Simon Harris (Wicklow, Fine Gael) | Oireachtas source

Absolutely. That is my clear understanding. I want to do what I have always done along this process, which is to wait for Dr. Scally's report, publish it and then act upon it.

Deputy Donnelly asked a number of questions on the backlog, the waiting times, the clinical risk, what is behind the delays and if they could and should have been avoided. I shall take those questions in sequence.

I am informed that the average return time for a smear test is up to 22 weeks. I am also informed that many people get their tests earlier than that, but as with any average, some people wait longer. The HSE has apologised to patients for this and said it is doing everything possible to improve the situation. I accept genuinely and absolutely the HSE's bona fides in that regard having seen how hard it is working to identify additional capacity in a very challenging environment. I heard people accept in the House that it is not just a matter of writing a cheque. There is a global shortage in cytology and the HSE is working very hard to identify additional capacity. The HSE is due to present me with a capacity report in the next number of weeks and I will be happy to share it with the appropriate committee of the House or to set out in the Chamber, whichever is the appropriate course.

Importantly, Deputy Donnelly asked what is the clinical risk here. This is what women will want to know. I will read to the House what I have been told by the HSE from a clinical point of view. The HSE has advised clinically that the natural history of cervical cancer indicates that the disease normally develops over a period of ten to 15 years. Due to this very fact, it is important that women of screening age attend for cervical screening each and every time they are invited to participate. The HSE advises clinically that in this context, the delay being experienced for the return of cervical screening results, while undesirable, is not dangerous and poses a very low risk to women. That reassurance is important. I do not suggest that delay is any way desirable. Of course, it is not and the anxiety of waiting is certainly not good either. However, that is the clinical opinion.

Deputy Donnelly asked the fair question of whether the backlog could or should have been avoided. There are two parts to the answer. Not all of the backlog consists of free repeat smear tests, which we accept. I am waiting for exact figures from the HSE as to how much is made up of new women entering the screening programme but indicative figures suggest it could be up to one third. Truthfully, I must wait for that to be validated before I can fully stand over the figure. However, it means an awful lot of the backlog is made up of people availing of the repeat test, which I very much acknowledge. It was the right decision to make. The Deputy was good enough to acknowledge that if was not free, women who could afford to do so would have been tested which would have led to the bizarre, awkward and unfair situation in which women who could not afford it would not. The Deputy outlined a number of people who said the repeat smear test was not a good idea, all of them, by my calculation, did so significantly after the decision was made by me. It was not clear in some of the charges levelled in recent years, but the advice available to me within the Department, including working with the chief medical officer, was that this was an appropriate step to take as part of the reassurance process and it was welcomed, to be fair, by people here. All speakers have made the fair point that while they welcomed the decision, they would have hoped the resources would have been put in place. As I said yesterday in reply to Oral Questions, also fairly, nobody could have predicted the exact number of people who would go for this nor could anyone have predicted how long the public concern and anxiety would last. Deputy Clare Daly was very honest on the latter point.

Deputy Donnelly asked also about the approximately 4,600 people who will be invited for retests. He acknowledges that it is a separate issue to the backlog and relates to HPV secondary testing. It is not an issue caused by the backlog. Dr. Peter McKenna, whose view people would much rather hear than mine, given that he is acting clinical director of the programme, described the clinical risk as exceedingly low. Again, Deputy Clare Daly was very honest in this regard. This is a programme picking up errors and acting on them by inviting retests, albeit as a precautionary measure. The Director General of the HSE gave information today to the Joint Committee on Health that the majority of retest letters have been issued. My understanding is that the rest of the letters will be issued by the end of the week.

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