. In 2018 there were an additional 84,000 tests. The HSE has referred to this as unprecedented demand and it led to a total of approximately 350,000 tests last year. The mid-west region saw an increase of 300% in referrals for further examination by October. Sufficient additional resources were not put in place.

While I accept that had the Minister not made the offer, it is highly likely that the demand for testing would have increased anyway based on concerns, the amount of coverage cervical screening had received and on women finding out the information on the leaflets was misleading. These leaflets said that the test was not 100% accurate when describing its accuracy as 70% would have been more accurate. It is, however, reasonable to conclude that at least a portion of the additional demand was due to the offer of free testing. It is also reasonable to conclude that the additional material demand on the system contributed, at least partly and probably very materially, to the delays experienced. This link has been backed up numerous sources including the laboratories, the clinicians, and the CervicalCheck team itself.

This brings us to the final issue. Should the offer of retests have been ended more quickly, thereby addressing the lengthening delays and any potential related clinical issues? As the Minister said, it has been alleged that he acted against official advice and that he was advised repeatedly to stop the tests as they offered no clinical benefit and were overloading the system. Yesterday the Minister strongly refuted those claims, and has done so again today. He said:

The charge was that I offered free repeat smear tests to women against official advice. That is false.

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